Nurse Kephine Ojung’a mentioned she has “seen a lot” after practically three a long time of working in reproductive well being care in Kenya’s Kilifi County, on the east African nation’s coast. But issues bought markedly worse for girls there previously yr amid sweeping cuts to US aid packages.
Throughout creating components of Africa, US funding as soon as supplied free birth control, maternity checkups and different reproductive well being care by way of cellular medical clinics – providers that abruptly vanished because the Trump administration dismantled the US Agency for International Development (USAID) and slashed funding for household planning.
“Each day in Kilifi, we count several unwanted pregnancies,” mentioned Ojung’a, who works for the nonprofit Reproductive Health Network Kenya. The nonprofit has warned that clinics all through the nation have run out of birth control. “We’ve seen cases that lead to death… and we are still yet to see more, coming with sepsis, coming with hemorrhage, coming with shock.”
The frontline nurse described seeing firsthand the detrimental well being impacts of ladies making an attempt to terminate their very own pregnancies by taking excessive dosages of painkillers, acquiring medication for abortion with no prescription or medical supervision, or consuming poisonous substances like detergent.
Over the previous six months, NCS has spoken to a number of medical suppliers and nonprofits in six nations, who described layoffs of well being workers, widespread shortages of birth control, and persistent provide chain challenges, significantly in distant areas the place girls have few choices, as elements making the state of affairs worse.
It’s a disaster in household planning drugs that’s taking part in out throughout the African continent within the wake of aid cuts by the US and other donor nations.
The International Planned Parenthood Federation estimates that funding cuts have pressured practically 1,400 medical clinics to shut world wide, leading to 9 million folks dropping entry to sexual and reproductive well being providers in 2025.
Now, the Trump administration’s budget request for fiscal yr 2027 proposes much more cuts to international well being packages, decreasing funding by billions of {dollars} and particularly eliminating all reproductive well being packages. The price range proposal says the White House goals to guarantee no funding helps “unfettered access to birth control.” The president’s price range request will not be binding, as Congress approves funding, however it’s indicative of the administration’s spending priorities.
Nabeeha Kazi Hutchins, president of PAI, a reproductive rights NGO primarily based in Washington, informed NCS the proposal’s wording “makes it very clear that what they’re advancing is a political ideology and not public health evidence,” and that it reveals an “incredible abandonment” of a long time of bipartisan US dedication to worldwide household planning.
In 2024, 43% of world household planning aid was funded by the US, in accordance to well being coverage nonprofit KFF. That funding previously gave 47.6 million girls and {couples} entry to fashionable contraceptives, in accordance to an evaluation of the 2024 price range by the Guttmacher Institute, a analysis group centered on sexual and reproductive well being that helps abortion rights. US coverage bars worldwide NGOs that present abortions, give counseling about abortions or advocate for secure entry to abortion from receiving US authorities funding.
But early final yr, the Trump administration froze and then scrapped household planning grants as soon as administered by USAID. Then, in July, Congress rescinded $500 million supposed for household planning and reproductive well being packages. The US administration additionally stopped all contributions to the United Nations Population Fund, the UN’s sexual and reproductive well being company, and withheld $9.7 million worth of US-purchased contraceptives in warehouses in Belgium relatively than delivering them to girls abroad.
Experts warn that the affect of additional spending cuts on girls’s lives will probably be vital within the 41 nations that after acquired USAID household planning help, a lot of them in Africa.
In Mozambique, aid workers reported a 7% enhance in recorded teen pregnancies final yr in areas the place providers have been scaled again, after US funding cuts to UNFPA and the Global Fund hampered efforts to attain among the most susceptible communities.
“There is a direct correlation between the withdrawal of our assistance and the increased vulnerability of young girls,” Santos Simione, director of the Mozambican Association for Family Development (AMODEFA), informed NCS by electronic mail. “Every percentage point of this increase represents girls dropping out of school, the perpetuation of the cycle of poverty, a rise in HIV infections, and an increase in child/early unions.”
In Malawi, one of many world’s least developed nations, the native NGO affiliated with the International Planned Parenthood Federation raised the alarm late final yr concerning the impacts on girls who had misplaced entry to cellular clinic care and contraceptives in 2025.
“I waited for the clinic to come,” 24-year-old Ulemu Kapile informed the Family Planning Association of Malawi on the time. “They used to come every month. But after the aid freeze, they never came back, and by the time I realized it, I was already pregnant.”
Medical suppliers and nonprofits working in Africa say US cuts to household planning providers have led to deaths, unsafe abortions, hemorrhages and worsening maternity care.
Asked by NCS concerning the claims, a US State Department spokesperson mentioned: “The American people expect their tax dollars to support programs that save lives, advance U.S. interests, and reflect American values, not fund abortion-related activities, left-wing social agendas, or wasteful overseas bureaucracies.”
