INTENSIFY GHANA'S FAMILY PLANNING PROGRAMME (PAGE 11)

Abibata Fuseini (not real name) is a 30-year-old farmer who lives in a remote village in the Upper West Region of Ghana.
Having married after eloping at 15 years, she became a mother. Thinking that a maximum of three children would be okay for her, Abibata was soon to realise that it was going to be difficult for her to stand by her decision.
Now at 30 years, she has 11 children with the majority of them malnourished. What has happened to the family planning programmes initiated some years ago?
The Ghana National Family Planning Programme (GNFPP) was established in 1970 to serve as the vehicle for the promotion and provision of family planning education and services in the country.
Although family planning was largely seen and used as an instrument by the government to achieve national development objectives, the health benefit rationale for family planning was not totally ignored. Some of the health benefits for children, among which are the low risks of premature birth, low birth weight and prenatal, infant or early childhood death, were significantly reduced.
As a result, the benefits include lower risks of death and complications of pregnancy and labour such as anaemia, pregnancy-induced hypertension, haemorrhage and infections.
The Ghana Demographic Health Survey (GDHS, 2003) estimated that 34 per cent of married women had an unmet need for family planning; 22 per cent for those who wish to space births and 12 per cent for those who have decided not to have any more children.
There is a wide rural-urban disparity in unmet need for family planning; 38 per cent of the demand for family planning, “Implying that the needs of more than one in two Ghanaian women are currently not being met” (GDHS, 2003)
The results of the GDHS (2003) indicate that overall, 16 per cent of pregnancies are mistimed.
In the words of the Upper West Regional Population Officer, Mr Mark Abugnaba, “Many unintended pregnancies probably end up as unsafe abortions, which also result in between 20 and 30 per cent of all maternal deaths in the country”.
Furthermore, infant and child mortality rates have worsened while the maternal mortality ratio has not significantly improved. Recent estimates in Ghana indicate that if current birth intervals of between 18 and 24 months are increased to 36 months, the infant mortality rates would drop by 27 per cent and 23 per cent, respectively. This means that the lives of 21,700 children under five years of age would be saved every year.
Similarly, fulfilling unmet need would avert 4,419 maternal deaths between 2000 and 2015 by reducing the number of unintended pregnancies and recourse to unsafe abortion.
“Apart from preventing unwanted or mistimed pregnancies, contraceptives contribute to improve health for women by reducing the risk of Sexually Transmitted Infections (STIs) including HIV and AIDS and certain cancers of the reproductive tract,” Mr Abugnaba said.
It is in the light of the numerous benefits that the country stands to gain that family planning must be repositioned. Repositioning family planning in the country will help increase public awareness and acceptance of and political commitment to it as an essential component of national health and socio-economic development and poverty reduction goals.
This must be done in collaboration with the metropolitan, municipal and district assemblies (MMDAs).
The MMDAs have critical roles to play in promoting and financing family planning activities and programmes.
They, therefore, require assistance to strengthen their technical and management capacities to integrate population issues in general and family planning in particular, into their development planning activities and to mobilise local resources including social support for planning.
In achieving this, selected staff in the Northern, Upper East and Upper West regions must be trained to do so. This, the writer believes would go a long way to avert situations like the one Abibatu Fuseini finds herself in.