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Unformatted text preview: Series 1810 www.thelancet.com Vol 368 November 18, 2006 Sexual and Reproductive Health 3 Family planning: the unfi nished agenda John Cleland, Stan Bernstein, Alex Ezeh, Anibal Faundes, Anna Glasier, Jolene Innis Promotion of family planning in countries with high birth rates has the potential to reduce poverty and hunger and avert 32% of all maternal deaths and nearly 10% of childhood deaths. It would also contribute substantially to womens empowerment, achievement of universal primary schooling, and long-term environmental sustainability. In the past 40 years, family-planning programmes have played a major part in raising the prevalence of contraceptive practice from less than 10% to 60% and reducing fertility in developing countries from six to about three births per woman. However, in half the 75 larger low-income and lower-middle income countries (mainly in Africa), contraceptive practice remains low and fertility, population growth, and unmet need for family planning are high. The cross-cutting contribution to the achievement of the Millennium Development Goals makes greater investment in family planning in these countries compelling. Despite the size of this unfi nished agenda, international funding and promotion of family planning has waned in the past decade. A revitalisation of the agenda is urgently needed. Historically, the USA has taken the lead but other governments or agencies are now needed as champions. Based on the sizeable experience of past decades, the key features of eff ective programmes are clearly established. Most governments of poor countries already have appropriate population and family-planning policies but are receiving too little international encouragement and funding to implement them with vigour. What is currently missing is political willingness to incorporate family planning into the development arena. Programmes to promote family planning in developing countries began in the 1960s in response to large improvements in child survival, which in turn led to rapid population growth. In Asia, the main motive was to enhance prospects for socioeconomic development by reducing population growth, 1 and governments took the lead. In Latin America, initiatives were galvanised by evidence of increases in illegal unsafe abortions, 2 and eff orts to remedy the situation by providing access to modern contraceptives were spearheaded by non- governmental organisations. We present our key messages in panel 1. The number of developing countries with o cial policies to support family planning rose from only two in 1960 to 74 by 1975 and 115 by 1996. 3 International funding increased in parallel from US$168 million in 1971 to $512 million in Panel 1: Key messages Family-planning promotion is unique among medical interventions in the breadth of its potential benefi ts: reduction of poverty, and maternal and child mortality; empowerment of women by lightening the burden of excessive childbearing; and enhancement of environmental sustainability by stabilising the population of the planet.enhancement of environmental sustainability by stabilising the population of the planet....
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This note was uploaded on 02/03/2011 for the course EEP 153 taught by Professor Marsh during the Spring '11 term at University of California, Berkeley.
- Spring '11