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Why Ghana needs to reduce population growth rate to a sustainable level

BY: Graphic.com.gh
Dr Leticia Appiah - Executive Director of the National Population Council
Dr Leticia Appiah - Executive Director of the National Population Council

Two population experts have stressed the need for Ghana to reduce its population growth rate to a sustainable level to ensure sustainable socio-economic development.

The National Population Council (NPC) said the annual addition of 700,000 to Ghana’s population posed a huge challenge to development, ensuring quality of life for the population and some national policies such as the Ghana beyond aid.

The experts including the Executive Director of the National Population Council, Dr Leticia Appiah, were speaking at a press briefing marking the beginning of a weeklong activity towards the commemoration of this year’s World Population day in Accra Thursday (July 7, 2022).

Instituted by the United Nations Governing Council in 1989 and marked every July 11, World Population Day (WPD) to focus global attention on the urgency and importance of population issues to global, national and human development.

The commemoration calls for critical analysis of relevant population and its related issues that supports or hinder accelerated socio-economic development for national attention and action.

The global theme for this year's commemoration is "A world of 8 billion: towards a resilient future for all, harnessing opportunities and ensuring rights and choices” while the national commemoration is on the theme “Prioritising rights and choices; harnessing opportunities, the road to a resilient future for all.”

Other local activities will include public forums on demystifying family planning and contraceptive use among others.

Below is a copy of the address of Dr Leticia Appiah

2022 WORLD POPULATION DAY CELEBRATION, STATEMENT BY DR LETICIA ADELAIDE APPIAH EXECUTIVE DIRECTOR, NATIONAL POPULATION COUNCIL, 7TH TH JULY, 2022

