Temie Giwa: Contraceptives – The game changer (YNaija FrontPage)

In the end the struggle to reduce population growth rate must be focused on women’s health, not on population growth or economic growth. This is about doing what is best for women and its time Nigeria pays attention.

A while ago, I wrote about the dire state of sexual reproductive health in Nigeria, the abortion rate, at 500,000 a year and the country’s high fertility rate. I concluded that it is the government’s responsibility to subsidize the cost of contraceptives for the most vulnerable women, the poor, undereducated, and rural women. At the time it seemed no one cared. However, recently, President Goodluck Jonathan stated his administration’s concern over the 2.5% annual population growth rate. This interest seemed promising.

Even more promising is the new focus in international health circles on each woman’s human right to determine the number of children she wants. The recent Family Planning Summit hosted by the Bill and Melinda Gates Foundation and the Department for International Development raised more than US $2 million in investment for family planning commodities. Governments of developed countries and developing countries, including our own, pledged to increase investment in procurement of family planning commodities so that they are readily available to every woman, should she want it. This is promising indeed and women’s health will be better for it.

However, it is important to ask why Nigeria’s fertility rate remains stubbornly high and why Nigerian women are having 5.5 children on average. Some claim that women simply aren’t educated enough about family planning and its ability to bring health and prosperity. This is wrong as this economist makes the case here with strong data.

Some claim that Nigerian women are simply not empowered to choose contraceptives but again data proves this wrong, as the most popular contraceptive method among married women in Nigeria is Depo Provera; an injectable hormonal contraceptive undetectable by any other person but the woman and her health care giver. This shows that Nigerian women are empowered enough to bypass their husband’s consent by choosing the best thing for their bodies whether he approves or not. Thus, lack of empowerment is not the culprit. However, the fertility rate is still high.

Are women in Nigeria simply more traditional than women in the rest of Sub Saharan Africa? Perhaps our culture simply dictates that women have more children and women agree with this standard and thus are having more children. However, data seems to paint a different picture.

The unmet need for contraceptives measures the number of married women who do not want any more children, who want to space their children, or who want to postpone their next child and are not using any modern contraceptives. The last National Demographic and Health Surveys (NDHS) show that 20% of Nigerian women had an unmet need for contraceptives. Although this is still 6% lower than the regional average, it is still high enough to be a game changer in better health and a sustainable population growth. Another anecdotal evidence of the scale of this unmet need was presented recently by a Marie Stopes worker who wrote that during a trip to Nigeria she met 70 women who had travelled overnight just to get to the clinic where they can access family planning services. This is a common trend all over the country.

The real truth of Nigeria’s alarming population growth, maternal mortality and child death is the lack of access to life saving contraceptives, not education nor empowerment. Helping women have easier lives demands a focus on procuring contraceptive commodities that women already want. It seems that the Nigerian government is listening. The government last week announced that it plans to invest US$33,400,000 on contraceptives over the next four years. This is a step in the right direction but it is imperative that the procurement plan be made public so that health care professionals, policy makers, and Nigerian women can have a say in how this money will be spent to give access to those who need it the most.

In the end the struggle to reduce population growth rate must be focused on women’s health, not on population growth or economic growth. This is about doing what is best for women and its time Nigeria pays attention.

 

Op-ed pieces and contributions are the opinions of the writers only and do not represent the opinions of Y!/YNaija.

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Comments (8)

  1. What you do not realize is that the telcos are actually making a killing off the small percentage of middle class and upper class (32% and 5% respectively). A population is strength only when it is one of quality: healthy, wealthy and progressing. Ours isn't such now.

  2. Temi Dear, I still do not understand how reducing population will affect Farouk/Otedola style corruption, NNPC ‘secret’ accounts, increase in lawmakers’ salaries. Our chief problem in Nigeria is corruption. Our population has actually been our strength – Nigeria is a HUGE market – ask the telecom companies who makea fortune here in spite of everything. It’s that same market that makes the Gates ready to invest $2 million in contraceptives – they’ll make the money ten times over and Nigerian women won’t be any richer, except in the side effects of contraceptives – increases in blood pressure, blood clots, and breast cancer. And since we don’t have well equipped hospitals – only God will save us! If Jonathan can only assure us steady electricity and security, Nigerians’ resilient spirit will do all else. Or perhaps contraceptives can be used to generate electricity or placate Boko Haram? salaries. Our chief problem in Nigeria is corruption. Our population has actually been our strength – Nigeria is a HUGE market – ask the telecom companies who makea fortune here in spite of everything. It’s that same market that makes the Gates ready to invest $2 million in contraceptives – they’ll make the money ten times over and Nigerian women won’t be any richer, except in the side effects of contraceptives – increases in blood pressure, blood clots, and breast cancer. And since we don’t have well equipped hospitals – only God will save us! If Jonathan can only assure us steady electricity and security, Nigerians’ resilient spirit will do all else. Or perhaps contraceptives can be used to generate electricity or placate Boko Haram?

  3. Temi Dear, I still do not understand how reducing population will affect Farouk/Otedola style corruption, NNPC 'secret' accounts, increase in lawmakers' salaries. Our chief problem in Nigeria is corruption. Our population has actually been our strength – Nigeria is a HUGE market – ask the telecom companies who makea fortune here in spite of everything. It's that same market that makes the Gates ready to invest $2 million in contraceptives – they'll make the money ten times over and Nigerian women won't be any richer, except in the side effects of contraceptives – increases in blood pressure, blood clots, and breast cancer. And since we don't have well equipped hospitals – only God will save us! If Jonathan can only assure us steady electricity and security, Nigerians' resilient spirit will do all else. Or perhaps contraceptives can be used to generate electricity or placate Boko Haram?

  4. Hi Nonso,

    I agree about the "early marriage" bit and we will need to get to those girls in like 5 years or so. Its so important to delay marriage and while contraceptives won't help there, education and economic opportunities for young women will.

    If we get those women who are already in a union to delay, space or stop having children, which 20% of them want to, it will be a major game changer in slowing our population growth.

    So I say target this niche in the short run, focus on early marriages in the long run, and not only would we save women's lives, we'd have a sustainable economy.

    Temie

  5. Hi,

    just something i have been thinking about: contraceptives ( or making contraceptives more available ) only helps reduce fertility if the women involved use them and actually do NOT want more kids. I noticed that the states with the highest fertility rates are also the states with the highest incidence of teen marriage. The median age at first marriage is 15 in 3 of such states. Early marriage means more children even with good birth spacing

    You probably know of the kind of unfair pressure women in Nigeria face once married. Perhaps figuring out how to delay marriage might also be important.

  6. The statistics stating that only 20% of women have an unmet need for contraceptives cannot be correct. What of all the women in the village? And indeed the poorer and uneducated people in Nigeria? Or the younger girls in the university? Remember too that if you are unmarried and looking for contraceptives society in Nigeria automatically "categorizes" you….Surely this constitutes closer to 60% than 20%!

    1. Hello Lois,

      Like most surveys, especially the nationwide ones, there is a lot of room for error. But that is what the data says for now. See here: http://nigeria.usaid.gov/programs/health-populati….

      The Unmet need only measures married women not all women so I am sure the overall demand for Family Planning Services is much higher than 20%.

      Thanks for your comment.

      Temie

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