Birth Contraceptives in Developing Countries

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Birth contraceptives, also known as birth control, are methods of preventing unexpected pregnancies amongst both men and women. Many individuals in developing countries do not have access to the advanced birth contraceptives that developed countries do. Developing countries have low living standards, are not industrialized and have a low Human Development Index (HDI) compared to other countries. Due to financial limitations and lack of knowledge, developing countries are unable to easily obtain modern contraceptive methods. [1] [2]

History

In the 1960s, various international organizations and governments began to raise concerns regarding the steady growth of populations and unwanted births among individuals in developing countries, primarily due to the lack of access to birth contraceptives. To this day there are several organizations that have made great strides towards addressing the lack of birth contraceptives in developing countries. For example the Bill and Melinda Gates Foundation, which is a non-profit organization that has the goal to "to bring access to high-quality contraceptive information, services, and supplies to an additional 120 million women and girls in the poorest countries by 2020 without coercion or discrimination, with the longer-term goal of universal access to voluntary family planning." Another organization that works towards similar goals is the World Health Organization (WHO). In particular WHO works to "promote family planning by producing evidence-based guidelines on safety and service delivery of contraceptive methods, developing quality standards and providing pre-qualification of contraceptive commodities, and helping countries introduce, adapt and implement these tools to meet their needs." In addition WHO is also developing new contraceptive methods, including male methods, to reduce the unmet need for contraception."

Less than 20 percent of women in Sub-Saharan Africa and barely one-third of women in South Asia use modern contraceptive.

Contraception Methods

Generally, developing countries only have a few methods of birth contraceptives offered to the public. In developing countries, the most common birth contraception methods include female sterilization (21%) and the IUD (15%). [3]

African countries typically have incredibly low accessibility for every method of birth control. In 1999,

  • 73% of African countries offered condoms,
  • 65% offered the pill,
  • 54% offered IUDs,
  • 42% female sterilization,
  • 26% male sterilization.[4]

In other countries, the government and various health organizations have only started providing birth contraceptives to the public. Afghanistan only started distributing increasingly more condoms and birth control pills in 2002, after the demise of the Taliban. [5] Studies have found that in countries where there is a high availability of a specific method, usage of that method is also high.

Limitations

Individuals living in fully developed countries, such as the United States and Canada, have easier access to birth contraceptives than individuals in developing countries, such as Sub-Sahara African and South Asian countries. People with a low income, low education, remain unmarried or reside in rural parts of the country endure the greatest barriers and have limited access to birth contraception methods [6]. Areas with higher education levels and availability have a greater percentage of contraceptive users [7]. Limitations to access of birth contraceptives include restrictions to knowledge about methods [8], concerns about health effects [9], limited options and availability of contraceptives [10], and cultural and religious oppositions regarding birth control [11].

Most developing countries only provide a finite choice of contraceptives. This restricts couples to choose an approach that adapts their reproductive needs [12]. When couples do have the freedom to choose which contraceptive they would like to use, there is typically a lack of availability. In most countries, birth control pills and condoms are easily available to the public. However, access to IUDs and female sterilization is steadily increasing [13].

Similarly, many developing countries lack in quality of their services available. This includes a deficiency in the training of hospital staff members or biases among doctors and staff regarding specific birth contraception methods [14] based on their cultural and religious oppositions [15].

Benefits

Health

Without birth contraceptives, women in developing countries are unintentionally getting pregnant and giving birth multiple times. Also the spread of HIV/AIDs has had dire consequences of many underdeveloped and developing populations that do not have protected, and safe sex. Access to condoms, circumcision services, treatment, and harm reduction services are essential to enable individuals to put their knowledge about HIV and safe sex into practice. In Botswana, the Ministry of Health distributed close to 20 million condoms while the charity Population Services International distributed almost 10 million.The short periods of time in between each birth has an enormous effect on their bodies and mental health, which also wears them down with each birth. Additionally, pregnancy and childbirth creates complications for both the mother and the child. Women and newborn children are at risk for diseases and health risks, and occasionally mortality. With the implementation of more birth contraceptive options in developing countries, and therefore usage amongst women, developing countries can prevent unintended pregnancies, reduce the amount of abortions, and lower the death rates in relation to pregnancy and child birth [16].

