Laos Puts Family Planning on Its Economic Roadmap

VIENTIANE, LAOS – In a strategic move to graduate the country from Least Developed Country (LDC) status by 2020, the Lao People’s Democratic Republic – commonly known as Laos – has held its First National Conference on Family Planning, with the theme “Investing in Family Planning for Economic Prosperity.”

Initiated by the ministry of health and supported by the UNFPA, the conference brought together more than 200 delegates, including officials from key government ministries, provincial governors and vice governors, health officials and members from both the civil and private sectors.

“This is our vision for the future,” Dr. Phouthone Muongpak, Laos’ deputy minister of health, said in his keynote address.

Though Laos has made huge advances in recent years in addressing maternal mortality and providing better access to contraception, its rates are still alarmingly high on a global scale. Currently, there are still 206 maternal deaths per 100,000 live births, a rate well beyond those in developed nations. The adolescent pregnancy rate is close to 1 in 10, contraception prevalence stands at just 50 percent and 20 percent of family planning needs remain unmet nationwide, a rate that climbs even higher in some remote areas.

With Laos identified by the Family Planning 2020 initiative as one of 69 priority countries, its government last year pledged to support the rights of all women to decide freely and for themselves whether to have children, when to have them if they are wanted, and how many to have.

“We believe … that access to contraception is a fundamental human right and has important impacts on gender equality, and access to rights for women and girls,” said Beth Schlachter, FP2020’s executive director, via video link from Washington, D.C.

But it’s not just the well-being of mothers and babies at stake for Laos. Family planning is seen as vital to build a skilled workforce that can sustain the country long-term and to curb escalating pressures on the health system.

Sally Birmingham, the World Bank’s country manager for Laos, was forthright: “This goes beyond a women’s [or] a health issue – this is an economic issue.”

“Increasing our government’s investment in family planning commodities, including contraception, will be cost-effective on so many fronts. Spending $1 on contraceptives can reduce the cost of pregnancy related care by $7, and eventually help save millions of dollars in direct healthcare costs averted,” Dr. Kikeo Chanthboury, Laos’ vice minister of planning and investment, noted.

But still there are challenges. Though the Laotian government has pledged to prioritize family planning and a number of development agencies are on board to offer support, the conference also provided a forum for those who sit on the front lines – provincial governors and health workers – to air their concerns.

For some, the issue of access to contraception and the need for more trained health workers and midwives was paramount. For others, whose provinces are home to ethnic groups living in remote areas, culturally specific information and local language literature and dissemination methods are key.

“You need to bring in all the sectors, civil society, the private sector, government so that they all work together,” UNFPA representative Frederika Meijer told News Deeply. “There’s a member of the Women’s Union in every village, for example, so she could play a proactive role.”

The government, with the support of UNFPA, is now planning to roll out new measures, and has defined the figures needed in a cost implementation plan. The roadmap, which is still being finalized, outlines what is required to help Laos lose its LDC status, including finding $15 million to spend over four years across 18 provinces. The funding will focus on promoting and providing information on long-acting reversible contraception, increasing the number of midwives able to provide such contraception, improving capacity at health centers and campaigns targeting young people.

For those who attended, the conference on May 3-4 is a milestone, the first time the major players have come together to discuss family planning goals for the whole country and in the context of economic and social growth.

“I think we really made history here,” Meijer said. “Before, family planning was mainly seen as simply birth control, limiting the amount of people, and the governors were very concerned they wouldn’t have enough working population. But here, there has been a huge mind shift. They see now that family planning is about saving lives, working on quality of life, and having an influence on economic prosperity and social development.”

PPAL Launches Youth Family Planning Awareness For Grand Bassa County

Buchanan, Grand Bassa County – The Planned Parenthood Association of Liberia (PPAL) on May 17 launched a community engagement for youth family planning Program in the port city of Buchanan, Grand Bassa County.

The colorful program which brought together students, youth groups and community members was held at the newly constructed Buchanan Hotel.

The project is sponsor by the United States Agency for International Development (USAID) and targets youth between ages 11 to 24 years. 

Speaking at the launching, the Chief Executive Officer of PPAL, Madam Martha Kiawu Cojolo said the program seeks to improve sexual and reproductive health and rights (SRHR) for the population. 

She said the objective will be achieved through programs development and implementations, training and technical assistance in SRHR information including family planning services and youth friendly service provision amongst others. 

