Why family planning matters for maternal deaths and child survival

Contraception empowers women to plan the number of children they will have.

Family planning improves child survival and reduces maternal deaths. But the uptake of family planning in Africa is only 33%, nearly half the world average of 64%. The contraceptive prevalence rate in African countries is considerably low despite an increase in demand.

Niger has one of the highest fertility rates globally. Women of reproductive age have, on average, eight children. Niger has a maternal mortality ratio of 553 per 100,000 live births and an under five mortality rate of 104 per 1000 live births. Mauritius has the lowest child mortality rate in Africa at 12 per 1,000 live births.

In Niger 13% of children under five years die from various illnesses. The country is one of the top five that account for half of these deaths in the world.

The low provision of family planning across sub-Saharan Africa is cited as one of the main reasons for the region’s high maternal mortality rates. A lack of family planning leads to unintended pregnancies and often means that women deliver their babies with very low skilled assistance. This in turn pushes up the rate of newborn deaths.

Access to family planning services, particularly in developing countries, should be improved.

The impact

Research shows that increasing contraceptive use averts maternal mortality. Investing USD$8.4 per person each year in developing regions would result in 224,000 fewer maternal deaths in sub-Saharan Africa.

There are now a range of contraceptive methods that can be offered to women. These range from medical procedures like sterilisation and implants in men and women to condoms, injectables and emergency contraceptive pills.

Family planning interventions should focus on passing this message to people living in remote rural areas.

Success stories

Malawi, Ethiopia and Rwanda have achieved dramatic strides in ensuring access to family planning as well as uptake. Strong political support, community engagement, effective strategies and systems and good partnerships are the backbones of successful programmes.

Ethiopia’s success has been driven by health extension workers taking family planning services to rural households. The country expanded access to quality primary health care that was promotive, preventive and curative.

In Rwanda, family planning champions were trained and actively involved in advocacy at a community level.

But success can’t be achieved without addressing the root causes of low rates of contraceptive use.

Studies have shown that low contraceptive use is usually due to a combination factors. These include:

  • poverty

  • low female literacy rates

  • cultural values on misconceptions of family planning

  • lack of spousal or partner approval

  • lack of women autonomy in decision making on reproductive health, and

  • inaccessibility of health services.

Way forward

Targeted and sustained public health awareness campaigns on the benefits of contraception should be rolled out at village level to all people of reproductive age.

The campaigns should also encourage male involvement. Studies have shown that the uptake of contraception improves when men are involved in family planning. And encouraging women to speak about their fertility preferences with their partners makes a significant difference.

Governments need to strengthen family planning programmes by understanding and using data on unmet needs to establish community based strategies. Funding for these initiatives should be prioritised.

The global organisation, Family Planning, has proposed a target of getting 120 million women and girls – particularly from sub Saharan Africa – to use contraceptives by 2020.

Robust family planning policies also have the added advantage of changing a country’s age profile by reducing the number of young people dependent on the productive population for their livelihood. This is known as the demographic window, which in turn allows countries to take advantage of reaping demographic dividend.

Family planning can affect the demographic profile of countries in positive ways too – for example by increasing the life expectancy and well-being of women and couples.

But none of this can be achieved unless African countries pay more attention to family planning, put proper policies in place with the necessary resources behind them.