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Presented at the KNUST Annual Scientific Conference 26TH AUGUST 2010

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1 ADDRESSING THE MILLENNIUM DEVELOPMENT GOALS - THE ROLE OF FAMILY PLANNING.
Presented at the KNUST Annual Scientific Conference 26TH AUGUST 2010 by Dr. Gloria J. Quansah Asare Director, Family Health Division Thank organizers for invitation and interest in topic Relevance of theme – “Reproductive & Child Health: Current Trends and Challenges”

2 Content MDGs Current Country Status (Health Related MDGs) FP FP & MDGs
Conclusion Way Forward References

3 Millennium Development Goals
Millennium Development Goals are a UN framework for global development There are a total of 8 MDGs and 4 goals are directly related to health: End Poverty & Hunger Universal Education Gender Equality Child Health Maternal Health Combat HIV/AIDS Environmental Sustainability Global Partnership

4 MDG 1: End Poverty & Hunger
Goal: eradicate extreme poverty & hunger Target: to halve, between the proportion of people who suffer from hunger Indicators: - prevalence of underweight children under five years of age

5 MDG 4: Child Health Goal: reduce child mortality
Target: to reduce, by 2/3, between under-5 mortality rate Indicators: - Under-five mortality rate - Infant mortality rate - Proportion of 1 year-old children immunised against measles (increase by 2/3)

6 MDG 5: Maternal Health Goal: reduce maternal mortality
Target: to reduce by 3/4 between maternal mortality ratio Indicators: - Maternal mortality ratio - Adolescent birth rate - Unmet need for family planning (Increase) - Proportion of births attended by skilled health personal -Contraceptive prevalence rate -Antenatal care coverage

7 MDG 6: Combat HIV/AIDS, Malaria and Other Diseases
Goal: combat HIV/AIDS, Malaria and other diseases Target: have halted by 2015 and begun to reverse the spread of HIV/AIDS Indicators: - HIV prevalence among population aged years - Condom use at last high-risk sex - Proportion of population aged with comprehensive correct knowledge of HIV/AIDS

8 MDG 6: Combat HIV/AIDS, Malaria and Other Diseases cont.
Goal: combat HIV/AIDS, Malaria and other diseases Target: achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it Indicators: - Proportion of the population with advanced HIV infection with access to antiretroviral drugs

9 MDG 6: Combat HIV/AIDS, Malaria and Other Diseases cont.
Goal: combat HIV/AIDS, Malaria and other diseases Target: have halted by 2015 and begun to reverse the incidence of malaria and other major diseases Indicators: - incidence and death rate associated with Malaria - Proportion of children under five sleeping under insecticide-treated bed nets - Proportion of children under 5 with fever who are treated with appropriate anti-malarial drugs - Incidence, prevalence and death rates associated with tuberculosis - Proportion of tuberculosis cases detected and cured under directly observed treatment short course (DOTS)

10 INTERVENTIONS & CURRENT STATUS

11 MDG 1: End Poverty & Hunger
INTERVENTIONS Prevalence of Underweight Children Under 5 years (weight-for-age -2 std. devs) Nutrition education Promotion of complementary feeding Promotion of good eating habits Promotion of exclusive breastfeeding Rehabilitation of undernourished children Food supplementation

12 MDG 4: Child Health Interventions
Under-5 Mortality, Promotion of exclusive breast feeding Promotion of early introduction of complementary feeding + breastfeeding School health services Vitamin A supplementation Immunisation Growth promotion and nutrition Curative care for minor ailments IEC

13 MDG 4: Child Health Infant Mortality, 1993 - 2008
Proportion of 1 year-old children immunised against measles, - Add neonatality data Source: DHS-Ghana, 1988, 1993, 1998, 2003 , 2008

14 MDG 4: Child Health Challenges Way forward
High Neonatal mortality rate Traditional/ Cultural practices Limited access to services Poor utilization of services Health seeking behaviours Way forward Improve skills Improve Community actions Operatios Research

