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.
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