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Contraception is not a panacea

The UK Government/Gates Foundation summit on family planning is a good thing, but we can't be fooled into thinking it can solve all our problems.

Indian programme officer G. Shilpa poses with a female condom
Indian programme officer G. Shilpa poses with a female condom at an awareness camp in Hyderabad. Photograph: Getty Images

Every day around the world 1,000 women die from complications related to pregnancy or childbirth. Think about it: that’s 365,000 women every year – almost as many as the total population of Bristol.

In many of the world’s poorest countries early marriage, overstretched healthcare services and low adoption of modern contraception methods together create a situation where pregnancy can be a cause for real concern as well as celebration.

So it is great news that the prime minister will tomorrow host a joint UK Government/Gates Foundation summit on family planning intended to provide 120 million women with access to contraception over the next eight years at a cost of £2.6bn.

David Cameron and International Development Secretary Andrew Mitchell certainly deserve real credit for putting the issue of family planning firmly on the development agenda. Giving millions more women the means to choose when and whether to start families will not only save lives, it will also help families who are struggling to feed their existing children avoid unwanted pregnancies. And it could play a role in helping younger brides delay pregnancy until they are ready to have children.

But the government needs to avoid the misconception that contraception is a panacea. Girls forced into early marriage, for example, often have less control over the choice about when to start a family. Handing out contraceptives is necessary but not enough. These efforts need to be backed up by education and support services that empower women to assert their rights. And women who choose to get pregnant will still die unnecessarily unless there are good quality health services to take care of them.

Alongside the provision of contraception we need more programmes like the one Oxfam runs in Hadrahmout Governate in Yemen where only a quarter of the population has access to primary healthcare.  There we are building health facilities, distributing home delivery kits and supporting health education and awareness raising programmes. We are also training midwives, a process which not only improves healthcare but can also raise the status of women in society.
These issues may not get much airtime at the summit, to be held on July 11, World Population Day, which is planned as the government’s latest effort to communicate to the British public the benefits our aid brings. In these tough economic times, ministers deserve a loud cheer for its unwavering commitment to keeping Britain’s promises to the poorest in the face of some significant opposition on their own backbenches and beyond.

There are potentially two reasons why ministers find family planning an attractive topic for such an event. Firstly, giving women a chance to gain control of their own reproductive health is something that can save lives, and that we can all understand.

Critics opposed to aid or who believe that our concern for the poorest should begin and end at home have two simple questions to answer: do you believe that it is right that women in Sierra Leone, for example, are more than 70 times more likely to die as a result of pregnancy or childbirth than those in the UK? If not, what would you do about it?

The second attraction of family planning is potentially more problematic. Population growth is the public’s number one concern about development– yes, higher than corruption. This goes beyond simple prejudice about growing numbers of Africans or Asians (although that doubtless does exist) - it is also fuelled by concerns that population growth is responsible for climate change and other environmental problems.

This is based on a fallacy. It is consumption in the rich rather than the poor world that is primarily responsible for the pressure on our planet. In the 25 years to 2005, for example, Sub-Saharan Africa accounted for almost a fifth of the growth in the world’s population but only 2.4 per cent of the increase in CO2 emissions. By contrast, North America was responsible for four per cent of population growth but a staggering 13.9 per cent of the rise in emissions.

These facts did not stop the Optimum Population Trust deciding a couple of years ago, ahead of the Copenhagen climate summit, to launch a carbon off-setting scheme where instead of planting forests your money was used to fund family planning in poor countries.

It is the government’s job to challenge public prejudice which is not based on fact. It needs to find ways to ensure that tomorrow’s summit avoids reinforcing such lazy and (for us high consumers) convenient thinking.

Barbara Stocking is Chief Executive of Oxfam