The PPAL CEO then cautioned participants about the high rate of teenage pregnancy and infection in Grand Bassa County, while calling on parents to educate their children about the positive and negative aspects of sex. 

According to Madam Cojolo educating girls and boys about sex will help reduce the risks of infection and teenage pregnancy. 

The launching of the community engagement for youth family planning in Grand Bassa County attracted smiles from many young girls and boys that have discovered the importance of the service, although many of them are still rejecting it. 

Many teenagers claim they stay away from family planning due to misconceptions that it may gave users infections and make female users overweight than their normal body structure or size. 

Giving an overview, the program manager of PPAL, Mrs. Ernree Bee-Neeplo said it will increase the social acceptability of young people and their approval of using family planning services in Grand Bassa County. 

The program will increase youth knowledge and understanding of sexual reproductive health Issues, family planning services and methods to help improve the process, Bee-Neeplo said. 

“We are going to work with the five electoral districts of Grand Bassa County and train 100 selected community Health volunteers,” she told participants, adding that a monthly health forum using participatory learning methods will be conducted. 

These forums will also involve action cycles in focal districts in order to address barriers to voluntary family planning services for young people as defined by community dwellers, she added. 

Mrs. Bee-Neeplo lamented the increasing rate of teenage pregnancy in Grand Bassa County which she said is caused by having unprotected sex.

She also said PPAL will conduct community meetings, forged partnership with local community youth groups and the facilitation of local youth listeners’ program amongst others.  

At the program, participants lauded PPAL for bringing “a big learning program to them”. 

In separate statements, some participants called on the NGO to put in more time to educate them “because there are lots of speculations that are actually scaring them away from family planning in Grand Bassa County”. 

Some participants said misinformation about family planning is preventing many of them from using the service which is consequently causing the increase in teenage pregnancy in the county. 

Most of youth attending the program pledged their support to the project. 

PPAL was founded in1956 with the objective of improving the health of the population of Liberia by providing comprehensive sexual reproductive health information and services including contraceptives for men, women, and young people of reproductive ages. 

Population growth is linked to development: Aseefa Bhutto Zardari

KARACHI: Aseefa Bhutto Zardari has stressed that rapid population growth is an issue that cannot be seen in isolation from development, as the effects of population growth affect all development sectors.

Speaking as a guest of honour at the 6th meeting of the Sindh FP2020 Working Group here, she pledged her support for the objectives of the FP2020 Working Group on unchecked population growth.

The meeting was chaired by Dr. Azra Fazal Pechuho, MNA and the Chair of Sindh FP2020 Working Group.

Aseefa Bhutto Zardari said she may also visit rural and remote areas to play her role to mobilise young women and girls so that Sindh can achieve its policy objectives under international commitments made by Pakistan.

Dr. Azra Fazal Pechuho, while chairing the meeting said that Planned Parenthood is one of the ways to address poverty.

She pointed out the need for integrating Life Skills Based Education (LSBE) methods into the curriculum so that adolescents are educated about their basic needs of nutrition, hygiene, planning their future and other needs.

Shahnaz Wazir Ali, Coordinator for Public Health OversightCommittee, Sindh said that the efforts by the Sindh FP2020 Working Group are regarded as best practice by other provinces.

Dr. Talib Lashari, Technical Advisor, CIP and Focal Person,FP2020 gave a detailed presentation on linkages between planned parenthood and socio-economic development and the status ofimplementation on CIP activities in Sindh.

The representative from the Finance and Planning and Development Departments also committed their support in the ongoing work towards achieving Sindh’s FP2020 goals.

The meeting was attended by the members of FP2020 Working Groupconsisting of multiple stakeholders, including public sectororganisations; USAID and its partners; United Nations Fund forPopulation (UNFPA); non-government organisations, professionalorganisations like Society of Gynecologists of Pakistan (SOGP);NCMNCH; donors and other development partners.

Stop lying, child planning is beneficial to Kenyan families

Recently, several prominent personalities including Kilifi gubernatorial aspirant Kazungu Kambi have been reported telling crowds at political gatherings to ‘multiply and fill the earth’.

This is not the first time that a public figure has made such an argument. No less than five members of the National Assembly have been quoted in the press encouraging their constituents to have more children so that their communities can capture leadership or get a bigger allocation of resources. Many of them have been recorded encouraging their audiences to stop using contraceptives and give birth to many children to boost their voting numbers. Some, including a Cabinet secretary, have even gone to the extent of offering cash rewards for every birth or pregnancy.