15 MDG 5: Maternal Health Interventions
Services being provided nutrition education, Iron folate supplementation Tetanus immunisation Education on breastfeeding and care of the new born IPT VCT and PMTCT education to improve capacity of family and community members in home based, life saving skills Family planning services comprehensive abortion care services as permitted by law Increased access to Essential, comprehensive and basic obstetric care access to blood transfusion services coverage, content and quality of antenatal and post natal services proportion of deliveries conducted by skilled attendants Promote the prevention of unsafe abortion and post abortion care the prevention &management of reproductive tract infections the prevention and management of harmful traditional practices e.g. FGM The management of cancers of the reproductive system

16 Package of Services Safe Motherhood Emergency Obstetrics care
Essential Newborn Care PMTCT MIP Family Planning Comprehensive Abortion Care Services IE &C

17 Maternal Mortality Ratio, 1990 – 2015 Projections
MDG 5: Maternal Health Maternal Mortality Ratio, 1990 – 2015 Projections GAP Source: WHO, 2008

18 MDG 5: Maternal Health Medically Assisted Deliveries 1993 – 2008
Antenatal Care (at least 1 visit) 1988 – 2008 Source: DHS-Ghana, 1988, 1993, 1998, 2003, 2008

19 MDG 5: Maternal Health Age-Specific Fertility Rate: 15-19, 1993 – 2008
Contraceptive Use: Any Method 1988 – 2008 Contraceptive prevalence still very low Source: DHS-Ghana, 1988, 1993, 1998, 2003, 2008

20 Unmet Need for Family Planning, 1993 – 2008
MDG 5: Maternal Health Unmet Need for Family Planning, 1993 – 2008 Success! * Unmet Need figures are derived from both the number of women who want to delay childbirth or have no more children and the number that are not using contraceptive methods. Source: DHS-Ghana, 1988, 1993, 1998, 2003 ,2008

21 MDG 5: Maternal Health Challenges 3 Delays
Decision Taking, Reaching Facility, Receiving Care Limited geographical access by some clients Human resources; ageing midwives, and their numbers Inadequate EmOC equipment Way Forward Collaboration with civil society organisations, NGOs, Communities and other MDAs Training in midwifery Improve communication (mobile telephony)

22 MDG 6: HIV - Interventions
Counselling and testing services Prevention of Mother to Child Transmission Management of STIs Condom Promotion: provision of condoms to Social marketing agents Safe blood transfusion Provision of HIV test kits for all health institutions Screening of blood HIV exposure prevention in health facilities Health promotion and demand creation Treatment care and support Improve quality of treatment services Increase access to ART Strengthening care and support services for PLHIV

23 Number of Persons on ART, 2003 – 2008
MDG 6: HIV HIV Prevalence Rates, 2000 – 2008 General Population Number of Persons on ART, 2003 – 2008 Ages 15-24 Source: NACP

24 MDG 6: HIV Condom use at last high-risk sex (with a non-marital, non-cohabitating partner), 2003 & 2008 - Add def of high-risk sex Source: DHS-Ghana 2003 & draft 2008

25 MDG 6: HIV % of population (15-24 years) with comprehensive correct knowledge of HIV/AIDS, 2003 Source: DHS-Ghana 2003

26 MDG 6: Malaria Interventions
Improvement of malaria case management in health facilities e.g. ACTs, Promotion of home-based care of malaria with emphasis on symptoms detection and seeking early treatment Promotion of the use of insecticide-treated nets for children under-five and pregnant women Provision of intermittent preventive treatment for pregnant women Promotion of indoor residual spraying (IRS) Larviciding Proportion of children under 5 sleeping under insecticide-treated bed nets, 2002 – 2008

