April 3, 2012

Family planning: A force for good across Africa

Last year, I visited a mother’s group in the Korogocho slum in Nairobi to learn more about family planning in Africa. At the end of our conversation, a woman named Mary Ann told me something I’ll never forget. She said she plans her family because she wants to “bring every good thing” to one child before she has another.

That desire to bring every good thing to our children must be universal, because it is also why my husband and I planned our family. We have three children, and we spaced them three years apart so we could give each one the attention they deserved. One billion people around the world use contraception for the very same reason.

My top priority as a Co-chair of the Foundation I run with my husband is making sure that all families have access to safe and effective contraception tools that empower them to make a decision about what’s best for them and their family. And that means encouraging aid donors and governments here in Nigeria and across Africa to make family planning a priority.

Family planning saves lives. In Nigeria, just 10 per cent of married women use modern methods of contraception and women face a 1 in 23 lifetime risk of dying during pregnancy or childbirth. Globally, more than 100,000 women who didn’t want to be pregnant die during childbirth every year.

And about 600,000 women who didn’t want to be pregnant give birth to a child who dies in her first weeks of life. Spacing births three years apart is much healthier for mother and child. If all births were spaced at least 36 months, it would save almost 2 million children every single year.

Saving so many lives is justification enough. But family planning doesn’t just save lives; it also makes life better for families and communities, becoming a key driver of economic development. When parents can have the number of children they want, when they want them, they are more likely to be able to care for them properly. They can invest more in their health and education, and in the long run their children have greater opportunity.

The data prove this. In Bangladesh, there is a district called Matlab where researchers have been collecting data on 180,000 inhabitants since 1963. It may be the longest-running, most rigorous study in the field of global health, and it proves in minute statistical detail how access to contraceptives transforms a family’s prospects.

Starting in the 1970s, half the villages in Matlab were randomly chosen to get easier access to, and extra education about, family planning. Twenty years later, the people in those villages had a higher quality of life than their neighbors in many ways. They were better nourished, their households had more assets, and their children attended more school.

If you multiply these effects times millions of families—and combine them with investments in areas like nutrition and vaccination—the product can be large-scale economic development. A lot of people talk about the East Asian economic miracle of the 1980s, when the Gross Domestic Product in countries throughout the region skyrocketed. It wasn’t really a miracle; in large part, it was the result of many countries supporting families’ desire to plan.

These sweeping national and regional trends start with individual families making decisions about what is best for their children. When families in Nigeria and across sub-Saharan Africa are given the opportunity to make those decisions, it will contribute to a virtuous cycle of development in many African communities.

Our foundation is based on the belief that all lives have equal value. One of the most damaging inequities I’ve seen is the lack of access to family planning services across the African continent. A relatively small and extremely cost-effective investment will help families bring every good thing to their children. It is time for governments to make that investment. It will be a force for good across the continent.

Melinda Gates Co-Chair of the Bill & Melinda Gates Foundation wrote this.