  1. Honourable Deputy Minister of information Madam Fatimatu Abubakar, UNFPA Country Representative Mr. Barnabas Yisa, Representative from the UN Systems, CSOs and MDAs, the Media, Invited Guests, Ladies and Gentlemen.
  2. It is a great honour to be invited to deliver this statement as part of the 2022 World Population Day celebrations organized by the National Population Council and its partners.
  3. Globally, 11th July was set aside for the celebration of annual World Population Day (WPD) in 1989 by the Governing Council of the United Nations in all countries. The celebration calls for critical analysis of relevant population and its related issues that supports or hinders accelerated socio-economic development for national attention and action.
  4. The global theme for this year’s celebration is “A world of 8 billion: towards a resilient future for all, harnessing opportunities and ensuring rights and choices” and our national theme is ‘Prioritizing rights and choices; harnessing opportunities, the road to a resilient future for all.’
  5. My presentation will be brief on selected contributors to population growth globally and mainly on Africa and Ghana’s contribution. For Africa and Ghana, my statement will highlight the need to prioritize rights and choices in addressing unmet need for family planning, child marriage and teen pregnancy in line with our national theme and some recommendations.
  6. Globally, United Nations World Population Prospects recorded 139,821,086 births and 60,119,439 deaths in 2021. Europe welcomed 4,047,432 births and recorded 5, 186,787 deaths whilst Africa had 49, 034,104 births and 13, 378,519 deaths. Nigeria our big brother, welcomed 8,424, 582 and buried 2, 777,541 according to the United Nations Department of Economics and Social Affairs, Population Division in 2021. In Ghana, our births stood at 1,053,400 and deaths 288,378. The difference between births and deaths is the net increase Europe’s population decreased by over a million people and Africa’s increased by over 35 million in 2021 alone with Ghana contributing over 700,000.
  7. The world is hitting 8 billion people; whilst Europe is contributing to slowing down the population growth down to a sustainable level, Africa is contributing to its accelerated growth also in an unsustainable fashion.
  8. Below replacement level fertility (2.1) in Europe ultimately translates into population with fewer young skilled workforce and a larger proportion of older people which poses a threat for economic growth and the maintenance of social welfare systems such as pensions and healthcare.
  9. In order for European countries to address its negative population growth rate, many countries in European Union have instituted some social policies promoting fertility, increased age of retirement and organized migration of skilled workforce. Additionally, they invented automation and other technologies such as auto-pilot cars, computerized scans and algorithms that respond to customer service inquiries substitute for some activities humans were previously performing to increase productivity and improve lives.
  10. On the other hand, fertility rates above replacement level in Africa and Ghana drive fast population growth on the continent and in Ghana thus constantly contributing to a large proportion of young people and fewer skilled workforce posing challenges with provision of quality healthcare resources, relevant education, employment as well as sustainable economic growth.
  11. With high unemployment and majority of people in the informal sector, automation and the use of current technologies could worsen the unemployment situation. A report by McKinsey Global Institute in 2017 revealed that about half the activities people are paid to perform globally could theoretically be automated by 2030 using current technologies.
  12. Africa and Ghana’s high population growth rate are in part supported by high rates of teenage pregnancies, high levels of child marriage and high unmet need for family planning with its associated high social, environmental and economic costs. For Africa and that matter Ghana to reduce its population growth rate to sustainable levels, it is important for the leaders to recognize the established fact that reproductive health policy is a vital economic policy and so respecting reproductive health rights and choices of all especially girls and women should be of high priority.
  13. Prioritizing rights and choices mean providing all with adequate sexual reproductive health information and services to facilitate informed decision making in their fertility choices efficiently for their own good as well as the wellbeing of others. This will not only slow Africa’s and Ghana’s population growth rate down significantly, it is fundamental to bridging the inequality and inequity gaps in health, education, employment within and between genders which is a necessary condition for sustainable development.
  14. One of the consequences of lack of prioritization of reproductive rights and choices is high unmet need for family planning. Unmet need for family planning measures the gap between woman’s reproductive intentions and their contraceptive behavior. Data from the 2014 Ghana Demographic and Health Survey (GDHS), unmet need for family planning stands at 30%. Reducing unmet need for family planning will reduce the high levels of unintended pregnancies, unsafe abortions, maternal and neonatal morbidity and mortality with accompanied health and financial benefits and a reduction in the population growth rate.
  15. Another manifestation of the lack of prioritization of reproductive rights and choices for cultural reasons is child marriage and other teen pregnancies which supports high growth rate. Child marriage disproportionately affects young girls with far reaching consequences that negatively impacts not only the lives of children who are married, but also the lives of those around them and the nation at large. When girls marry young before their minds and bodies are fully developed, they get pregnant before they become adults.
  16. Pregnancy is number one cause of mortality among girls aged 15-19 worldwide and child marriage/ teen pregnancies reinforce the gendered nature of poverty whose impact extends throughout a girl’s adult life into the next generation.
  17. Prioritizing sexual and reproductive rights and choices of women in Ghana and Africa by decisively tackling child marriage, teen pregnancies and unmet need for family planning will improve maternal and child health and well-being at a reduced health, social, environmental and economic costs. This will significantly reduce the unsustainable level of population growth rate in Africa and Ghana. It will help produce fewer healthier young people and increase the proportion of skilled workforce leading to accelerated socio-economic development. It is important that policy makers, implementers and takers appreciate the health, social, environmental and economic benefits of prioritizing reproductive health and services. This in my opinion will help bridge the inequality gaps, improve the health of citizens, free up funds for relevant quality education and skill acquisition and make it easier to build a resilient future for all.
  18. Child marriage, teen pregnancies and unmet need puts strain on family and national income whiles increasing family and national expenditure mainly on consumption to the disadvantage of production.
  19. Ignoring these seemingly harmless small issues is akin to the little foxes that spoil the vine in the bible. Songs of Solomon 2 vrs 15. Catch for us the foxes, the little foxes that ruin the vineyards, our vineyards that are in bloom.
  20. In conclusion, as the world population hits 8 billion, for Africa to reduce its population growth rate to sustainable levels for national development, and create the Africa we want and Ghana beyond Aid, I suggest a concerted effort at reducing or eliminating child marriage, teen pregnancy and unmet need for family planning should attract attention and commitment from all stakeholders especially the media, the economists, the traditional, religious and political leadership.

For sustainable socio-economic development of Ghana and Africa, sexual and reproductive health policy should and must be seen and treated as an economic policy and a security policy.

Thank you for your attention.

MEDIA KIT FOR 2022 WORLD POPULATION DAY CELEBRATION

THEME: Prioritizing Rights and Choices: Harnessing Opportunities, the Road to a Resilient Future for All.