The administration’s focus, the spokesperson added, is “on implementing life-saving care in global health priority areas, including HIV/AIDS, tuberculosis, malaria, and maternal and child health.”
Research shows, nevertheless, that entry to fashionable contraceptives, and the power to stop or area out pregnancies, improves maternal mortality charges, household incomes and infants’ well being. What’s extra, well being suppliers in a number of nations informed NCS that birth control providers are sometimes built-in with different medical work, like HIV-AIDS prevention and obstetrician-gynecologist care, which have additionally been impacted due to the cuts.
“If nothing is done, then there are going to be some dire consequences,” mentioned Patrick Kinemo, the Tanzania nation director for a corporation known as MSI Reproductive Choices, which works in dozens of countries to present reproductive well being care.
Tanzania alone is dealing with a funding hole of round $18.3 million for contraceptives like birth control capsules, implants and intrauterine gadgets (IUDs) this yr, in accordance to MSI. Those contraceptives would affect girls’s lives for a few years past 2026, MSI mentioned, however this yr alone it could have prevented 1,600 maternal deaths, in accordance to its personal evaluation.
He famous that improved household planning is chargeable for a major discount within the nation’s maternal mortality charge. “Without these commodities, that could reverse.”
Adequate area between pregnancies additionally lowers toddler mortality charges. That is essentially as a result of moms can breastfeed for longer intervals of time, which improves baby well being and diet indicators and reduces progress stunting, in accordance to earlier research from USAID. It additionally permits girls to work, with elevated family earnings serving to to enhance household well being, Kinemo mentioned.
As aid cuts restrict their choices, extra girls could also be pressured into taking health-endangering measures. Dr. Bakari Omary, the undertaking coordinator on the Tanzanian reproductive well being nonprofit UMATI, informed NCS final yr: “We are fearing unsafe abortion, and there has been an increasing number.” In a number of of the nations through which well being workers spoke to NCS – together with Malawi, Nigeria and Tanzania – abortion is severely restricted by legislation.
In Zambia, aid workers mentioned they feared that heavy staffing cuts have been negatively impacting the care that younger girls and soon-to-be-mothers have been receiving.
“The quality is definitely compromised. You can’t have the same quality with two people working when you had six,” mentioned Amos Mwale, govt director of the Centre for Reproductive Health and Education in Zambia. There are actually far fewer midwives in clinics, he mentioned, which implies girls should wait till they’re additional on in labor to get care.
Pregnant girls are “walking long distances, and then they have to also wait for longer hours than normal if they have to access antenatal services,” Mwale mentioned.
Aid workers mentioned nations have been struggling to fill the gaps left by the steep funding cuts amid different budget pressures.
A spokeswoman for the Family Planning Association of Malawi mentioned the nation’s nationwide Ministry of Health was supporting its work, however that it couldn’t afford to prolong providers to probably the most rural areas. The group has acquired some stopgap funding from IPPF to proceed its work. But in some areas left with out satisfactory funding, US-backed companions “completely shut down the services… so the women are absolutely desperate,” the spokeswoman mentioned.
In fiscal yr 2024 – earlier than Trump got here again to workplace – US funding in international household planning is estimated to have prevented 17.1 million unintended pregnancies and 34,000 maternal deaths, in accordance to the Guttmacher Institute. The US funding additionally averted an estimated 5.2 million unsafe abortions, it mentioned.
Although Congress lately passed more funding for international well being aid in fiscal yr 2026, which incorporates cash for household planning and reproductive well being, price range specialists informed NCS that there will probably be a yearlong lag time for that cash to be spent.
Meanwhile, reproductive well being advocates warn that the funding may nonetheless be redirected or rescinded, because it was in 2025.
The US State Department continues to be evaluating household planning packages and funding for the 2026 monetary yr, the spokesperson for the division informed NCS in March.
As the worldwide household planning sector is squeezed, girls say they concern dropping control of their very own reproductive selections.
“Everybody is scared of getting pregnant,” mentioned Peace Adizue, a pupil in Abuja, Nigeria, who used to depend on backed birth control. She mentioned that girls have been anxious the unavailability of sure contraceptives meant they’d have to change to much less dependable strategies.
Birth control prices have additionally soared amid aid cuts and contraceptives being out of inventory. “I am shocked at the difference in the price,” Adizue mentioned.
For service suppliers, the state of affairs is tough to see. “What is currently happening… sometimes makes me shed tears,” mentioned nurse Ojung’a, in Kenya.
Over and over in current months, her clinic has been pressured to flip away girls who’ve walked miles hoping for contemporary medical care or contraception.
“Today, my shelves are empty,” she has had to inform them. “In most cases we have, in Swahili, hakuna. Hakuna means nothing.”