Repositioning Family Planning in West Africa

Repositionnement de la Planification Familiale en Afrique de l’Ouest

Sponsored by: U.S. Agency for International Development (USAID), World Health Organization (WHO), Action for West Africa Region Project - Reproductive Health (AWARE-RH), Advance Africa, the POLICY Project

The Evolution of Family Planning in West Africa:

1964-2004

byDr. Richard B. Turkson

February 15, 2005La Palm Hotel-Accra,

Ghana

Introduction/Background

• From where have we COME• Where are we NOW• Significant landmarks in evolution of

FP in West Africa• What factors have influenced the

various phases• Where are we all HEADED!!

Whence come we?…• Pre 1960s

- Modern FP non-existent in West Africa region- Francophone W. Africa & the French Anti-

Contraception Law of 1920

• The period 1960-1970s- Changes began to emerge - Some Countries with official government policies- In others, perception of the problem of under-

population

• The period 1980-1990s- Reverses in economic gains of the 1970s- High rates of population growth – Credibility

of the FP moment enhanced- EXPECTANT SLOGANS ‘ FP for all! etc

The 1990s- period of RISING EXPECTATIONS

• Earlier in the 1984 Arusha Declaration, FP seen as integral part of socio-economic development and a contributor to QUALITY HEALTH

• Preparatory regional meetings produced the DAKAR-NGOR Declaration – Re-affirmation of Arusha Declaration

• The historic ICPD, Cairo 1994 - 20 year POA

• World-wide recognition of FP as a basic HUMAN RIGHT

• This right translates or should translate into the necessary social, economic and cultural conditions under which the individual’s legitimate aspirations and dignity may be realized

Ten years on - What is the SITUATION?

10.3

78.1

20.911.5

81.1

18.9

0

10

20

30

40

50

60

70

80

90

More developed regions Less developed regions Africa

1994

2004

Source: World Population Prospects, 2002

Percent of World Population Distribution

Ten years on - What is the SITUATION?

Source: World Population Prospects, 2002

5.63

3.4

1.69

4.91

2.921.56

0

1

2

3

4

5

6

7

8

More developed regions Less developed regions Africa

1990-95

2000-05

Total Fertility Rate (Ave. # of children per woman)

Ten years on - What is the SITUATION?

TFR and CPR, West Africa

19

46

98

0

5

10

15

20

2530

35

40

45

50

Benin

B. Fas

o

Camer

oon

C. Ver

deCha

d

C. d'iv

oire

Gam

bia

Gha

na

Gui

nea

G. B

issau

Liber

iaM

ali

Mau

ritin

ia

Niger

Niger

ia

Seneg

al

S. Leo

neTog

o

TFR

CPR

Source: PRB, 2004 World Pop. Data Sheet

In Sum…..….

• Evidence available indicates awareness has been created

• This has led to significant changes in official positions and attitudes to FP

• YET, major challenges remain since FP/RH is central to development and in meeting the MDGs

Some of the challenges……• Strengthen FP programmes-expand

coverage in rural areas-improve access to basic health services as well

• Do community outreach• Expansion implies improved logistics and

commodity supply – resource mobilization• Comprehensive review of laws, policies,

administrative regulations and socio-cultural practices relating to SRH

• Build stronger partnerships and collaboration

To Conclude……• ICPD Programme of ACTION needs to be

continuously explained, promoted and defended• ADVOCACY- to keep the relevant issues on the

front burner• Continue to involve Males, expand scope and

coverage of such programmes• Continue and conclude research into method mix.

eg male methods • Resource mobilization still critical to our success –

see quote from UN Secretary General

“The messages 10 years after the Conference are clear:current levels of resource mobilization are inadequate to fully implement

the Cairo agenda; resource gaps are especially large in poor countries. The consequences of resource shortfalls include significant increases in unintended pregnancies, abortions,

maternal morbidity and mortality, infant and child mortality, as well as AIDS-related morbidity and mortality… Without a firm

commitment to population and reproductive health and gender issues and the concomitant allocation of resources, it is unlikely

that any of the goals and targets of the conference or the Millennium summit will be

effectively met”.

Quote from Mr. Kofi Annan, UN Secretary General: Progress Report on Implementation of ICPD-POA