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A matter of choice

Dirk Jena
Thursday, November 15, 2012

EVERY year, the United Nations Population Fund (UNFPA) releases a report on the state of world population which essentially discusses evidence-based realities that significantly influence global population dynamics, as member countries implement their respective development agenda.

This year, the organisation brought to the fore the issue of family planning, discussed in the context of human rights and development.

The report is largely global in nature, though the little mention of the Pacific region does not necessarily make the report less applicable to us: if anything, estimates by the authors of the report should be red flags on the potential impact of this year's theme on our tiny population bases.

This column has already discussed the International Conference on Population and Development (ICPD) in 1994, which among other things, saw 179 governments affirm the individual's right to family planning; the Program of Action (PoA) which came out of the ICPD is what guides our work.

The ICPD PoA states that "the aim of the family planning programme must be to enable couples and individuals to decide freely and responsibly the number and spacing of their children and to have the information and means to do so". This declaration also marked a shift of doing business at UNFPA: population issues were not treated simply based on statistics but rather contextualised by factors which were influencing the statistics.

In a nutshell therefore, you are free to have as many children as you want but spacing them well would translate to fewer complications during child births; spacing pregnancies by three to five years could reduce infant death by 46 per cent in developing countries. This in turn reduces the country's maternal mortality rate, one of the indicators of how well it is doing as far as its responsibility of providing good maternal health care is concerned.

Ensuring universal access to voluntary family planning is a matter of protecting human rights. Family planning is a tool individuals can use to exercise their reproductive rights (being able to decide the space or how many children she would have). Once thus empowered, studies have shown over and over again that this usually paves the way for individuals to realise other rights.

A woman with such confidence goes on to realise other basic rights like education and this translates to increased income in the home, better health for her and her family and contributing to decision-making both at home and in the community. An adolescent who becomes pregnant is often forced out of school and unintended pregnancies can endanger a woman's health, undermine her opportunities to earn a living and trap her and her entire family in a cycle of poverty and exclusion.

When women and men together plan their childbearing, children benefit immediately as well as in their long-term prospects. But it is also a matter of economic and social development as this column has been trying to say by emphasising the importance of integrated household resource management. Evidence shows that investing in family planning helps reduce poverty, improve health, promote gender equality, enable adolescents to finish their schooling and increase labour force participation.

In Bangladesh, women who used family planning earned one-third higher in wages than women who had not used family planning. Another study concludes spacing pregnancies by th­r­ee to five years could reduce infant deaths by 46 per cent in developing countries.

Every adult, adolescent and young person everywhere, regardless of sex, social status, income, ethnicity, religion or place of residence must be empowered to decide freely and responsibly how many children to have and when to have them — having children by choice, not by chance. Family planning helps avoid unintended pregnancies, which can adversely affect the ability of a woman to enjoy a range of other rights.

The figures coming out of the report are startling. For instance in 2012, it is projected that 80 million unintended pregnancies will occur. If the reported unmet need among 222 million women (situation of women who do not want to become pregnant but are not currently using contraception) were reversed, this could avert 54 million unintended pregnancies and eliminate the 50 per cent of them who recourse to abortion. Worldwide, research has provided overwhelming evidence that where family planning supplies, information and services are widely available, abortion rates are markedly lower.

Apart from shortages of contraceptives, millions of people are still unable to exercise their right to family planning because they are restricted by poverty, negative social pressures, gender inequality and discrimination. Action would therefore have to be multipronged: simultaneously strengthening health systems, introducing or enforcing laws that protect individuals' rights, reducing poverty, challenging harmful traditional practices, eliminating child marriage, ending discrimination, removing logistical impediments and ensuring a broad range of supplies.

Global trends among adolescents and youth should ring warning bells for us: this group records high levels of unintended pregnancies, due in part to poor access to contraceptive information and services and such non-use of voluntary family planning account for some 40 per cent of unsafe abortions that mean an another avoidable risk to their young lives worldwide.

Pregnant girls of 18 years or younger face four times greater risk of maternal death than women who are at least 20 years old and more girls between 15 and 19 years from poor backgrounds get pregnant than the same age group from wealthy families.

The UNFPA hopes the world will wake up to how preventable deaths of women and infants continue unabated by increasing financial support to ensure access to rights-based family planning to all who want it; making family planning available to all who need it including adolescents, young people and marginalised populations; eliminating economic, social, logistical and financial obstacles to voluntary family planning; ensuring access to a range of family planning supplies including emergency contraception; promoting family planning as a right; integrating voluntary family planning into broader economic and social development initiatives and engaging men and boys in family planning and in supporting the rights of women and girls.

My message this week was aptly phrased by the UNFPA executive director Babatunde Osotimehin in his foreword of the report: "The international community made a commitment in 1994 to all women, men and young people to protect their rights as individuals to make one of life's most fundamental decisions. It is high time we lived up to that commitment and made voluntary family planning available to all."

nDirk Jena is the director and representative of the United Nations Population Fund Pacific sub-regional office. The views expressed are his and not that of this newspaper.


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