Family Planning: The Link to Achieving All 8 MDGs
12/01/2009
Why is there renewed emphasis on family planning after 15 years of relative quiet?
Family planning is the link to achieving all the MDGs. Photo by Jim Daniels/FHI
The International Conference on Family Planning in Kampala, Uganda, in November drew more than 1,000 family planning researchers and experts, program managers and health ministry officials from across the globe. This conference is a seminal event marking the reinvigoration of our global commitment to family planning.
Why is there renewed emphasis on family planning after 15 years of relative quiet? Perhaps it is because as 2015 approaches, we've realized we're not on target to achieve the Millennium Development Goals. Perhaps we've also finally understood that family planning may indeed be "one of the most cost-effective development investments," as the UN Meeting on Maternal Health declared in Ethiopia last month. Here's my take on why family planning is important to achievement of the MDGs.
GOAL 1: End poverty and hunger - Family planning reduces poverty. Per capita GNP correlates with the prevalence of modern contraceptive methods. Moreover, an increase in women's weekly income is associated with fewer pregnancies. Family planning also reduces aggregate demand for food.
GOAL 2: Achieve universal primary education - Unintended pregnancy is a major obstacle to school attendance, since many girls drop out once pregnancies occur. By age 18, nearly half of all women in the poorest countries have had children or are pregnant.
GOAL 3: Promote gender equality - Unplanned pregnancies interrupt education, work and career plans. Not surprisingly, women who use long-acting methods of contraception are more likely to be gainfully employed. Half the Sky, by Nicholas Kristof and Sheryl WuDunn, shows that investments in women's empowerment, including in their ability to control their fertility, is the most important driver of development.
GOAL 4: Reduce child mortality - Family planning saves infant lives. Spacing births and limiting unintended births increases child survival. Currently, 2.7 million infant deaths are averted each year by the prevention of unintended pregnancies.
GOAL 5: Improve maternal health - Family planning is the most cost effective means of decreasing maternal mortality. The risks of unsafe abortion are among the main causes of maternal death in young women. Access to family planning prevents unwanted pregnancy, thus reducing the demand for abortion.
GOAL 6: Combat HIV/AIDS and other diseases - Contraception is the best kept secret in HIV prevention. Women with HIV who have unintended pregnancies run the risk of transmitting HIV to their child during pregnancy, delivery or breastfeeding. Preventing pregnancies among HIV-positive women who do not wish to become pregnant reduces HIV-positive births and the number of children needing HIV treatment, care and support - three times as many as would be prevented by providing antiretroviral treatment to mothers during pregnancy, birth and breastfeeding.
GOAL 7: Ensure environmental sustainability - Environmental degradation is fueled by per capita consumption, the technology used to produce what is consumed, and population growth. Preventing unintended pregnancy is the factor in population growth most amenable to intervention. Many women want fewer children, and over 200 million have an unmet need for contraception.
GOAL 8: Develop a global partnership - Family planning promotes global partnerships. Four decades of global investment in family planning programs have contributed to strong collaboration among international agencies, government ministries, multinational organizations and local communities. The current focus on health systems strengthening and systems integration is founded on linkages between family planning and HIV services.
Family planning won't solve all our problems. It is, however, a highly effective cross-cutting development imperative that can contribute to achieving the Millennium Development Goals. Achieving universal access to family planning is within our grasp, but we need to increase investment in contraceptive technology research, development of more evidenced-based policies, engagement from the public and private sectors, and overall commitment worldwide. This month's meeting in Kampala is a great opportunity to revitalize the Cairo Consensus of 1994.
Learn More
See what Ward Cates and FHI are doing at the International Conference on Family Planning: Research and Best Practices.
Ward Cates Jr, MD, MPH is president of research at Family Health International.
My wife has tried 3 types of contraceptives, but bleeds sevely immediately after administering the methods. She started with an injection, then pills, then coil. what could be the problem? How can we convince our people that these methods are safe?
— mbabazi tadeo on 2009-11-13
All contraceptives have pros and cons. The bleeding side effects from the 3 methods you mention are important to an individual’s satisfaction with the method, however it is not a safety issue. Fortunately a wide array of contraceptive options allow individuals to choose methods which suit their personal needs.
— Dr. Ward Cates, Family Health International on 2009-11-14
Family planning can be termed as a life saver for Uganda but how does the general population perceive it? In Uganda, I can say that a lot has been achieved as far as awareness of FP is concerned, however, little has been realized in terms of reduction of the average number of children per home, more especially in the rural settings. Reasons for this is low adoption rate of the FP practices and another key observation of greater concern to me is that people who attempt to use some of the LAPMs have received alot of criticism from their communities, including fellow women.That has instilled fear in women in addition to the misunderstood side effects of the methods. I end by saying that the struggle for change of pessimistic attitudes of people towards FP still has a long way to go but I just hope and believe that there will be a light at the end of the tunnel.
