Family Planning: Is It Back?
by Jay Gribble, vice president, International Programs
On the first day of the International Family Planning Conference, held at the Speke Conference Center outside of Kampala, Uganda, ministers of health, finance, and planning assembled to discuss financing the health-related Millennium Development Goals. The day-long session included representatives from more than a dozen countries and raised a number of interesting and relevant questions. The first question, perhaps asked rhetorically, was “Is family planning back?”
As competing priorities for scarce resources have led to less attention being paid to family planning, this question is relevant also because of the stagnation in contraceptive use in many countries throughout sub-Saharan Africa. HIV/AIDS has taken both the spotlight and the majority of funds. Even though the region continues to struggle with the epidemic, ministers discussed the need to focus on family planning, especially as a way of reducing maternal mortality.
The speaker who posed this question, Dr. Khama Rogo of the World Bank, acknowledged the challenges to getting family planning back as a priority: country leadership, donor coordination, overcoming the inadequacies of government budgets to address family planning, the large out-of-pocket expenditures that individuals pay for services and commodities, and innovations in policies, strategies, and financing—which require finding new ways to get family planning into national development priorities.
Each of these challenges can be addressed through the efforts of skilled advocates and committed policymakers. However, as Dr. Rogo pointed out, if family planning is an “externally funded mandate, then it is not back at all.” While donors and outside organizations have a role to play in addressing family planning needs, unless the issue is owned by local stakeholders and governments, family planning will not get the traction that it needs to move forward.
He went on to suggest recommendations to help ensure that family planning is back—including having national governments follow through with their commitment to allocate 15 percent of national budgets to the health sector; the development of country-led strategies that respond to local issues and that do not rely on donors; increasing community participation in family planning service delivery—especially through community-based distribution; a policy environment that promotes public-private partnerships so that the challenge for responding to family planning needs is spread throughout other sectors; and improving stewardship—national and local leadership—in addressing the family planning needs of women and couples.
Dr. Rogo made a comparison that was perhaps the most memorable line from the ministers’ seminar: family planning is to maternal health what vaccination programs are to child health. This insight places family planning squarely where it belongs: as a health intervention, family planning is central to reducing maternal mortality and disability. Given the importance of this way of looking at family planning within sub-Saharan Africa, Rogo’s insight should be used by advocates to refocus attention on family planning and make sure that it is back to stay.
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December 8th, 2009 at 8:19 pm
Family planning allows women to actually be a part of society instead of staying at home to raise children. Its important to women to be able to contribute to society instead of just being a baby machine.