My first stop when I arrived in Nakasongola, Uganda, on a hot day in 2004 was the small hospital that served this rural district north of Kampala. I was paying a courtesy call to the District Medical Officer, Dr. Gerald Ssekito. He looked tired when I arrived, explaining that he and other hospital staff had not slept the night before. A pregnant woman had been brought in on the back of a motorbike in the middle of the night. She had delivered the first of her two twins the day before in her remote village, but continued laboring at home unable to birth the second. Finally, after 24 hours, her family put her on a motorbike for the long journey to the hospital, but she bled heavily and died on the way to the hospital.
Tagged: family planning
This week, more than 3,700 participants will gather in Kigali, Rwanda, for the fifth International Conference on Family Planning (ICFP). What is at stake? The lives and well-being of an estimated 214 million women of reproductive age in developing countries who want to avoid or delay pregnancy but are not using an effective form of modern contraception.
Why do women who do not want to get pregnant choose not to use modern family planning methods? While this question is not bounded by geographies, the most recent Guttmacher Institute report, which focused on the low- and middle-income countries, is most illuminating. The two most common answers given by married women were health reasons/side effects or fear of side effects (26 percent) and claims of infrequent sex or not being sexually active (24 percent). Among unmarried women, infrequent sex (49 percent) was the top reason.
Equally informative are recent FHI 360 findings from a user preference study in Uganda and Burkina Faso showing that 75 percent of women currently using a method would be open to trying new technologies. It quickly becomes clear that existing methods do not satisfactorily address the changing needs of women throughout their 30- to 40-year reproductive journey.
How can an adolescent girl succeed in school if she is not protected from sexual violence inside the classroom? How does a child thrive when his mother must choose between buying medication or nutritious food? We know that poverty, lack of access to education, poor health and violence are intimately linked, and how we tackle these problems is a global issue with important implications for the way the United States funds international development programs for women and girls. At the moment, we tend to compartmentalize our efforts in top-down, single-issue solutions, not because that is the most effective way to meet the needs of women and girls, but because it meets the needs of funders and their implementing partners. As we enter the new era of the Sustainable Development Goals (SDGs), we need to do better.
There is an obvious starting point.
We need to be a lot more deliberate and get a lot better at integrating efforts to improve the well-being of women and girls. Given the siloed nature of how we organize development work, especially in terms of funding and specialized expertise, we tend to think and act with narrowly predetermined notions of cause and effect. As a result, we miss vital connections and opportunities for action and impact. For example, I recently asked an African Minister of Health what was the biggest obstacle to women’s and girls’ health, and he immediately responded, “access to transport” to get to health facilities and obtain medicines. And yet, how often does transport come up as a priority when funders and development agencies plan health programs?
In a statement declaring the clusters of birth defects that appear to be linked to Zika virus infection in Brazil “a public health emergency of international concern,” the World Health Organization recommends important measures for tackling this emerging infectious disease threat: improving surveillance, developing better diagnostic tests, intensifying vector control efforts and carrying out other prevention and treatment measures.
More remarkable were calls from public health officials in Colombia, Ecuador, El Salvador and Jamaica for women to postpone pregnancy until more is known about the association between the Zika virus and microcephaly, a severe birth defect affecting the brains of newborns. Salvadoran health officials have even advised women to delay pregnancy until 2018, when the risk of being infected with Zika may be lower.
The spread of Zika in the Americas adds urgency to the need to help all women — and their male partners — avoid unintended pregnancies. But, women and couples in countries affected by Zika face formidable barriers to achieving their fertility intentions, including lack of access to contraceptives and other reproductive health services, some of the world’s most restrictive abortion laws and high rates of sexual violence.
Placing the burden of protecting unborn children from the virus’ effects solely on women who have limited reproductive rights and contraceptive options is discriminatory and unsustainable. Expanding access to reproductive health services must be part of a comprehensive response to the Zika virus, and these services should be supported in ways that protect and strengthen the reproductive rights of women and girls.
No pipeline, no promise: The role of contraceptive R&D at the International Conference on Family PlanningWritten by
This week, nearly 3,000 health professionals and researchers gathered in Nusa Dua, Indonesia, for the 4th International Conference on Family Planning (ICFP), the world’s largest conference focused on family planning. At this and similar events, we often hear about the barriers that prevent women and men around the world from having reliable access to safe, affordable contraceptive services. “No product, no program!” “No provider, no program!” These are common refrains in the family planning community, and they speak to the importance of having both sufficient contraceptive commodities and adequately trained health care providers to ensure high-quality services for individuals who need them.