This is a picture of a roadside sign in Botswana. The sign is used to educate people about HIV and AIDS. The sign reads as 'Avoiding AIDS is as easy as... Abstain, Be faithful and Condomise'. This sign is a first step in publicly acknowledging the AIDS crisis in Botswana.

In developing countries, death in childbirth is 20x more likely than in developed countries. Maternal mortality risk is increased with consecutive pregnancies. For example, in Sub-Sahara Africa, women have a 1 in 18 chance of dying in childbirth [17] - the highest mortality rate due to childbirth amongst women[18]. Approximately 168,000 women die from birth affiliated causes, and half had no intentions of becoming pregnant [19].

If developing countries had accessibility to modern contraceptive methods, 48,000 maternal deaths and 555,000 infant deaths would be prevented [20].

Similarly, women's generally lives would approve substantially. Without constantly giving birth and taking care of children, women would have the opportunity to obtain an education and enter the workforce; thus giving them more economic opportunities and increased income [21].

Economic

An increase in unwanted births, and ultimately an increase in population growth affects the economy in the long run. Since many women are constantly giving birth to children every year, they are unable to enter the workforce. This stunts the economic growth of the country.

With birth contraception in developing countries, there would be fewer children born per year and ultimately more women in the workforce, thus increasing the economic growth of the country.[22] Similarly, with fewer children, families would have more disposable income. Women who are in the workforce are more likely able to afford proper healthcare and education for themselves and their children [23]. Some argue that decreasing the birth rates in countries is important for economic growth in countries.

Population Growth

Unwanted births due to lack of access to contraceptives is the leading cause to population growths. Between 1995 and 2000, fertility rates amongst the least developed countries was approximately 5.46 children per woman.[24]

As one of the world's leading developing, low-income countries, Africa has the highest population per square kilometer - 350 people per square kilometer.[25] The high population density is due to the lack of contraceptives available to them.[26]. According to the World Resources Institute, by 2050, the world's population will grow by 34% [27].

Statistics

On average, contraceptive use in developing countries is 61%. However, rates are lower than 40% in countries such as Sub-Saharan Africa, Melanesia, Micronesia, and Polynesia. 77% of developing countries have increased contraceptive usage rates since 2000. [28]

Contraceptive use in Africa rose to 30% in 2006, from the previous statistics of 5% in 1991.[29] In 2012, 42% of Sub-Saharan African women between the ages of 15 and 49 preferred to avoid pregnancy, however only 17% of them were actually using birth contraceptives - similar to what it was in 2008 [30]. Although the number of women using modern birth contraceptive methods has increased substantially, the growth is not enough to keep up with the growing population of reproductive women [31]. To fully meet the contraceptive needs of Sub-Saharan Africa, it would cost $2.7 billion annually. Fully met contraceptive needs would include constant supply of a variety of modern birth contraceptive methods, education of methods, and service distribution. Currently, the costs of contraceptive support is approximately $381 million per year [32].

Demand for Contraception

Women who do not want to conceive a child yet are not using contraception are considered to have an unmet need for contraception. Approximately 122.7 million women in developing countries have an unmet need for contraception. The area with the highest unmet need of 19.4% is in Sub-Saharan Africa. The majority of Sub-Saharan African countries have a higher unmet need for contraception than women using some sort of contraception.

