A recently concluded conference on reproductive health rooted for the use of contraceptives among women and integration of family planning services in HIV care.
African Women Leaders Network for Reproductive Health and Family Planning (AWLN) brought together women from various sectors including health stakeholders in Nairobi to discuss ways of saving 300,000 mothers between 2012 and 2020.
Another summit on Family Planning was held in London last year to call for global political commitments and resources that will enable 120 million more women and girls to use contraceptives by 2020.
The Nairobi conference explored the connections between family planning and reproductive health and rights, abortion related deaths, HIV/Aids and gender-based violence.
Reports say HIV is still the leading cause of death among women of reproductive age. It was also pointed out during the meeting that accessing family planning has been a major barrier to women living with HIV/Aids thus making it impossible to prevent mother-to-child transmission.
This is because majority of HIV infections are sexually transmitted or associated with pregnancy, childbirth and breastfeeding. Thus to be able to effectively deal with HIV epidemic, it is important to focus on these underlying issues.
Reproductive health services
Since HIV does not eliminate desire for children, the people living with this condition should not be left out when rolling out reproductive health services.
While some people living with HIV believe that having children gives them hope to live, others bear children to avoid raising suspicions about their health status in some societies where the condition is still stigmatised according to reports.
The stigma leads to fear of making the status known to loved ones, makes it difficult to discuss safe sex and leads to reluctance in getting tested.
This is another reason why HIV services should be integrated into comprehensive family planning because unmet need for contraception and unplanned pregnancy are prevalent among HIV-positive women in sub-Saharan Africa.
While research has shown that women on contraceptives are healthier, wealthier and better educated, there are still numerous challenges to fully achieve this. This starts with the myths surrounding modern family planning methods and lack of enough information to target the right group.
Several women do not even know about contraceptives and those who know about it fear to embrace the same due to misconceptions that surround the same including fear of infertility.
Studies have pointed out that concerns about side effects of contraceptives especially irregular bleeding has been a major issue that needs to be urgently addressed for family planning to be effectively embraced in Africa.
Faith based organisations
Not to mention some faith based organisations that do not support family planning. For instance in DR Congo, Catholic schools are very reluctant to discuss these methods in school.
Thus penetrating faith based organisations that do not support these methods remain an uphill task across the continent.
Speaking during the conference, Halima Sharrif from Advance Family Planning in Tanzania called for advocacy for research in the subject to help various African governments to domesticate to their relevant environments.
She also pointed out that packaging of family planning products and messages needs to be appropriate as opposed to traditional population billboards indicating that the best family consists of two children.
She also said the way society intercepts woman’s ability to make choices regarding reproductive health leaves a lot to be desired. Information we receive is gendered and it is entirely left as a woman’s burden as men sit to watch from a safe distance.
This lack of male focus is a glaring gap in the effective adoption of family planning which needs to engage both men and women.
Ms Sharrif commended Tanzania government saying the enabling policy environment in the country has enabled contraceptive users to double from 2.1 million to 4.2 million. This, she said, is because of the expanded access to the products and services through public and private facilities.
“Community based services also need to be strengthened to reach as many people as possible,” she said.
Ms Murugi Murekio from the International Planned Parenthood Federation, Africa said for family planning to work effectively, all stakeholders need to be involved. She emphasised that many a times; youth who are sexually active are left out leading to faster spread of the HIV virus.
“Youth need to be involved in family planning since they are at a stage where they always want to experiment and reproductive health information is very crucial to them,” she said.
While urging legislators to ensure implementation of reproductive health services, Sarah Mukwasa who is a family planning lobbyist from Uganda gave an example of Ethiopia where budgetary allocation of family planning has increased from $7.6 million to $9 million.
“Uganda has also done remarkably well as far as reproductive health is concerned with $30 million being earmarked for the same. Seventy-five per cent of this amount will be dedicated to family planning,” she said.
Because of this, contraceptive use in Uganda has increased from 25 per cent to 30 per cent in Uganda even among people living with HIV.
She urged parliamentarians to use their positions to demand that HIV prevention and treatment services are linked to sexual and reproductive health services and that enough resources are put into addressing the same.
It is also good to replicate successful practices in some countries like Swaziland for instance where the government has launched ambulances to eight kilometres radius for every clinic in the four administrative regions of the tiny kingdom.
According to Nohlanha Dlamini who is Swaziland’s government chairperson for health, the ambulances operate for 24 hours to help transport people to the nearest hospitals.
“This has significantly reduced the number of women giving birth at home unattended and lowers chances of transmission during birth,” she said.
In Zanzibar, community health workers are required to bring report on a monthly basis on reproductive health.
According to Ms Hanuni Sogora from Zanzibar’s Ministry of Health, “the community health workers are annually given refresher courses on family planning and HIV services to ensure they work effectively,” she said.
The way forward is to eliminate new infections among newborns and ensure their mothers are alive as stipulated in the fifth Millennium Development Goal of improving maternal health by preventing HIV infection among women and providing family planning for women living with HIV of childbearing age.
This means family planning would not only help reduce the number of unplanned pregnancies among women living with HIV but also stop new infections.
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