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Family planning: poverty reduction key

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Through her soft voice, a depressed and exhausted woman keeps talking to her twin babies who are crying deafeningly because they cannot get essential food.

For some mothers, the undue baby crying might be perceived as normal.

But this woman knows what the twin babies are looking for but she cannot provide it.

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She lives a miserable life without any hope and inspiration. The family of seven lacks reliable source of income.

We meet Chikondi James surrounded by her six children in Mchemera Village in Traditional Authority (T/A) Kawinga in Machinga.

The elder child is 13 years while the youngest is a year and six months old.

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Two of the youngest children have diarrhoea while the rest look weak and miserable.

Frequent drug stockouts and long distance to the hospital do not lure the weak hungry-stricken lactating mother to taking her children to hospital for treatment.

“We slept on an empty stomach last night, hence my breast cannot produce enough milk for my children,” says Chikondi, adding: “We don’t have money to buy either food or medicine.”

Despite government distributing relief maize to 2.8 million food-insecure people, the family which is facing severe hunger, did not make it on the list of beneficiaries.

The husband Chesimonjire James arrives in the middle of the conversation.

Chesimonjire has a black plastic bag containing smoked fish worth K200.

Looking at the family, one would doubt if family planning exists in their world.

“Availability of health and family planning services is rare and remains a farfetched dream in rural areas, hospitals are also kilometers apart,” Chikondi says.

The family also thought the husband being at 70, the woman could not conceive of him, hence the seven children.

The family cannot afford to send the children to school, buy nice clothes for the children and themselves or even provide three meals per day.

But lack of family planning services combined with a decline in child mortality that the country has experienced in recent years as the case stands in James’ family confirms fears that the country’s population might reach 23 million and 37 million by 2025 and 2050 respectively.

Government, however, says it has made substantial improvements in addressing population challenges, especially by advocating use of modern contraceptive methods, currently at 46.1 percent according to the 2016 Malawi Demographic Health Survey.

“Children by Choice” campaign says a person needs to decide if and when to have children.

Indeed, slowing population growth means ensuring that all women who want to plan their families have access to family planning information and services.

Unfortunately, this is currently not the case for 215 million women, 59 percent of them live in the Indian subcontinent and sub- Saharan Africa – where Chikondi lives.

These women and their families represent roughly one billion of the world’s poorest people, for whom unintended pregnancies and unwanted births are an enormous burden.

The United Nations Population Fund estimates that meeting the needs of these 215 million women who lack reproductive health care and effective contraception could each year prevent 53 million unwanted pregnancies, 24 million induced abortions and 1.6 million infant deaths.

Shifting to smaller families also brings generous economic dividends. For instance, analysts say $62 spent to prevent an unwanted birth could save $615 in expenditures on other social services.

But a survey Youth Response for Social Change (YRFSC) conducted in 2015 reveals that 65 percent of women have never used family planning methods while male condom use was only at 13.2 percent in Machinga.

The survey says 71 percent of married women had never used any contraceptive method as well.

Rampant cases of obstetric fistula were reported with 48 cases referred to Bwaila Health Centre while 16 cases diagnosed with cervical cancer.

These revelations triggered the youth in the area with financial assistance from Southern African Aids Trust to sign a memorandum of understanding with Machinga District Health Office to prioritise sexual reproduction health rights programmes in 2016.

A year down the line, teenage pregnancy dropped from169 to 92 from April – November 2016 and 306 women out of 1, 856 women were screened and 43 out of 163 targeted were referred for further treatment of cervical cancer from April – August 2016, according to YRFSC Executive Director Lamecks Kiyare.

“We have set of priority activities to demonstrate our commitment to promoting general health services and social inclusion and ensure that the commitment translates into action,” Kiyare says.

Such actions are in response to circumstances like that of James’ family but unfortunately the youth organisation covers only Sub- T/A Mchunguza due to limited resources.

However, in the absence of a Family Planning Policy in the country, Health and Rights Education Programme Executive Director Maziko Matemba doubts if Malawi will ever escape from the cycle of poverty.

“Family planning can ease pressure on available resources; contribute to sustainable economic growth and development, and leads to a healthy and prosperous nation,” Matemba says.

Japan, which cut its population growth in half between 1951 and 1958, is among countries to have benefited from the demographic advantages.

South Korea and Taiwan followed, and more recently China, Thailand and Vietnam, have been helped by earlier sharp reductions in birth rates.

Although this effect lasts for only a few decades, it is usually enough to launch a country into the modern era.

Yet Malawi, a country currently ranked as one of the poorest in the world, witnessed close to half a million babies being born in 2014 alone across public hospitals only according to a snap survey Malawi News conducted in May 2015.

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