Background on WPD celebration

World Population Day (WPD) is observed on 11th July every year. The day seeks to focus on the importance and urgency of population issues. It was established by the Governing Council of the United Nations Development Programme in 1989. This year the world’s population will hit 8 billion, prompting the attendant responses such as the institution of the Sustainable Development Goals, 2030 Agenda for Sustainable Development and Africa Union’s Agenda 2063; the Africa We Want. The global theme for this year’s WPD celebration is ‘A World of 8 billion; Towards a Resilient Future for All- Harnessing Opportunities and ensuring Rights and Choices’ whilst the national theme is, ‘Prioritizing Rights and Choices: Harnessing Opportunities, the Road to a Resilient Future for All.

Prioritizing Rights and Choices

Prioritizing rights and choices means providing all with adequate information and services to enable them make their own informed decisions and act more efficiently for their own good and the well-being of others.

Sexual Reproductive Health and Rights (SRHR) and choices are fundamental to bridging inequality and inequity gaps in health, education, employment within and between genders. They are a set of rights that apply to all people in the world, regardless of religion, ethnicity, culture, gender, age or impairment (UNFPA, 2010). With regards to the rights, men and women have the right to be informed and have access to safe, effective, affordable and acceptable methods of family planning of their choice as well as other methods, for regulation of fertility for optimal health and economic outcomes.

High Unmet Need for Family Planning

One of the consequences of lack of prioritization of Reproductive rights and choices is high unmet need for family planning. Unmet need for family planning comes about when currently married or sexually active fecund women who want to postpone their next birth for two or more years or who want to stop childbearing altogether but are not using a contraceptive method due to unavailability, inadequate knowledge, cost constraints or cultural barriers.

It measures the gap between women’s reproductive intentions and their contraceptive behavior. Reducing unmet need for family planning will reduce the high levels of unintended pregnancies, unsafe abortions, maternal and neonatal morbidity and mortality with attendant health and financial benefits. Data from the 2014 Ghana Demographic and Health Survey (GDHS) indicates that total unmet need for family planning is highest among the youngest women aged 15-19 years (51 per cent) and lowest among the oldest women aged 45-59 years (14 per cent). Unmet need is only slightly higher in rural areas than in urban areas (31 per cent and 29 per cent respectively).

Unmet need is lowest among women with a secondary or higher education (24 per cent). It is therefore in our national interest to prioritize family planning in the health sector in general with a special focus on teen girls with little or no education.

Reducing High Rates of Child Marriage

Another manifestation of the lack of prioritization of Reproductive rights and choices for cultural reasons is child marriage. Child marriage disproportionately affect young girls with far reaching consequences that negatively impacts not only the lives of children who are married, but also the lives of those around them and the nation at large. When girls marry young before their minds and bodies are fully developed, they get pregnant before they are ready. Pregnancy is number one cause of mortality among girls aged 15-19 years worldwide and child marriage reinforces the gendered nature of poverty whose impact extends throughout a girl’s adult life into the next generation.

According to the National Strategic Framework on Ending Child Marriage (2017 – 2026), on the average, one (1) out of five (5) girls is married before their 18th birthday, thus, the percentage of girls aged 20 – 24 years who were married or in union by the age of 18 is 21 per cent nationally. This amounts to 260,000 affected girls in the country. Also, according to the Multiple Indicator Cluster Survey 2011, child marriage is prevalent in rural areas compared to urban areas, i.e., 36 per cent and 18 per cent respectively. The data above vividly reveals how child marriage is a profound manifestation of gender inequality. It disproportionally affects girls over boys.

Among boys aged 20 – 24 years, only 2 per cent were married before the age of 18 compared to 21 per cent of girls. Reducing child marriage will significantly lower maternal and child mortality and malnutrition. Another important benefit from ending or reducing child marriage would be an increase in women’s expected secondary or higher education completion rate and increase in earnings in the labor market.

TEENAGE PREGNANCY

With the issue of teenage pregnancy, according to the 2017 Ghana Maternal Health Survey, 14 per cent of adolescent women aged 15-19 years had begun childbearing: 12 per cent had already had a live birth and 3 per cent were pregnant with their first child. The proportion of teenagers who have begun childbearing increases dramatically with age, from 3 per cent of those aged 15 years to nearly one-third (32 per cent) of those aged 19 years. The issue of adolescent fertility is important on both health and social grounds. Children born to very young mothers are at increased risk of sickness and death. Teenage mothers are more likely to experience adverse pregnancy outcomes and are more constrained in their ability to pursue educational opportunities than young women who delay childbearing. Additionally, according to the Ghana Health Service, between 2016 and 2020, 555,575 teen pregnancies were recorded; and in 2020 alone 107,023 pregnancies were recorded among girls aged 15 to 19 years. This brings to sharp focus the importance of improving adolescent reproductive health services and information as a cost saving intervention both at the family and national levels.

