The program has been running for just over a year, and for Ms. Mbeba it is too early to know the full impact it is having, although requests for condoms among youth have increased, and there are early signs that births have declined. “Change is happening,” she says. Many of the young people who participate will be discussing the topic for the first time, since their parents won’t broach the subject with them. Ms. Mbeba says women’s advocates are also close to an agreement with the local government to permit girls to return to school after having a baby.
Ms. Mwaya says that if she had received the information she now provides, she would not have become pregnant so soon – there was no discussion of contraception at her village. Now she plans to have three children. But, she says, “I will make the decision myself when to get married and when to have kids.”
- Currently, the number of women who have an unmet need for modern contraception in 2012 is 222 million. In the developing world, this number declined slightly between 2008 and 2012, but increased in the 69 poorest countries.
- Use of birth control will prevent 218 million unintended pregnancies in developing countries, averting 55 million unplanned births, 138 million abortions, of which 40 million are unsafe, 25 million miscarriages and 118,000 maternal deaths.
- If every woman seeking modern contraception methods in all developing countries were supplied, an additional 54 million unintended pregnancies would be prevented, including 21 million unplanned births, 26 million abortions, of which 16 million would be unsafe, and seven million miscarriages. This would also prevent 79,000 maternal deaths and 1.1-million infant deaths.
- The Cost Contraceptive care in 2012 will cost $4-billion in the developing world. To meet the need of all women in the developing world would cost $8.1-billion per year.
Four solutions for change
Keep girls in school
The longer young women stay in school, the less likely they are to get pregnant. Schools are also a good location to educate youth about contraception and reproductive rights. In some countries, such an Tanzania, girls are prevented from returning to school once they have had a baby – even if they are lucky to have the resources otherwise to support their child.
Educate about sexual health
In places where on-the-ground education is expanded, particularly by people trained within communities, contraception use rises significantly. In a 2007 study of four African countries, more than one third of the youth surveyed did not know where to get contraception devices. Governments and community leaders are also being called upon to reduce cultural stigma. In countries such as Rwanda, for instance, where the government has expanded family planning funding and promoted education, not only has contraception use increased but the ideal number of desired children has declined.
Ensure a stable supply
Maintaining a reliable stock of condoms and birth control injections, is complicated, especially when they need to travel far inland, or require cold storage. African women often report in surveys that culturally-appropriate or practical contraceptions are not available. Even if they are, some villages will be short of health-care workers trained to administer them. Groups are advocating “task-shifting,” which would involve training more people such as midwives to deliver them.
Spend more on R&D
In recent years, pharmaceutical research for contraception has stalled. But more efficient methods of taking them needs to be invented, as well as using generic drugs to reduce cost, says Jennifer Woodside, the London-based head of advocacy and communications at the International Planned Parenting Fund. For instance, one Seattle-based company working with Pfizer is now testing a new version of Depo-Provera, which women would be able to inject themselves.