Southern African nation praised for meeting contraception demands, but challenges loom as nation’s youth—now 50 percent of population—approach childbearing age
LILONGWE, MALAWI (10 January 2013) – As a UN task force crafts a new set of development goals to replace those that will expire in 2015, a high-profile delegation that features former presidents, prime ministers and leaders in global health and philanthropy gathered today in one of the world’s poorest nations to demand a dramatic increase in donor support for family planning services.
The officials are members of the Aspen Institute’s Global Leaders Council for Reproductive Health (GLC). They chose Malawi as the place to make their stand for reproductive rights because the country has made unprecedented progress in improving access to family planning services. The Council delegation in Malawi includes former Irish President Mary Robinson, former Latvian President Vaira Vīķe-Freiberga, former South African Deputy President Phumzile Mlambo-Ngcuka, former Minister of Health of Botswana Joy Phumaphi, Musimbi Kanyoro, President and CEO, Global Fund for Women, and Annie Lennox OBE, singer, songwriter and HIV activist.
“Malawi embodies the challenge confronting many nations in the developing world where leaders are trying to save thousands of lives and improve living standards for all by respecting women’s rights, and giving women the tools to decide how many children to have and when to have them,” said Joy Phumaphi.
President Mary Robinson noted that while Malawi has made great strides, recent studies by two independent research groups suggest thousands of women continue to lack access to basic reproductive health services. She said meeting their needs is crucial to reducing the high rate of maternal mortality in Malawi, where it is the leading cause of death among women of child-bearing age. In Malawi, on average 800 women die every day either in childbirth or from pregnancy related problems, and 90 percent of those deaths are considered preventable.
Drop in aid for reproductive health services puts success at risk
Despite the desperate need in Malawi and other countries in Africa and parts of Asia and Latin America, family planning aid trails behind other health funding. As a proportion of total health overseas development assistance to all developing countries, funding for family planning has steadily decreased over the last decade—from 8.2 percent in 2000 to 2.6 percent in 2009. Family planning aid to 68 priority countries for maternal and child health fell from US$723 million in 1995 to US$404 million in 2008.
“There are many things contributing to this tragedy but a key part of the solution in Malawi and elsewhere in the developing world is to ensure that just like in wealthy countries, every woman is able to decide when she wants to get pregnant and how many children to have,” said Dr. Musimbi Kanyoro. “When the more than 220 million women worldwide who want contraception are given access to it, we will see fewer unintended pregnancies, fewer unsafe abortions, and a dramatic drop in the number of maternal and infant deaths.”
A recent study by the United States Agency for International Development (USAID) shows the potential to rapidly scale-up family planning services in Malawi, noting that that between 1992 and 2010, contraception use jumped from 7 percent to 42 percent. The authors linked the progress to work undertaken by the Government of Malawi and buttressed by the efforts of NGOs and investments from donor nations.
Yet today, one out of four women in Malawi who would like to plan her family still cannot obtain contraception, a problem that contributes to the country’s high maternal mortality rate.
“Women who get pregnant too young or too often are the ones most at risk of dying from pregnancy complications,” said President Banda. “I launched the Presidential Initiative for Maternal Health and Safe Motherhood, because we must improve access to reproductive health services for women in Malawi. By helping our women to be strong and healthy, we will lift our nation out of poverty.”
A second study by the African Institute for Development Policy (AFIDEP) and Population Action International warns that, with youth comprising 50 percent of the nation’s population, maternal health problems in Malawi are likely to intensify absent larger investments in family planning services. Family planning also is viewed as a critical component of efforts to deal with the effects of population growth on food security.
Malawi’s population has surged from 3 million in 1950 to 15 million in 2010. It is expected to reach 50 million by 2050 and more than 120 million by 2100. “This growth is mostly driven by high fertility, which has declined modestly from 7.2 children per woman in 1970 to 5.8 children per woman in 2010,” the study said.
“As a Council, we also want to promote empowerment of girls directly from an early age,” said Mlambo-Ngcuka. “This way, they can make the right choices, avoiding premature sexual engagements and staying in school longer.”
Singer Annie Lennox said her approach to advocacy builds on her experience of being a woman and mother to engage women worldwide in the battle for the rights to reproductive health services and good medical care. “My entry into this is through my gender,” Lennox said. “I am a mother and I have given birth to a stillborn child. I realized at the time that millions of other women have gone through this experience, and if I did not have good medical care, I could easily not have survived.”
Global Leaders call nation’s political commitment unprecedented, but urge role for donors
Robinson noted that Malawi’s President Joyce Banda and her administration remain committed to family planning as an essential health service. She said President Banda is reaching out to women in rural areas, working at the village level to convince men and influential elders that by improving maternal health, reproductive services ultimately contribute to stronger and more stable families and communities.
Malawi was one of three countries in sub-Saharan Africa awarded the 2012 Global Leaders Council Resolve Award for its efforts to dramatically improve access to family planning services.
“The President has launched a new Initiative on Maternal Health and Safe Motherhood that seeks nothing short of universal access to reproductive health services,” Robinson said. “Now we need to see the international community step up and support a government that is ready to act and has proven it can achieve results quite quickly.”
Robinson is the chair of the Global Leaders Council, a group of eighteen women and men who are sitting and former heads of state, high-level policymakers, and leading voices in international health. Their goal is to increase attention to this neglected area by working with leaders at the highest level and by linking reproductive health issues to the broader economic development agenda of already vulnerable nations.
“President Banda is a founding member of the Global Leaders Council for Reproductive Health, serving as a model for other African and world leaders in advocating for reproductive rights for women worldwide,” said Global Leaders Council Director Peggy Clark.
“The President’s message is clear, whether she is speaking to the world’s leaders at the General Assembly in New York or to the chiefs who run Malawi’s villages,” Clark said. “She reminds all of them that investing in reproductive health will pay enormous dividends in development. When women and men have access to voluntary family planning, poverty rates go down, education rates go up and greater prosperity for families and their communities follow.”