Despite being identified as an important tool in the prevention of child and infant deaths, unintended pregnancies, risky births, unsafe abortions, and maternal mortality deaths, findings show that budgets for family planning are either not released or released late, thus meeting set targets remain unrealistic.
It will be recalled that the federal government had a target in 2012, to increase Modern Contraceptive Prevalence Rate (mCPR) to 36 per cent by 2018. However, on July 11, 2017 at the family planning summit in London, this target was rebased to 27 per cent by 2020.
Meanwhile, two years later, the modern contraceptive rate in the country remains at 12 per cent.
With the consistent dwindling of funding from donors, coupled with the unmet need for modern methods of contraception in 2021 (which was 12.3 per cent of all women), the call for government at all levels to increase domestic funding for improved access to family planning services has heightened.
A professor/consultant obstetrician and gynecologist, College of Medicine, University College Hospital (UCH), Ibadan, Prof Christopher Aimakhu, said if all unmet needs for modern contraception in the country were satisfied, unintended pregnancies would drop by 77 percent, from 2.5 million to 555,000 per year. He added that the annual number of unplanned births would decrease from 885,000 to 200,000 and the number of abortions would drop from 1.3 million to 287,000.
Aimakhu, who spoke at a three-day training for media practitioners in Nigeria, organized by Rotary Action Group for Reproductive, Maternal and Child Health, said to make this happen, Nigeria would need $546 million each year for contraceptive services for all women.
“Meeting the need for modern contraception among all women in Nigeria who want to prevent pregnancy would cost $546 million annually.
“Fully meeting women’s needs for both contraceptive services and maternal and newborn health care in Nigeria would cost a total of $5.0 billion each year – $26.09 per capital – a total that is roughly the same cost as meeting the need for maternal and newborn care alone,” he explained.
The director, African Centre of Excellence for Population Health and Policy, Bayero University, Kano, Prof Hadiza Galadanchi, said even though family planning is one of the most effective means to addressing the challenges of maternal morbidity and mortality, the Contraceptive Prevalence Rate (CPR) in Nigeria has remained 17 per cent for several decades, which is the lowest around the world.
She said there are lots of women who want contraceptives but can’t get it, adding that “Unmet need is real, we did a study across Nigeria. Almost 30 percent of women in Lagos State are using traditional methods of family planning.”
In her response, the director, department of family health, Federal Ministry of Health, Dr Salma Ibrahim Anas spoke, that Nigeria has had a budget for family planning at the national level since 2011 when the government started contributing to the fund basket for the procurement of family planning commodities, while other partners also supported.
Anas disclosed that in 2012 after the family planning summit in London, the former minister of health, made additional commitments by increasing the budget from $3 million to about $4 million, adding that since then the federal government has been making efforts to meet the commitment.
Despite the COVID-19 pandemic and the impact it had on the Nigerian economy, the director said the ministry of finance approved last year $4 million for the procurement of family planning commodities under the 2021 budget and it will also be affecting the same for the 2022 budget.
She revealed that the money is not paid directly to the ministry of health but to the United Nations Population Fund (UNFPA), the organization responsible for the procurement of family planning commodities.
“We know the $4 million is not enough to provide family planning services to Nigerian women, other partners also contributed,” she added.
As donor funding dwindles, Anas said, “At the moment, we are strongly advocating for states to also contribute to the fund basket for the procurement of family planning commodities, because it is a lifesaver. I am happy to mention that 10 states out of the 36 states plus FCT have committed to the procurement of these commodities and we are working with them to see how they also contribute to the basket funding,” she disclosed.
On awareness, she said, “This year we are planning to have more awareness through traditional and religious leaders. We also plan to start engagement with traditional rulers and focus on child spacing. We are recording larger numbers of maternal deaths than COVID-19 but most of them are not being reported. Each life is important and every death of a woman or child should be accounted for.”
Meanwhile, program officer, reproductive health/family planning, Yusuf Nuhu, said that Kebbi, Nasarawa, Kano, Kaduna, Plateau, Benue, Kwara, Lagos, Oyo, Cross River, Taraba states are some of the states that have family planning specific budget lines while calling on other states to follow suit.
He also highlighted that while FP-specific allocations are important, timely funds releases and utilization are very crucial to ensuring services are provided. He called on all relevant stakeholders to ensure action and commitment by decision-makers to ensure the timely release of budgeted funds.
However, in joining the global movement, the federal government last week launched the Family Planning 2030 (FP2030) commitment and dissemination of other Reproductive Health Policy documents.
Speaking during the launch in Abuja, the minister of Health, Dr Osagie Ehanire, said the event was an opportunity for stakeholders to build on the efforts made on the FP2020 Initiative.
He said, “We are committed to continuing the journey into FP2030 Partnership Initiative and set in motion the process of charting a way forward towards a long-term sustainable family planning services as an integral part of the overall Reproductive, Maternal, Newborn, Child, Adolescent and Elderly Health Plus Nutrition (RMNCAEH+N) programming, which is a critical component of our vision to attain Universal Health Care Coverage Leaving No One Behind.”
Acknowledging that the improvement made so far is slow with huge gaps of unmet need for contraceptives, Ehanire expressed the federal government’s commitment to bridging the gaps.
“We are aggressively stepping up action and efforts, particularly at the subnational levels to traject the trend in the right direction and bridge the gaps.
“Efforts are ongoing to leverage additional domestic resources and harness the potentials existing within our large but youthful population through concerted and coordinated efforts of multi-sectoral players in the areas of health, women affairs, education and gainful employment, including humanitarian crisis as the insecurity has impacted negatively on the health education of girls and adolescents,” he explained.