Regrettably, the message by these prominent personalities is very compelling. It makes sense to many. Especially with the thinking behind the so-called tyranny of numbers. Many Kenyans will take this ‘multiply and fill the earth’ message seriously, and some will act on it.

This being the election season, chances are, many more politicians and other prominent personalities will say similar things and take similar actions (of rewarding pregnant women). However, data shows that child planning and spacing is beneficial to women, families, communities as well as the country.

Child planning and spacing allows individuals and couples to anticipate and attain their desired number of children and the spacing and timing of their births. Anticipating, spacing and timing the birth of children has many proven benefits to any society. One of the most vital rewards is that child planning and spacing protects the health of women and children by reducing high-risk pregnancies and allowing ample time between pregnancies.

This is especially important for Kenya which is walking the path of reducing maternal and child deaths. Child planning and spacing also reduces poverty by contributing to economic growth at the family, community, and national levels. It improves women’s opportunities for education, employment, and full participation in society.

Child planning and spacing enables girls and women achieve their ambitions. Whether they are in school, work in formal or informal occupations, women who have the benefit of choosing when to have children, how many children to have and how much time between each child, they are likely to do better in life. Studies have shown that women who have the ability to plan their children alongside their individual and family aspirations are able to go to school (and finish school), make better and higher incomes and are able participate in shared activities in their communities.

All these benefits not only accrue to the woman, but also her partner, her family and her community. Child planning and spacing also means better economic outcomes for counties and the nation.

Studies have shown that child planning and spacing leads to financial savings in the cost of healthcare service provision. Families are able to care for their children better. Feed, house, clothe and educate them better. Consequently, this reduces the burden on public amenities – health, water and sanitation as well as education.

As things stand, Kenyans who want to access family planning services to help them plan and space their children face high social and cultural barriers. We must not muddy the conversation with misinformation. Moreover, Kenya must continue to invest domestic resources towards quality family planning services at public health facilities to ensure Kenyan women (and their partners) who need it can access it.

Over the last 20 years, we have made good progress which we need to keep up. By investing more resources in public education and to have conversations about child planning and spacing, we can ensure that all Kenyans have the right information. This public education will help to dispel myths and misconceptions that have caused family planning to be misunderstood by many.

The media must also refrain from providing their platforms to politicians and other prominent personalities to misinform Kenyans about the benefits of child planning and spacing.

DOH hopes Supreme Court will lift TRO vs distribution of contraceptives

The Department of Health is hoping that the Supreme Court will lift its Temporary Restraining Order issued against the distribution and acquisition of contraceptives in the country.

In a media forum called ‘Legal Barriers to Family Planning: Putting Women’s Lives at Risk’, DOH Spokesman Dr. Eric Tayag said that though they are preparing for the ‘worst case scenario’, the agency remains confident that it would be wise for the Supreme Court to lift the TRO.

Dr. Tayag added that the DOH is confident that the highest court will respect the rights of Filipino women.

Dr. Tayag also mentioned that “it’s worth it”, waiting for the Supreme Court’s decision especially if it will favor them.

March of this year when the DOH and the Office of the President filed an Urgent Motion for the lifting of the TRO issued by the Supreme Court on their plan to distribute contraceptives, which has been effective since 2015.

A careful perspective

In our part of the world family planning is often ignored, especially in the rural areas of Sindh. You! takes a look…

Unplanned pregnancies and a woman’s ability to space and limit her pregnancies have direct impacts on her health and well-being. Unfortunately, a major part of our society still considers family planning immoral and against religious laws.

 

Most of the families residing in the villages of interior Sindh are associated with agriculture and work for more than eight hours a day in the fields. Due to poverty and lack of resources, the women also work in the fields along with their men on meager wages. Because these women are occupied with work at home and in the fields, they find it difficult to take care of their children and themselves. They return home after completing their jobs while carrying packs of grass fodder or fuel-wood on their heads even during pregnancy and at the time of delivery. Working in the fields not only takes a toll on the health of mother and the baby but also these expectant women face problems such as premature or abnormal deliveries. And at times even lose their lives.

