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Empowering women through family planning

It is time for Edna to get her dosage of Depo-Provera but she is not at peace.

The 18-year-old had a child at 14 years and she is not planning to have another one anytime soon. She is still sexually active though.

“Most of my peers and other members of the community despise me. They say I have loose morals because I am using contraceptives at my age. But that is the best option for me now,” laments Edna, whose boyfriend refused to own up to her first pregnancy.

She is in another relationship.

Edna lives in the densely populated Ndirande Township, Blantyre, with her parents and she was re-admitted to school.

“It has always been a problem when it is time for me to get my contraceptive. If I do not meet my mother’s friends then it is some ‘well-wisher’ pouring all sorts of advice on me to stop me from being ‘immoral’,” says Edna, who generally looks younger than 18 years.

She adds that, even though she feels discouraged by societal judgements, she cannot succumb to it because she understands the benefits of family planning.

Such are the attitudes that discourage most adolescents and the youth from accessing family planning methods, thereby contributing to early and unplanned for pregnancies.

The Malawi Demographic and Health Survey (MDHS) of 2010 says Malawi registers 106,000 teenage pregnancies annually.

However, the 2015-16 MDHS says this has increased from 26 teenage pregnancies per every 100 girls to 29 girls per every 100.

There could be many girls who are in Edna’s shoes while others are failing to access family planning methods altogether.

Ministry of Health youth data of 2015 says 31 out of every 100 young people (aged 15-24) have unmet family planning needs.

As the youth are facing this challenge, other women of child-bearing age also have unmet family planning needs.

These are the issues that policymakers the world over are reflecting on as they join hands in commemorating world population day.

The theme for this year’s world population day is ‘Family Planning: Empowering People, Developing Nations’.

In her message for World population day, acting executive director for United Nations Population Fund (UNFPA) Dr. Natalia Kanem, says Investments in family planning services leads to prosperity for all.

She also highlights that Family planning is critical to achieving Sustainable Development Goal One, to end poverty.

“It is also a key to achieving other Goals, such as ending hunger as well as promoting good health and gender equality….”

“Better reproductive health care, including voluntary family planning, can boost economies and contribute to sustainable development by empowering women to complete their education, join the paid labour force, be more productive in their jobs, earn higher incomes and increase savings and investments. In addition, for each additional dollar spent on contraceptive services above the current level, the cost of pregnancy-related care is reduced by $2.30,” she notes through a press statement for the world population day.

The statement highlights that every day, vulnerable women, especially those who are poor and refugees, face social, economic and geographic obstacles to voluntary family planning services and information.

It notes that despite the dramatic progress in family planning accessibility, challenges remain.

The statement says some 214 million women in developing countries (such as Malawi) lack safe and effective family planning methods. Most of these women live in the 69 poorest countries.

“Fulfilling their unmet demand would save lives by averting 67 million unintended pregnancies and reducing by one third the estimated 303,000 annual maternal deaths,” reads the statement in part.

A Guttematcher Institute report released in April this year says in Malawi (in year 2015 alone) an estimated 886,161 pregnancies occurred, for which 135,940 ended in miscarriages and 141,000 ended in abortions. In fact, 60 per cent of these resulted in complications.

The report, however, reveals that modern contraceptive use has increased substantially over the past decade in Malawi.

“Among married women aged 15-49, modern contraceptive use increased from 28 women per every 100 per in 2004 to 58 per every 100 women in 2015. Uptake has also increased in sexually active unmarried women even though it is still low,” the report says.

A statement from DFID says, today (July 11, 2017) the UK is co-hosting an international summit on family planning in London with the Bill and Melinda Gates Foundation and UNFPA.

The summit aims to boost global commitment to one of the smartest investments governments can make: ensuring women and girls have access to family planning services.

During this summit, the UK, with the Bill and Melinda Gates Foundation and UNFPA, will bring together governments, the United Nations, foundations, the private sector, civil society and youth advocates from around the world to accelerate progress to increase access to family planning services for women and girls in the world’s poorest countries by 2020, fix problems in supply chains and prioritise the needs of women and girls in humanitarian crises.

The statement says Malawi is represented by a high powered delegation and the Minister of Health, Peter Kumpalume, says: “There is high level commitment by Government, however, to address the issue of population growth by improving availability of, and access to, modern family planning commodities, by increasing government budgetary allocation specific for procurement of modern family planning methods over the years”

The Summit comes five years after the 2012 London Summit on Family Planning, which spurred massive commitments to family planning, including from Malawi, and led to the creation of the Family Planning 2020 partnership.

Further commitments made by Malawi and other nations and partners at the Summit will seek to accelerate progress on the commitment to increase modern contraceptive prevalence rate for all women to 60 per cent by 2020, thereby enabling 120 million additional women and girls to use contraceptives by 2020.

Nations are hopeful that adolescents such as Edna and other women will surely be empowered to make decisions on sexual and reproductive health issues with or without societal judgements.

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