Susan Anyangu interviews STAN BERNSTEIN, senior policy advisor UNFPA
KAMPALA, Nov 19 2009 (IPS) – Family planning: key to reducing child mortality and improving maternal health; a way to put less strain on the environment; and a smaller population makes the challenge of providing adequate education and health services that little bit easier.
The Millennium Development Goals are closely linked, and according to the United Nations Population Fund (UNFPA), achieving them by 2015 will require recognition of the benefits of slowing population growth.
IPS spoke to Stan Bernstein, a UNFPA senior policy advisor at the International Conference on Family Planning in Kampala, Uganda, who said failing to provide everyone with access to affordable and effective family planning threatens the attainment of all the MDGs.
IPS: How is the provision of effective and affordable family planning related to the attainment of MDGs? STAN BERNSTEIN: At the household level, having many, closely-spaced children affects the health of women, their children, and families, increasing the risk of maternal, child and infant mortality.
For development efforts to be achieved, (governments) must recognise the benefits of slowing population growth. And one way of doing that is to satisfy the current unmet need for family planning.
Many married women report having mistimed or unintended pregnancies or a desire to space or limit future pregnancies, but are not using modern contraceptive methods.
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Family planning helps countries reduce child mortality and improve maternal health. It also plays a major role in MDG 2 because a smaller population means fewer people in need of education and health services. Further, it means less strain on the environment and natural resources.
Full achievement of the MDG targets costs less and is more manageable logistically when countries focus on provision of family planning services to reduce population growth.
IPS: What is UNFPA s recommendation at this point? Is it too late for a turnaround to be achieved? SB: Governments should increase budgetary allocations towards family planning as a matter of urgency if they are to meet their MDGs. At the moment the current pace of increasing family planning uptake is still low, contributing to an increase in unwanted pregnancies and maternal deaths as a result of unsafe abortions and child deaths.
The maternal mortality rate remains high, yet it was (supposed to) be cut by three quarters by 2015. This would have required a reduction of five percent per year from the 1990s to 2015. However, the reality in Africa has been a reduced maternal mortality rate of 0.5 percent per year since the 1990s to date. This is simply not good enough and at this pace MDG 5 will never be achieved.
However, all is not lost if governments renew their commitment to increase the prevalence of family planning and reduce unmet need. This should be scaled-up because in half of the countries in Africa the levels remain alarmingly low and more prevalence rate is needed.
IPS: With the ongoing worldwide economic crisis governments have little money to spare, let alone divert into provision of family planning services. What is the incentive for them? SB: Evidence indicates that improved government commitment through increased budgetary allocations to family planning has had tremendous results.
Rwanda is an example of a country where political commitment has had a significant impact. In 1994, (Rwanda s) Demographic Health Survey showed a contraceptive prevalence rate of 10 percent. The 2008/2009 survey shows a prevalence rate (the proportion of people using contraceptives) of 26 percent a marked increase.
This has significantly reduced deaths of children under the age of five, with an increased coverage of immunisation among children.
Despite Rwanda s unmet need for contraceptives being over 20 percent, it remains a good example. It shows that once the government renewed its efforts in provision of family planning, demand went up because now more people are aware of it and want the services.
While it is the reality that increased commitment means governments must give more money, it has been proven even very small investments in family planning sector will pay off in terms of improved lifestyles among the reduced population.
The impact of not putting in any money is four times more costly than providing funds for family planning.
African governments should also strengthen the health care sector to avert the mass exodus of health works to the West in search of better opportunities. This is unfortunate since it is happening at a time when demand for family planning in Sub-Saharan Africa is increasing.
Governments are thus being urged to review the training of health workers at all cadres to ensure that all can deliver family planning services to the community. And here training of community health workers is being advocated to ensure they are competent enough to supply family planning services.
In Malawi, the Ministry of Health decided to allow health surveillance assistants to administer injectable contraceptives at the community level, a move that has served to increase contraceptive prevalence in that country.
IPS: Is it only up to governments? What is the role of activists working in the family planning sector as well as donors? SB: While the onus is on governments to re-commit to the family planning sector, advocates in the area are being challenged to devise new strategies to mobilise commitment and resources for family planning programmes through using evidence-based strategies that will get through to the governments, donors and policy makers.
Donors who since the 1990s refocused on HIV also need to appreciate the need for funding in the family planning sector. And if governments show commitment it may be worthwhile to reward countries through donor investment in this area.