Consistent Efforts, Persisting Challenges

Evaluation of Dutch contribution to sexual and reproductive health and rights (2012–2022)

Kunstenaar maakt activistische graffiti tegen kindhuwelijken in Mozambique
Image: ©UNFPA Mozambique

Results – Evaluation of Dutch contribution to SRHR

IOB conducted an evaluation of Dutch policy on sexual and reproductive health and rights (SRHR) – including HIV/AIDS. It focuses on the period 2012–2022, and includes both development cooperation and diplomatic efforts.


Compass to indicate the introduction or background of the evaluation

Promoting universal fulfilment of SRHR has been a priority of Dutch development cooperation for many years. The previous IOB evaluation on SRHR covered the period 2007–2012 and was published in 2013. Between 2012 and 2022, Netherlands Ministry of Foreign Affairs allocated 10% of the Dutch development-cooperation budget to this theme, nearly EUR 5 billion. Diplomatically, the Netherlands is an outspoken actor on SRHR issues.

Through its policy on SRHR, the Netherlands strives to contribute to commitments made in the Sustainable Development Goals. Despite global progress on various SRHR-related indicators, such as HIV incidence, major challenges persist. These include issues like the autonomy of women to make informed decisions about their sexuality, and the denial of sexual and reproductive rights for certain groups.

The evaluation draws on primary data collection in Uganda and Bangladesh, and includes an analysis of Dutch diplomatic efforts. Additionally, it incorporates findings from available evaluation reports of supported SRHR-projects. To broaden the evidence base about what works and what doesn’t, IOB commissioned a systematic search, which yielded a comprehensive database of 368 systematic reviews on SRHR interventions in sub-Saharan Africa.

Collage van aidswerkers in verschillende landen
Image: ©Cordaid/ Lisa Murray & UNFPA Mozambique/Alejandra Perez

Central question

To what extent has the Netherlands contributed to the improvement of Sexual and Reproductive Health and Rights and contributed to halting the spread of HIV/AIDS in low- and lower-middle-income countries, and what lessons can be learned for future policy?

Main conclusion

Icoon van een vergrootglas voor conclusies en bevindingen

IOB concluded that the Netherlands has contributed to improvements in SRHR and a reduction of the burden of HIV/AIDS in low- and lower-middle-income countries. Dutch support of SRHR contributed to improved SRHR outcomes through increased access to reproductive- and health commodities. At the same time, the evaluation also revealed that various supported interventions did not lead to the expected results, including behavioural change of and decision-making by young people about sexuality or reproduction. There are, furthermore, various ‘blind spots’ for which there was either no evaluation available at all, or the evidence on effectiveness was inconclusive or of insufficient quality.

Consequently, IOB has been unable to determine the extent of the contribution of the entire Dutch policy to SRHR.

IOB bases this main conclusion on the subsequent six sub-conclusions, described in full in the evaluation report.

Sub-conclusion 1:
Dutch policy on SRHR has been consistent over the years and has simultaneously responded to the existing and emerging needs of intended target groups in low- and lower-middle-income countries. However, key policy assumptions were often not clearly articulated, and policy choices were not always evidence-based.

Sub-conclusion 2:
Efforts towards enhancing SRHR and addressing the spread of HIV/AIDS in low-and lower-middle-income countries have resulted in a variety of effects.

Sub-conclusion 3:
Although Dutch parliament and the general Dutch public are annually informed of the results achieved on SRHR, the M&E systems have several limitations that hinder the validity and reliability of reported results, especially at outcome and impact levels.

Sub-conclusion 4:
Economic efficiency of supported SRHR projects and interventions is unknown. The organisational efficiency and timeliness of supported organisations presents a mixed picture, with room for improvement, both for multilateral and international organisations and for NGO partnership projects.

Sub-conclusion 5:
Coherence within and between instruments and organisations supported by the Netherlands was insufficient.

Sub-conclusion 6:
SRHR projects generally come to a halt once Dutch funding ends, since there are hardly any stakeholders willing and able to take over supported activities. In addition, there is only limited insight into the sustainability of results achieved.

Collage, van links naar rechts: Het hijsen van de LGBTQ+ vlag, Minister op event voor feministisch buitenlandbeleid, en een event voor familieplanning in Oeganda
Image: ©MinBZ & UNFPA Uganda


Icoon van een netwerk met verbindingen voor de aanbevelingen

IOB formulated six recommendations. Under each one, practical suggestions are offered for implementation. These are described in full in the evaluation report.

Report presentation

On Tuesday 30 January 2024, IOB will organise an online event to present the findings of its SRHR evaluation, followed by a panel discussion and Q&A. The event will be organised in collaboration with SRHR Knowledge Platform Share-Net. You can register here.