By Eleanor Whitehead
The international community has put contraception back on the development agenda with commitments to reach 120m more women with family planning services by 2020.
Donors have committed $2.6bn to improve family planning services in developing countries, and several African governments vowed to increase their spend on contraception provision to bring voluntary family planning services to an additional 120m women by 2020.
The pledges, made at a summit hosted by the UK’s Department for International Development and the Bill & Melinda Gates Foundation, will result in 200,000 fewer women dying in pregnancy and childbirth, 110m fewer unintended pregnancies, 50m fewer abortions, and 3m fewer babies dying within their first year, the Gates Foundation said.
The London Summit on Family Planning, held on World Population Day, was designed to reverse years of dwindling funding to family planning, which has seen aid for reproductive healthcare programmes, as a share of global health aid, decline from 30 percent in 1994 to 12 percent last year, according to World Bank data.
“The investments in reproductive health, particularly in family planning, really fell off. In large part that was because of the politics of it, because we live in an environment that has become a little more conservative, so there was a pushback from all parts of the world – developing and developed,” explains Dr Babatunde Osotimehin, executive director of the United Nations Population Fund (UNFPA), which is partnering with Dfid and the Gates Foundation on the initiative.
Donors have increasingly focused on other healthcare crises such as HIV/AIDS and malaria. “But a woman or girl’s ability to choose, and her right to do so, without coercion, is important for strong development – of a community and a country,” Dr Osotimehin argues.
Every $1 invested in family planning services yields up to $6 in savings on health, housing, water, and other public services, the Gates Foundation says. Contraceptive use also implies greater access to education and greater economic opportunities for women.
The UNFPA will double the proportion of its resources focused on family planning to 40 percent, bringing new funding of $174m per year. The Gates Foundation promised to double funding to $140m for eight years. The EU pledged $28m ahead of the summit.
Over 20 developing countries also made vows to address policy, financing and delivery barriers impeding the distribution of contraception; among them was Nigeria. Health minister Muhammad Ali Pate said his country would reach a contraceptive prevalence rate of 36 percent by 2018. “Achieving this goal will mean averting at least 31,000 maternal deaths. Over 700,000 mothers will be prevented from injuries or long-term complications due to childbirth,” he said at the summit.
He also promised to triple Nigeria’s spend on reproductive health over the next four years, to over $8bn annually. Women in the country’s richest wealth quintile are over 10 times more likely to have access to family planning services than their poorer counterparts, for whom the access rate is only 3.2 percent.
Senegal – whose contraceptive prevalence rate of 12 percent is one of the world’s lowest – promised to more than double the number of women using contraception to 27 percent by 2015. The government will also increase its spend on procurement by 200 percent, and double the budget for its family planning programme, investing in a mass communication campaign. The country’s minister of health, Awa Marie Col-Seck, claimed support of the Catholic church and said that Muslim leaders sit on family planning coordinating committees: “If the religious leaders are with us, we can really make headway,” he said.
Tanzania’s president Jakaya Kikwete also pledged to double contraceptives prevalence rates to 60 percent by 2015, while other countries including Malawi, Rwanda, Sierra Leone, Uganda, Zambia, Ghana and Côte d’Ivoire and Tanzania made similar pledges. Ethiopia announced a five point action plan to meet its funding gap for family planning services.
“Recognising that early childbearing is a major contributor to maternal mortality, we are now targeting our efforts on adolescent girls who have the highest unmet need for family planning,” said the country’s health minister,Tedros Adhanom Ghebreyesus.
“There’s a myth going around to say that Africa is not receptive to family planning, but we’ve now had a clear demonstration of where Africa stands,” says the UNFPA’s Dr Osotimehin. “We have the big players coming on board, putting money on the table, and saying: ‘We are going to do this and do it well.’
“It was important to bring up the issues of commitment by Africa to help itself. This is not just a situation of trying to get money from the donor community: it is building momentum to address this issue within Africa.”