Sindh Population Policy 2016 draft shows that the population of Sindh has doubled in less than 29 years (1981-2010) and will further escalate in the coming years. According to Dr Talib Lashari, Technical Advisor, Costed Implementation Programme (CIP) of Sindh Population Welfare Department, Sindh’s birth rate is 1,240,467 per year. “It is not only causing poverty, but all the resources present are becoming insufficient for people. CIP is working with various government and nongovernmental organizations to implement Family Planning 2020 (FP 2020), which was set by FP 2020 Summit in London in 2012, with the aim to approach 69 targeted countries,” shares Lashari.

“The current stats show that 45 per cent children suffer from malnutrition, 1,73,900 infant deaths were reported in the last few years, 8500 maternal deaths and 74,300 deaths of children under the age 5. With 1.9 per cent growth in Pakistan’s current population at 189 million, it is estimated that the percentage will go up to 310 million by 2050. This will also result in the increase in social-economic demands,” adds Lashari.

Even though, the percentage of birth rate is way too high, the initiatives by the Sindh government are a step forward in the right direction. Moreover, they have been investing to achieve global agenda of controlling birth rate in the province. This is not all! The government has extended a move with district health departments and non-government entities, which are working on health, activating Lady Health Workers (LHWs), Lady Health Visitor (LHVs), Community Midwives, Rural Health Centres (RHCs) and Basic Health Units (BHUs), but the challenges are still there which need to be resolved.

Also, Sindh has 628 Family Welfare Centres (FWCs), which are said to be the pillars of population welfare programme. But the reports collected from the non-governmental organizations working in the health sector, reveal that a majority of FWCs have been non-functional for long.

In order to know more about the situation in Sindh, You! spoke to Lady Health Worker (LHW), Rizwana Mumtaz, who is part of a strong network comprising 22,575 LHWs and 770 Lady Health Supervisors (LHS) working in Sindh. Reportedly the LHWs have approached almost 50 per cent of women to address the issue of family planning. There are around 22 LHWs in each union council in rural areas, each one deals with at least 1500-2000 married women. These workers reach out to women at their homes, providing them with effective temporary contraceptive methods.

 

“I work in different areas of Sindh. In Hala, Matiari district, I have successfully influenced at least 35 married women, most of whom have more than 7 children. They followed my guidance to stop conceiving children further,” she says with pride.

According to her, it took at least two years to convince those women that it was in their own interest. “However, majority of the younger women were unwilling to accept any guidance to ease their lives and take care of their reproductive and general health. Many of them did not know the importance of breast feeding required for a specific period of two years, essential for the baby’s growth and nurturing.”

There are around 1300 families, residing in huts or scattered on agricultural fields near Hala. “I visit them to administer vaccination and provide them help regarding reproductive health. It is one of the most populous villages in the district and I try my best to convince them to have fewer children but they are reluctant to accept it despite being poor and unable to feed their babies,” informs Mumtaz.

On the issue of family planning, Rizwana Mumtaz cited the example of a fellow LHW. “When she got married, her husband rejected all her arguments regarding birth control. Having kids one after the other without any gap not only put her life in jeopardy but her child’s life as well,” she shares.

“Even educated families keep on producing kids in order to have desired sex of child. In this situation, we (LHWs) are unable to convince families to adopt family planning methods. My fellow LHWs and I often come across women who want us to create awareness among mothers-in-law and husbands as these women are too shy to discuss such matters,” adds Mumtaz.

 “We work with commitment and dedication and try our best to promote the use of various birth control methods. The success rate is good too but the government does not offer us any reward and we do not even get our salaries on time. And there is no job security either. What we do helps achieve the socio-economic and development goals and progress in the province but unfortunately, we don’t get anything in the end,” concludes Rizwana Mumtaz.

DOH confident SC will favor women’s rights

Two years into the Supreme Court’s temporary restraining order (TRO) on the distribution of contraceptives and pregnancy-control devices, the Department of Health (DOH) continues to keep faith with the justices’ “respect for the rights of women.”

“We’re positive that the [Supreme Court] will issue a decision in our favor,” said Dr. Eric Tayag, spokesperson for the DOH.

“[But] it’s up to them when to decide. We cannot force them, but we know that they are studying the matter thoroughly. We are confident that the Supreme Court will respect the rights of Filipino women,” Tayag said, referring to the TRO that also restrains the Food and Drug Administration (FDA) from granting any and all pending applications for the registration or recertification of contraceptives.

With the country’s supply of contraceptives reduced by the 2015 TRO, women have switched from pills and implants—among those covered by the court ruling—to cheaper and more readily available alternatives like condoms. Some are even considering more permanent options like vasectomy and tubal ligation.

