When people ask which inventions have had the most profound impact on humanity, I have two answers for them: the washing machine and contraception. Viewed from the perspective of a woman, and a working mother, my life would have been very different without access to both of these.
The Family Planning Summit held in London on 11 July had ambitious objectives to expand access to affordable and effective contraception and advice to millions of women around the world. Co-hosted by the Bill and Melinda Gates Foundation, UNFPA and DFID, with Ministers of Health and Development from over 60 countries, the Summit aimed to generate new commitments on a number of different aspects of the agenda.
Committing the UK to increase support for family planning by 20%, spending on average £225million per year for the next five years, Secretary of State Priti Patel said, ‘There are 214 million girls and women in the developing world who don’t want to get pregnant but aren’t currently using modern contraception.’ A woman’s ability to be in charge of her reproductive health is transformational. She can decide if, when and how many children to have, enabling her to plan her family and her life. This can have a profound affect on her ability to lift herself and her family out of poverty, and enable her to contribute economically to her community and wider society.
Although there has been significant progress in delivering family planning services for the poorest since the 2012 London Summit, decisions by President Donald Trump to cut finance for organisations delivering these critical services will have far reaching impacts. Progress will undoubtedly be set back and the demographic dividend a country can achieve when birth rates reach more sustainable levels will be lost.
As Melinda Gates said: ‘This is a difficult political climate for the family planning community. I’m deeply troubled—as I’m sure you are—by the Trump administration’s proposed budget cuts to global family planning.
If empowering women is more than just rhetoric for the president, he will prove it by supporting funding for family planning efforts.’ She went on to commit an additional $375 million dollars to be used over the next three years to reach the women and girls left behind.
The challenges associated with delivering family planning are not solely related to lack of resources. Though many women cannot afford to use contraception, often the products they need are simply not available. The last mile of the supply chain to reach remote communities, or those in conflict-affected environments, is often not in place.
It was encouraging to see the commitment of nine francophone counties in West Africa who together have formed the Ouagadougou Partnership to promote family planning. Professor Nicolas Meda, Minister of Health from Bukina Faso said ‘since 2016, these countries have been resolutely engaged in accelerating support to family planning’.
The Governments of India, Uganda and Bangladesh also committed to increase their domestic expenditure and health service provision for reproductive health.
However, the importance of education was not given the profile it deserves. We know that girls able to access quality education, especially at secondary levels, are less likely to marry early, and more able to learn how to take charge of their reproductive health. An educated woman is likely to have fewer children, and a literate mother, will be able to support her children as they learn.
Equally boys and men are key if women are to access their reproductive rights. As one minister from Uganda put it ‘ I may only have two children but many men in Uganda have children with many women, it is not unusual for a man to father over 100 children!’
Breaking social taboos that discourage discussion about contraception is also essential. There are frequently mis-understandings about different types of contraception which can lead to misuse, or women feeling concerned about the longer-term impact on health and fertility. Information and public debate is so important.
As we look to the future and population projections that will see over 8 billion people living on the planet by 2030, over 9 billion by 2050, it is clear that access to modern and safe reproductive services is essential. Population growth will take place in the poorest parts of the world, where health, education and infrastructure are already struggling to cope. The Summit pointed a spotlight on an issue often surrounded in taboo and misconception. But, focusing on products and supply chain will not solve the problem, a more holistic approach that reaches across both health and education systems will be required.
Fundamentally success will only be achieved if communities, their women and their men, are empowered with information as well as products and services. We must never forget that the decision to use contraception is a deeply personal one. Sadly for many women having a large family is still seen as the best route to ensure at least some of them survive childhood and are able to support their families and parents in their old age.
Oshun Partnership working with Vivace, produced the Family Planning Summit for the Bill and Melinda Gates Foundation, UNFPA and Department for International Development.