27 Malaria Case Fatality Rate Under 5, 2002 – 2008
MDG 6: Malaria Malaria Case Fatality Rate Under 5, 2002 – 2008 Proportion of children under 5 with fever who are treated with appropriate anti-malarial drugs, 1998 – 2008

28 MDG 6: TB Interventions DOTS quality expansion programme
Provision of infrastructure for supervised treatment in some district hospitals. Public –Private Mix (PPM) DOTS Integration of TB and HIV prevention, care and support activities Community based TB Care system of case holding and defaulter tracing with active community participation. Enablers package TB in prisons Advocacy , communication, social mobilization Promote behavioural change communication to support TB control Monitoring, supervision and evaluation

29 Tuberculosis Case Detection 1997-2008
Tuberculosis Treatment Outcome: Treatment Success Vrs Adverse Outcome, This is a major challenge – to improve case detection. Case detection currently estimated around 35% With reference to TB treatment Adverse outcomes include : death, treatment failure, defaulters and those who were transferred out Treatement success refers to those cure or those who completed treatment

30 MDG 6: HIV/ AIDS Challenges Way forward Delays in reporting
Human Resource: Multi tasked personnel Procurement delays Delays in initiating care (CT,PMTCT and ART) Way forward All regions to be resourced to carry ART training to increase access to HAART Increase access to CT, STI services

31 MDG 6: Malaria Challenges Way Forward
Delay in in the approval of anti malaria drug policy Some hospitals do not adhere to new anti malaria policy Existence of several mono therapies in the system Acceptability and utilisation of some brands of LLINs Improvement in diagnosis and prescription Way Forward Improvement in drug regulation Treatment of other materials other than bed nets Scale up Indoor Residual Spraying Improve diagnostic capacity of including laboratory support Scale up use of rapid diagnostic test kits

32 MDG 6: Tuberculosis Challenge Way Forward Low case detection rate
Address reasons for low case detection rate through monitoring, supervision and research Develop standard operating procedures for TB case detection Conduct national TB prevalence survey to assess magnitude of TB problem Involve ex TB patients in Tb control activities to improve case detection rate PPM DOTS expansion

33 Family Planning Family planning services include methods and practices to space births, limit family size and prevent unwanted pregnancies. Fertility by choice, and not by chance is a basic requirement for women’s health. Fertility regulation is also a major element in aiding safe motherhood strategy. reduces the number of unwanted pregnancies decrease in the total exposure to risk of pregnancy decrease in the number of unsafe abortions. Family Planning is a way of managing one’s fertility. It includes methods and practices to postpone or space births, limit family size and by so doing preventing unintended pregnancies which are often unwanted. It means that individuals and couples have “fertility by choice and not by chance”. Thus FP is a basic requirement for women’s health and reproductive rights. (ICPD and other conferences and meetings ->RH, implications, SH Improves the quality of life for Women Children Men Family as a whole Nation The earth Family planning services serve as a link to other reproductive health services.

34 Goal The goal of family planning is to assist couples and individuals of all ages to achieve their reproductive goals and improve their general reproductive health. The goal of family planning is to assist couples and individuals of all ages to achieve their reproductive goals and improve their general reproductive health. Family Planning is now seen as a human right –basic to human dignity. People and Governments around the world understand this.

35 Eligibility All individuals and couples including adolescents are eligible for family planning services.  

36 Family planning methods available in Ghana
Short term Condoms (male and female) Spermicides Oral Contraceptive pills (Combined & Mini-pill) Injectables – (3 monthly) Injectable (Monthly) Lactational Amenorrhoea Method (LAM) Long Term (Reversible) Intra Uterine Device Implants Natural Family Planning Method (Permanent /Irreversible) Tubal Ligation ♀ Vasectomy ♂ Female condoms and the monthly combined injectable contraceptive – Norigynon were introduced into the country’s method mix in 2000. Diaphragms and cervical caps are currently not offered. Emergency Contraception

37 “Planning for Progress and Development” 1969 Population Policy
“Population Growth in excess of 2 % per year is among the structural factors inhibiting the achievement of a wide range of development objectives” (UN Population Division) Ghana Population Policy, 1969 FP was seen essentially as an instrument for attaining specified demographic targets and socio-economic development objectives.

