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.