Civil society organizations (CSOs), women’s groups and nongovernmental organizations (NGOs) have joined their voices to the clamor for the lifting of the TRO, which the Supreme Court imposed on contraceptives after a probirth group had claimed that these induced abortion.

Online petition

Aside from Purple Ribbon Movement for Reproductive Health, which started an online petition to urge the Supreme Court to lift the TRO, CSOs like Likhaan Center for Women’s Health have assumed part of the government’s responsibility for the reproductive rights of its citizens.

The group provides direct health care services to women in marginalized communities, said one of the group’s founder and director, Dr. Junice Demeterio Melgar.

As the CSOs’ representative in the National Implementation Team of the country’s Reproductive Health law, Likhaan supports the DOH and its allied agencies like the FDA, PhilHealth and Commission on Population (Popcom) in its policies on family planning, Melgar said.

“Likhaan has tried to respond to this looming contraceptive crisis by educating women in poor communities, providing family planning services, and supporting government agencies in their actions to lift the TRO,” she said.

Despite the TRO, Likhaan continues to provide contraceptives in poor areas like Malabon, Port Area in Manila, Pasay, Bulacan, Quezon City, and Eastern Samar, where its staff also do organizing work.

“Luckily for us at this time, the contraceptives that poor women use still have viable registrations and we are able to access supplies from the DOH and the UN Population Agency and mobilize the supplies to remote areas where the demand is high. So the contraceptives are used before their registration expires,” Melgar said.

The groups’ proactive stance on the issue was a response to the TRO, which, according to Melgar, “is terribly inconsiderate of women’s specific needs and downright discriminatory. It is a gross violation of women’s human rights by the Supreme Court, which makes seeking accountability extremely difficult.”

Optimistic

Health Secretary Paulyn Ubial, who remained optimistic that the Supreme Court would eventually heed the DOH appeal to lift the TRO, said the department continued to coordinate closely with its partner NGOs.

“The TRO was [directed] at the DOH so the private sector, the NGOs, can still provide these contraceptives,” Ubial said, adding that the DOH continues to distribute supplies not covered by the Supreme Court order.

Even with the TRO still in effect, there are other contraceptive products and services accessible and available to women, she said, including injectables, pills, condoms, IUDs, sterilization and vasectomy for men, and tubal ligation for women.

“If eventually the [Supreme Court] decides not to lift the TRO, we’d be left with condoms and sterilization,” Ubial said.

She said the DOH hoped a decision would be reached soon, as the hormonal contraceptives Implanon and Implanon NXT in their storage would expire in 2018.

As a last resort, should the TRO stay, the supplies could be donated to another country before their expiration date, she said.

“What we’re trying to negotiate right now is for the Philippines to donate these commodities to other countries that can use them instead of wasting P300 million worth of subdermal implants,” Ubial said.

Out of stock

There are still adequate supplies of public commodities, but the more expensive brands of pills, including those used for PCOs (polycystic ovary syndrome), have gone out of stock, Melgar said.

“Yet it is not easy to counsel women with PCOS to shift brands because brands have different contents and effects on people,” she said.

“It is ironic that the crisis in FDA registration is affecting affluent women more, meaning those who need the pills not for contraception but to treat an ovarian problem that is preventing them from getting pregnant. Perhaps the Supreme Court justices would be moved to act if the capacity to get pregnant by rich women was most affected?” Melgar said.

For Tayag, the more pressing issue is not the availability of contraceptives, which are produced regularly, but their registration.

“Even if, let’s say, there are donated contraceptives, they cannot be used unless they are registered,” he said.

“The issue is not about running out of supply. The issue is before you can use them, there has to be certification, registration with the FDA,” he added.

According to Tayag, the DOH is currently conducting an inventory of contraceptives, particularly the implants that can no longer be used because of the TRO.

“Except for the implants, we have already distributed the other contraceptives to the health centers. Anyway, these are not covered by the TRO,” Tayag said.

Worst case scenario

According to Executive Order (EO) No. 12, signed in January by President Duterte and which calls for the full implementation of the Reproductive Health Law, some 6 million Filipino women have unmet needs for modern family planning methods.

Of this number, a third—or 2 million—have been identified as poor women who should be given access to contraceptives by 2018 and thereafter, according to the EO.

The TRO, however, contradicts the executive order’s avowed goal.