References

  1. http://www.gatesfoundation.org/What-We-Do/Global-Development/Family-Planning#AreasofFocus
  2. http://www.who.int/mediacentre/factsheets/fs351/en/
  3. http://www.un.org/esa/population/publications/contraceptive2011/wallchart_front.pdf
  4. Ross, John, Hardee, Karen, Mumford, Elizabeth, Eid, Sherrine. "Contraceptive Method Choice in Developing Countries". International Family Planning Perspectives, March 2002.
  5. "AFGHANISTAN: Battle lines drawn over contraception". IRIN Asia, March 2009.
  6. "Costs and Benefits of Investing in Contraceptive Services in the Developing World". UNFPA Fact Sheet. June 2012.
  7. Radboud University Nijmegen. "Birth control good for education, women's work, growth in Africa." ScienceDaily. October 2013
  8. DaVanzo, Julie, and Adamson, David M. "Family Planning in Developing Countries." RAND. 1998.
  9. DaVanzo, Julie, and Adamson, David M. "Family Planning in Developing Countries." RAND. 1998.
  10. Urban, Annie. "When Saving Women's Lives Becomes Controversial". Care2. July 2012.
  11. Urban, Annie. "When Saving Women's Lives Becomes Controversial". Care2. July 2012.
  12. Ross, John, Hardee, Karen, Elizabeth, Mumford, and Eid Sherrine. "Contraceptive Method Choice in Developing Countries". International Family Planning Perspectives, March 2002.
  13. Ross, John, Hardee, Karen, Elizabeth, Mumford, and Eid Sherrine. "Contraceptive Method Choice in Developing Countries". International Family Planning Perspectives, March 2002.
  14. Ross, John, Hardee, Karen, Elizabeth, Mumford, and Eid Sherrine. "Contraceptive Method Choice in Developing Countries". International Family Planning Perspectives, March 2002.
  15. Urban, Annie. "When Saving Women's Lives Becomes Controversial". Care2. July 2012.
  16. "Costs and Benefits of Investing in Contraceptive Services in the Developing World". UNFPA Fact Sheet. June 2012.
  17. DaVanzo, Julie, and Adamson, David M. "Family Planning in Developing Countries." RAND. 1998.
  18. Rao, Chalapati, Lopez, Alan D., and Hemed, Yusuf. "Disease and Mortality in Sub-Saharan Africa. 2nd edition". The International Bank for Reconstruction and Development. 2006.
  19. "Costs and Benefits of Investing in Contraceptive Services in the Developing World". UNFPA Fact Sheet. June 2012.
  20. "Costs and Benefits of Investing in Contraceptive Services in the Developing World". UNFPA Fact Sheet. June 2012.
  21. Radboud University Nijmegen. "Birth control good for education, women's work, growth in Africa." ScienceDaily. October 2013.
  22. Canning D., Schultz TP. "The economic consequences of reproductive health and family planning". Lancet. July 2012.
  23. DaVanzo, Julie, and Adamson, David M. "Family Planning in Developing Countries." RAND. 1998.
  24. Levine, Ruth, Langer, Ana, Birdsall, Nancy, et. al. "Chapter 57: Contraception". Disease Control Priorities in Developing Countries: 2nd Edition. 2006.
  25. Ndaruhuye, Dieudonné Muhoza, Broekhuis, Annelet, and Hooimeijer, Pieter. "Demand and Unmet Need for Means of Family Limitation in Rwanda". International Perspectives on Sexual and Reproductive Health. September 2009.
  26. Singh, Susheela, and Darroch, Jacqueline E. "Adding It Up: Costs and Benefits of Contraceptive Services". UNFPA. June 2012.
  27. Rust, David L. "The Ethics of Controlling Population Growth in the Developing World". Intersect. 2010.
  28. http://www.un.org/esa/population/publications/contraceptive2011/wallchart_front.pdf
  29. Cleland, John G., Ndugwa, Robert P., and Zulu, Eliya M. "Family planning in sub-Saharan Africa: progress or stagnation?" World Health Organization. 2011.
  30. "Costs and Benefits of Investing in Contraceptive Services in the Developing World". UNFPA Fact Sheet. June 2012.
  31. "Costs and Benefits of Investing in Contraceptive Services in the Developing World". UNFPA Fact Sheet. June 2012.
  32. "Costs and Benefits of Investing in Contraceptive Services in the Developing World". UNFPA Fact Sheet. June 2012.