This week at ICFP, Dr. Laneta Dorflinger, director of Contraceptive Technology Innovation at FHI 360, offered an additional perspective. “No pipeline, no promise!” she asserted during the Family Planning+Social Good event to highlight the importance of continued investment in contraceptive research and development.
World leaders recently ratified the 17 Sustainable Development Goals, which set 169 ambitious targets to be achieved by 2030. Reaching these goals would greatly improve the lives of people worldwide. Women and girls have much to gain, especially because two of the targets call for ensuring universal access to sexual and reproductive health services, including family planning.
Given the contributions that family planning can make to nearly all 17 of the goals, we think that universal access to family planning could be a Sustainable Development Goal of its own. Still, the global community has taken a big step in the right direction.
Now, how can we ensure that universal access to family planning becomes a reality? Here are five ways.
1. Bring new and lower-cost contraceptive methods to market.
More than 225 million women in developing countries want to avoid or delay pregnancy but are not using an effective method of family planning. For many of these women, the currently available products do not meet their needs and preferences.
Some popular methods in the United States, such as the levonorgestrel-releasing intrauterine system (LNG-IUS), remain largely unavailable to women in developing countries because of cost. The introduction of more affordable products, such as the new LNG-IUS from Medicines360 and Sino-implant (II), can be game changing for diversifying the method mix accessible to women.
A version of this post originally appeared on K4Health. Reposted with permission.
The international community is abuzz with excitement about the new global development agenda, the Sustainable Development Goals (SDGs). Officially being launched this month, the aims laid out are more ambitious and all encompassing than ever before. As such, they’ve generated an expectedly broad, diverse and loud chorus of suggestions for their implementation. Everyone seems on the hunt for the best new idea or technology to carry the agenda forward. Yet, after decades of work and untold millions of dollars in investments in research and ideas, surely we must know something useful today that could be put to good use? Perhaps while smartly pursuing innovations that keep pace with our changing world, we can also put some real investment behind some of even the simplest things that we already know to be true and which might just need a little more traction before we can finally benefit from their full potential impact.
For example, right now we have a tool available to us that spans almost every SDG. It’s a relatively inexpensive solution that can simultaneously improve global outcomes in education, health and wealth. It can help preserve our environment and ensure food security for people around the world. You may be wondering why you have not heard of this amazing tool, but it’s far from new. Drumroll … it’s fully meeting the global demand for contraception. That’s right — sound evidence from around the world tells us several things.
The 2014 Kenya Demographic and Health Survey showed that rural women have a total fertility rate of 4.5 children per woman versus 3.1 for urban women, and the poorest women have more than twice as many children on average than the wealthiest. Meanwhile, unmet need for contraception among poor and rural Kenyan women is higher than any other groups. Clearly, innovative solutions are needed to support women and couples in poor, remote rural areas in achieving the number and timing of pregnancies they desire.
Advancing a no-missed-opportunities approach through integrating family planning and immunization servicesWritten by
When Lorpu*, a mother in Liberia, brought her baby to a clinic to receive routine immunizations, she was also counseled about family planning and offered a contraceptive method. Lorpu expressed relief about having received same-day provision of both family planning and immunization services: “When I go for [my child’s] vaccine, I can also get family planning. I don’t have to leave and come back.”
Lorpu received these integrated services as part of a pilot program in Liberia implemented by the U.S. Agency for International Development’s (USAID) predecessor flagship Maternal and Child Health Integrated Program (MCHIP) and the Liberian Ministry of Health and Social Welfare. In participating clinics, women who brought their infants for routine immunization services were provided brief messages about family planning by the vaccinator and offered a referral for same-day services. This approach, now used by MCHIP’s successor program, the flagship Maternal and Child Survival Program (MCSP), has led to substantial increases in family planning uptake, and women have expressed positive feedback about the convenience of having access to both family planning and immunization services during the same visit.
Integrated health care delivery is critical in the year after childbirth, when there are numerous opportunities to reach women and their infants with services — including postnatal care, immunization, growth monitoring and family planning. A no-missed-opportunities approach recognizes that every service contact presents an opportunity to comprehensively address women’s and children’s health needs.