Tayag said the DOH was also preparing for the worst case scenario should the TRO stay: an increase in population that could endanger the health of women, and possibly increase the number of maternal deaths and of abortion.

With contraceptive supplies thinning out, the country’s population could balloon to 106 million this year, Popcom Executive Director Juan Antonio Perez III said in an earlier interview.

Tayag said the DOH would soon release a list of contraceptives affected by the TRO and the expiration dates of their certificates of product registration for reference.

Ubial said the DOH submitted a motion for reconsideration to the Supreme Court last year, and made a follow-up in March.

“But we have yet to receive a reply,” she said.

Nasarawa Assembly will pass Bill for law to give family planning legal backing ―Opkede

The Nasarawa State House of Assembly will pass a bill for a law to give family planning programmes full legal backing, to effectively tackle maternal mortality in the state.

Alhaji Mohammed Opkede (PDP-Doma North), Chairman, House Committee on Health, disclosed this in Akwanga at the end of 3-day workshop on “Development of the Nasarawa State Costed Implementation plan for Family Planning.”

The News Agency of Nigeria (NAN) reports that the workshop was organised by two NGOs-Pathfinder International Nigeria and Partnership for Advocacy in Child and Family Health (PACFaH) in collaboration with the Nasarawa State Government.

Opkede said that the bill, if passed and becomes a law, would also promote healthy living among the people of the state, considering the enormous benefits of family planning to the development of the state.

He commended the NGO’s and the state government for organising the workshop and called for its sustenance.

“Nasarawa State House of Assembly belongs to the people of the state.

“We are going to do everything humanly possible as legislators through collaboration with the executive arm to support any programmes that would improve the health and wellbeing of our people.

“Family Planning programme is a critical area that needs attention because its importance cannot be over-emphasised to the development of the society, as it helps in reducing maternal mortality and promote healthy living.

“It also strengthens the health of the woman directly and the man indirectly as it enables the woman rest adequately in between pregnancy and child delivery.

“It also enables sexually active women and girls protect themselves from unwanted pregnancies.

“It is in view of this that we are ready to pass a Bill that will give it full legal backing in the state to encourage our people to embrace family planning.” he said.

Dr Usman Adis, the Executive Chairman,Nasarawa State Primary Health Care Development Agency, said government was putting in place all necessary machinery to take full ownership and sustenance of family planning programme.

Adis, represented by Dr Madawa Absalom, Director in the agency, reinstated the state government commitment in addressing problems confronting family planning.

Earlier, Ms Aanu Rotimi, Mr Yemi Osanyin, PACFaH and Pathfinder facilitators said that the workshop was to help the state develop an implementable work plan for the success of the family planningprogrammes in the state.

They added that the workshop was to also help the state develop a plan that would be usable in order to encourage family planning in the state.

They also called on the government to take full ownership of the family planning programmes with a view to giving it necessary support.

They stressed the need for government funding of the program to ensure the availability of family planning contraceptives and other services in public facilities in the state.

Too early, too many

“I work but the income I make is not enough to take care of my family,” says 20-year-old Salamatu Abubakar.

Although not married, Salamatu is a mother of three children. At age 17, she was already a mother of a set of twin boys, two years later, she got pregnant again and gave birth to a baby girl but says she did not plan for both pregnancies.

“I already come from a big family and it is difficult for us to survive, so I did not want to be in such a situation like my mother but it just happened,” she explains.

But it did not just happen as Salamatu puts it, she, like many other adolescent girls in Ghana, was exposed to sexual situations when she lacked the right information to negotiate for safe sex through the use of modern contraceptives.

Unmet Need

The Ghana Demographic and Health Survey (GDHS) data analysis shows that over 564, 000 Ghanaians aged 15 to 19 years are currently sexually active.

On average, adolescents who had sex before the age of 20, adolescent girls first have sexual intercourse at age 16.7 years and adolescent boys at 16.8 years.

Among adolescents who become parents before age 20, the average age at which Ghanaian adolescent girls have their first baby is 17.2 years, while the average age at which adolescent boys first become fathers is 18.4 years.

Almost all active adolescent girls report not wanting a child in the next two years, yet more than a half of sexually active adolescents are not using any form of contraception, creating a huge unmet need for contraceptive usage in the country.

Only one out of four married women who want to space their birth or do not want to get pregnant use a modern contraceptive method while one out of two unmarried women use contraceptives in Ghana.

