There is still need for contraception. This month, the global community took a stand to improve access to reproductive health services, in order to boost the over all well-being of women. WINIFRED OGBEBO reports on the importance of family planning to nation building

Access to safe, effective methods of contraception is considered one of the most cost-effective investments a country can make in its future.

Studies show that every US $1 invested in family planning services yields up to $6 in savings on health, housing, water, and other public services.

The estimated resource requirement for sustaining the current use of contraception by 260 million women in the 69 poorest countries is approximately US$10bn over eight years from 2012 to 2020.

These resources â€" which are principally provided by country governments through their health budgets and are supported by contributions from consumers and external donors â€" need to be sustained.

Reaching an additional 120 million women will require resources equivalent to an additional US$4.3bn over the next eight years. This number includes resources and infrastructure supported by developing countries. Of the $4.3bn total resource requirements, donors will need to contribute $2.3bn in funds above and beyond the level of funding provided for family planning in 2010.

  On July 11th, a historic Family Planning Summit focusing global attention on one of the most serious and neglected public health issues, reproductive health, was held in London.

The Chairman, National Population Commission (NPC), Eze Festus Odimegwu, identified poor reproductive health services as the root cause of infant and maternal mortality especially in the developing world.

Speaking at the 2012 world population day in Ilorin, Kwara state, Odimegwu, said maternal morbidity and mortality are most commonly associated with high-risk pregnancies and birth inherent in too early pregnancies and birth, having more than four births, and late pregnancies (after 35 years).

"When a woman dies giving birth or a child is orphaned, the ripple effect on the society is enormous. The consequences extend beyond the existence of these individuals and have implications for societal peace, prosperity and stability", he said.

Odimegwu restated the government's commitment to reducing child mortality and improving maternal health, with assistance of the United Nations Population Fund (UNFPA), by 2015.

The NPC chairman said the emphasis on reproductive health was to build smaller and stronger families where every child is wanted and safe, adding that it is also to ensure a higher quality of life for the whole family, where women would be healthier and stronger to contribute to the socio-economic development of the country.

He said that public enlightenment on the use of contraceptives must be stepped up especially in rural areas where statistics had shown high fertility, infant and maternal mortality rates, adding that a culture of contraceptives use should be enthroned through persistent public education and enlightenment.

Odimegwu noted that 23 per cent of women in Nigeria age 15-19 are already mothers or are pregnant with their first child, adding that, "early marriage and age at first intercourse have implications for total fertility rate which, at 5.7, is undesirably high. If women give birth at an interval of less than two years, and they have to do that six times as is the case in some parts of the country, the pressure on their health is great", he said.

At the summit, the Minister of State for Health, Dr Muhammed Ali Pate, said Nigeria was committed to achieving the goal of  contraceptive prevalence rate of 36% by 2018.

Achieving this goal, he noted, would mean averting at least 31,000 maternal deaths as over 700,000 mothers will be prevented from injuries or long-term complications due to childbirth.

 According to the Minister of State for Health, the structure of Nigeria's population is such that the working age to non-working age population ratios have remained fairly stable over the last 50 years, driven by relatively high annual growth rates.

Contraceptive use also leads to more education and greater opportunities for girls, helping to end the cycle of poverty for them and their families. Up to a quarter of girls in Sub-Saharan Africa drop out of school due to unintended pregnancies, stifling their potential to improve their lives and their children's lives.

"We are aware that favourable ratios of working age to non-working age population enhances human capital investment as well as household savings potential.  We realise that in order for Nigeria to reap its demographic dividend, and fulfill our aspiration for it to become one of the world's largest 20 economies by 2020, there is need for purposeful government effort to meet the currently unmet need for family planning commodities, enhance education of both girls and boys and empower our women."

 In Nigeria, it is estimated that the average total fertility for uneducated women is more than twice that of women who have had above secondary education.  

Says Pate, "Thus, girl-child education remains an important area of focus to improve reproductive health and reduce maternal and child mortality. Girl-child education focusing on completion of quality primary, secondary and post-secondary education for our future mothers is critical.  But, girls alone do not make babies. We will continue to pursue efforts to improve overall quality of education for all children. These efforts will take time, and perhaps even more time because of the already large birth cohorts that are constantly coming into the education system. So, access to reproductive health services and commodities remains the first priority in this context."

 According to Pate, "In addition to our current annual commitment of US$3 million for the procurement of reproductive health commodities, we are now committing to provide an additional US$8,350,000 annually over the next four years, making a total of US$33,400,000 over the next four years. This additional amount will be programmed within the existing projection for the Subsidy Reinvestment and Empowerment Programme funds for Maternal and Child Health."

 Furthermore,  he disclosed that in the case of family planning in Nigeria, women in the richest wealth quintile are more than 10 times likely to have access to family planning services (35% versus 3.2%) regardless of geography, ethnicity or religion.

"We are committed to increasing the awareness and demand for family planning and reproductive health services by women regardless of their socio-economic status. In our quest to save one million lives in Nigeria by 2015, we consider all lives have equal value," said he.

In order to achieve this, the minister said a lot of interventions are going to be put in place which include; the training of frontline health workers to deliver a range of contraceptives, and especially to improve the utilization of long acting methods like intra-uterine devices and injectable contraceptives. 

Secondly, the participation of the private sector to engage in domestic manufacturing of essential health commodities, including contraceptives and also work towards making the commodities more affordable through efficient regulation and improving in-country logistics system.

 The Summit underscored the importance of access to contraceptives as both a right and a transformational health and development priority.

 The Secretary of State for International Development, Andrew Mitchell, said: "This is a breakthrough for the world's poorest girls and women which will transform lives, now and for generations to come. The commitments made at the Summit today will support the rights of women to determine freely, and for themselves, whether, when and how many children they have."

"Enabling an additional 120 million women in the world's poorest countries to access and use contraception, something women in the developed world take for granted, will save millions of lives and enable girls and women to determine their own futures."

By 2020, the collective efforts announced will result in 200,000 fewer women dying in pregnancy and childbirth, more than 110 million fewer unintended pregnancies, over 50 million fewer abortions, and nearly three million fewer babies dying in their first year of life.

Melinda Gates, co-chair of the Bill & Melinda Gates Foundation, said: "When I travel and talk to women around the world they tell me that access to contraceptives can often be the difference between life and death. Today is about listening to their voices, about meeting their aspirations, and giving them the power to create a better life for themselves and their families."

The Summit has raised the resources to deliver contraceptives to an additional 120 million women which is estimated to cost $4.3 billion. More than 20 developing countries made bold commitments to address the policy, financing and delivery barriers to women accessing contraceptive information, services and supplies. Donors made new financial commitments to support these plans amounting to $2.6 billion â€" exceeding the Summit's financial goal.

The Summit galvanized the global community to create transformational change, calling for innovative solutions and robust public-private partnerships that put women at the heart of the equation. Commitments announced today will give women more options, easier access, and improved health care.