A renewed commitment to family planning
by Dr Ward Cates
blog from Global Health Magazine
The International Conference on Family Planning in Kampala, Uganda, from 15-18 November will draw 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.
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.
Ward Cates Jr, MD, MPH is president of research at Family Health International.
