The Unmet Need for Family Planning - Countdown 2015 Europe

Q Why is a ‘mix’ of methods important? Don’t we already havethe pill and the condom? Isn’t that enough?A Different people need different methods. Sometimesthat’s because they experience side-effects in responseto a particular method (such as a pill or implant). Or ifa woman’s husband or family doesn’t want her usingcontraception, she needs a method she can use discreetly(such as going to a clinic for injectables once everythree months, instead of having to take a pill every day).Contraceptive needs also vary over a person’s lifecycle.For example, some women, especially older women, wanta permanent or long-acting method, to avoid pregnancyaltogether, and this is very different from a young woman whowants to have children in the near future.Q I understand that the largest generation of young peopleare coming of age and becoming sexually active. Can’tyoung people get contraceptives in the same places thatadults get them?A In some places, young people may be denied contraceptivesdue to social, cultural or religious restrictions. In other places,although there may not be specific legal or communityrestrictions on young people’s access to contraceptives,existing services may not be appropriate. For example,most existing family planning programmes are designed tomeet the needs of married women, rather than the specificneeds of young people; and such services may be locatedin places that are difficult or inconvenient for young peopleto get to, or at times when they cannot attend. Where familyplanning is fee-based, as it is in many countries, young peoplemay simply not have the money to pay for contraceptives.It is also important to note that in many parts of the world youngpeople may have limited accurate knowledge about sexual andreproductive health, including contraception. This underscoresthe need to ensure that every generation gets comprehensivesexuality education, which enables them to make informedchoices about their sexual and reproductive lives.Q To slow climate change, shouldn’t we slow the growth ofpopulations in developing countries?A Climate change is mainly due to consumption and greenhousegas emissions in developed countries, but less-developedcountries are and will continue to be most affected byit (Bryant, Carver et al. 2009; Lancet/UCL 2009; UNDP2010). Indeed, many developing countries have identifiedrapid population growth as one of the things that hinderstheir abilities to adapt to climate change (Bryant, Carver etal. 2009). However, coercive ‘population control’ policies– like those seen in the 1960s and 1970s – were largelyineffective and violated the human rights of millions of people.of a comprehensive policy which also includes, for example,investments in food security, safe water supply, improvedbuildings, reforestation, and other strategies (Lancet/UCL 2009).Q Family planning is only one aspect of women’s rights.Shouldn’t we focus more generally on improving equalityfor women – for example, through micro-credit schemes oreducational programmes for girls?A A woman’s ability to control her fertility is vital to herfreedom and autonomy, and is a fundamental human right.In fact, one of the key indicators of women’s empowermentat the household level is the ability to make childbearingdecisions and use contraception (Grown, Gupta et al. 2003).Meeting women’s needs for contraception empowers thempersonally, socially, economically and politically (Center forReproductive Rights/UNFPA 2010), while also supportingother efforts to promote women’s rights. For example, moderncontraceptive use by women and girls increases their accessto education, in part by reducing the number of girls forced todrop out of school due to pregnancy (Barot 2008). In addition,women who use contraceptives are more likely to be activeand productive in the workforce, which means they haveincreased earning power that allows them to improve their ownand their family’s economic security (FHI; WHO 2010).Q In a nutshell, what needs to be done?A Donors and governments need specific budget linesfor reproductive health and family planning, or moretransparency in existing budget lines for ‘population’.This needs to be maintained with more political supportand policies that recognize how important familyplanning is to human and economic development.Policies and budget lines should focus on giving people accessto the full range of modern contraceptive methods, witheffective distribution, accompanied by accurate information orcounselling on how to use them and potential side-effects.These need to be available at low prices or for free, in locationswhere people can get them easily. Health system strengtheningefforts should always include a family planning component.We also need evidence-based education programmes foradolescents and women about modern contraceptive methodsand the risks of pregnancy, and to educate men to promotepositive attitudes about contraception.On the other hand, voluntary, rights-based family planningprogrammes can help developing countries to achieve asustainable population and mitigate the effects of climate change(Lancet/UCL 2009). Voluntary family planning needs to be partwww.countdown2015europe.org25