Based on an analysis of a dataset incorporating evidence from the Contraceptive Security Indicators survey (2010–2021):

Increased national government contraceptive financing (in contrast to donor funding) is strongly correlated with modern contraceptive prevalence rate (mCPR) and private-sector contraceptive method mix strategy.

Health insurance coverage for family planning is correlated with mCPR in middle- but not low-income countries.

A logistics management information system that includes family planning commodities is strongly correlated with mCPR in low- and middle-income countries.

Ministries of health and international funding agencies should prioritize the policies and activities that show substantiated evidence of success in raising contraceptive prevalence.

Stakeholders should acknowledge the benefits of financing contraceptives directly by national governments (versus external contributors) when allocating resources; however, funding agencies should continue to minimize any residual gaps in this fundamental investment to the extent possible.

Health insurance coverage for family planning, while correlated with mCPR, may be related to decreased contraceptive choices in the private sector. To better capitalize on their investments, countries should recognize this paradox and devote efforts to encourage private-sector choice offerings.

Understanding the impact of family planning policy and actions is essential for building effective strategies to increase contraceptive use. This study identifies policies that correlate with modern contraceptive prevalence rate (mCPR) and private-sector contraceptive method mix strategies (the number of contraceptive methods offered in the private sector) in low-income and middle-income countries. While education, contraceptive choices, and economic growth are known determinants of contraceptive prevalence, many national policies intended to increase contraceptive prevalence in the short term to medium term have ambiguous evidence that they indeed do so. By developing beta and Poisson regression models using 12 years of reported Contraceptive Security Indicators Survey data (2010–2021) from 59 countries, this study investigated the effect of 20 independent variables on mCPR or method mix strategies. Furthermore, to help interpret the potential consequences of economic status, separate models segmented by gross national income (low, low-middle, and upper-middle) were assessed. Of 20 independent variables, 10 are implicated with mCPR and 6 with a method mix strategy. Of these, increasing the share of domestic financing (versus donor funding) for contraceptives had the broadest and strongest contribution. mCPR is also predicted by the existence of national insurance systems that cover contraceptive costs, contraceptive security committees, family planning logistics management information systems, and, inversely, by client fees. A comprehensive private-sector method mix strategy—which itself influences mCPR—is also driven by these, as well as the inclusion of more contraceptives on the national essential medicines list. These findings have implications for countries seeking to expand access to and use of contraceptives through policy initiatives.

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