Hand in hand: life-saving family planning and universal health coverage
After being thwarted by the eruption of Mount Rinjani last November, the 4th International Conference on Family Planning is now underway. More than 3,000 participants are expected, from all corners of the world. For months, the importance of family planning has been highlighted on social media, in anticipation of this event.
The message is clear – family planning saves lives. It is estimated that satisfying the current unmet need for contraception would reduce unintended pregnancies by 70% and unsafe abortions by 74%, thereby avoiding the preventable deaths of thousands of women and girls, mostly in low-income countries, every year. We know that enabling women to decide if and when to have children is essential for their own health and the health of their families. Access to safe, effective, voluntary and acceptable contraception of their choice allows women to time and space their pregnancies, thereby reducing the numbers of premature births and low-weight babies and improving the survival and health of newborns and infants.
But more than 200 million women worldwide still do not have access to effective contraception and, while rates have been declining, some 303,000 women were estimated to die of complications during pregnancy and childbirth in 2015. And 5.9 million children under-five died in 2015, from largely preventable causes – with neonatal deaths accounting for almost half of under-five deaths. It is still the poorest, those with the least education and those living in remote areas who have the highest rates of preventable mortality and ill-health. Increasingly, attention is being given to adolescents, who often face particular barriers to accessing sexual and reproductive health services.
We all know what needs to be done to ensure the health and rights of women and children. Ending preventable maternal and child deaths and ill-health requires changes and interventions that are well understood:
- enabling women and girls to exercise autonomy over their sexual and reproductive lives and the full enjoyment of their human rights, as well as access to health services and information and freedom from coercion, violence and discrimination
- a commitment to universal coverage of essential healthcare – including good-quality reproductive, maternal, newborn and child health services – free at the point of use, for everyone, not just those who can pay for it.
Over 20 years ago, the Cairo Programme of Action, agreed by 179 governments, committed to ensuring human rights and dignity, including the equal rights of all women and girls, and universal access to sexual and reproductive health. Fast-forward to 2015 and the new Sustainable Development Goals (SDGs) include a target to ensure universal access to sexual and reproductive healthcare services by 2030. It should not take this long.
Family planning must be fully integrated in the reproductive, maternal, newborn and child health continuum of care. And governments must make their commitment to the SDG target on universal health coverage a reality by putting sexual and reproductive health services at the heart of primary healthcare.
The family planning conference will be followed by the Women Deliver 4th Global Conference and the G7 leaders meeting in Japan, in May. Both are opportunities to demonstrate a clear commitment to universal health coverage as key to reaching all women and children with essential health services. They are also an opportunity to break down silos and combine efforts in advocating for stronger, integrated healthcare systems that can provide quality care for all women and children everywhere, without incurring the risk of destitution or of detention for inability to pay hospital fees.
As highlighted recently in The Lancet, universal health coverage and the new Global Strategy for Women’s, Children’s and Adolescents’ Health go hand in hand. Both are a necessary pre-requisite for making real and equitable progress on maternal and child health and realising the ambition of the SDGs.