"Effective family planning will reduce poverty,
increase productivity and economic development"
Dr. Frederick T. Sai
17 November 2011
Rose is a mother of four, with a fifth on the way.
At a time when she should be eagerly awaiting the
birth of her child, she is instead worried about how
to prevent her next pregnancy. She'd like to wait at
least two years, but she doesn't have that say
because she doesn't have access to family planning.
Rose’s story isn’t unique, although she is one in a
million. Correction - she is 1 in 215 million.
That’s how many women around the world today know
they need modern contraception. And the numbers who
do not know are even higher. In Sierra Leone, just
7% of married women use contraceptives regularly.
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On average, each woman will have 5 children in her
lifetime, and has a 1 in 21 chance of dying during
pregnancy or childbirth.
It is the fundamental human right of couples and
individuals to control their fertility; to choose
whether and when to have children, and how many to
have.
This right, though affecting women most, is often
denied them through cultural, legal or religious
requirements of various kinds.
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Such denial, overt or covert, is an injustice to women
and leads to much unnecessary suffering and death.
Women are quietly crying for family planning and not
getting access in many parts of Africa. Overall,
30-36% of women in union have a felt need for
contraception, which is not being satisfied.
This results in unplanned and unintended pregnancies.
With inadequate or even poor health care services
and facilities such pregnancies are more likely to
result in maternal injury or death, and poor health
for infants and children.
In Sierra Leone, ensuring family planning use is
therefore a key strategy to reducing maternal,
infant, and child deaths, which remain unacceptably
high.
Yet family planning is not just about women. It is
about the rights, health and socio-economic
development of men and young people also, and it is
about entire communities and nations. Family
planning is about sustainable consumption and
development of the world’s resources for mankind.
Helping individuals to plan their families reduces
poverty by enabling increased productivity and broad
economic development in turn. The world loses an
estimated $15 billion a year in productivity as a
result of maternal deaths and injuries — preventing
unintended pregnancies could alter this number
dramatically.
In contrast, recent studies show that investing in
contraceptive services could yield as much as a
4-fold return in medical cost savings, making it one
of the most cost-effective development approaches
out there.
Whether each of us realizes it yet or not, we all
have a role to play.

Mrs.
Sia Koroma (left) |
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Last month, the world’s population surpassed seven
billion. It’s an impressive milestone that signifies
both achievements and grave responsibilities.
We must work to protect the health, wellbeing, and
rights of those on our planet, whilst ensuring that
individuals can plan their families and contribute
to the balance between our numbers and resource use.
Leaders and advocates in Sierra Leone know this.
Recently, Sierra Leone's First Lady - Sia Nyama
Koroma, advocated for the repositioning of family
planning in the country and launched a campaign to
prevent teenage pregnancy.
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In just a few weeks, on 29 November – 2 December,
Sierra Leonean reproductive health advocates will
join nearly 2,000 policymakers, researchers, and
donors from around the world in Dakar, Senegal for
the International Conference on Family Planning.
The timing and location of this meeting are
significant – it will be the largest meeting of its
kind aimed at signifying a true renaissance in both
funding and political will for this issue. The event
is purposefully set in West Africa, where women have
some of the highest fertility rates, lowest
contraceptive usage and the highest unmet needs for
contraception in the world.
Now of all times, African leaders have a momentous
opportunity to demonstrate leadership on this issue,
and set the bar high for donors, policymakers, and
advocates worldwide. In the face of such high unmet
family planning needs here in Sierra Leone and in
Africa generally, all levels of leadership -
political religious and traditional, cannot and
should not stand idly by.
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As advocates, we must build on this momentum and call
on our own leaders, in Sierra Leone and across
Africa to champion access to family planning. We
must also hold donor governments accountable for
their commitments.
We can do better at delivering the solutions we have,
and be more innovative in developing new approaches
to meeting contraceptive needs.
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Family planning should be integrated into the broader
network of health services, including maternal and
child health and HIV/AIDS care – to strengthen
health systems, increase efficiency and access, and
reduce costs.
Investing in family planning today will not only pay
dividends now, but will also help history’s largest
generation of young people forge a brighter future.
Let me be clear – this is not just a woman’s issue,
but a human one.
It is not one region or nation’s issue but a global
one. Access to family planning remains a critical
human rights, public health, and development issue –
and now is the time to take action.
Dr. Frederick T. Sai is an international
reproductive health adviser and former Senior
Population Adviser to the World Bank.
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