By Chioma Umeha
Research shows that effective population control measures are the need of the moment. Studies have also confirmed that birth rate is mainly responsible for rapid population growth, hence experts have endorsed family planning as one of the most effective measures to reduce birth rate. CHIOMA UMEHA writes.
Worried by stock-out of contraceptive commodities and consumables, experts at the Performance Monitoring and Accountability (PMA) 2020, a recent family planning (FP) review, advocated increased funding for FP by state governments.
In view of high incidence of unplanned pregnancies, Funmi Olaolorun, the Co-Principal Investigator, PMA 2020, stressed that increased funding by state governments would tackle stock-out of contraceptive commodities and consumables in many states.
According to Olaolorun, many women who are unable to access contraceptives at the FP clinics end up with unintended pregnancies following commodities out-of-stock.
Many youths who are involved in such unplanned pregnancies procure illegal abortions as abortion is permitted under the laws of Nigeria only when the life of the mother is in danger as a result of the pregnancy; only then, can a medical abortion be done – to save the life of the mother.
Unintended pregnancies are pregnancies that are mistimed and unplanned at the time of their conception.
Unfortunately, many Nigerian teenagers, adolescents and married women find themselves with pregnancies that were never planned.
Figures from the Nigerian Urban Reproductive Health Initiative (NURHI), it is estimated that 6.8 million pregnancies occur in Nigeria annually, and for every four of these pregnancies, one is unplanned.
According to the World Health Organisation (WHO), a woman in developing nations including Nigeria dies of complications arising from an unsafe abortion every eight minutes.
Every year, worldwide, about 42 million women with unintended pregnancies choose abortion, and nearly half of these procedures, approximately 20 million of them, are unsafe.
Also, 68,000 women die from unsafe abortion annually, making it one of the leading causes of maternal mortality across the world. In Nigeria, unsafe abortion contributes 13 per cent of maternal deaths.
Of the women who survive unsafe abortion, five million will suffer long-term health implications. Unsafe abortion is therefore a pressing public health issue, according to medical experts.
Similarly, the Federal Ministry of Health (FMOH) statistics shows that more than one-third of all pregnancies in the country are unintended, and one in five end in abortion.
In addition, the FMOH figures shows that two-thirds of unintended pregnancies occur among women who were not using any method of contraception.
Olaolurun therefore reasoned, “The way out of unintended pregnancies is to prevent contraceptive stock-out by making FP commodities easily accessible all year round to those that need them.”
Presently, the contraceptive prevalent rate (CPR) of Nigerians in the reproductive age bracket is 15 per cent. What this means is that of the total number of women in this age bracket needing contraceptives only 15 per cent accesses and uptakes these live-saving commodities.
Dr. Habeeb Salami, Assistant Director for Reproductive Health & Family Planning at the Pathfinder International, described the current CPR in the country as very low, bemoaning that this has been increasing unintended pregnancies, often resulting in unsafe abortions.
The Federal Government has intensified the campaign to increase uptake of FP with the formulation of the new policy to increase the CPR to 36 per cent by 2030.
The goal is to improve the CPR uptake with a view to tackle unintended pregnancies and unsafe abortions
Presently, the Lagos State Government is executing a policy that targets the achievement of 70 per cent CPR in its domain.
Habeeb who is a medical doctor with a specialisation in obstetrics and gynecology, blamed many state governments for stock out of contraceptive commodities, adding that their lack of commitments to making FP commodities available all year round was at the centre of the problem.
According to him, although, the Federal Government has paid for FP commodities, imported them and stored same at the Central Stores in Oshodi, Lagos, the failure of some state governments to transport the products to their states and point of delivery ultimately creates scarcity of same products that sometimes waste away at the Central Stores.
Habeeb said; “Federal Government procurers all FP commodities and sends them to the Central Stores; the state governments don’t pay.
“It’s so bad that when the Federal Government procures and sends them to the Central Stores in Lagos, a lot of states have difficulties in picking them up from Lagos.
“The Federal Government goes the extra mile to send these products to State warehouses; yet, there are still challenges from the States to get these commodities from the State warehouses to the health facilities where they are needed.
The Assistant Director for Reproductive Health & Family Planning explained; “The Federal Government and its partners are still working on getting those commodities to facilities where they will be used
“The Federal Government has done so much that the states need to complement those efforts.
“Based on the Federal Government procurement, FP commodities in all states should be free. What a client that needs them is expected to do is simply walk into a FP clinic, discuss with the provider, agree on a method, they give it to the fellow and the person walks away.”
However, the set back is that the states are not able to buy consumables including cotton wools, gloves, all of which the providers need to deliver the services.
“These are the things that should be available which states need to provide funding for so as to ensure that FP services are provided free,” he added
The assistant director for Reproductive Health & Family Planning at the Pathfinder International, painted a picture of how citizens are denied the contraceptives which the Federal Government has provided free.
He lamented that when people who need FP services arrive to access them, FP commodities are available but consumables are lacking and they are told to pay for the consumables which may be as little as N200. “A lot of women can’t still afford the N200; so, they walk away.”
Based on what plays out afterwards, Habeed said, “The next time you see these women they are pregnant, not because they want to be pregnant.”
However, some factors hinder these group of women from uptaking FP services , he said, stressing that it is stock out which is either occasioned by non-availability of FP commodities in facilities where they are needed and lack of consumables.
Another factor hindering uptake of FP commodities is financial barrier, he added.
Confirming that Lagos state is trying to earmark some money for consumables, Habeeb said “but it is not enough.”
He noted that there is need for budgets on consumables by local government councils and Primary Health Care Wards in Lagos state, adding that this will ensure that there is no out-of-stock.