World must act now to prevent contraceptive crisis

Posted: 18 July 2009

As the world focuses on the global economic crisis, one of the most trusted, most cost-effective and proven poverty-reduction interventions is in danger of being marginalised and neglected, according to a new report. The measure is contraceptive services.

Contraception at a Crossroads cover
Contraception at a Crossroads cover
Released to coincide with World Population Day, observed worldwide throughout July, the report, Contraceptives at a Crossroads: Averting a Global Contraceptive Crisis by the International Planned Parenthood Federation (IPPF) describes the deep rooted problems that bar individuals and couples from access to reproductive health supplies such as contraception and condoms.

One of these barriers, says IPPF, is that women who use traditional methods of contraception are generally considered to have their contraceptive needs met. In fact,traditional methods of family planning have repeatedly proved to be ineffective in preventing unwanted pregnancies and protecting against sexually transmitted infections.

Unless governments and donors act to provide a range of modern methods, the health and human rights benefits that family planning and contraception services have delivered over the years will be reversed, and global development efforts will not be achieved, the report said.

Pregnancy outcomes in developing countries
Pregnancy outcomes in developing countries
35% of pregnancies in developing countries are unintended, revealing a huge unmet need for family planning.
It cites UN projections showing that the number of contraceptive users in developing countries and countries of the former Soviet Unionwill jump from 552 million people in 2000 to 764 million in 2015. With over half the world’s population aged under 25 years and 1.5 billion adolescents entering their sexual and reproductive years, it is estimated that the global demand for contraception will grow by 40 per cent during the next 15 years.

But despite the increasing demand, donor funding for contraceptives has remained more or less constant since 2001, says IPPF. When the rising demand is accounted for, donors are satisfying a smaller proportion of people’s needs for contraceptives every year.

The global shortage of condoms is just one example of this under supply, says the report. Condoms are the only effective means of protection against HIV and most other sexually transmitted infections, but the supply is running out.

Escalating demand

The cost of providing contraception to the approximately 655 million women and their partners who are already using contraception in 2007 was US$873 million, without including the needs of the 200 million women who have expressed a desire for contraception but are not currently using it.

But this figure is boosted to US$1.4 billion when condoms for HIV prevention are included. In 2007, donors provided US$223 million – or 16 per cent of the total required – in commodities and condoms for HIV prevention.

This would not be a problem if national governments were spending enough money from their own resources to family planning supplies, but this is not the case in most developing countries. "There is a vast and growing financial void between what the international community and national governments contribute to the supply of reproductive health commodities and the cost of providing modern contraceptives to women in the poorest countries." says IPPF.

"Sometimes women with seven or eight [children] come to me and cry," said a community-based reproductive health agent in the Ouina market in Uganda, according to the report. "They say they wish they had known about family planning before, so they could have spaced their children. Women who work a lot don't want to be pregnant the whole time."

In 2008, the World Bank urged more focus on contraception, citing data that showed tens of millions of unplanned pregnancies occur because women lack access to contraception. "Giving women access to modern contraception and family planning... helps to boost economic growth while reducing high birth rates so strongly linked with endemic poverty, poor education, and high numbers of maternal and infant deaths," the bank statement said.

The report recommends that donors and developing countries increase funding for reproductive health supplies to match demand. It said such supplies should be incorporated into national health plans and that governments should collaborate more with the private sector to ensure supply availability and to promote sexual and reproductive health and rights.

Read the full report at www.ippf.org