When I read that the worlds’ population would soon reach 7 billion people, it wasn’t so much that we reached the next billion that was a surprise, it was the pace at which it happened. Only 12 years after we reached 6 billion in 1999, we have added another billion people to the planet and unfortunately, the majority of growth is in developing countries. Also concerning is that one half of the world lives in poverty (living on less than $2 per day) and amazingly Africa will double it’s population by 2050.
These alarming numbers should have us thinking about how to slow the world’s growth. One obvious place to start is to prevent unintended growth i.e. unplanned pregnancies which are estimated to be over 70 million in developing countries. By reducing these unplanned births, we will not only slow the growth of our population but also on the flip side, reduce the number of maternal deaths and complications, and unsafe abortions. According to a UNFPA publication, it is estimated that meeting the needs for modern contraceptives would prevent about one quarter to one-third of the 500,000 maternal deaths that occur each year in developing countries. Since family planning is included as one of the Millenium Development Goals (MDGs), more countries and NGO’s will be looking to create or expand family planning programs.
So you can either advocate for family planning because you want to stop unnecessary births or stop unnecessary deaths – either way it’s an investment worth making. So what kind of family planning programs work? As I mentioned in a prior blog entry, designing public health interventions should be an evidence-based process so looking for examples of success is the place to start.
The book “Case Studies in Global Health Millions Saved” describes the Bangladesh Family Planning Program as a successful intervention. In a nutshell, their community-based approach coupled with the provision of a wide range of contraceptive services to the people increased contraceptive use from 3% to 54%. The fertility rate in Bangladesh was reduced from 6.3 in the 1970’s to 2.7 in 2007. The key components of this program include the deployment of outreach workers who conduct home visits offering contraceptive services and information, the provision of a wide range of contraceptive methods and the establishment of family planning clinics in rural areas.
It’s clearly not a one-size fits all problem – solutions will need to be created to suit each country’s needs and context. The UNFPA’s 25th Anniversary edition of Outlook, entitled “Reducing Unmet Need for Family Planning: Evidence-Based Strategies is a good summary document.
The Bangladesh program does prove that once people were educated about their options, they made better decisions. Once the world’s most remote communities are connected to the internet (either wireless or by cable – this day is inevitable and likely not far away) we will need to use our creativity to teach the world’s poor about contraception. Maybe we could eventually offer a reduced fee for internet service for families with less than 3 kids…just a thought.
Better family planning is one way to stop both unintended growth and unnecessary death.