Family Planning

This article was originally posted on K4Health’s Blog.

It’s late in the evening in a hard-to-reach village in the Malawian District of Nkhotakota.  There is no electricity in this village, nor in the Bua community health center that serves 11,280 people, including a pregnant mother who goes into pre-term labor. The local Health Surveillance Assistant (HSA) is called to provide assistance because the local maternity nurse is not at home.

A common challenge in advancing family planning is overcoming the misconceptions religious leaders have about the use of contraceptives.

Concerns from religious leaders are often based on misconceptions about family planning methods rather than their religious beliefs. The fear that hormonal methods will cause infertility or are dangerous, are commonly expressed as concerns from religious leaders.

These methods are 300 times safer than becoming pregnant in Afghanistan and about 100 times safer than pregnancy in Yemen, Malawi, and Tanzania is an appropriate way to look at the risks versus benefits.  My experience in these four countries has been that this message was well received by both Muslims and Christians, along with the sound evidence for improved child and maternal health outcomes with healthy timing and spacing of pregnancy (HTSP). 

With sometimes impenetrable terrain and limited infrastructure, Yemen presents a very challenging environment for delivering health services to rural areas. Basic health services do not reach most women; rural areas lack health facilities; and Yemen’s conservative cultures do not allow women to receive health services from men, or to freely come and go from their home.

In Yemen, through a pilot program, the Extending Service Delivery (ESD) Project supported the Basic Health Services (BHS) Project to assist midwives with setting up private practices in rural communities where facilities did not exist or were too far away. Midwives are generally respected in Yemen communities and, most husbands allow their wives to visit the midwives in their homes.

Next month in Vienna, Austria, thousands of activists, community workers, donors, health leaders, and government officials will gather for the VVIII International AIDS Conference.  This year’s theme is Rights here, right now: a mandate on the importance of health as a human right for all.  While it is easy to talk about health as a human right, it is much more difficult to deliver to diverse communities in some of the poorest countries around the world. 

Last year when President Obama announced his Global Health Initiative (GHI), he spoke about meeting the health needs of the world by leveraging current resources and integrating programs for greater health impact. Integrating HIV & AIDS services with other health services such as reproductive health (including family planning), TB, malaria, or maternal and child health increases effectiveness and ultimately sustainability. 

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