38 Post –ICPD, 1994 Global Consensus that National Development aspirations were best achieved through Comprehensive Reproductive Health Programmes including FP. Benefits of FP extend beyond slowing pace of Population Growth National RH Service Policy & Standards Adolescent Health & Development Programme Road Map for Repositioning Family Planning etc.

39 Population Targets & Performance
Year TFR CPR Projected Achieved 1988(DHS) 6.7 5.0% 1993(DHS) 5.5 10.5% 1998(DHS) 4.4 13.0% 2003(DHS) 19.0% 2008(DHS) 4.0 17.0% 2000 5.0 15% 2010 28% 2020 3.0 50%

40 TFR and use of any and modern contraceptive methods, Ghana 1988-2008
A brief conclusion from the above is that while TFR has been declining and CPR has gone up markedly in the current 2003 GDHS, Ghana continues to have one of the highest unmet need for family planning of 34 percent. If the national programme were to meet some of this need, it would make a significant contribution towards meeting the population policy target of CPR of 50 percent by Unmet family planning need provides a unique opportunity for policymakers in all sectors to respond to the expressed fertility preferences of their populations while simultaneously improving health, slowing the rate of population growth and contributing to achievement of national and millennium development goals. The total fertility rate (i.e. the number of children women of reproductive age are having in Ghana) has reduced from 6 to 4 children over the 15 year period from There is a corresponding increased use of contraception among married couples. Traditional methods include mainly periodic abstinence and withdrawal methods. While modern methods include condoms, hormonals, IUD and surgical methods. Some Achievements of the FP Programme in Ghana are: Contributed to a reduction in Total Fertility Rate High levels of knowledge of at least one FP method 99% of men and 98% of women Increasing use of contraception Expansion of range of commodities in-country Major IEC/BCC Campaigns “I Care”, “Long Term Methods”, “Life Choices”, “Vasectomy” Private Sector partnerships A brief conclusion from the above is that while TFR has been declining and CPR has gone up markedly in the current 2003 GDHS but declined in 2008, Ghana continues to have one of the highest unmet need for family planning of 34 percent. If the national programme were to meet some of this need, it would make a significant contribution towards meeting the population policy target of CPR of 50 percent by Unmet family planning need provides a unique opportunity for policymakers in all sectors to respond to the expressed fertility preferences of their populations while simultaneously improving health, slowing the rate of population growth and contributing to achievement of national and millennium development goals.

41 Unmet Need for FP Unmet need refers to women who do not want to get pregnant for the next two to three years (spacing) or women who do not want to have any more children (limiting) but are not using any method. Unmet need is 34% 10% higher in Rural area Program Factors Contributing to Unmet Need for Family Planning in West Africa Shifting / stagnating donor and government resources for family planning Shortages of contraceptives and other commodities Lack of trained managerial and technical staff Inequity in access to family planning (urban versus rural) Vertical programming leading to missed opportunities (need for FP/MCH/HIV/AIDS integration) Communications focus on population control rather than health needs of women and children, and high risk fertility behaviors linked to mortality The urban-rural difference in unmet need and contraceptive use in Ghana is serious and indicates that we have to find appropriate strategies to make services more accessible (physical, social and financial access) and of good quality to the rural areas.

