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NIGERIA is currently the 7th most populous nation in the world with a fertility rate of 5.4 and an annual growth rate of 2.6 per cent. By 2050, the country is projected to become the 3rd most populous nation.
With a much lower annual GDP growth rate than the USA, the country’s resources cannot meet the needs of this rapidly growing population. But 15.7 million of the 45 million women of reproductive age in Nigeria want to avoid a pregnancy.
Sadly, 9.5 million (60.5 per cent) have an unmet need for modern contraceptives, also known as birth control, which helps women who want to plan their families and prevent pregnancy.
This results in the increasing rate of unintended pregnancies which can lead to unsafe abortions that account for 5-13 per cent of all maternal deaths and unplanned births.
Although the Nigeria Family Planning Blueprint, 2020-2024, outlines the country’s plans for achieving a revised target modern Contraceptive Prevalence Rate (mCPR) of 27 per cent by 2024, funding remains inadequate to cover the unmet need for family planning services.
In addition to the reduction of allocation to family planning in the 2021 budget, there was the recent announcement of an 85 per cent cut in funding to United Nations Population Fund, UNFPA by the UK government, further putting pressure on family planning programmes.
To press home the need for improved funding to ensure access to FP services, the Nigeria Health Watch last Thursday, June 24, hosted a family planning policy dialogue with the theme, ‘Domestic Resources Mobilization for sustained Family Planning Services in Nigeria.’’
The need for a strategic objective to improve domestic funding to adequately cover family planning costs countrywide through mobilisation of resources from new public and private sector funding sources formed the major crux of the discussion.
The dialogue brought together speakers and participants from federal and state governments, development partners, civil society organisations, youth groups and the public who discussed the current landscape for family planning services in Nigeria.
Participants also identified and discussed the consequences of the reduction in funding for family planning.
Seeking domestic sources to fund FP services
While delivering the keynote address, Co-founder of Rotary Action Group for Reproductive, Maternal and Child health, Emmanuel Adedolapo, a professor, said there was an impelling need to shift emphasis on reliance on foreign donors and leverage on local sources for funds to tackle family planning needs in the country.
He noted that the best way to achieve this would be for critical stakeholders to come together and prepare documents that would convince sources, both private and public, that every penny injected into the services would be well spent.
“We shall embark on a massive advocacy campaign to ensure that we get the proportion we need to inject into FP and sectors such as banking, oil and gas and communications, will be helpful in providing the required funds, “he said.
Earlier in her address, Managing Director of the Nigeria Health Watch Vivianne, Ihekweazu said it was worrying that the Nigerian population was increasing more than the economy, resulting in low investment in critical sectors, such as health which was just 0.6 per cent of GDP.
Impact of reduced funding on FP services
The impact of lack of adequate funding for FP services is far-reaching. Among these impacts as Head of Programs, Education as a Vaccine, Nigeria, Toyin Chukwudozie, noted, was the reduction in the availability of commodities for FP services.
Chukwudozie said this had resulted in increasing rate of unintended pregnancies which could disrupt education for young girls and lack of access to economic opportunities.
She maintained that there was the need to understand that behind the statistics of women with unmet needs for contraceptives, were real and young people who formed a greater percentage of Nigeria’s population.
Lending his voice, Country Director of Marie Stopes International Effiom Nyong Effiom said that the reduction in funding for FP services was partly as a result of the impact of COVID-19 on both foreign donors and the Nigerian government.
He however regretted that state governments had failed to reflect funding for FP services in their budgets, noting that FP was the cheapest means of reducing maternal death.
Recommendations to improve domestic resource mobilization
Part of the reason why several sectors continue to lag behind in Nigeria is the lack of favourable and well-thought-out policies by the government.
If FP services must improve in Nigeria, Country Representative of the United Nations Population Fund (UNFPA) Ulla Elisabeth Mueller said the right kind of policies and an enabling environment must be in place.
“We must think about our revenue and ensure that funds for FP services are not only captured in the budget but also allocated and prioritised, “she said.
She further noted that one of the major impediments to accessing family planning services was the proven dimension between men and women because only 46 per cent of Nigerian women aged 15 to 49 years made their own decisions regarding health care, contraception, and sex with their husbands or partners.
Similarly, Chairman of the Technical Management Committee, Association for Advancement of Family Planning (AAFP), Ejike Oji, a doctor, said it was necessary to begin with policy-driven investment such as making sure that it was made a legislative agenda at the National Assembly so it could get the kind of attention it deserved.
“We must educate our leaders so they can understand the importance of FP and where to invest funds. It is not just about asking them to provide funds. They need to know how important it is for the country, “he said.
In his address, Senior Health Specialist for the World Bank Nigeria Olumide Okunola said that to achieve a reduction in total fertility rate from 5.4, where Nigeria stood to 4, where the country needed to be, there was the need for a 24.53 per cent increase in mCPR.
If unmet needs for modern contraception in Nigeria are satisfied, unintended pregnancies would drop by 77 per centfrom 2.5 million to 555,000 per year while the number of unplanned births will drop from 885,000 to 200,000. Similarly, the number of abortions would drop from 1.3 million to 287,000.