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Intro: Why Family Planning? » Family Planning

Intro: Why Family Planning?

October 9th, 2008 by maggie chen Leave a reply »

My choice to blog on family planning is inspired by this statistic, and many others like it:

A survey in sub-Saharan Africa found that, of women who either did not want another child or wanted to delay their next birth, nearly 30% had no access to contraception. (The World’s Women 2000: Trends and Statistics. United Nations Publication, New York, 2000.)

Also, this op-ed in today’s New York Times by Nicholas D. Kristof discusses the importance of supporting family planning measures (especially US funds for contraception in other countries), in a time when the Bush administration plans to cut off access to birth control for some of the poorest women in Africa. This cut will take place through a U.S. Agency for International Development (USAID)* mandate to ensure that six African countries do not allow any U.S.-funded contraceptives to be distributed to Marie Stopes International, a British-based aid org that offers reproductive health services in poor countries.

On a personal level, I have seen the importance of having access to family planning through my work as a health educator at reproductive health clinics in San Francisco. By counseling patients one-on-one about birth control options, pregnancy, STIs, school, family, jobs, domestic violence, and drug use, I have come to believe that having access to contraception at certain times in a woman’s life is a fundamental factor in her life trajectory.

I was introduced to the world of zero-family-planning access this summer when I spent time in the Enga province of Papua New Guinea, where a woman’s options for birth spacing are simply: 1. rhythm/calendar method (having/not having sex based on when a woman ovulates), or 2. hysterectomy (removal of the uterus and sometimes fallopian tubes and ovaries). If a woman lives in a larger town and her husband agrees that they had had enough children, she may be able to have a tubal ligation. While many people in PNG want large families, the women with whom I spoke expressed the desire to have more control over when they have babies.

Thus, I will be blogging on innovative ways to increase access to family planning for women who have few or no birth control options. This includes programs outside of major international aid orgs that bring contraceptives to women who have limited access, as well as new birth control methods that are in development (especially longer-term methods).

Please email me (magchen@stanford.edu) or leave a comment if you hear of any info that is relevant to these topics!

*Lastly, a disclaimer for future entries: I’m not a fan of USAID’s methods of action. When I was studying in Cape Town, South Africa this spring, my research group worked for an NGO, HOPE Worldwide South Africa, that is largely funded by USAID. While I was initially happy to hear that the US was supplying funds to the townships outside of the city, I was disappointed to learn about the strict agenda that comes along with those funds. The Bush administration’s abstinence-only slant that has become the norm in many US public schools over the last eight years must be followed closely by orgs that receive USAID funding. This means that counselors at the HOPE male HIV clinic where my research group worked were only allowed to promote the ABCs: Abstinence, Be faithful, Condomize. The counselors and peer educators who work for HOPE were caught in a bind between wanting to offer advice on contraceptives and wanting to keep their jobs. While I don’t think that USAID should distribute funds without any guidance, there needs to be room for the grantees to decide on culturally appropriate ways to deliver their services.

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5 comments

  1. Max Romano says:

    I really like your tone and willingness to take this issue head on with a positive goal in mind (i.e. finding methods outside the mainstream that work). The contextualizing with current events and articles was also really helpful (I need to learn how to link articles like that). As for the USAID comment at the end, I am constantly amazed by public opinion around foreign aid in the US. To think that we contribute less (as a percentage of total GNP to foreign aid than most developed countries and we deliberately use conditional aid as a manipulative foreign policy tool is unreal. I’ve never heard of the ABC’s before (ABCs: Abstinence, Be faithful, Condomize), but the absence of woman-directed forms of birth control is clear. I look forward to reading more.

  2. amylk@stanford.edu says:

    As someone who is blogging on the topic of abortion and family planning as well, I am very interested in reading more about the innovative ways to increase access to family planning. One of the programs you mentioned was an international program to distribute condoms to women with limited access to contraceptives. From some of the readings from class, I think it would be interesting to see the effect of these programs on sexual relations as we learned that in many cases even if there are condoms available women often lack the power to negotiation within relationships for their use. I also found it interesting that many women have only the rhythm method and hysterectomies as options for birth control, and that often times male sterilization, although easier and less medically invasive, is not really considered an option.

  3. apatel21@stanford.edu says:

    Hey Maggie,

    The last comment on your blog struck me my surprise. Does the granting process with the USAID really exclude any say from the grantee? Even with the ABC policy, it seems that there should be some compromise as to what method is more/less appropriate for a particular region. Is it an all or nothing grant? Please let me know if you know more about it. I am really interesting in knowing how the grant process works.

    Anisha

    P.S.- Fortunately, the ABC policy will not be much longer after the upcoming election!

  4. jliebner@stanford.edu says:

    Maggie, I liked how you opened with the staggering statistic that 30% of women in SSA lack access to contraception. According to Prof Murray, there are over 150 million women worldwide with an unmet access to contraception. I’m interested to learn more about your thoughts on increasing access to contraception. One thing I learned about while reading on Jamaica was that contraceptive use was low among Jamaican teens despite contraception distribution projects. I think it would be interesting to address what “access” really means – are the methods available for use, but even if so, will the women use them? As Amy mentions above, often women who have access to condoms do not have the social status to make their own sexual decisions (including whether or not a condom is used). I agree that getting methods of contraception to a country is definitely an important step, but that it is also essential for women to be able to use such methods. In the case of Jamaica, it appears that young people feel too embarrassed to ask for contraception at clinics or drug stores, or in some cases judgmental providers prevent distribution. It appears that more modern contraception methods like voluntary sterilization are becoming more popular as a result, where the burden falls on women rather than men. Female sterilization is in fact the most prevalent method of contraception in the US and the developing world – however, this method is often not appropriate for younger girls given its irreversibility. And while female sterilization may solve the problem of unwanted pregnancies, it does not address sexually transmitted diseases. HIV is gaining ground in the Carribbean particularly, where infection is spreading faster than in another other place in the world. So what can be done for these younger girls? I think half of it is getting contraception on site, but the other half depends on penetrating a complex web of social and cultural values as well as promoting education that will encourage use of such methods.

  5. anjalid@stanford.edu says:

    Hi Maggie,

    Just wanted to say that I really liked the last paragraph in your post – it’s so interesting to read about how you’ve actually had personal experience with how USAID policies actually affect people. It reminds me of this article that I just read on the Guttmacher website on USAID policies and how they affect certain African countries: http://www.guttmacher.org/media/index.html#news1.

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