42 Some Challenges Decreasing Contraceptive Prevalence rate
19% to 17% (GDHS 2003, 2008) Persistently High Unmet Need for FP 34-35% Rumours, Myths & Misconceptions about contraceptives Contraceptive Security issues Reduced or Dwindling Funding Procurement of contraceptives Programme activities particularly demand generation (IE&C, BCC) Sub optimal integration of FP with other services

43 A Pivotal Service in RH Family Planning
A component of Reproductive Health Also a component of Safe motherhood Cuts across most components of RH Post Abortion Care, Comprehensive Abortion Care STI/HIV/AIDS Prevention and Management Infertility Prevention and Management Adolescent and Male Services Gender-based Violence Family Planning is a component of Reproductive Health. It is one of the components of safe motherhood which aims at reducing ill health and death due to complications of pregnancy and improving women’s and infant health. and also stands on its own merit since all individuals and couples are eligible. It cuts across and is relevant to most of the other components of Reproductive Health. The major component areas are Post Abortion Care, Comprehensive Abortion Care STI/HIV/AIDS Prevention and Management Infertility Adolescent and Male Services

44 FP Benefits All! Women Children Men Families Communities Nations
The Earth Family planning providers can be proud of their work because family planning helps everyone. Some of the ways are: Women: FP helps women protect themselves from unwanted pregnancies. Since the 1960’s family planning programmes have assisted women around the world avoid over 400 million unwanted pregnancies thus saving women’s lives from high-risk pregnancies, unsafe abortions and the reduction of pregnancy related deaths (maternal mortality). This could fall by 25% (one in four) if all women could avoid unwanted pregnancies. Also many FP methods have other health benefits e.g. some hormonal methods prevent certain cancers while condoms help prevent STIs including HIV/AIDS. Children: Family Planning saves the lives of children by helping women space births. Globally, between 13 and 15 million children under age five years die each year. There is evidence that if all children were born at least 2 years apart, 3 to 4 million of these deaths could be avoided. Men: FP helps men-and women- care for their families. Men around the world attest to the fact that planning their families helps them provide a better life for their families. It also improves male reproductive health e.g prevention of STIs. Families: Couples with fewer children are better able to provide food, clothing, housing, schooling etc for their children. This extends to communities and nations. Communities and Nations: Family Planning helps nations develop. People’s and whole nations economic situations are improving in countries where women are having fewer children than their mothers did. The Earth: If couples have fewer children it will take the world’s population longer to double thus reducing future demands on the earth’s natural resources such as water and fertile soil and a better opportunity for a good life.

45 Evidence of longer birth intervals effects on health
For Children Lower risk of: Child death Infant death Neonatal death Fetal death Stunting and underweight Small for gestational age Low birth weight Preterm birth For Mother Lower risk of : Maternal death Puerperal endometritis Premature rupture membranes Anemia Third trimester bleeding Conde-Agudelo A., Effect of Birth Spacing on Maternal and Perinatal Health: A Systematic Review and Meta-Analysis. Rutstein, S. Johnson & Conde-Agudelo A. Systematic Literature Review and Meta-Analysis of the Relationship between Interpregnancyor Interbirth Intervals and Infant and Child Mortality. Reports submitted to CATALYST Consortium, October 2004, Conde-Agudelo, A. and Belizan, J.M. Maternal morbidity and mortality associated with interval: Cross sectional study. British Journal (Clinical Research Ed.) 321 (7271): Nov. 18, 2000.

46 Family Planning is Pivotal to SRH & Relevant in All 8 MDGs!

47 FP and MDG’s 2 Education 1. Poverty 3 Gender 4 Child Health 5
Maternal Health 6 HIV, Malaria, Other 7 Environment 8 Partnership

