Reproductive health: Key to sustainable development
As a young doctor in Ghana, I saw at first hand what happens when women lack access to family planning and reproductive health services. I saw the botched abortions, the mothers who died needlessly in childbirth. I saw the swollen bellies of small children afflicted with “kwashiorkor,” or malnutrition, because they were born too soon after a sibling.
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Determined to alleviate their suffering, I have spent much of my life working to improve reproductive health in Ghana and around the world. And, while great progress has been made, much remains to be done.
Today, more than a third of women in regular sexual relationships in Ghana have an unmet need for family planning – they wish to prevent pregnancy but are not using effective modern contraception. Worldwide, some 222 million women lack access to family planning. According to a recent UN report, this results in 80 million unplanned pregnancies, 30 million unplanned births and 20 million unsafe abortions every year.
Now there is an important opportunity to address this problem. The Open Working Group on Sustainable Development Goals—which includes Ghana as a member—meets in New York. Created at last year’s Rio “Earth Summit,” the Open Working Group is charged with drafting a set of Sustainable Development Goals (SDGs) that will guide national and global priorities for years to come.
As the delegates draft the SDGs, I urge them to remember that reproductive health is a key component of sustainable development. For example, it is a proven poverty-fighting strategy: Where women are able to plan and space their childbearing, they and their children are less likely to become poor.
Reproductive health is a cornerstone of public health. If all women who need it had access to family planning and reproductive health services, we could prevent 79,000 maternal deaths and more than 1 million infant deaths each year. Reproductive health services are also essential to stanch the AIDS epidemic that has ravaged our continent.
Simply enabling couples to space births more widely would yield enormous health benefits. Research has shown that if there were at least two years between a birth and a subsequent pregnancy, deaths of children younger than five would fall by 13 per cent; if the gap were three years, those deaths would decrease by 25 per cent.
The other established fact is that family planning leads to lower birthrates, saving money that nations can invest in health care, infrastructure, and job creation. This “demographic dividend” is thought to account for one third of the explosive growth seen in the Asian Tiger countries over the last few decades. As birthrates decline, African nations may have an unprecedented opportunity to seize that dividend and improve our people’s well-being.
At the same time, lower birthrates and slowed population growth could help African governments deal with a broad range of challenges, from food and water shortages to civil and regional conflict. Rapid population growth is not the cause of these problems, but it does make them more difficult to solve.
Take water, for example. Africa is the world’s second driest continent, after Australia. Over 300 million Africans already face water scarcity, and water shortages could grow by a third by 2050. Slower growth would reduce the scale of vulnerability, and afford us more time and resources to address the problem.
And slower growth is crucial to environmental sustainability. Today, world population stands at 7.2 billion. That number could grow to anywhere from 8 billion to 11 billion by midcentury, depending on—among other things—whether couples are able to plan their families. Many environmental problems—climate change, biodiversity loss, and deforestation—would be far easier to address if world population peaks at 8 rather than 11 billion.
Moreover, reproductive health is a cost-effective investment: every dollar spent on family planning and reproductive health reaps savings of up to $9 in other development sectors.
In short, reproductive health is good for women, families, and the planet.
When I was a young doctor in Ghana, I saw women and children suffer and die because reproductive health services were not available. Now, decades later, so much has changed—and yet the needless suffering continues. As Ghana and other nations meet to draft the next generation of sustainable development goals, it is time to make family planning and reproductive health a priority.
By Dr. Fred Torgbor Sai
The writer is the former President of the International Planned Parenthood Federation and a member of the Global Leaders Council for Reproductive Health