Population surge threatens achievement of SDGs

Family Planning Will Avert 140,000 Maternal Deaths Yearly- NPC

As the world prepares to mark this year’s World Population Day on Tuesday, July 11, Nigeria’s alarming population explosion in the midst of rising poverty, absence of basic amenities, and very poor per capita income are coming up strong as major concerns.According to the recent United Nation’s report, Nigeria’s population, with a growth rate of 54.8 per cent, will topple that of United States (over 300million) in year 2050.

The report, which the global body published in its new “World Population Prospects: The 2015 Revision,” projects Nigeria to become the world’s third most populous country in the next 33 years.

According to the UN, this population surge would sure pose a challenge againstachieving the Sustainable Development Goals (SDGs), which are aimed at improving healthcare, education and equality, as well as, ending poverty and hunger particularly in the developing world.

On September 25, 2015, Nigeria was among the 193 member states of the UN to unanimously adopt the 2030 Agenda for the 17 SDGs. But with the high population growth, global partners are worried that malnutrition, hunger, disease will be difficult to eliminate, especially since budget allocation to health, education remain poor.

Presently, about 2.5 million children are at risk of death from severe acute malnutrition, while more are dying from vaccine preventable diseases, according to the United Nations Children’s Fund (UNICEF). The insurgence in the North East has further increased the hunger and malnutrition crises, making it difficult to access potable water, and health facilities, their report said.

Up till now, the country’s maternal and under-five mortality rate remains one of the worst in the world, with 111 women are dying every day from pregnancy-related causes, as well as 2,300 under-five children, going by the National Demographic Health Survey (NDHS, 2013).Despite these public health challenges facing the country, the health budget remains low, that is less than five per cent of the national budget, which of course is a far cry from the 15 per cent benchmark agreed by African heads of states.

Also worrisome is the depreciated value of the naira against the U.S. dollar; rising inflation; withdrawal of foreign donors, all of which are affecting standards of living. In addition to this is the fact that in spite of the country’s high disease burden, 70 per cent of the population still pay for health services out-of-pocket, according to  the World Health Organiation’s Global Health Expenditure database.

In the midst of this poverty, many women are saddled with the emotional and physical trauma of unplanned pregnancies. This has been linked to the nation’s high fertility rate and lack of access to family planning. The NDHS, 2013 states that Nigerian women have a high fertility rate of 5.5, meaning an average woman in her productive stage would give birth to an estimated five or six children.

The report also added that there is a large number of married women, who wish to avoid unplanned pregnancies, or delay pregnancies, but they don’t know how to go about it. Still from the report, there is an unmet need for family planning -about 16.1 per cent, and only 15 per cent of currently married women in the country are using either modern or traditional contraceptive methods to prevent pregnancy. Hence there are increasing reports of unplanned pregnancies among young girls and married women, with many of the babies ending up being aborted or thrown into thrash cans.

Factors like these, perhaps necessitated the global theme for this year’s World Population Day, which is “Family Planning, Birth Spacing: Empowering People.”Speaking on the theme of this year’s WPD at a pre-event in Abuja, Chairman, National Population Commission (NPC), Eze Duruiheoma (SAN), said the theme lays emphasis on family planning as a key strategy to economic growth and sustainable development.

He said investing in family planning is investing in the health and rights of women and couples worldwide. “As the theme of the 2017 World Population Day suggests, family planning/child spacing is not only about saving lives of mothers and their children; it’s also about empowering the people, improving the quality of their lives and achieving sustainable development.

“Investing in family planning is the right and very positive thing to do because Nigeria has a rapidly growing population with a large pool of young people and few working people taking care of them. When the size of the dependent population shrinks relative to the size of those of working age, it creates an economic advantage. From the combination of increased wage earners, decreased dependency and implementation of the right policies we can fuel major economic growth …”

The chairman who said a year’s supply of modern contraceptives for each contraceptive user in the country would cost only $11, stressed that “if adequate funding is provided for the health sector, investment in family planning could consequently receive a boost. In this regard, if married women who desire family planning have their needs met, Nigeria’s modern contraceptive prevalence rate would rise from the current 10 per cent to the stipulated national target of 36 per cent by 2018.”