Thus, if all married and unmarried women like Salamatu were to use FP methods, the contraceptive prevalence rate (CPR) of the country is projected to significantly increase to over 55 percent, according to the Ghana Family Planning Cost Implementation Plan.

Dr Olive Sentumbwe-Mugisa, Family Health and Population Advisor, World Health Organisation (WHO) Uganda, says contraceptive use reduces maternal mortality and improves women’s health by preventing unwanted and high-risk pregnancies and reduce the need for unsafe abortions.

“It is estimated that 2,000 maternal deaths could be avoided each year if all women who said they want no more children were able to stop childbearing,” she says.

Demographic Dividend

Salamatu is not as worried over taking care of her three children as taking on the responsibility for her other nine siblings.

She is responsible for their school and their up-keep because their parents do not earn enough income from peasant farming. “Once a while, they bring us some food stuff but since I am the first child and I am working, I have to take care of them,” she says.

Taking care of her children and siblings all by herself is a huge task she has been shouldering alone in the past five years with the meagre income she earns in her beads trade.

“I don’t have a man to support me and sometimes when they get sick, it is very difficult for me. But we are surviving,” she narrates.

Salamatu expresses her wish to have limited or spaced the number of children she had had but already she has three in three years. “I love my children but I wish I had not had them now,” she says.

Dr Jotham Musinguzi, Director General, National Population Council, Uganda, explaining the benefits of birth spacing or limited pregnancies, says when family size is lower, more resources are available to benefit all members of the family, especially the mother and children.

“This means more food, better clothing and school achievement, for the children and improved maternal health and economic productivity for the mother… These choices when added together can have profound effects on the country, one such effect is the Demographic Dividend (DD),” he asserts.

Demographic dividend as not only an improved health and well-being for the family but an opportunityfor economic growth and development that arises as a result of changes in population age structure.

This is because when fertility rates decline significantly, the share of the working-age population increases in relation to previous years.

A larger working-age population can enable a country to increase its GDP and raise incomes because they are able to save and invest rather than spend on supporting a large non-working (young) population.

Dr Musiinguzi says Africa still has an opportunity to reduce the fertility rate but it is not automatic as it depends on investments and reforms in three sectors: family planning, education, and economic policy.

“It is late but not too late, we must start now or we miss it and once it is closed it has closed,” he added.

FP2020

In line with ensuring that every woman has access to family planning information, services and suppliers, world leaders representing close to 70 countries pledged to specific commitments to ensure that additional 120 million women and girls in 69 of the world’s poorest countries have unlimited access to family planning methods by 2020.

Achieving the targets of the agreement (FP2020) would mean preventing a staggering 100 million unintended pregnancies, 50 million abortions, 200,000 childbirth-related and maternal deaths, and three million infant deaths.

Ghana, recognising that the high rate of population growth strains the country’s natural resources, which in turn drives up the poverty rate and threatens future development gains and knowing that Ghana’s population dynamics can be turned into a valuable ‘demographic dividend’ only if investments are made in FP and reproductive health (RH) signed up to the agreement.

Since then, the country has laid up plans in achieving its target. Government has committed to offering expanded contraceptive choices, including a wider range of long acting and permanent methods.

Presently, the method mix includes condoms, pills, implants, IUDs/IUS, vasectomy and bilateral tubal ligation.

Health care officers have also been trained in adolescent reproductive health and are encouraged to offer adolescent friendly services.

Ghana has 218 fully functional adolescent friendly corners and 54 were built in 2015-2016 currently.

But there are hindrances that still face young people like Salamatu in accessing modern family planning methods. Factors like infrequent sex, fear of the side effect or health concerns and breastfeeding are barriers that prevent people like Salamatu from opting for a voluntary family planning method.

“When I go to the hospital the nurses think I am a bad girl so I make my new man use a condom because I do not want to get pregnant again. Now I want to take care of my children and siblings,” she says

PF & SDGs

Family planning can accelerate progress across the five Sustainable Development Goals (SDGs) themes of people, planet, prosperity, peace, and partnership and is critical to achieving the goals and the post-2015 development agenda.

Dr Sentumbwe-Mugisa says empowering women to choose the number, timing, and spacing of their pregnancies is not only a matter of health and human rights but also touches on many multi-sectoral determinants vital to sustainable development, including women’s education and status in society.

“Without universal access to family planning and reproductive health, the impact and effectiveness of other interventions will be less, will cost more, and will take longer to achieve,” she adds.

