By STANSLOUS NGOSA-
HEALTH experts have long emphasised the benefits to maternal and child health, of helping women and couples avoid unintended pregnancy.
Family planning reduces health risks to women and gives them more control over their reproductive lives.
With better health and greater control over their lives, women can take advantage of education, employment and civic opportunities.
Families with fewer children are often able to send them to school, so girls get a chance to attain higher education.
And as an outcome, the age of their first marriage is often later and their years of fertility reduced.
They also benefit from being an employee.
In addition, it is not difficult for parents to clothe and feed their children if they can limit their family size.
The expenses that they need to care for a small-sized family will be less, so they can save more and be self-sufficient.
This can help save essential resources and thereby contribute to the economic growth of the nation as a whole.
In general, having a larger proportion of well-educated, healthy, productive and self-sufficient families can contribute a great deal to the sustainable development of a country.
In this regard, the social and economic benefits of the family are essential.
Health benefits to the mother
Contraceptive use reduces maternal mortality and improves women’s health by preventing unwanted and high-risk pregnancies and reducing the need for unsafe abortions.
Some contraceptives also improve women’s health by reducing the likelihood of disease transmission and protecting against certain cancers and health problems.
Avoiding too early and too late pregnancies; family planning helps mothers avoid pregnancy when they are vulnerable because of their youth or old age.
The risk of having pregnancy-induced hypertension (high blood pressure) is much higher in younger mothers.
On the other hand, older mothers, who have given birth to five or more children, have a tendency to have uterine rupture during labour, which can cause severe vaginal bleeding and shock.
In places where emergency obstetric care facilities are lacking, these two consequences of age have been leading causes of maternal deaths.
Limiting the number of pregnancies; once the desired number of children has been achieved, a woman can avoid further pregnancy by using family planning methods.
The risk of dying from multi-parity that is giving birth more than once, increase for a woman who has given birth to five or more children; her risk is 1.5 to three times higher than those who have given birth to two or three children.
Preventing abortion; most abortions result from unwanted pregnancy, and significant numbers of maternal deaths can be attributed to unsafe abortion induced by untrained practitioners.
In Addis Ababa, abortion is one of the leading causes of maternal death. Family planning helps mothers prevent such unwanted pregnancies.
Benefits to the children
Together with other health services, such as diarrhea and pneumonia management, the nutrition programme and the expanded programme on immunisation, family planning directly contributes to the improvement of children’s health and growth.
It also indirectly contributes to children’s wellbeing and development by improving maternal health.
Adequately spaced children can be well fed and healthier than closely spaced children.
Mothers can have ample time and good health to care for their children.
Parents should be able to seek healthcare for them without being constrained.
What is the situation in Zambia?
Lack of information on family planning is one of the factors that have contributed to high maternal mortality in Zambia, which currently stands at 481 deaths per 100,000 births.
According to United Nations Population Fund (UNFPA, 33 per cent of Zambians have access to contraceptives, and about 27 per cent of women want to space their children but cannot access contraceptives.
On average, a Zambian woman will have 6.2 per cent children during her reproductive years.
With a growth rate of 2.8 per cent, Zambia’s population growth rate is one of the fastest in the world and is unmatched by growth of the resource envelope.
If current trends continue, the population is projected to increase to 15.5 million by 2015 from the current 13 million, and to double by 2030.
Family planning is the ability of couples and individuals to decide, freely and responsibly, the number and spacing of their children and to have the information and means to do so.
It allows families to delay, space and limit pregnancies – thereby helping to achieve the highest health outcomes for women and children and ultimately reducing maternal mortality.
Family planning also improves the lives of women and girls. By enabling them to choose the number and spacing of their children, women and girls can seek education, empowerment and economic activities.
Family planning also reduces economic strain on families and thereby help reduce poverty.
There are many challenges faced in terms of access and utilisation of family planning services, hence the need for all stakeholders to join hands and help address these challenges.
Research shows that women, especially those in rural communities, are unable to access family planning as evidenced by the high fertility rate in Zambia. There is also limited information and options for family planning.
In addition, there are a number of myths and misconceptions around family planning, hence many women shun its use even where it is accessible.
What progress has been made in the recent past?
The percentage of married women between the ages 15-49 using contraception has increased from 15 per cent in 1992 to 41 per cent in 2007.
Zambia launched a cost eight Year Family Planning Scale-up plan in 2013, which aims to increase contraceptive prevalence rate from 33 per cent to 58 per cent by 2020.
There has been commitment from Government to increase access to family planning by doubling the budgetary allocation to contraceptives and addressing policy barriers.
There has been integration of family planning within the comprehensive reproductive health services offered in health facilities.
What are the recommendations for priority actions?
Speaking during –a training for media personnel, on one of the goals of the Programme of Action of the International Conference on Population and Development, Family Planning, UNFPA country representative, Mary Otieno said the fertility rates in Zambia are likely to increase if family planning is not accessible to all women.
Against this background, Dr Otieno said that there is need for the media to educate the public on the need and benefits of family planning as doing so would help reduce maternal deaths among women, especially among adolescents.
“Although UNFPA has taken a lead in implementing the International Conference on Population and Development Agenda which highlights the significance of family planning, its scope and depth requires the participation of a broad coalition of actors – the non-governmental organizations, the government and the private sector” Dr Otieno said.
She said special attention is needed to ensure that the contraceptive needs of adolescents, young women and other disadvantaged groups such as poor and rural women are met.
Speaking at the same event, UNFPA Reproductive Health Officer, Stephen Mupeta also urged journalists to be objective when reporting the issue of sexuality so that people can make informed choices and decisions with regard to their reproductive health.
This will subsequently contribute to the attainment of the Millennium Development Goals (MDGs) on health.
Dr Mupeta added that the media need to help people understand myths and misconceptions concerning the side effects of contraceptives – which often make women shun using them.
He said family planning is not about stopping people from having children but rather helping them plan their families.
“It is about enabling men and women to make informed decisions about the welfare of the woman, the children, and the family as a whole,” he said.