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.
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.
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.
This year’s International Conference on Family Planning (ICFP) saw the largest youth delegation in its history. Approximately 300 young people between the ages of 18 and 25 attended, doubling the number who participated in 2011. These young family planning activists moderated panels, delivered plenary presentations and assisted in launching ground-breaking publications, such as the United Nations Population Fund’s State of World Population 2013 report on adolescent pregnancy and the International HIV/AIDS Alliance’s paper on young people living with and affected by HIV. Young people’s needs were a major focus of conference presentations, events and press coverage. Government officials publically recognized the importance of young people and encouraged their active participation as emerging leaders in the field of family planning and reproductive health.
The attention to the unique needs of this population could not be more timely. Every day, 20,000 girls under the age of 18 in developing countries give birth. That is roughly 833 girls every hour, or 14 girls each minute. Of the 7.3 million girls who give birth each year, two million are under the age of 15 (UNFPA). Adolescent mothers face devastating social, educational, economic and health outcomes. Girls who become pregnant confront discrimination within their communities and are often forced to drop out of school or get married. Pregnancy during adolescence increases the risk of anemia, postpartum hemorrhage, prolonged obstructed labor, obstetric fistula, malnutrition and mental health disorders. Complications from pregnancy and childbirth are the leading cause of death for 15- to 19-year-old girls (UNFPA). Furthermore, adolescent mothers are more likely to have a lower income and have more children at shorter intervals throughout their lifetime.
Armamentarium. It’s a big word. It’s what we in the U.S. like to call a fifty-cent word. An armamentarium refers to the full range of resources that are available to tackle a problem, often in the arena of health care.
Today, we have an unequivocal need to expand the contraceptive armamentarium for women around the world.
In some cases, this means expanding access to existing, underutilized family planning methods. In too many settings, women do not have adequate access to a full range of options, including long-acting and permanent contraceptive methods. Barriers to access include frequent stock-outs of commodities; a lack of adequate health care facilities or trained staff to administer contraceptives, especially in rural areas; prohibitively expensive client fees; a lack of comprehensive, accurate information for clients; a provider bias against the provision of long-acting methods to some women; and opposition from family members or community institutions.
This week, over 3,000 program implementers, health care providers, researchers, faith-based leaders, donors and policymakers gather in Addis Ababa, Ethiopia for the third International Conference on Family Planning. The theme of the week-long event is “Full Access, Full Choice.” The organizers explain that this is more than just a conference; it is part of a movement to garner commitments globally to implement evidence-based solutions targeting the persistent barriers to access that women and men face every day.
In addition to identifying effective service delivery and policy approaches to increase access to existing methods, we must also take advantage of this moment in Addis to make a long-term commitment to expand the contraceptive armamentarium to include new, innovative methods. The basket of family planning methods available has remained largely unchanged for several decades. There are gaps in the method mix that, if filled, could result not only in increased uptake of contraceptives by women, but also in improved continuation rates by better meeting individuals’ needs and desires.
The sun is setting on the Millennium Development Goals (MDGs). In 2015, the world will shift its focus toward a new development agenda. We know that family planning improves the health and well-being of women and families around the world. Now, as the next-generation goals expand the focus from social and human development to also include economic and environmental objectives, we should not underestimate the positive ripple effects of family planning across all three areas.
Let’s first remind ourselves of family planning’s connection to all eight MDGs. Family planning: generates wealth and reduces hunger (MDG 1); prolongs education (MDG 2); empowers women and girls (MDG 3); saves infants (MDG 4); improves maternal health (MDG 5); prevents pediatric HIV (MDG 6); reduces pressure on the environment (MDG 7); and promotes global partnerships (MDG 8).
Moving beyond 2015, the three health-related MDGs are likely to be condensed into one goal (Ensuring Healthy Lives). It is reassuring to see that “ensuring universal sexual and reproductive health and rights” is among the five sub-targets proposed within this goal. Moreover, exciting new support for family planning has been generated by passionate champion Melinda Gates and through global movements like Family Planning 2020. This promising momentum will not realize its full potential, however, without bold, outside-the-box approaches that reach people with family planning information and services. Given family planning’s wide-ranging benefits, we must now strengthen support for it in development sectors beyond health.