Political will, right investments key to global family planning
General Jose “Oying” Rimon II, Director, Bill & Melinda Gates Institute for Population and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, tells LILIAN KAIVILU what governments need to do to accelerate uptake of family planning.
What would you say is the state of family planning uptake, especially in Africa?
Africa is doing well in many ways. Kenya, in the last two demographic health surveys, has increased its modern methods of contraception by about two to three per cent a year.
One may think that two percent is not that high, but it is spectacular. With a growing population, the improvement is significant.
There has also been huge increases in use of modern contraceptives in Ethiopia, which has a very effective primary healthcare system through the health extension workers of which family planning is a prominent part of their work.
We have also seen major increases in uptake of modern contraceptives in Malawi.
Of course, there are areas where the growth trend is stalled, but this is a question of time and they will also begin to catch up.
What does this mean for the specific countries in the continent in terms of planning?
In my opinion, there is no way countries in Africa can reach their own version of Sustainable Development Goals without investing in family planning and reproductive health.
When you invest in family planning, you reduce maternal deaths by up to three quarters, infant deaths by 25 per cent and empower women by relieving them of having to take care of so many dependents.
Investment in family planning will also allow women to enter the labour market. If there is one investment you can make as a politician or policy maker is to invest in contraception and you will positively affect all SDGs.
For every dollar you invest in contraception, you can reap an equivalent of Sh12,000 benefit to society.
Do you think the upward trend in the uptake of modern contraception is due to political goodwill or a change in people’s attitudes?
It is both. If you have political commitment and will, 50 per cent of the solution is already there.
This way, the resources will be available, the right progressive policies put in place and pursued, and more likely to be sustained over time. But political will is not enough.
The kind of investments you make makes a difference. We, at the Gates Institute, believe in the 20-80 per cent approach where you pick the best 20 per cent of the high impact intervention and get 80 per cent results. This way, you don’t have to do everything.
The Bill and Melinda Gates Institute has been running the 120 Under 40 Leaders programme. What has been the impact so far?
Absolutely stunning. For a long period after the 1994 International Conference on Population and Development (ICPD), we were looking for people to offer leadership in family planning, but we couldn’t find them.
We then decided to choose 100 people by 2020. That’s how the 120 Under 40: The New Generation of Family Planning Leaders programme was born. These are young people who are champions of family planning.
This opened doors for them to be recognised, raise money and so on. If one is a member of the 120 under 40, they can also apply for a fund up to Sh2 million to support their idea. It is a global competition and Peter Ngure is one of the beneficiaries.
One of the issues around the ICPD25 Nairobi Summit was the commitment to achieving zero unmet need for family planning information and services. Is there such thing as zero unmet need for contraceptives?
There is no such thing as zero unmet need. That is just a conceptual idea because in many countries in the world where contraceptive prevalence is below 35 per cent, the more you increase it, the more the unmet need increases. But the numbers differ from country to country.
That’s why statistically speaking, zero unmet need is almost impossible. Populations are growing every day and more people are getting to the reproductive age daily.
