Family Planning…up to #3?

So where does women’s health sit on the global health agenda? Doubtful that it’s at the top of the list. There is limited support for an agenda that addresses the health and welfare of women and girls. Perhaps because when we think of “women’s” health, our minds drift toward reproduction and the associated mystique (?) that it is associated with.  We forget that women have cardiovascular disease, mental illnesses, and skeletal systems that need attention. Well, for now I’ll play along. An issue near and dear to my heart within this capacity, is family planning.

Family planning is certainly not only a women’s health issue, but definitely a global health issue. Our population is still growing, and our resources are not unlimited. But more than population control, one’s ability to control fertility is paramount to being able to ensure the success of the family at large.  Quite simply, the more mouths to feed, the more resources needed, and often, the more stress on the provider(s). In addition, the control of fertility for the woman is also important. Pregnancy and childbearing take a toll on the body physically and are not without high risks.  The disparities in maternal mortality rates alone provide this information. And that is not to say that maternal mortality is not a key topic of discussion globally, it is just that our management strategy has not taken full advantage of the use of family planning to help women on the large scale. The UNFPA supports the use of family planning to prevent unwanted pregnancy and promote reproductive health, but also recognizes the vast unmet need and limitations to provide for the women who seek other options.  We need to work harder to spread the message that family planning is a key factor in the push toward improvements in global health.

Moving family planning up on the global health agenda is not an easy task, but a necessary one. Using the framework explained by Bump et al, we can set up a similar evaluation tool for family planning to see how the agenda may be changing. 1)Trends in treatment coverage: the increased use of intrauterine devices and implantable devices worldwide has provided for more reliable and long-term methods of birth control. Access to the treatment remains a problem, as more providers need training for these methods. 2)Changes in perceived priority: the topic was the keynote opening session for the 2013 annual meeting of the American College of Obstetrics and Gynecology. Dr. Malcolm Potts gave the address and his presentation addressed family planning from a global perspective, not just in the United States. 3) Changes in financial support and institutional involvement: in the U.S. there is a rapidly growing fellowship in Family Planning which trains physicians to be experts in contraception and abortion training. This fellowship is sponsored by an anonymous donor, and is currently hosted at 29 academic institutions. 4) Bibliographic changes: a PubMed search of “family planning” or “contraception” provides a great deal of information to sift through, and the research is still coming from all parts of the world. By continuing to support family planning, we move it up on the global health agenda, where its implications can have widespread benefits.

 

Bump, JB, Reich RR, Johnson AM. “Diarrhoael Diseases and the Global Health Agenda: Measuring and Changing Priority.”  Health Policy and Planning 2012; 1-10.

United Nation’s Population Fund. Reproductive Health. http://www.unfpa.org/rh/planning.htm. 18 September 2013.

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