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September 20, 2018

Birth control linked to progress but yet to get universal approval

Family planning drug / FILE
Family planning drug / FILE

Two months to sitting her KCSE exam, Mercy Muthoni, now 20, gave birth to her firstborn. The father was her agemate. Having been brought up by a single mother, she says it was not easy throughout her pregnancy and even in raising her child.

Felistus Ndunge, 39, is now a mother of five. She first gave birth at 18 in 1997 and then in 1999, 2000, 2002 and 2007. It was not her wish to have as many children and that fast, but she said her husband was against family planning, saying if she used contraceptives, she would give birth to deformed babies. And when she finally started using contraceptives (pills), she would forget to take them within the required period. They didn’t help.

Evelyne Were is a mother of seven and her surviving children were born in 1981, 1984, 1986, 1989, and the lastborn in 1997. She said she had a hard time raising her children, with her husband earning only Sh800. She could not afford school fees and even food. So bad was it that her firstborn got kwashiorkor and only survived when well-wishers rescued him and took him to Kenyatta National Hospital.

Then there is Bishop Benjamin Mutuku of the Male Champions for Family Planning. Married in 1970, Mutuku is a father of five. The firstborn is 46, while the lastborn is 26. And as soon as they got married, they agreed to have five children and agreed on two-three year spacing with his wife. This, he said, helped him educate all his children without much problems.

They shared these experiences during a media roundtable at a Nairobi hotel organised by Mama Ye, a reproductive health organisation, on Wednesday, under the theme: “Contraceptives: Remedy to rising cases of Nairobi’s unplanned pregnancies”.

HUMAN RIGHT

Today, Kenya joins the world in marking World Population Day under the theme "Family Planning is a Human Right". Some of the key emerging and controversial issues in this regard are family planning and early/teenage pregnancies. There are those for population control and those who want to hear none of it.

According to Mama Ye, one in 11 women of reproductive age want to but are not able to plan children, leading to a high risk of unintended pregnancies.

In April, 30 per cent of Nairobi’s subcounties, according to a study by the organisation, did not receive family planning commodities. And 40 per cent of all contraceptives were below the minimum stock required across Nairobi.

Unintended pregnancies lead to increased maternal deaths, as a result of pregnancy-related complications and unsafe abortion.

According to a study by the World Health Organisation and the Guttmacher Institute published in The Lancet on September 28 last year, worldwide, 25 million unsafe abortions (45 per cent of all terminations) occurred every year between 2010-14. The majority of unsafe abortions, or 97 per cent, occurred in developing countries in Africa, Asia and Latin America.

The Kenya Demographic Health Survey (2014) cited maternal mortality and other birth-related complications as the leading causes of death for girls aged 15-19. By March this year, health facilities in Nairobi recorded up to 2,106 cases of teenage pregnancy, according to data from the District Health Information Centre.

Muthoni, who now works as a peer leader, blamed the increase in pregnancies on ignorance, lack of information and myths and misconceptions about contraceptives.

Speaking during a media roundtable meeting, the organisation's national advocacy coordinator George Ogola said the lack of family planning commodities is an abuse of the constitution and undermines access to universal healthcare coverage, which is a pillar in President Uhuru Kenyatta's Big Four agenda.

"Every person has the right to the highest attainable standard of health, which includes the right to healthcare services, including reproductive healthcare," Ogola said.

Read: Family planning key to stabilising rapid population growth

POPULATION CONTROL?

World Population Day, it has been argued, is about countering any notion of “population control”, strengthening the global rights and development frameworks that support it, and “ensuring that future generations never take a hard-won human right for granted”. However, this has been countered by some quarters, which argue it propagates population control.

Population growth hurts availability of resources, and thus the economy. Poverty and lack of jobs stimulate faster population growth and increase incentives for environmental degradation. This is normally though exploitation of the already scarce resources.

The world population, according Worldometers, is growing at a rate of around 1.09 per cent per year, compared to three per cent global economic output growth recorded last year. The current average population increase is estimated at 83 million per year. However, according to the Financial Times, after years of recovery from the 2008 financial crisis, most advanced and developing economies have closed the output gap between actual and potential economic growth. Emerging and developing economies, which grew by 4.3 per cent as a group last year, are likely to hit ceilings and contribute less to global growth.

Annual growth rate reached its peak in the late 1960s, when it was at around two per cent. The rate of increase has nearly halved since then, and will continue to decline in the coming years. It is estimated to reach one per cent by 2023, less than 0.5 per cent by 2052, and 0.25 per cent in 2076 (a yearly addition of 27 million people to a population of 10.7 billion).

World population has doubled in 40 years from 1959 (three billion) to 1999 (six billion). It is now estimated that it will take another nearly 40 years to increase by another 50 per cent to become nine billion by 2037.

The latest world population projections indicate world population will reach 10 billion persons in the year 2055 and 11 billion in the year 2088.

And one of the contributing factors to the decrease in population growth is civilisation, education and use of family planning.

Family planning, says John Bongaarts, is now considered a key part of a comprehensive development strategy. The UN Millennium Development Goals reflect this international consensus. The 2012 London Summit on Family Planning, hosted by the UK government and the Bill and Melinda Gates Foundation, affirmed political commitments and increased funds for the project, strengthening the role of family planning in global development.

 BIRTH CONTROL ‘SINFUL’

Family planning has also faced opposition, especially from the Catholic Church. The church believes artificial contraception is sinful and immoral and may frustrate a divine plan to bring a new life into the world. Instead of using birth control methods such as the pill, IUDs, diaphragms, and condoms, Catholics can use Natural Family Planning techniques.

The argument is that birth control pills are not true contraceptives. They don’t prevent the sperm and egg from conceiving. Instead, they work as an abortifacient, “causing the uterus to eject potentially fertilised eggs”. Catholics hold that life begins at conception and any fertilised egg is an embryo and a person.

In January, the Catholic Church renewed the war against contraceptives as soon as Kenya won the global Excellence in Leadership for Family Planning Award for accelerated use of birth-control products. Kisumu Catholic Archbishop Zacchaeus Okoth said distribution of free contraceptives and abortions had resulted in a population decline in the past five years in the region.

In his The Joy of Love book, Pope Francis says a couple’s individual conscience — not dogmatic rules imposed across the board — must guide their decisions and the church’s pastoral practice. “Let couples, not the Church, decide on contraception,” Pope Francis wrote.

And Melinda Gates, a Catholic, in a BBC Radio interview on July 11 last year, said contraception is “one of the greatest anti-poverty innovations the world has ever known”.

The Gates Foundation primarily aims to enhance healthcare and reduce extreme poverty across the world. Melinda has said she is “optimistic” Pope Francis will change Church teaching on contraception.

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