Ensuring Family Planning Access, African Leaders Should Do More

Rose is a mother of four, with a fifth on the way. At a time when she should be eagerly awaiting the birth of her child, she is instead worried about how to prevent her next pregnancy. She’d like to wait at least two years, but she doesn’t have that say because she doesn’t have access to family planning. Rose’s story isn’t unique, although she is one in a million. Correction - she is 1 in 215 million. That’s how many women around the world today know they need modern contraception. And the numbers who do not know are even higher. In Rwanda, just 45% of married women use contraceptives regularly. On average each woman will have 5 children in her lifetime, and has a 1 in 35 chance of dying during pregnancy or childbirth. It is the fundamental human right of couples and individuals to control their fertility, to choose whether and when to have children, and how many to have. This right, though affecting women most, is often denied them through cultural, legal or religious requirements of various kinds. Such denial, overt or covert, is an injustice to women and leads to much unnecessary suffering and death. Women are quietly crying for family planning and not getting access in many parts of Africa. Overall, 30-36% of women in union have a felt need for contraception, which is not being satisfied. This results in unplanned and unintended pregnancies. With inadequate or even poor health care services and facilities such pregnancies are more likely to result in maternal injury or death, and poor health for infants and children. In Rwanda, ensuring family planning use is therefore a key strategy to reducing maternal, infant, and child deaths. Yet family planning is not just about women. It is about the rights, health and socio-economic development of men and young people also, and it is about entire communities and nations. Family planning is about sustainable consumption and development of the world’s resources for mankind. Helping individuals to plan their families reduces poverty by enabling increased productivity and broad economic development in turn. The world loses an estimated $15 billion a year in productivity as a result of maternal deaths and injuries — preventing unintended pregnancies could alter this number dramatically. In contrast, recent studies show that investing in contraceptive services could yield as much as a 4-fold return in medical cost savings, making it one of the most cost-effective development approaches out there. Whether each of us realizes it yet or not, we all have a role to play. Last month, the world’s population surpassed seven billion. It’s an impressive milestone that signifies both achievements and grave responsibilities. We must work to protect the health, wellbeing, and rights of those on our planet, whilst ensuring that individuals can plan their families and contribute to the balance between our numbers and resource use. Leaders and advocates in Rwanda know this. The country has long been a leader in family planning, establishing effective programmes, increasing access to contraceptives, and expanding educational opportunities. In just a few weeks, on 29 November – 2 December, Minister of Health, Dr. Agnes Binagwaho will join nearly 2,000 policymakers, researchers, and donors from around the world in Dakar, Senegal for the International Conference on Family Planning. The timing and location of this meeting are significant – it will be the largest meeting of its kind aimed at signifying a true renaissance in both funding and political will for this issue. The event is purposefully set in West Africa, where women have some of the highest fertility rates, lowest contraceptive usage and the highest unmet needs for contraception in the world. Now of all times, African leaders have a momentous opportunity to demonstrate leadership on this issue, and set the bar high for donors, policymakers, and advocates worldwide. In the face of such high unmet family planning needs in Africa, generally, all levels of leadership political religious and traditional cannot and should not stand idly by. As advocates, we must build on this momentum and call on our own leaders to champion access to family planning. We must also hold donor governments accountable for their commitments. We can do better at delivering the solutions we have, and be more innovative in developing new approaches to meeting contraceptive needs. Family planning should be integrated into the broader network of health services, including maternal and child health and HIV/Aids care – to strengthen health systems, increase efficiency and access, and reduce costs. Investing in family planning today will not only pay dividends now, but will also help history’s largest generation of young people forge a brighter future. Let me be clear – this is not just a woman’s issue, but a human one. It is not one region or nation’s issue but a global one. Access to family planning remains a critical human rights, public health, and development issue – and now is the time to take action. Dr. Frederick T. Sai is an international reproductive health adviser and former Senior Population Adviser to the World Bank. Ends