48 FP & MDGs MDG1: Poverty Eradication
2. Education 3. Gender 4. Child Health 5. Maternal Health 6. HIV, Malaria, Other 7. Environment 8. Partnership FP & MDGs MDG1: Poverty Eradication MDG2&3: Education & Gender With exception of a few oil rich states,no country has pulled itself out of poverty while maintaining high fertility E.g. Thailand, South Korea and Taiwan all lowered fertility before achieving economic success # of school age children double every 20 years, undermining quality Girls tend to have educ stopped or shortened “If you educate a woman, you education a nation.” Dr. J.K. Aggrey There is a large “unmet need” for family planning, that if we satisfied this unmet need (that is to say if all these women started using a contraceptive method) in addition to those already using. we would have a contraceptive prevalence rate of over 50%. (52%) With regard to family planning. This would put us in the company of countries such as (Indonesia, Thailand, South Korea, Taiwan, Malaysia). The economic success of these countries is something we want to emulate. And it is no mistake that they increased their contraceptive prevalence rate before they were able to achieve their economic successes. Lower birth rates are a necessary, but not sufficient condition for a developing country to escape poverty. A “demographic dividend” occurs when family size falls rapidly, and there are relatively more people of working age with fewer dependent children. Thailand, South Korea and Taiwan are three countries that have successfully managed to take advantage of their demographic bonus, raising the living standards of millions of their citizens. In developing countries where the birth rate has fallen, between 25% and 40% of economic growth is attributable to the demographic change. 3 In Ghana we can do the same in our aspiration to become a middle income country. Except for a few oil rich states, no country has pulled itself out of poverty while maintaining high fertility.” Conversely, many countries that lowered their birth rates have eradicated or greatly reduced poverty. 3 We aim to be counting Ghana among countries that have pulled themselves out of poverty. So we see that family planning is a critical element of success for achieving and sustaining Millennium Development Goal #1 a reduction in poverty in the nation. And family planning programs are one of the key elements that will help us to achieve and sustain all of the MDGs. MDG2- UNIVERSAL PRIMARY EDUCATION IN GHANA Rapid population growth undermines basic education in a vicious cycle. The number of school age children can double every 20 years in high population growth countries. As pupil-to-teacher ratios rise, educational quality is at risk. MDG 3- PROMOTE GENDER EQUITY AND EMPOWER WOMEN IN GHANA The ability of women to control their own fertility is absolutely fundamental to women’s empowerment and equality. Fertility management is the most important step to full empowerment and gender equality. And is a major factor in the ability of young women to complete their education. We remember Dr. J.K. Aggrey’s famous saying: “If you educate a woman, you educate a nation”.

49 FP & MDGs MDG4: Child Health MDG5: Maternal Health
1. Poverty 2. Education 3. Gender 4. Child Health 5. Maternal Health 6. HIV, Malaria, Other 7. Environment 8. Partnership FP & MDGs MDG4: Child Health MDG5: Maternal Health Closely spaced children lead to increase in child deaths # of child deaths averted if unmet need for FP in Ghana were met: 200,000 over 10 years = 20,000 per year = 55 child deaths per day Risk of maternal death increases if woman is: Too old, too young Has many children or closely spaced children # of maternal deaths averted if unmet need were met: 4000 over 10 years = 400 per year = >1 per day the very real health benefits of family planning to mothers and children, MDG#4 and MDG#5, and how family planning can help us to achieve them. Need to emphasize the magnitude of the impact that family planning can have on the health and well-being of our families, and ask you to imagine your own family and what this can mean for you. Based on an analysis by the Health Policy Initiative of the Futures Group International, the Ministry has told us that addressing the unmet need would avert almost 200,000 child deaths over a 10-year period in Ghana. That’s an average of 20,000 child deaths per year or 55 child deaths every day in Ghana. 4 With regard to maternal health, fulfilling the unmet need for family planning in Ghana would avert almost 4000 maternal deaths over a 10 year period. That’s almost 400 maternal deaths per year, or more than 1 maternal death per day, every single day in Ghana. That means in just one year 400 Ghanaian families would be spared the heartache and catastrophe of losing their mother and wife to maternal-related death. 4 For these benefits alone, the large and well-documented unmet need for family planning must be addressed.1 But there are even more benefits to the nation and to families.

