Between the 9th-15th of November 2018, my organization, Marie Stopes Ghana supported me to participate in the 5th International Conference on Family Planning (ICFP) in Rwanda.
As was my first ICFP, I made it a point to listen keenly and take copious notes of key concepts and good practices I could learn from and replicate in our Ghana Country Programme to support our Family Planning interventions in the private and public sectors.
I thought I could share a few of these lessons below.
a) Family Planning as a Development Goal
My first observation was the fact that, as a
But you see, FP goes beyond health; it is a fundamental development issue. In the opening preamble of our 1994 National Population Policy, the country’s population is described as the instrument and objective of development.
The Policy identifies population management, especially through fertility management as a major strategy
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FP is positioned as a fundamental development
I am yet to come across a single evidence of a country which has developed over the past 70years which did not prioritize fertility management through family planning as part of its development goals. The reason for development is the people; they are also the instruments for development.
At any point in time, you must have a strategy to ensure that the numbers you have are by choice, not chance. You should be able to determine how many people you want and can adequately provide for.
This decision is taken in leadership, and heavily promoted in the home, where all the beautiful policies receive interpretation in the bedroom. The first point of consideration in development planning should
It is following this determination that we can begin to make plans for quality health, education, jobs, infrastructure and security for these same people. As a regular conference convener, the first question my team and I have always asked at the start of every project has been ‘how many people are we expecting?’.
That informs all other decisions – the budget, the venue, feeding, sanitation, security etc. Meanwhile, it seems that is the last question we always ask as a people. We are so eager to implement social policies such as free education and healthcare without pausing to ask how many people can be supported by such interventions in the most sustainable manner over the long term.
This is our bane; the most important question has become the least considered in our development discourse.
Quite recently, the Executive Director of the National Population Council, Dr. Leticia Adelaide Appiah granted an interview on the overpopulation crises of Nigeria and made some very staggering revelations I think are worth re-iterating here as lessons for Ghana. Dr. Appiah shared that by 1960, Nigeria had a population of 45.1million whilst the United Kingdom had a population of 52.2million. By 2017, however, Nigeria’s population had increased to 191million, whilst that of the
Thus although the UK was more populated than Nigeria at her independence from the UK, Nigeria today has three times the population of the UK.
The impact of population growth on the two countries
Dr. Appiah shared further that some economists have posited that, at one percent population growth rate, there must be a corresponding 6.5 -7% growth in GDP in order to maintain the same quality of life for the citizenry. At our current 2.2-2.5% annual population growth rate, we can all estimate the level of annual GDP growth rate we need to even maintain the current quality of life for our people.
Meanwhile, FP can easily help us avoid this undue stress on ourselves and our development agenda as a people, by helping to prevent unintended pregnancies, and ensuring that every birth is wanted. It is
b) Ghana is Lagging Behind in Family Planning
My second observation from the ICFP was the fact that Ghana is seriously lagging behind in improving the use of Modern Contraception. Our rate of utilization of FP services is low. With our current modern Contraceptive Prevalence Rate (
At the Conference, I got to know that in 13years, Rwanda had improved its
As I listened to the Prime Minister of Rwanda, and the Minister of Health of Burkina Faso on what had accounted for their quantum leaps into success, I understood why Ghana had been such a slow player. Both Governments have committed to investing heavily in health, especially FP and have also positioned FP as a major development goal.
They really want to bring down fertility rates amongst their women, and ensure that they have family sizes they can adequately cater for, whilst also protecting the lives of their women.
The story is, however, not so for Ghana. We have not and are not investing enough in this important service. Ghana is economically more endowed than these two countries we are talking about here, yet they have found it needful to commit very significant proportions of their resources to
c) Ghana is Behind in Investment in Health and Family Planning
My third observation was also the fact that, Ghana is very much behind in terms of investment in health. I have observed with much sadness the ever decreasing budgetary allocation by successive governments to health since the Abuja Declaration of 2001, at which Ghana committed to allocating at least 15% of its annual budget to health.
Today, Rwanda commits 20% of its annual budget to health. A significant part of these resources
Again a significant proportion of these resources go into sexual and reproductive health. In both countries, there is a very strong Presidential support for FP: both Presidents are key advocates for FP services. Clearly, there is an opportunity for Ghana to learn from these examples of
Percentage of annual national budget allocated to health
2006 2007 2008 2009 2010 2011 2012
16.24% 14.57% 14.87% 14.27% 11.04% 12.46% 13.3%
2013 2014 2015 2016 2017 2018
11.08% 9.26% 6.97% 7.78% 7.77% 7.23%
We are currently not meeting even half the Abuja commitment, and that is a huge challenge for us as a people. This has always been my argument as one trained in Practising Sustainable Development. True development starts with the people; it starts with the health of the
And so in that order, human capital development starts with investments in firstly the health of the people, and then education, and then job creation, and
We do not invest in Public Health; we invest millions to build curative health
The Table above is reflective of budgetary allocations to the health sector in general, a large proportion of which goes into remuneration and not capital investment and services. When I tried gathering data for investments in family planning and sexual and reproductive health in general, the findings were too depressing to share. If we really want to improve the use of modern contraception, then it is vital that
I would not formally conclude my article because it is the first of a series I aim to share with our leadership as a country and our people. In my next episode of Testimonies from Kigali, Lessons for Ghana, I will tell you about how we have been playing with the future of our adolescent girls with our lip services on teenage pregnancies. I am an optimist, and believe in our ability to rise up as a people and solve our problems; that is the Ghanaian spirit I was introduced to as a child. We can do it if we decide to; it is just about re-aligning our
The writer is the Advocacy Manager and Adolescent Focal Person for Marie Stopes International Ghana, an international NGO headquartered in the UK, and with