Family planning: Because her future is our future

By Ritsu Nacken

Since 1989, the world has collectively marked World Population Day on 11 July. This day provides a global platform for focused attention on the importance of population issues. 

This year, the theme for World Population Day is ‘Family Planning: Empowering People, Developing Nations.’ As Sri Lanka launches the Review of its National Family Planning Program, this is indeed a timely topic. It provides a renewed opportunity for the country to reintegrate family planning into national policies and programs and to further understand its relevance and importance in achieving the 2030 Agenda for Sustainable Development.  

But first, why is family planning so important?  

Family planning  

= human right

Family planning is a human right. It provides a woman with the right to make an informed decision on whether, when, and how many times to become pregnant. 

The 1994 International Conference on Population and Development (ICPD) marked a paradigm shift in the field of population and development. It replaced a demographically driven approach towards family planning with one that is based on individuals’ and couples’ rights to decide freely and responsibly whether or when to start a family. This rights-based approach towards family planning recognises that people are actors in their own development, not just passive recipients of services. 

Despite the recognition of the importance of family planning services, recent statistics show that some 214 million women who want to avoid pregnancy are currently not using safe and effective family planning methods. As a human right, it must be available to all who wish to have it. 

Reaping economic benefits 

Investing in family planning is not only the right thing to do, but also makes economic sense. It can help eradicate poverty and drive sustainable economic progress. When a woman can make a decision about her reproductive life, it gives her more opportunities to seek and keep better jobs. It helps her to contribute to family income, national development, and global prosperity. Clearly, benefit of family planning goes well beyond women’s health and wellbeing. Indeed, family planning is a national development issue.

More specifically, the new Guttmacher Institute research shows that for each dollar spent on contraceptive services, cost of pregnancy-related care is reduced by $2.30 because access to contraceptive services reduces unintended pregnancies. 

It is not a coincidence, therefore, that world leaders are meeting in London on this year’s World Population Day to discuss ways to expand access to voluntary family planning to 120 million additional women by 2020 – A global partnership called “FP2020”. 

The FP2020 recognises the economic and social benefits of investing in family planning. It recognises that it is more economical and holds greater social benefits to invest in planning pregnancies than to invest in consequences of unplanned pregnancies or maternal death. Sri Lanka is also one of the FP2020 focus countries.

Reducing incidents of violence 

Family planning is central to gender equality and women’s empowerment, and could contribute to lowering the incidence of sexual violence. Gender-based violence is prevalent in many parts of the world, and despite all the efforts being made by Governments, we have a long way to go to effectively prevent and respond to such violence. Regular access to family planning health care provides an important entry point for screening of partner violence. 

In Sri Lanka, the Ministry of Health recently introduced a package for newly married couples, which focuses on prevention of sexual gender-based violence and advice on family planning. Women who access family planning services and information exercise their right to make informed decisions and planned pregnancies. This results in better health outcomes and higher levels of education through informed decisions about their reproductive lives, thereby reducing instances of violence. 

Towards global prosperity  

Family planning is also part of the larger journey towards a more equitable and sustainable society. In September 2015, the 193 United Nations Member States unanimously adopted the 2030 Agenda for Sustainable Development. This comprises of the 17 Sustainable Development Goals (SDGs) that aim to transform the world by 2030. These goals are designed to eliminate poverty, discrimination, abuse and preventable deaths, address environmental destruction, and usher in an era of development that leaves no one behind.  

Family planning is an integral part of the efforts to achieve the SDGs. It helps to achieve Goal 1, to eradicate extreme poverty, by allowing women to expand their options for education and work by planning pregnancies and to assist in leading a healthier life. Family planning supports the realising of Goal 3, for good health and wellbeing, by reducing maternal mortality through increased access to reproductive health services. Family planning also promotes Goal 5, for gender equality, by empowering women with the right to make an informed decision on their reproductive lives.

Family planning in Sri Lanka 

In Sri Lanka, the unmet need for family planning is 7.1% (Family Health Bureau, 2014). The contraceptive prevalence rate is 66%, which includes access to traditional and modern methods of contraception. In comparison to the other countries in the region, Sri Lankans have wider access to family planning information and services. However, issues remain. Three key recommendations for Sri Lanka are: 1) dispelling misconceptions; 2) reducing maternal mortality; and 3) ensuring universal sexual and reproductive health services and information. 

Recommendation 1: Dispelling misconceptions 

A common misconception about family planning in Sri Lanka, and around the world, is that it is all about population control. This is an old concept, and the world has moved away from this demographically driven approach. Access to safe and voluntary family planning is a human right. It empowers a couple and individuals to decide when to have or not have children, and how many children to have or not have. It aims to avoid unwanted pregnancies and unsafe abortions through access to modern methods of contraception and information relating to traditional methods. Family planning also includes the treatment and prevention of subfertility for women and men. 

Another common misconception about family planning is around the side-effects of modern contraceptives. All women must have access to reliable and accurate information on family planning by skilled healthcare workers. This ensures that women live happier and healthier lives, with more choices and opportunities.  

Recommendation 2: Saving lives through family planning

In 2015, the Family Health Bureau reported 113 maternal deaths in Sri Lanka. Unmet need of family planning contributed to one in four of these preventable maternal deaths. We must all agree that even one preventable maternal death is too many.  

Family planning saves lives. Women who choose family planning face a lower risk of maternal death. Children born to women who space their pregnancies tend to be healthier and face reduced risk of death in their first five years. Without access to family planning services, women are unable to make informed decisions about their reproductive lives. Unplanned pregnancies and complications can be fatal. Investing in family planning means, therefore, stopping preventable maternal death.

Recommendation 3: Leaving no one behind 

The success of the 2030 Agenda for Sustainable Development is in reaching the furthest behind first. In the Sri Lankan context, this includes the need to ensure accessibility of family planning services for widows, unmarried women, divorcees, people living with HIV/AIDS, people with disabilities, migrants and partners who have been left behind by migrant workers. In addition, youth is an under-served population group for family planning services. 

According to the Family Health Bureau, 5% of maternal deaths were among single women who were divorced, unmarried, or widows in Sri Lanka (2015). According to the National Family Planning Program Review, vulnerable women are reluctant to access family planning services due to fear of stigmatisation. This data highlights the need to address the issue of discrimination and stigmatisation, and increase the quality of family planning services.

The need for universal access to sexual and reproductive health information and services among youth, including family planning, must be met. According to the National Youth Health Survey 2012-2013), Sri Lankan youth lack a basic level of understanding of sexual and reproductive health. Access to accurate information and equitable services empowers youth to make informed decisions about their bodies. Contrary to the myth that access to sexual and reproductive health information would facilitate early onset of sexual activities, data shows that sexuality education actually helps young people avoid risky behaviours, even delay sexual activities, and avoid being infected with sexually transmitted infections.

UNFPA’s continued commitment to Sri Lanka 

The launch of Sri Lanka’s National Family Planning Program Review provides a renewed opportunity for the country to reintegrate family planning into national policies and programs and to further understand its relevance and importance in achieving the 2030 Agenda on Sustainable Development. UNFPA is proud to be part of this important and timely review in Sri Lanka. Going forward, we hope that the review helps the Government of Sri Lanka to further improve its policies and programs related to family planning.

UNFPA will continue to work closely with the Government of Sri Lanka and other partners to ensure universal access to family planning services. Family planning and sexual and reproductive health should be one of the strategic national priorities. At this occasion of World Population Day, 11 July, we invite you to deepen your understanding of family planning and its instrumental roles in national development because her future is our future. 

[The writer is Representative of the United Nations Population Fund (UNFPA) in Sri Lanka.]