News and Events
The right to plan
By Ugochi Daniels
Country Representative, a. i., UNFPA Nepal
At the very heart of the Universal Declaration of Human Rights is the freedom of choice. World Population Day serves as a reminder of this commitment to human dignity. Being able to choose when and how many children have to allow women to exercise their basic human rights.
Family planning is essential to women's empowerment and gender equality. When a woman can plan her family, she can plan the rest of her life. Having fewer, healthier children can reduce the economic pressure on poor families and allow them to invest more in each child's care and schooling, helping to break the cycle of poverty. Smaller families mean education is more likely for all family members- a particular benefit for girls.
Family planning as a part of reproductive health services protects the health of women, mothers and their babies. An estimated 68,000 women die every year from unsafe abortions. Millions more suffer long-term disability. It means every minute, somewhere in the world, a woman dies in pregnancy or childbirth.
Women's lives are put at risk when they lack access to health services vital for maternal health: skilled attendance at birth, emergency obstetric care and family planning. One in three of all deaths related to pregnancy and childbirth could be avoided if women, who wanted effective contraception, had access to it.
In Nepal, despite a significant decline from 539 mothers' deaths per 100,000 live babies born in the late 1990s to 281 deaths per 100,000 live births ten years later (Nepal Demographic and Health Survey 2006), an estimated 18 percent of all female deaths fall into the category of maternal deaths. This is still a significant number.
The most vulnerable are young girls. Complications during pregnancy and childbearing are the leading causes of death for girls aged 15 to 19 in developing countries. They are twice as likely to die in childbirth as women in their 20s. The issue is pertinent in Nepal as, according to different estimations, 10 to 20 per cent of women in Nepal are married by the age of 19.
Young women have unequal power in negotiating safer sex. They also face challenges in accessing services, including lack of information, shame, discriminatory laws, health provider attitudes and practices, and social norms. Married adolescent girls generally do not have control over condom use and cannot refuse sexual relations. They are often married to older men with more sexual experience, which puts them at risk of contracting STDs, including HIV.
According to the Nepal Demographic and Health Survey 2006, while there is hardly a person in Nepal who has not heard about at least one method of contraception, the unmet need for contraception among women is estimated at 22 percent. This means one in five women between 15 and 49 years is unable to plan her life. The average marks an even greater unmet need for women from poorer backgrounds than for women from middle and upper classes, who use modern methods of contraception more often.
Improving access to information on family planning and contraceptives is essential and affordable. Universal access to contraception education and materials, as well as to counseling in sexuality, health and reproductive rights are necessary. In addition, access to a range of safe and effective contraceptive methods in health facilities and through social marketing and local outreach are necessary if the right to family planning is to be ensured.
National and local discussions of the rights of men and women in relation to their bodies, health, education and access to economic and social resources should be promoted. The work of NGOs and civil society are crucial, particularly for creating a broad coalition of support from groups and individuals. Involving men in promoting family planning cannot be overlooked, as they are partners in decisions and choices concerning the right to family planning. Mass media have their role to play through campaigns to educate people on the benefits of smaller families.
Family planning should be among the priorities in the development agenda as it is an investment. High-level political and financial commitment to promote family planning is urgently required. According to UNFPA estimations, each dollar spent on family planning can save governments up to US$31 in health care, water, education, housing, sewers and other waste disposal, etc. World Population Day is an occasion to plan for accelerating efforts to achieve the Millennium Development Goals to eliminate extreme poverty and hunger and to improve the health of people. UNFPA reassures its commitment to support health and equal opportunity for people in Nepal and supports the government to ensure universal access to reproductive health.
Published in 'Kathmandu Post', July 11th, http://www.kantipuronline.com/kolnews.php?&nid=153129
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