The World Contraception Day was marked on September 26 to celebrate the importance of contraception.
Emphasising sexual and reproductive health has always been a cornerstone of the celebration of the Day with family planning being the crux.
In Nigeria, an NGO, Partnership for Advocacy in Child and Family Health @ Scale, held a press conference to mark the day and make a case for modern contraception as necessary to achieve the nation’s goals in maternal, neonatal and child health.
Why World Contraception Day (WCD)?
World Contraception day was launched by a group of non-governmental organisations (NGOs) in 2007 and since then has been championed by the World Health Organization (WHO). The Day aims to raise awareness about the various methods of modern family planning options available for women and men of reproductive age (aged 15-49 years) to avoid unplanned pregnancies and live sustainable lives.
WHO said among the 1.9 billion women of reproductive age (15- 49 years), 270 million have an unmet need for contraception. In Nigeria, there remains a low uptake of contraception as evidenced by the high maternal and infant mortality rates.
Women, child and family health
In recent decades, the enhancement of contraceptive uptake garnered global attention with the universal understanding being that the topic of family planning is not just a national population issue, but is largely a health issue. Evidence has shown that in countries with high rates of contraceptive use, there is a lowered rate of maternal and infant mortality, with overall improvement in the health of women, children and families.
Moreover, access to contraception and family planning is also key to attaining several Sustainable Development Goals (SDGs) targets in connection to gender empowerment. Indicator 3.7.1 of SDG 3, the health SDG, emphasises that women of reproductive age have their need for family planning satisfied with modern methods.
The benefits of modern contraceptive methods include longer spacing between pregnancies, preventing unplanned pregnancies, delay in births, and improved survival rates of neonates and children as there will be more time for quality parenting and care of children.
WHO links the use of contraception with improved maternal health outcomes. What’s more, the International Federation of Gynecology and Obstetrics (FIGO) observed that the use of contraceptives halved mortality rates in women.
Further research has shown a correlation between the level of contraceptive use and infant mortality rates. In one study, researchers noted an average infant mortality rate of 100 deaths per 1,000 live births in countries with a less than 10 per cent contraceptive use. In contrast, countries with a contraceptive use rate of between 10 and 29 per cent saw an appreciation in average infant mortality rate only 79 per 1000 live births.
Uptake of modern contraception methods in Nigeria
In 2018, the global use of contraceptives led to the prevention of 12,000 maternal deaths. In the same vein, the use of contraception averted 12,000 infant deaths, all according to the National Family planning Blueprint statistics.
The federal government of Nigeria accepts and endorses the importance of modern contraceptives as a key strategy to support the family health of Nigerians. This is captured in the National Family Planning Blueprint 2020-2023; and the 2007 Integrated Maternal, Neonatal and Child Health Strategy; among other policies.
The Nigerian Federal Ministry of Health, in recognition of the benefits and the strategic importance of modern contraceptive, committed to achieving a modern contraceptive prevalence rate (mCPR) of 27 per cent by the year 2023. As at 2018, the mCPR stands at 17 per cent, suggesting that Nigeria is unlikely to attain the 27 per cent target.
The mCPR varies widely from state to state in Nigeria. The 2018 Demographic Health Survey shows low uptake of mCPR for both married and unmarried women in states in the North East, North West and North Central as well as the South East state of Ebonyi and the South South state of Bayelsa. But it shows high rates in states such as Anambra, Enugu and Lagos. Across the country, however, in all states there was high unmet demand for modern family planning commodities.
NGO advocacy for modern contraceptives to mark World Contraception Day
At the Press Conference to mark World Contraception Day, the NGOs in the Partnership for Advocacy in Child and Family Health at Scale (PACFaH@ Scale) project identified the cause for the poor uptake of modern contraceptives in Nigeria as inconsistent and inadequate funding for family planning at national and state levels.
The PACFaH NGOs also called out the government for weak management and health systems for managing FP commodities at both national and state levels. PACFaH@Scale also noted that while misinformation, cultural and religious beliefs are an impediment to demand, these are all factors that can be addressed by an adequately funded and well organised FP programme in which services are delivered by new providers under the Task Shifting and Task Sharing policy, where providers are well trained and stock-outs and commodity logistics challenges are solved by good management.
The PACFaH@Scale NGOs led by the Association for the Advancement of Family Planning (AAFP) in Nigeria called on the federal government to release the funds allocation for family planning commodities, logistics and training of providers budgeted in the 2020 budget. They also called on state governments to release funding for commodity, logistics, training and the management of family planning service delivery.
Lastly, PACFAH called on the government to honour its fiscal commitment by releasing funding to improve the regulatory environment for private providers and to strengthen the management of family planning service delivery at all levels of the public health system.