The United Nations Population Fund (UNFPA) has launched its 2012 State of World Population report entitled "By Choice, Not by Chance". The new publication places renewed focus on the need for more policy and programmatic action to ensure that all people can equally access family planning services - which is critical to individuals’ abilities to exercise their reproductive rights.
This rights-based approach, the report says, might be the premise for the global sustainable development framework that would succeed the 2015 Millennium Development Goals (MDGs).
By enabling individuals to choose the number and spacing of their children, family planning has allowed women, and their children, to live healthier, longer lives. However, not everyone can yet plan their sexual and reproductive life. The report highlights that a staggering 222 million women of childbearing age in developing countries still do not have access to modern contraceptives. This places them at higher risk of HIV. Women and girls of reproductive age are the hardest hit by the HIV epidemic in Zimbabwe, for example, and HIV is responsible for about one in four maternal deaths. In Malawi, lack of information, long distances to services and unfriendly providers contributed to high rates of unintended pregnancy and HIV among adolescents and young people.
Despite international commitments to remove barriers to family planning for all population groups, research finds that young people’s needs remain largely neglected. The report notes that the largest generation of young people in history is unable to fully exercise their reproductive rights and prevent unintended pregnancies, mitigate the risks of school dropout, or protect themselves from sexually transmitted infections, including HIV.
Each day, 2 500 youth, the majority of them female, become newly infected with HIV, the report states.
A number of other important population groups are neglected by family planning systems or sometimes face insurmountable barriers: young people, unmarried adults, people who are separated from their partners, older men, people with disabilities, refugees, people living with HIV and ethnic minorities. An enormous need exists to provide focused and sustainable services to these groups. The report finds that the costs of ignoring the right to family planning will exacerbate poverty, exclusion, poor health and gender inequality.
There are signs of progress, however. Viet Nam has expanded its reproductive health services, for example, to include family planning, pre- and post-natal care and HIV prevention.
Last July, at the London Summit on Family Planning, donor countries and foundations together pledged $2.6 billion to make family planning available to 120 million women in developing countries with unmet needs by 2020. Developing countries themselves also pledged to increase support.
But, according to the report, an additional $4.1 billion is necessary each year to meet the unmet need for family planning. This investment would save lives by preventing unintended pregnancies and unsafe abortions.
Money is just one part of the solution, it says. The report also calls on governments and leaders to take or reinforce a rights-based approach to family planning; secure an emphasis on family planning in the global sustainable development agenda; ensure equality by focusing on specific excluded groups; and raise the funds to invest fully in family planning.