Global strategies and partnerships—and health decision makers at all levels—must leverage the abundance of available research, evidence, and the range of justifications presented here to prioritize family planning as a foundational component of health, rights, and long-term development strategies.

Thus, like Salamatu, countless number of teenage girls are missing out on family planning methods while they await a friendly adolescent clinic.

“If I get a clinic where they will not judge me but give me the assistance I need, I will go there,” Salamatu says.

PIX SAVED IN NEWDAILY AS FP

PULL OUT

The central role of family planning in achieving the Sustainable Development Goals (SDG) across the five themes of people, planet, prosperity, peace, and partnership.

PEOPLE

Family planning advances human rights. Family planning helps reduce poverty. Family planning contributes to improved nutrition outcomes. Family planning saves lives. Family planning prevents HIV/AIDS transmission. Family planning supports women’s and girls’ education. Family planning advances gender equality and empowerment.

PLANET

Family planning mitigates population growth’s effects on access to water and sanitation. Integrated population, health, and environment projects can expand access to clean and renewable energy. Family planning contributes to building resilient infrastructures. Family planning contributes to building safe, resilient, sustainable cities. Family planning helps reduce population effects on food and chemical waste. Family planning helps address the challenges of climate change. Family planning helps to protect declining marine resources. Family planning helps mitigate the effects of deforestation and unhealthy interaction among humans, domestic animals, and wildlife.

PROSPERITY

Family planning contributes to economic growth.

PEACE

Family planning promotes inclusive societies by addressing the needs of disadvantaged populations. Family planning contributes to peace and stability.

PARTNERSHIP

Family planning partnerships can support the achievement of the SDGs.

Adewole: FG to Upgrade Standard of Midwifery Practices in Nigeria

The Minister of Health, Prof. Isaac Adewole, has said the federal government has concluded plans to improve the standard of midwifery practices in the country.

 This is coming as a Nollywood actor and producer, Jim Iyke, was unveiled as the Special Envoy/Goodwill Ambassador for Maternal, Newborn and Child health.

Adewole made this known yesterday during the commemoration of the 2017 International Day of the Midwife (IDM) in Abuja.

He stressed that a knowledgeable, skilled and motivated health workforce is an important catalyst to achieve the Universal Health Coverage, adding that there was also need for pre- service training which would involve regular curriculum review and provision of adequate funding.

 He pointed out that the National Health Policy considered primary healthcare as the framework to improve health services for all  Nigerians, which include the provision of health education, adequate nutrition, safe water and sanitation, reproductive health among others.

 The minister hinted that the National Primary Healthcare Development Agency (NPHCDA) was established to provide strategic support for the development and delivery of primary healthcare, which includes developing guidelines on the implementation of primary healthcare services and enforcing such guidelines.

 He said the state government was also expected to establish State Primary Healthcare Development Agency (SPHCDA) to directly oversee the implementation of primary healthcare services in the various states.

 Adewole further explained that the Midwives Service Scheme (MSS) launched in 2009 aimed at ensuring skilled birth attendants through the recruitment and deployment of midwives to underserved areas as frontline workers was currently being reviewed.

 “Our plan was to modify the scheme based on lesson learnt to improve efficient service delivery in our drive to revitalise the primary healthcare service delivery in the country,” he added.

He emphasised that the ministry of health was committed to revitalising primary healthcare in Nigeria as bedrock of the health system.

While thanking other development partners especially UNFPA for strengthening the midwifery workforce over the years, the minister commended the wife of the Senate President, Mrs. Toyin Saraki, for supporting government initiative of providing quality Maternal, Newborn and Child Health Services in the country through her NGO, ‘WellBeing Foundation’.

 Earlier, Mrs. Saraki stressed the need for government,  non-governmental organisations and development partners to invest in capacity building for the midwives and nurses.

In a related development, the White Ribbon Alliance Nigeria (WRAN) has appointed Jim Iyke as the face of Maternal, Newborn and Child Health in the country.

 The National Coordinator, WRAN, Mr. Tonto Ibraye, said the popular actor was selected because of his affection for women and a committed father.

“One of the reason we selected him is that he is easy going and for the fact that he has a son. Over the years, we have been engaging a lot of women; it’s time we engage men and Jim Iyke is going to be that face,” Ibraye said.

 Accepting the appointment, Jim Iyke pledged to bring the issue of maternal health to the front burner, lamenting the high rate of maternal and mortality in Nigeria, making it the second in the world.

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