Chikezie Omeje

A new report launched on Tuesday by the Family Planning 2020, FP2020, has ranked Nigeria among the worst countries in the delivery of family planning services. Nigeria is second to India in a global ranking on the number of women that die as a result of pregnancy.

The report used as baseline the target set at the 2012 London Summit on Family Planning where countries made a commitment to mobilise resources to enable 120 million women and girls use modern contraception by 2020 in 69 poorest countries, including Nigeria.

Despite significant global progress which has given more than 30 million additional women and girls access to modern contraction across the 69 FP2020 focus countries,  Nigeria is still among the poor performing countries.

According to the report, there are more than 300 million women and girls using modern methods of contraceptives this year, a development that has  averted 82 million unintended pregnancies, 25 million unsafe abortions and 124,000 maternal deaths.

Nigeria’s poor records of family planning have been attributed to the inability of the Nigerian Government to fulfil the pledge it made at the London Summit in 2012.

Nigeria made a commitment to increase its total funding for reproductive health commodities from $3 million to $11.3 million annually over four years, but it has so far released only about $3 million since 2012.

Chairman, Association for Advancing Family Planning, AAFP in Nigeria,  Ejike Oji said the government has failed in its commitment  to family planning as only about $3 million has been released so far by the federal government since 2012.

In Africa, according to the FP2020 Report, Eastern and Southern African countries have experienced the fastest growth in the use of modern methods and the steepest decline in unmet need, adding that for the first time, more than 30% of women are using a modern method of contraceptives in the regions.

The progress in eastern and southern African countries is in sharp contrast with Nigeria where only 2.7% of women of reproductive age are using a modern method of contraceptives whereas Nigeria committed at the London Summit to increase the percentage of women and couples using contraceptives by 2% each year to reach 36% by 2018.

Nigeria is in the group of poorest performing countries, such as Benin, Central Africa Republic, Chad, DR Congo, Eritrea, Gambia, Guinea, Mali, Mauritania, Niger, Somalia, South Sudan, and Sudan.

Due to the poor performance of these countries, the FP2020 fell short of reaching 19.2 million women and girls to be on the right track of achieving the 2020 target. Though the report noted that exciting progress has been achieved and more women and girls have been reached more than historical trends would predict.

Oji, a medical practitioner, said family planning could reduce the number of women that die as a result of pregnancy by up to 30%.

He lamented that within every three hours, 15 Nigerian women and girls will die due to pregnancy related causes, noting that about 70% of these deaths occur among women aged between 13 and 19 years.

He disclosed further that  Nigeria currently has a maternal mortality ratio of 576 deaths out of every 100,000 live births. “This translates to about 40,000 women dying every year, 111 dying every day, or 5 people dying every hour,” he added.

FP2020 Report noted that Nigeria has only added 1,628,000 modern contraceptive users since 2012 which resulted in increased contraceptive prevalence rate to 14.7%, compared to 12.1% in 2012.

This little progress by Nigeria, according to FP 2020 Report, averted 1,450,000 unintended pregnancies and prevented 9,000 maternal deaths through the use of modern contraceptives in the past year.

The report stressed the need for Nigeria to accelerate progress on family planning services as the population of women of reproductive age grows by more than 1 million every year in the country.

The President of Association for Reproductive & Family Health,  Oladapo Ladipo, a professor, called on Nigerians to push for the ban on child marriages as girls are too young and often have obstructed labours which contribute mainly to a large proportion of girls that die from pregnancy-related causes.

He said family planning revolves around three reasons which include health, economy and human rights, pointing out that family planning would reduce infant and maternal mortality as well as reduce poverty.

Ladipo said that family planning is central to achieving Sustainable Development Goals, SDGs, noting that women should have access to free family services.

The representative of Nigerian Urban Reproductive Health Initiative, Charity Ibeneme pointed out that family planning is not just about women and there are also family planning services for men.

She argued that Nigerian men should start using vasectomy to complement their spouses while emphasising that both Christianity and Islam support family planning.

Evidence from the Nigerian Demographic and Health Survey of 2013 indicates that Nigeria has not made a significant improvement in its uptake of family planning services over the last 10 years. The contraceptive prevalence rate has remained the same at 10% for the past 10 years with a marked difference between the urban and rural areas which are 17% and 6% respectively.

The use of the modern method of conception is particularly very low in the northern part of the country with less than 3% of women in the North East using contraceptives while in the South West, as much as 25% of women of reproductive age make use of modern contraceptives.

The FP2020 Report urged Nigeria to change social norms around family planning so that the topic is less taboo and also improve counselling and education to increase demand for contraceptives.

Nigeria was also admonished to  ensure women can exercise informed choice as well as establish the infrastructure and health care  providers to deliver quality family planning services.

The report noted that the low rate of contraceptive use by Nigerian women reflected high fertility desires and limited access to information about family planning, thereby making it difficult for Nigeria to accelerate progress.