Prioritizing the rights and choices of men and women will impact positively on key population indicators such as growth rate, maternal mortality rate, total fertility rate and contraceptive prevalence rate which will go a long way to improve quality of education, employment and life as a whole.

Harnessing Opportunities

For a country to reap the demographic dividend, quality human capital accumulation for resource exploitation is critical. This is possible when the population has more people in the working age group compared to the dependent group. Harnessing potential is thus difficult with a youthful population because of the needed timely investment in good quality public education, expansion of job opportunities for the youth, promotion of healthy and responsible behaviors as well as the provision of training and skills development programs by relatively few working population. The role of the government in harnessing this opportunity cannot be underestimated.

Good governance that hinges on data, determines how resources are equitably distributed among the various sectors of the economy namely health, education, agriculture and industry. Harnessing opportunities in public policy direction, programmatic and institutional interventions would potentially impact quality of education, improve employment opportunities and access to quality healthcare and services. This includes fiscal discipline, technical innovation and substantial investments in human resources.

CONCLUSION

In Prioritizing Rights and Choices: Harnessing Opportunities, the Road to a Resilient Future for all, the following recommendations for policy makers, policy implementers and policy-takers will help uncover potential at reduced health, social and economic cost.

Recommendations for Policy Makers:

The government should ensure adequate funding for family planning commodity supply.

To Reduce Child Marriage through a multi-prolonged intervention to alter social norms and legal framework.

Increase awareness regarding child marriage laws and the consequences of child marriage among individuals, families and communities.

The Criminal Offences Act, 1960 (Act 29) which pegs the age sexual consent at 16 years old needs to be amended and increased 18.

The Children’s Act, 1998 (Act 560), which provides in section 14(2) that the minimum age for marriage is 18 needs to be amended and increased to 20.

Recommendations for Policy Implementers:

National Health Insurance Authority (NHIA) should upscale family planning commodities nationwide in all National Health Insurance Scheme (NHIS) accredited facilities to reduce unmet need for family planning.

Ghana Health Service should integrate community-based provision of family planning services into antenatal, post-partum and post abortion care to improve coverage.

The National Youth Authority, National Commission for Civic Education and the Ghana Health Service needs to collaborate with the National Population Council to create awareness on teenage pregnancy, about its negative effects, mobilizing child and youth clubs, using peer and community pressure, providing life skills education, life skills training for adolescents, promotion of peer leaders and advocacy efforts with duty bearers.

Overcoming barriers to family planning uptake through mass media communication campaigns to raise awareness of the benefits of family planning, legitimize small families, and change reproductive preferences.

Increasing access to family planning would require using innovative and adolescent friendly approaches to make family planning methods and services available to young people. Increasing access to secondary or higher education, and paid employment potentially empowers women and girls on their rights to choose when and how they decide to form their families.

Further, actively involving men and boys in contraceptive uptake discourse reduces the burden on women and girls on how pregnancies and families should be planned.

Recommendations for Policy Takers:

Advocate for family planning as an important issue for the nation’s economic growth and social development, using the slogan “Planning our families is planning for our nation’s development.”

Advocates need to convince officials to adopt supportive policies and allocate funds to family.

KEY POINTS

1. Women must be empowered educationally, economically and politically to exercise their choice over their bodies and fertility.
2. Prioritizing reproductive health and rights for all through access to right information and service are, key areas to transform women in their fertility age to thrive.
3. Negotiating cultures for gender equality, women’s empowerment and human rights required reflective critical and comprehensive approaches.
4. When women and girls lack access to reproductive health information and service their health right suffer.
5. When young people are able to make healthy transition from adolescence into adulthood, options to expand their future are broad and bright.
6. Achieving the SDG agenda in 2030 is to make people in their reproductive health age more resilient particularly when it comes to reproductive health rights and choices in family planning.
7. Reproductive Health Rights embraced certain human rights that already exist in the national laws, international human rights documents and other United Nation consensus documents.
8. Lack of information on Sexual Reproductive Health Rights jeopardizes the education and the future of the young ones.
9. Lack of Family Planning and contraceptive services result each year in unwanted pregnancies or end in high risk abortions which ends in the deaths of women and girls each year