Family planning: Why it’s a human right

By: 
CARE
A woman in the village of Danamadja, Chad

On 11 July world leaders will gather in London for the Family Planning Summit. So what’s it all about, and why is it so important?

Five years ago, governments – and organisations like CARE – met up to make public pledges to support women around the world to achieve universal access to contraception. Now they are meeting again, to renew their commitments to enable an additional 120 million women around the world to use contraceptives.

Here’s a quick reminder of why this is so important (stats from the World Health Organisation):

  • The leading cause of death for 15-19-year-old girls globally is complications from pregnancy and childbirth.
  • About 16 million girls aged 15 to 19 and some 1 million girls under 15 give birth every year.
  • Every year, some 3 million girls aged 15 to 19 undergo unsafe abortions.
  • Between 1990 and 2015, the number of women and girls dying during pregnancy dropped by 44%.
  • Even with this staggering improvement, more than 800 women and girls die every day from preventable pregnancy and childbirth causes.
  • Almost all these deaths occur in developing countries, particularly in rural communities, where women and girls have limited access to health services, contraception and family planning advice.

And if that sounds like just a lot of numbers, here’s what it means in real life, as told to us by Koutou Ndoringar, a teacher who lives in Chad, central Africa:

I’m married and have four living children. I want to share my story as a user of contraception.

“My story is about my work as a teacher, my pregnancies which came quickly one after another, and my conviction about using modern contraceptive methods.”

As you know, teachers have to be physically in the classroom to teach children. Each year I was getting pregnant, to the point of nearly being unable to continue in my job.

“I heard about the CARE family planning project, and they suggested using a modern contraceptive method. We talked about it at home and decided to use the family planning service so I could keep my job and protect the well-being of our family.”

That’s how I started using contraceptives. I have no more problems with work – I have a permanent contract and I can work full-time.

“I decided to get involved with the Women’s Association to promote family planning after a CARE training in community dialogue. During this time I have worked with many women who were reticent at the start, like I was, but who end up using contraception and are now living testimony to our awareness-raising sessions.”

The story that most drew my attention was a women who had 10 children. At the first community dialogue she did not approve of using contraceptives, and she wanted to have more than 12 children.

“She thought contraceptives caused cancer, sterility and many other complications, even including death. She carried on with this way of thinking until she had a uterine prolapse with her 11th labour. Since then, she has used contraception (IUD).”

Put simply, access to contraceptives and to family planning services is about a woman’s right to have control over decisions about when and how many children to have.

And at a time when women’s sexual and reproductive rights are under threat, this is a critical moment for the world to renew strong commitments to universal access to contraception and family planning.

What is CARE asking for?

We’re calling on world leaders to accelerate progress and fill key gaps to ensure we reach all people with the contraception/family planning services they want and need. In particular, as one of the world’s leading humanitarian agencies, we’re calling for increased access to family planning for people affected by disasters, crises and conflicts.

There are 32 million women and girls affected by crisis and conflict in the world today. Their needs are even greater than women and girls living in more stable settngs – but many of those displaced from their homes by conflict or crisis have limited or no access to life-saving family planning services.

In 2012 the issue wasn’t even on the table, but now the issue is being prioritised during the conference, including a high-level event about family planning in humanitarian crises – where CARE's work in Chad, the Democratic Reublic of Congo and Pakistan will be highlighted.

CARE’s work in Chad

Chad is a very poor country with high unmet need for family planning. There is only one doctor for every 28,680 people (compared to 2.8 doctors per 1,000 people in the UK).

Official government policy effectively blocked women – especially poor women and women living in rural areas – from getting access to the full range of contraceptive methods, including certain highly effective and long-acting methods many women want. The policy said only doctors were authorised to provide these highly effective methods – in essence, creating a powerful barrier preventing most women from accessing them.

What did CARE do? In refugee camps in Chad, CARE partnered with the Ministry of Health to develop evidence that showed trained nurses and midwives could effectively and safely provide contraceptive methods. And once all these methods were available to women, we saw a dramatic increase in demand for contraception – and specifically a great demand for these highly effective and long-acting methods. So, there had been a latent demand for these services, but before, no one was able to meet women’s needs.

We had created a policy solution: train and authorise the nurses and midwives on the frontlines of service delivery. We used this evidence to change a policy that previously prevented nurses and midwives from providing the full range of contraceptive methods.

This policy solution will be a game changer for women. When it was adopted, the number of healthcare workers authorised to provide the full range of contraceptives increased eight-fold, from 528 (doctors only) to 4,319 (doctors + nurses and midwives). This new policy has the potential to unlock equitable access for thousands of women and adolescents. And the policy will help Chad in meeting its own national goal of increasing the number of women using contraception by 15%.

Learn more about the Family Planning Summit at the CARE Insights website.

Follow the Summit on #HerFuture.

With thanks to Roslyn Dundas from CARE Australia

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News and stories are provided by CARE staff working to support our emergency responses and long-term development programmes.