28 May 2013; Kuala Lumpur: From 2830 May, Kuala Lumpur plays host to the Women Deliver conference, billed as “the largest global event of the decade to focus on the health and empowerment of girls and women.” This is particularly timely as May 28th is the International Day of Action for Women’s Health, which highlights access to contraceptives and family planning as a human right. Women’s ability to choose the number, spacing and whether they wish to have children is a basic human right, an important indicator of women’s empowerment, and is a cornerstone for improving women’s health outcomes. It is also very much a development issue, as it is linked to poverty alleviation and attaining food security and sovereignty.
Globally, approximately 222 million women have unmet need for modern contraception, according to the Guttmacher Institute and the United Nations Population Fund (UNFPA). Of these, 140 million women come from AsiaPacific. Women who have an unmet need for contraception are those who are sexually active and wish to delay or stop having children, but are not using modern contraception. The Malaysian case is a good example through which to view the problem of unmet contraceptive need. According to the UNFPA, the Contraceptive Prevalence Rate (CPR) in Malaysia has stagnated at approximately 50% in the last 20 years. CPR refers to the percentage of women of reproductive age who are using some method of contraception; comparatively, countries like Australia, Thailand and Vietnam have a contraceptive prevalence rate of over 70%.The Reproductive Rights Advocacy Alliance Malaysia (RRAAM), one of ARROW’s Malaysian national partners, states that Malaysia’s low CPR results in high unwanted pregnancies, and “clearly indicates the continuing problem of public perceptions about the safety of modern contraception and the inadequacy of family planning programmes and the media to accurately inform and reassure people.” This is a common theme across much of AsiaPacific. Sivananthi Thanenthiran, the Executive Director of ARROW, says, “Unmet need is routinely underestimated in AsiaPacific as the data does not reflect unmarried women except in Cambodia and the Pacific.”
But why is access to contraception important? It reduces unwanted pregnancies, which limits demand for unsafe abortion. The lack of access to safe, legal abortion services kills and disables thousands of women in the global South each year. Spacing of children would also reduce pregnancy and childbirthrelated deaths, one of the top killers of women in the Asia- Pacific. Access to contraception is critical to achieving the Millennium Development Goal of reducing maternal deaths by three quarters by 2015.
Beyond the above, Thanenthiran emphasises, “We need to understand that sexual and reproductive health is not only an issue of access to health services. Women being able to decide on the number, timing and spacing of the children they bear is an important indicator of women’s autonomy over their bodies.” Unmet need for contraception tends to reflect wider concerns of gender inequality. Due to the fact health care is not universally available either for free or at subsidised rates in Asia Pacific, women who experience complications during pregnancy or childbirth can face substantial costs that drive them into poverty.
The Women Deliver conference is unique in that it brings together researchers, policy makers and civil society organisations from all around the world in order to problem solve for better health outcomes for women and girls. This is the first Women Deliver global conference to be held in Asia and signals the growing sentiment that women’s health and girls health are of crucial importance to the health and success of growing and developing Asian economies.
By Gaayathri Nair
Guttmacher& UNFPA study:
Reproductive Rights Advocacy Alliance Malaysia (RRAAM): http://www.rraam.org
Women Deliver: www.wd2013.org
World Health Organisation: http://whqlibdoc.who.int/publications/2010/9789241599528_eng.pdf