Background: Access to family planning is a fundamental human right and is crucial to empowering women and girls. It is also one of the most cost-effective investments a country can make towards sustainable development. In Kiribati, 28% of married women of reproductive age wish to avoid pregnancy but are not using any form of contraception.
Method: To identify the costs and health, social and economic impacts of reducing unmet need for family planning, three population models were generated using the demographic modelling program Spectrum 4.55. Models were created for the period 2010-2015 based on three hypothetical family planning scenarios.
Results: In 2009, 28% of women of reproductive age who were married or in union had an unmet need for family planning. If all this need was met by 2020, the total contraceptive prevalence rate would rise from 22.3% to 50.3%. Meeting the need for family planning by 2020 would reduce unintended pregnancies by 65%, averting an average of 810 unintended pregnancies and 542 unplanned births and miscarriages each year between 2010 and 2025. Allowing healthy timing and spacing of pregnancies by meeting all the need for family planning by 2020 would reduce the number of avoidable high-risk births in Kiribati by nearly 45%, decreasing the incidence of poor maternal and perinatal outcomes. Meeting the need for family planning by 2020 is estimated to reduce the number of births to adolescent girls aged 15-19 by 32%, dropping the adolescent fertility rate from 27 births per 1000 girls to below 19 births per 1000 girls in 2025. In addition to reducing annual population growth, reducing unmet need for family planning by 2020 would also reduce the proportion of the population who are dependant compared to people of working age (15-64 years). If all family planning needs were met by 2020, 66% of the population would be aged 15-64, reducing the dependency ration to 51. Assuming that GDP growth is the same across all three scenarios, by 2025 GDP per capita could increase to AUD$1,651 if all needs were met by 2020, 7% more than if unmet need remained constant. This analysis demonstrates that there are considerable health, development and human rights imperatives to ensure that no women or girls in the Pacific are overlooked.