Women’s health in the United States has long been underfunded and undervalued. Despite women comprising over half of the U.S. population, only 8.8% of National Institutes of Health (NIH) grant spending from 2013 to 2023 was focused on women’s health research. Today, even that fragile progress faces renewed pressures as shifts in funding priorities and public policy threaten to weaken support for the very systems and services that millions rely on.

These changes are not happening in a vacuum. Increasing scrutiny of diversity, equity, and inclusion frameworks, along with the reallocation or reduction of major federal and state-level funding, are already affecting access to essential services like reproductive health, maternal care, and support for survivors of gender-based violence.

Title X, which provides critical family planning services, faces significant funding cuts, while looming threats to Medicaid (which covers over 40% of births) jeopardize coverage for low-income women and families. Issues that primarily or disproportionately affect women, such as reproductive health, maternal health, and domestic violence, have historically been siloed and marginalized from mainstream healthcare infrastructure, in part due to stigma and politicization, making them even more vulnerable to cuts and attacks.

In this moment of change, philanthropic funders face tough choices: step back and risk further erosion of hard-won gains or double down to protect, scale, and sustain solutions that work.

Drawing on Dalberg’s work with nonprofit, government, private sector, and philanthropic partners working to advance health and gender equity, we highlight five priority areas where philanthropic investment is especially critical in this moment:

Sex Education

Evidence-based, age-appropriate sex education is a foundational investment in young people’s health and agency. It equips adolescents with knowledge about healthy relationships, consent, body image, sexual and gender identity, contraception, and STI prevention and has the potential to transform how we relate to each other as respectful, engaged citizens. Yet, only 30 states require sex education of any kind, and even fewer require that it be medically accurate, culturally responsive, evidence-based, or responsive to the needs of today’s youth. Less than half of adolescents report receiving instruction on birth control before they had sex for the first time. Philanthropy can help shift the narrative, counter misinformation, and support trusted, community-rooted efforts. This includes building on the work of organizations like SIECUS that lead on policy and parent engagement. They can also help fund school-based, community-based, and digital sex ed programs, like Peer Health Exchange, which uses a peer-led model, and others working to expand access to inclusive, high-quality education.

Contraceptive Deserts

More than 19 million U.S. women live in contraceptive deserts—areas without reasonable access to birth control.  Reductions in public funding only deepen this gap. Philanthropy can help protect and expand access by supporting sustainable, community-anchored care delivery models, including mobile clinics (e.g., Plan A Health), telehealth, and community outreach. Moreover, philanthropy can also support state-level policy solutions that safeguard contraceptive access through protecting insurance coverage, making extended supply easier and enabling pharmacists to prescribe birth control. Organizations like Power to Decide are advancing this policy agenda by advocating for state-level reforms and providing data-driven tools, such as the Contraceptive Access Map, to identify where interventions are most needed.

Abortion Advocacy and Patient Support

The legal landscape for abortion care is becoming increasingly complex, with laws varying widely by state. As access contracts in some areas, many individuals seeking care now face fragmented information, logistical barriers, and multiple handoffs before they reach services.

At the same time, several states—and their residents—are taking action to protect access, with abortion consistently upheld through ballot initiatives and haven states developing innovative legal and policy strategies to safeguard and expand care. Philanthropy can help advance these state-level policy efforts, while also helping people who need abortions access care today.

As the care landscape becomes increasingly fragmented and contested, philanthropy also has a critical role to play in strengthening the connective tissue across the ecosystem and supporting more sustainable and patient-centric care models, both online and in clinics. Donors can help support models that streamline information for patients, via a patient-centered digital front door for abortion seekers, who often encounter many touchpoints before receiving care; help build and sustain coordination among providers, abortion funds, legal aid, and practical support organizations; and consider new models that foster a more resilient, patient-centered infrastructure that can withstand political attacks and deliver care with dignity.

Community-Based Maternal Care

Maternal mortality in the U.S. remains unacceptably high, with Black women nearly three times more likely than white women to die from pregnancy-related complications. Community-driven care, such as midwifery and doula models that enable continuous, personalized, person-centered support pre-, intra-, and postpartum, has been shown to improve outcomes and reduce disparities, especially amid continued shortages of obstetric providers. Philanthropic investment can help scale these solutions, especially those embedded in trusted, local systems of care. Funders can also help advocate for policies that enable sustainable funding for these care models, including insurance reimbursement, scope of practice reform, and extended postpartum Medicaid coverage, building on the policy leadership of organizations like the Black Mamas Matter Alliance.

Gender-Based Violence Support Infrastructure

An estimated 2 in 5 women in the US are impacted by intimate partner violence—one of multiple forms of gender-based violence—over their lifetimes. The infrastructure to support survivors of violence, including hotlines for crisis support (e.g., National Domestic Violence Hotline), emergency and transitional shelter to help get people to safety, and economic supports to help survivors gain financial security (e.g., FreeFrom and the Center for Survivor Agency and Justice), has long relied on federal funding, which is declining and under threat. Philanthropy can advocate to preserve critical federal supports like VAWA and fVPSA and help serve as a bridge to ensure survivors can access services amidst funding shocks, while helping to build a more resilient and sustainable long-term infrastructure. They can also help break cycles of violence through programs that provide holistic support, including trauma-informed health, mental healthcare, and wraparound services, to help kids and families who experience violence heal and thrive (e.g., the All In For Kids initiative).

Investing in women’s health is an investment in women, their families, and their communities, with multigenerational impact. Philanthropy has a critical role to play in preventing backsliding on issues that fundamentally affect women’s autonomy, participation, and opportunities, while helping to build a more resilient women’s health infrastructure for the future. This work to prevent erosion of core rights and services can sit alongside strategies that take a more future-facing view, advancing new innovations and driving momentum in emerging areas of research like hormonal health and women’s heart health.

For more on Dalberg’s work at the intersection of health, gender equity, and inclusive systems change, reach out to: