Family planning needs priority: UN

Mariani Dewi ,  The Jakarta Post ,  Jakarta   |  Fri, 05/16/2008 12:50 PM  |  National

Amidst ballooning oil and food prices, family planning seems to have been forgotten as a means to save lives and money, and should be made a priority again, UN officials say.

"Attention to family planning has begun to disappear because there is sort of sense that it is an old issue and we have dealt with it ... By picking one instead of the other, we tend to drop issues and then they come back to us in a much bigger form," United Nations Population Fund (UNFPA) deputy executive director Purnima Mane told The Jakarta Post recently.

With money from just 2.5 days of the world's military spending, Purnima said, we would have enough funds to deal with maternal, newborn and child health issues across the globe.

Donor funding for family planning had nose-dived from 54 percent in 1995, to 7 percent in 2008, she said.

"Limited resources are often used as an excuse by donors and often governments too. But by defending mothers and children, you are also defending your country's potential -- which is in fact 'defense spending' but is not regarded as such," she said.

Family planning relates to maternal health, HIV/AIDS and even economics she said. Reducing the population growth means fewer people need to be fed, lowering pressure on the food, education and health sectors, and cutting the overall costs of the economy. It also means fewer new jobs need to be created for a growing workforce.

Without family planning, Mane said, mothers would have more children than they could handle, neglecting their own health and reducing their chances to increase their capacity.

It would also reduce the quality of life of children and increase the numbers of abortions.

Mane worried that the oil and food crisis would increase spending on other areas, potentially leaving family planning out of reach for many.

UNFPA Indonesia representative Zahidul Huque said it would cost the same as eight packets of cigarettes (around US$8) per year per women of reproductive age, to save around 61 million women in Indonesia from reproductive health-related deaths, including from unintentional pregnancies.

Indonesia already sees around 20,000 maternal deaths each year, and around 11 percent of those are due to unsafe abortions. More than 70 percent of women seeking abortions are married, and one in 10 married couples does not have access to contraception.

Distribution of contraceptives is entangled between the Ministry of Health and the National Family Planning Coordination Board (BKKBN). BKKBN is responsible for the family planning program but has limited direct access to the public.

Huque said Indonesia did not need to look further for a successful model for family planning. The local family planning program has had huge successes but in recent times has produced mixed results after decentralization, due to different levels of priorities given to it by local governments, and the unclear status of BKKBN at a regional level.

"I was very impressed to see in Kalimantan the family planning program is still doing very well, but Sumatra is not doing very well. Each area has really different reasons for not doing well. They could learn so much from Pontianak or south Kalimantan," he said.

More advocacy is needed, linking population growth and reproductive health to development progress, he said.

Under the Millennium Development Goals, Indonesia must reduce its maternal mortality rate by two-thirds (from 307/100,000 births) by 2015.

Less than half of its 70,000 villages are served by paramedics or village midwives, forcing the rest to seek assistance from unskilled birth attendants (dukun) and family members.

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