222 million women around the world want to use modern forms of birth control to delay, space, or avoid becoming pregnant, but do not have access to them. The vast majority of these women are poor and live in developing countries. This unmet need for family planning will result in 75 million unintended pregnancies this year, putting women at serious risk of death or disability and costing huge sums.
What causes "unmet need" in family planning? Women usually face one or more of the following barriers to obtaining family planning -- affordability, access, acceptability or knowledge. A woman in a slum in Haiti may find that any form of modern birth control is unaffordable to her. A mother of five in remote rural Mali may want to take a break from childbearing, but cannot access contraception because the nearest clinic that provides it is more than a day's walk from her home. A new wife in India may prefer discreet monthly contraceptive injections, but they are not offered in any facility nearby. A husband in Yemen may oppose the use of contraception by his wife who wants it, although he is not fully informed about how it works or the negative impacts that closely spaced pregnancies are having on his wife, his children's health, and his family's financial well-being.
High levels of unmet need for contraception around the world have a very negative impact on women's and children's health and survival as well as on the prosperity of communities and nations. The benefits of meeting this need are clear. If these women had access to dependable voluntary contraception, unintended pregnancies would fall by more than 70 percent, 100,000 fewer women would die in childbirth, and nearly 600,000 fewer newborns would die each year. If every woman had the option to leave a two-year gap between a birth and a subsequent pregnancy, deaths of children under five would fall by 13 percent. Meeting the unmet need for contraception also contributes to reducing the incidence of HIV and STDs, and helps limit mother-to-child transmission of HIV.
Meeting the unmet need not only saves lives, it is also extremely cost effective. For every dollar added to programs to make modern contraceptives available to women in developing countries who want them, $1.40 is saved in additional maternal and newborn health service costs. The current level of contraceptive access in the developing world is about $4 billion annually. This investment in voluntary family planning saves $5.6 billion in maternal and newborn health service costs. Providing these services in family planning reduces unintended pregnancies and enables healthy timing and spacing of pregnancies, which is the simplest and cheapest way to reduce maternal, infant and child deaths.
Earlier this week in London, leaders from donor countries, developing countries and the private sector came together in the London Summit on Family Planning in an exciting moment to launch commitments to fundamentally improve the lives of women and girls by meeting the unmet need for contraception for an additional120 million women by the year 2020. The Summit is being led by Melinda Gates of the Gates Foundation, a recent convert to the central role of contraception in international health and development, and Andrew Mitchell, the UK's Secretary of State for International Development.
The U.S. Agency for International Development, one of the world's largest governmental donors of family planning aid, will continue its extensive voluntary family planning programs and is pledging further resources to help develop a new method of contraception. This effort also includes leaders of a dozen developing countries, Babatunde Osotimehin of the UN Population Fund, Tewodros Melesse of the International Planned Parenthood Federation, many other leading civil society organizations, such as Save the Children, Marie Stopes International, the UN Foundation, and dozens of other governmental and private sector leaders, including from the business sector. Donors are stepping up to generate the approximately $4 billion in new money annually needed to meet the goal of serving an additional 120 million more women with access to contraception by 2020.
Developing countries are redoubling their efforts to identify and address the causes of unmet need within their borders. India is committing to provide universal and free access to contraception to all women, and to make a variety of methods -- pills, condoms and emergency contraceptives -- available at the doorstep of every Indian woman. Uganda has committed to reduce its unmet need for family planning from 40 percent to 10 percent in 2022 and to increase its own funding for contraceptives by 50 percent for the next five years. The Ivory Coast is pledging to make contraception available in all governmental health facilities by 2015 and to subsidize contraception with a goal of increasing contraceptive use by women of child-bearing age from 9.5 percent now to 30 percent by 2015.
This type of across-the-board agreement is rare in assistance programs and is a testament to the overwhelming evidence that meeting the unmet need for contraception will have ripple effects that could profoundly change the world for the better in a short timeframe. Melinda Gates states the benefits of this well-timed effort: "giving women the power to save their lives, to save their children's lives, and to give their families the best possible future." Let's all get on board.
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