05 May 2008
JAKARTA, Indonesia: Reproductive
health and family planning advocates raised a red flag that
weakening international and national commitment to family
planning, specifically meeting the need of the poor, would
compromise efforts to reduce poverty.
The weakening international supports, said Ms. Purnima Mane,
Deputy Executive Director for Programmes United Nations Population
Fund (UNFPA) have resulted in lower funding support from around
55% of the population programme in 1995 to 5-7% now. “This
is a tragic trend. There are 200 million women, especially
in developing countries, who do not want to have children
but currently are not using contraceptive,” she told
a press gathering at the opening of the 2nd International
Conference on Reproductive Health Management (ICRHM) in Kuta,
Bali.
Every year, 536,000 women die in pregnancy or childbirth.
Around 50% of the maternal death can be prevented by reducing
unwanted pregnancies. And family planning alone can save the
lives of about 175,000 women and prevent 2.7 million infant
deaths a year. “Family Planning is one of the best investments
in the development package and we need to reenergize efforts
for international family planning and meet high unmet need,”
Ms. Mane said.
The trend in childbearing in countries around the world, UNFPA
Representative Dr. Zahidul Huque explained, had decreased
from 5.6 children per woman in 1971 to 2.7 in 1997 but since
then the fertility rates in many developing countries tend
to stall. “Women in Africa have the highest number of
children: on average, about five children each, compared with
nearly seven children 30 years ago.”
And the poorer a woman is, according to Catherine d’Arcanques
of World Health Organization, the less likely her contraceptive
need is met. And access to contraception continues to be a
challenge, especially for young people.
The conference -- emphasizing on family planning and attended
by 300 participants from 24 countries -- serves as a forum
for Reproductive Health managers and advocates to discuss
about the challenges and share lessons learned, best practices
in reproductive health, aiming to accelerate the attainment
of Millennium Development Goals set for 2015. Chaired by UNFPA
Representative Dr. Huque, it is jointly organized by the National
Family Planning Coordinating Board (BKKBN), the Philippines
NGO Support Programme (PHANSuP) and UNFPA. The first ICRHM
was held in the Philippines in 2006.
Martha Campbell from University of California, Berkeley emphasized
that education for women is important not only for their empowerment
and health, but also for their families and their communities.
However, education is not a prerequisite for adopting family
planning and/or fertility decline. “Access to technology
and information also play a role in reducing fertility and
the poor have low access to technology and information,”
she said, while contrasting the Philippines which had high
female literacy and high fertility and Indonesia which experienced
birth rate fall regardless of the economic and social factors.
Leadership in RH management
Chairperson of BKKBN Sugiri Syarief said that family planning
program contributes to economic growth and poverty reduction
in developing countries by reducing maternal death and HIV/AIDS,
promoting gender equality and empowerment. “To ensure
impact, managing family planning and reproductive health programme
requires leadership, community involvement and youth empowerment,”
he said.
A speaker from the International Council on Management of
Population Programmes (ICOM) Jay Satia underscored the importance
of leadership to address the many challenges in reproductive
health field, that include weak political will and commitment,
unpredictable funding and the shift of global thematic emphasis,
traditional and cultural resistances, shortage of well-trained
staff and low moral as well as lack of infrastructure. “With
the current situation, we are failing the poor because they
suffer the most,” he said.
And in a world that is undergoing transformational changes
driven by global and local forces: political, social, economic,
technological and environmental, efforts to improve RH field
should be directed at transforming the health system and encouraging
institutions involved in health to promote household and community
resourcefulness to produce (reproductive) health, not just
to add material resources.
“To change the way we act, we must change the way we
think. From believing that Ministries of Health (with doctors,
nurses, hospitals, health centers, etc) produce health to
recognizing that households and communities are the primary
producers of health,” Prof. Henry Mosley from the Johns
Hopkins University explained. And since women produce reproductive
and child health, women’s education and gender relation
become powerful determinants of reproductive and child health.
He added that there is a need to assure that the households
and communities have the knowledge, skills, technologies and
services to produce health more effectively and efficiently;
to promote useful practices and progress-promoting values
in the communities.
Decentralization process that is going on now proves to be
a challenge to RH and FP programme and better understanding
about population issues and its impacts to development efforts
among policy, law and decision makers at the province and
district level is key to sound development policies and regulations.
“The bigger the population, the bigger the budget required.
Unless the population issue is dealt with effectively, administrations
will erratically work to reduce population growth,”
explained Terence Hull of the Australian National University
(ANU).
Specifically in Indonesia - a country that is undergoing decentralization
where RH and FP issues are political, Adrian Hayes of ANU
said, RH/FP managers needs to avoid addressing one challenge
at the cost of ignoring others, imposing political solution
to solve the programme’s technical problems or avoid
believing that RH/FP managers can solve political problems
by technical means alone. “A dialogue is needed. They
need clear vision and clarify immediately if things can be
clarified, before losing supporters. We need to see that this
is a political issue too. We need extra expertise to solve
that.”
On youth issues, the fact that in developing countries, adolescent
reproductive health remains a taboo and sensitive was raised,
depriving the world’s largest population group, aged
15-24 years old, of the skill to make informed choice and
apply their sexual and reproductive health rights. With the
lack of ARH services and information and the alarming spread
of HIV/AIDS, investing in youth and marginalized groups to
empower them now would determine a country’s development
and future. Indonesia, The Philippines, Nigeria, Egypt, Bangladesh
and Sri Lanka highlighted youth issues in the poster presentations.
For further information please contact:
Maria Endah Hulupi
UNFPA Communications Officer: 0812 1115 116
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