He continued: “When the family planning needs of women are met, Nigeria can prevent more than a third of her total maternal deaths per year, saving 140, 000 to 150, 000 lives per year.The Lagos State Team Leader for Nigerian Urban Reproductive Health Initiative, NURHI-2 project, Dr Edun Omasanjuwa, is also of the view that investing in family planning would help the country achieve the SDGs.

He added that the SDG 1, which is aimed at eliminating poverty can be achieved at households level, when women use family planning to space their pregnancies and avoid unplanned pregnancies.

“Without unplanned pregnancies, a woman can have time to further her education, get a good job and take care of her family. Families with fewer children would have enough resources to take care of their children, giving them quality education and good food unlike families with large mouths to feed. This also applies to Goal Two, which seeks to end hunger by 2030,” he said.

For breastfeeding mothers, he said the breastfeeding method of family planning- the Lactational Amenorrhea Method (LAM), can help a woman to avoid unplanned pregnancy, breastfeed for a longer period, hence ensure better nutrition uptake for the baby.For Goal Three, which speaks of good health and wellbeing, he said family planning helps them avert maternal deaths and complication, thereby improving women’s and their babies health.

“Spacing pregnancies helps women replenish essential nutrients lost during previous pregnancies. It also gives mothers more time and resources to breastfeed their baby properly,” he said.Due to the fact that early pregnancies is one of the causes and consequences of dropping out of school, Dr. Omasanjuwa, said family planning also helps in achieving SDGs 4 and 5, which speaks of quality education and gender equality respectively.

“Family planning can help women and girls, especially those who have become mothers, stay in school, become literate, learn a trade, start a business, or otherwise achieve their educational and employment goals. It will also empower the girl child, helping her make decisions, particularly those regarding her reproductive health,” he said.

Meanwhile, the Senior Technical Advisor, Advocacy NURHI, Mrs. Charity Ibeawuchi, has expressed worry over poor family planning uptake and maternal health of Nigerian women.She said: “Although family planning alone reduces maternal deaths by more than 33 per cent, yet only 10 per cent use modern family planning methods.”

Ibeawuchi noted that the health of the women, particularly those of reproductive age (15 to 49 years) in the country was at risk, with the silent epidemic of poor maternal mortality and morbidity. Twenty-three per cent of our teenage girls (age 15 to 19) are already mothers or pregnant with their first child. Half of our teenage girls’ population are already married by age 18, while 61 per cent are married by age 20. Women in the country have an average of five to six children. Studies have shown the strong linkage between high fertility, high risk births, poor access to modern family planning/child birth spacing methods and high maternal mortality ratio.

The enormity of the current high maternal mortality and morbidity in Nigeria is staggering. The social and economic costs due to the complications and deaths to families and the nation are enormous and should be resolved as a national priority, she said.

While recognising Federal Government efforts including the adoption of National Family Planning Blueprint (Costed Implementation Plan) in October 2014, which is aimed at scaling up modern family planning services uptake, and enhancing positive behaviours among women and families, she pointed out that budget lines and funding dedicated to maternal health, including family planning information and services at the federal, state and local governments levels are grossly inadequate to achieve this goal.

Speaking on the low uptake of family planning methods in the country, Professor of Obstetrics and Gynaecology, Prof. Oladosu Ojengbede, acknowledged that the wide knowledge of family planning methods has not translated to its uptake, as religious connotations, and cultural issues such as men not supporting family planning; community misconceptions about it, religious undertones regarding family planning, and the failure to build enough confidence in the people to access quality services needed for family planning are drawbacks.

Ojengbede added that one of the way out of the situation remain working with traditional, religious structures, which the people have confidence and trust in, and which they would believe and obey. This he said would help dispel the myths, misconceptions, traditional and religious biases that people have against the use of contraceptives.

“The traditional rulers have a role to play, we should not think that these traditional and cultural structures will not support family planning as we have seen eminent, traditional rulers, who are talking about family planning. We need to bring them in, far more than we have done,” he stressed.