04/09/2014 11:25 am ET Updated Jun 09, 2014

When It Comes to Sexual Health and Family Planning, the Personal Is Still Political

When 16-year-old Esther Mukami Njoroge from Kenya became pregnant and had a baby while she was still at school, she felt depressed and disorientated. She thought the life she wanted was over. But actually, she was one of the lucky ones. Lucky for her that family planning nurses came to her village and, with their help, she was able to get contraception so she could plan her future pregnancies. All that meant she could go back to school and eventually, she was able to train as a teacher.

There are millions of women who aren't as lucky as Esther because they don't have access to family planning -- 222 million, a figure that if we don't act is only likely to go up.

Just say the global community was able to meet the needs of those 222 million women and adolescents now, what would that mean? What impact would it have?

The benefits would be huge. If governments did match the vast unmet need for contraception, it would avert 218 million unintended pregnancies in developing countries, which in turn would prevent 55 million unplanned births, 138 million abortions (of which 40 million are unsafe), 25 million miscarriages and 118,000 maternal deaths.[1]

There is no doubt that addressing the unmet need for sexual and reproductive health services would lead to significant reductions in women's mortality and morbidity rates. But there's even more to it than that.

It's been proven -- not just in Esther Njoroge's case -- that when women have more control over their reproductive health it has a knock-on effect on all aspects of their lives -- for example, the way in which they can engage in the labor market, which lifts them economically and also benefits their communities.

That women and girls have very little or no access to sexual and reproductive health services in some parts of the world has a profound effect on inequality.

There are many examples of the impact that has. Globally, 54 percent of all adults living with HIV are women. Young women worldwide make up more than 60 percent of young people living with HIV; in sub-Saharan Africa their share jumps to 72 percent.

The need for more sexual and reproductive health services is obvious and the benefits of providing them would have a dramatic impact on poverty reduction around the world.

And that is why the World Bank launched its Reproductive Health Action Plan in 2010. Its aim was to focus on three specific areas: reducing high fertility, improving pregnancy outcomes and reducing sexually transmitted infections, including HIV.

The links between reproductive health and sustainable development contribute to the Bank's overarching aims of reducing extreme poverty and ensuring that the benefits of economic growth are shared more equitably.

Its action plan, specifically focused on 57 'high burden' countries, sets out a broad results framework to provide guidance so targeted country level action plans, adapted to specific country needs, can be developed.

Now, four years into the plan, IPPF has assessed its success through a scorecard. The scorecard holds the World Bank to account and, despite the Bank's Action Plan being heralded as a turning point for the Bank's commitments to reproductive health, IPPF has concerns that, since its introduction in 2010, the plan's original ambitions have not been fully realized.

We want to make sure that the Bank's investment in and prioritization of reproductive health are sustained in years to come so the ambitions of the Reproductive Health Action Plan are met.

To meet the sexual and reproductive health needs of all people around the world, the Bank must increase its new investments in reproductive health each year up until 2015 and beyond.

We also call on the Bank to start work now to ensure that it has a new reproductive health strategy in place from 2015, when its current plan expires. This will ensure continued improvements in reproductive health outcomes across countries most in need of investment.

Finally, we know that in making a difference on the ground, it is critical that the Bank continues to work with national and local civil society organizations in priority countries using the expertise of civil society to ensure accountability and services for communities on the ground.

You only need to think about how much Esther Njoroge's life improved when she had access to contraception, and the ability to plan her family, to realize how much it could mean globally if every woman had the same chance.

[1] Guttmacher Institute and UNFPA (2012) "Adding It Up: The Costs and Benefits of Investing in Family Planning and Maternal and Newborn Health." New York. Guttmacher.
[2] UNAIDS (2012) "Adolescents, Young People and HIV." Fact sheet.

Founded in 1952, The International Planned Parenthood Federation (IPPF) is both a service provider and an advocate of sexual and reproductive health and rights. The organization is a worldwide network of 152 Member Associations active in over 170 countries. Learn more at