— Aku on 2009-11-16
I really appreciate the points stated above and they are obvious. However my concern is these suggestions should get adequate attention by policy makers, funding organizations and global leaders to up bring the efforts.
— Abraham Alano on 2009-11-17
It has been shown that small family norm is essential to acheive most of 8 millenium goals listed, but the question is who will advise family planning. Though most deliveries in developing countries are conducted by untrained personnel, but family planning practices are neglected even when delivery occurs at health facility. I would blame medical and nursing staff for this failure, who are apathetic to family planning advice.
A mother who comes for health checkup during antenatal period, or brings her child for several sessions for immunisations to health facility, why she is not apprised of need of family planning. Small family norm is the need of time and should be publicised well with examples of well-being of mother infant dyad, the teaching should start from middle school years and ,of course, in colleges too. I am often told by my colleagyes in opd of hospital , Why you are wasting your time in advice, it is useless Manswer is even if one of five women start contraceptive practices after my advice, it is worth it. Policy makers will make policies, it is for medical profession, health personel and couples who are motivated to spread the message.
— dr sudarshan kumari on 2009-11-24
The problem you describe was addressed at several sessions at the recent International Conference on Family Planning in Kampala, Uganda. Participants agreed that postpartum and immunization clinics present excellent opportunities to address the fertility intentions of women. Providing on-site contraceptive services can facilitate access for those women not currently wishing to become pregnant.
— Dr. Ward Cates, Family Health International on 2009-11-24
Dr Ward,
Thanks for stressing on the need for Family Planning. It is a much needed service for the population around the globe, more so in the developing world. Many of the health care indicators will improve if family planning is adopted as a way of life.
— Shabina Hussain on 2009-12-07
This is very good idea for The Link to Achieving All Eight MDGs and controlling population in over all world and specially in development countries that is Pakistan. The Pakistan is very ideal country for working in Family Planing and RH.
— Muhammad Aslam on 2009-12-15
What about the role of men in this whole picture? What have we done to increase responsiveness by the males towards uptake of FP?
— Moses Katende on 2009-12-15
This is indeed a timely attempt to rethink your strategy and probably refocus on family planning program particularly in the over-populated developing countries. My country (Bangladesh) made significant progress in 1980s and early 1990s in achieving its goal. After that, the program lost both its momentum and direction. We now realize that we have done wrong and would like to return to our community-based door-to-door family planning program. We want to survive!
— Abdullahel Hadi on 2009-12-15
You are absolutely correct, men must be further engaged in family planning - women do not conceive alone and so should not bear the entire responsibility for family planning. The First Lady of Uganda, who spoke at the International Conference on Family Planning in Kampala echoed similar sentiments. The struggle has been not whether to engage men, but how to do so effectively. Experience has shown that men do not respond to the term “family planning,” however, they are responsive to the evidence that smaller family size leads to greater financial stability and overall improved family health outcomes.
— Dr. Ward Cates on 2009-12-16
Indeed without FP/RH,the attainment of the eight MDGs will be a great challenge the world over. FP is not reduction in the number of population but having children that one’s capacity can handle in terms of education (Goal 2-UPE), medical care( Goal 4,5 and 6), Clothing and Feeding (Low demand for food) all leading to savings and thus reducing poverty (Goal 1). My country Uganda has made a reasonable progress in FP through the ministry of Health and its partners like PACE (psi), Marie Stopes.
— Nicholas Otto on 2009-12-16
Family Planning is a neglected issue by most health workers. Just like we did for HIV/AIDS, we need to invest a lot of efforts to counter the myths around FP, reduce stigma associated with FP, and raise demand for FP while at the same time work on the health worker’s attitudes, knowledge and practice related to FP. We need advocacy at various levels to push for FP to improve access and practice. We have developed a programme that is working on male involvement, raise demand for FP, and increase access to decent, community led FP services. We hope to share our experience in the future.
— Dr Mulongo Muhamed on 2009-12-18
Am quite happy to see most of these wonderful comments above about family planing. i would like to say that health workers have done a lot in health education on family planning but most are directed to women, and if you look at the women in our society, they are mostly influence by their husbands. Therefore, our attention to shift a bit and embrace the men to be able to achieve the 8 MDGs.
Am a master student wanting to do research on Men perception on family planning in rural and urban Gambia as my master’s thesis. I am looking for research tools to be able to do this. Any other assistance is welcome.
— Sulayman S S Jammeh on 2010-01-17
I recommend taking a Natural Family Planning class. Spouses attend class together and use the method together so it involves them man as well as the woman. It is proven to be as effective as condoms or the pill if used according to the rules. It is 100% natural so there are no side effects. It is never abortifacient (as some birth control methods are) so there is no danger of inadvertently killing your unborn baby. And statistically there are far fewer divorces in couples that use NFP than couples who use artificial contraception.
— Jo on 2010-01-23
This really sounds good. please can you throw more light on the subject please. Am interested. I would like to know how is done and can one start such a project.
— Sulayman S S Jammeh on 2010-01-24