Family Planning and the Millennium Development Goals

1. Family Planning and the Millennium Development Goals Ward Cates FHI 360 September, 2013

2. Global FP Perceptions – Findings from Gates Survey ‘09 Global FP is not an end in itself FP is a broad range of RH services, not just contraception FP is one of various means to improve health and quality of life Providing evidence of FP impact on health and development goals is crucial

3. Millennium Development Goals:What Are They? 2000-2015 targets for development Commitments by 181 UN nations Priorities for global funders Opportunities for multinational organizations

4. Millennium Development Goals • End Poverty and Hunger • Universal Education • Gender Equality • Child Health • Maternal Health • Combat HIV/AIDS • Environmental Sustainability • Global Partnerships

5. FP and MDGs End Hunger and Poverty FP

6. FP Generates Wealth Per capita GNP associated with prevalence of modern contraceptive methods Women’s weekly income directly associated with lower number of pregnancies Source: FHI Women’s Studies Project, PRB Fact Sheet

7. Smaller Family Size Contributed to “Asian Miracle,” 1960-2005 Children per woman GNI per capita Source: World Bank (2006)

8. FP Reduces Hunger Million Billion Days 108 1200 3.7 62 980 3.1 775 2.6 N/P World Grain Stocks Undernourished Total Population 1997 2007 2017 Source: Brown (2009)

9. FP and MDGs End Hunger and Poverty Increase Education FP

10. FP Prolongs Education Pregnancy a major obstacle to school attendance High levels of pregnancy in youth < half African girls complete primary school Population growth puts pressure on limited school infrastructure

11. FP and MDGs End Hunger and Poverty Increase Education FP Empower Women

12. FP Empowers Women Women who use FP more likely to be employed than non-users (Indonesia, Zimbabwe, Bolivia) Long-acting/permanent contraceptive methods associated with greater likelihood of working for pay (Brazil, Indonesia) Improves partner relations, family well-being, and community involvement (Philippines) Unplanned pregnancies interrupt work and career plans (Egypt) Source: FHI Women’s Studies Project

13. Empowering Women

14. FP and MDGs End Hunger and Poverty Increase Education FP Empower Women Improve Infant Health

15. FP Saves Infants Spacing planned births and limiting unintended births increases child survival Currently, 2.7 M infant deaths are averted globally each year by preventing unintended pregnancies Source: DHS

16. Child Mortality by Birth Interval Relative Risk Child Mortality Birth Interval (Months) Source: DHS; Rutstein (2005)

17. FP and MDGs End Hunger and Poverty Increase Education FP Empower Women Improve Infant Health Improve Maternal Health

18. FP Improves Maternal Health Unintended pregnancies affect women’s health Risks of terminating pregnancy – unsafe abortion Risks of continuing pregnancy – maternal mortality 70% of global maternal deaths could be averted if FP needs met

19. FP Reduces Abortion Russia (1988-1998) 178 Modern contraception Relative Contraceptive and Abortion Prevalence Abortion 47 Source: Westoff (2005)

20. FP Reduces Maternal Mortality * Percent of married women ages 15-49 using modern method Source: WHO (2004)

21. FP and MDGs End Hunger and Poverty Increase Education FP Empower Women Decrease HIV/AIDS Improve Infant Health Improve Maternal Health

22. FP Prevents HIV 4 Phase Approach to Perinatal HIV Prevention Prevention of HIV in women, especially young women Prevention of unintended pregnancies in HIV-infected women Prevention of transmission from an HIV-infected woman to her infant Support for mother and family Phase 1 Phase 2 Phase 3 Phase 4

23. FP and MDGs End Hunger and Poverty Increase Education FP Save the Environment Empower Women Improve Infant Health Decrease HIV/AIDS Improve Maternal Health

24. FP Protects the Environment Rapidly growing population exacerbates environmental degradation Slower population growth places less stress on limited natural resources, including fresh water and arable land Preventing unintended pregnancy is the factor in population growth most amenable to intervention Source: PRB, 2009

25. FP and MDGs End Hunger and Poverty Increase Education Support Global Partnerships FP Save the Environment Empower Women Improve Infant Health Decrease HIV/AIDS Improve Maternal Health

26. FP Promotes Partnerships Four decades of global investment in FP programs has contributed strong collaboration among: International agencies Governmental ministries Multinational organizations Local NGOs/community groups

27. FP and MDGs in Science

28. SRH and HIV: Key Linkages Key Linkages Learn HIV status Promote safer sex Optimize connection between HIV/AIDS and STI services Integrate HIV/AIDS with maternal and infant health • HIV/AIDS • Prevention • Treatment • Care • Support • SRH • Family Planning • Maternal & infant care • Management of sexually transmitted infections • Management of other SRH problems Source: WHO/UNAIDS, IPPF/UNFPA (2005)

29. FP Integration in Multiple Development Sectors

30. Beyond the MDGs • Enhance National Security • Defuse Explosive Societies • Optimize Financial Resources

31. The New Population BombChanging Demographic Composition and Distribution Shift in “demographic weight” from higher to lower-resource countries Aging of higher-resource countries Youth bulge in lower-resource countries Urbanization of lower-resource countries Source: Goldstone (2010)

32. FP Stabilizes Societies “High birth rates...produced a common problem ― a large, steadily increasing population of young men without any reasonable expectation of suitable or steady employment ― a sure prescription for social turbulence.” Source: The 9/11 Commission Report (2004)

33. Proportion of Youth Aged<25, by Region 0-14 15-24 100 75 50 25 0 Africa Latin East Asia South Middle North Europe America Asia East America Source: UN (2007)

34. The “Youth Bulge” Impact Disproportionate levels of young adults associated with political volatility and violence Countries with youthful age structure slow to become stable democracies ─ Middle East, Africa Democratic countries with high proportion of youth are less stable ─ Latin/South America Source: Cincotta (2009)

35. FP Saves Dollars Preventing unintended pregnancies is less expensive than treating maternal/ infant complications of pregnancy Longer acting contraceptive methods are the most cost-effective Up to $31 can be saved for every dollar spent on FP (UNFPA)

36. Family Planning and MDGs: Cost Savings in Zambia Total Savings: $111 M Malaria $4 M Maternal Health $37 M Water Sanitation $17 M Total Costs: $27 M Immunization $17 M Education $37 M Family Planning $27 M Source: USAID-Zambia (2008)

37. FP and MDGs End Hunger and Poverty Increase Education Support Global Partnerships FP Save the Environment Empower Women Improve Infant Health Decrease HIV/AIDS Improve Maternal Health • FP affects all 8 MDGs • FP is one of multiple interventions to improve health and development

38. Conclusion Investing in global FP programs will help achieve all 8 MDGs Strengthening global FP programs contributes to integrated, multisectoral development Investing in global FP programs will optimize financial resources