50 FP 1. Poverty 2. Education 3. Gender 4. Child Health 5. Maternal Health 6. HIV, Malaria, Other 7. Environment 8. Partnership FP & MDGs MDG6: Combat HIV/AIDS, Malaria and Other Diseases MDG7: Environmental Sustainability Rapid pop growth negatively impacts overstretched health systems Promotion and access of male and female condoms thru FP programs protect against HIV/AIDS & STIs Rapid pop growth negatively pressures: Forests, biodiversity Coastal and marine ecosystems, fisheries Surface water from agric and mining pressures Flooding in urban areas due to rapid in-migration MDG6- COMBAT HIV/AIDS, MALARIA AND OTHER DISEASES IN GHANA Rapid population growth negatively impacts on already overstretched health systems and facilities, making it even more difficult to provide adequate health care services for people. Contraceptive services, specifically male and female condoms, also help prevent HIV as well as unintended pregnancy. MDG7 ENSURE ENVIRONMENTAL SUSTAINABILITY IN GHANA Population pressures are adding to the difficulties in achieving environmental sustainability, particularly regarding agricultural lands, forests, water and biodiversity. Environmental degradation is accelerating. Coastal and marine ecosystems are facing increased pressure. Deforestation is intensifying. Contamination of surface water from intensive agriculture and mining activities is more prevalent. Flooding and the provision of basic services is a major challenge in urban areas that is exacerbated by rapid migration from rural to urban areas driven by population pressures on the land and economy in rural areas. 3

51 FP & MDGs FP should be Everybody’s Business!!!
1. Poverty 2. Education 3. Gender 4. Child Health 5. Maternal Health 6. HIV, Malaria, Other 7. Environment 8. Partnership FP & MDGs MDG 8: GLOBAL PARTNERSHIPS Foster Partnerships at all levels FP has the potential of fostering partnerships and also thrives in partnerships for Advocacy, Service Delivery, Research, IEC, Coordination, Integration, etc. at all levels. Internaltional National Public Private Partnership All Stakeholders – Men, women, youth, Religious Organizations, MDA.s , Private Sector, FP should be Everybody’s Business!!!

52 Way Forward Strengthened Partnerships in:
Repositioning Family Planning Advocacy Ensuring Increased Government Funding & Support for Contraceptive Commodities & Services Improved Service Delivery IE&C Family Planning Week Re Launch “Life Choices Campaign” Media Support Research and Dissemination of Information is Crucial!

53 Conclusions Ghana can do a lot more towards achieving the health MDGs by 2015 if resources are committed. FP has the potential to hasten Ghana’s Development efforts. Ensure FP is a centrally important component of the medium term health plan and features in all poverty reduction strategies in the country. Ensure budget support. Appeal to development partners for additional support to help buttress our efforts. Reposition FP as a development tool and a choice in Life to attain goals. CALL TO ACTION In conclusion, increased contraceptive use among our people will have a wide spectrum of benefits, including poverty reduction, health benefits, education, gender, and environment, urgent action must be taken to ensure family planning provision and promotion becomes an integral part of all our development efforts in all sectors of government and society. Therefore, let’s make the “Life Choices” initiative a catalyst for broader social mobilization on family planning. Ensure it is a centrally important component of the medium term health plan and features in all poverty reduction strategies in the country. Ensure budget support. Appeal to development partners for additional support to help buttress our efforts. In view of Government’s aim of quickly addressing the poverty gap in Ghana through the creation of economic opportunities, wealth generation and proactive policies, it has become imperative that Family Planning is given the attention and financing it deserves since it has the potential to leap frog Ghana’s development efforts. There is an existing need for better spaced and small size families, and efforts must be made to meet this need by providing family planning services to reduce the spate of unplanned pregnancies, associated unsafe abortions, pregnancy complications, infant mortality and ultimately the high maternal morbidity and mortality. We should all consider family planning or contraception as a choice we make in life towards attainment of our reproductive and other goals in life. I urge all to support the drive to reposition family planning as a development tool and an important choice one makes at various stages of their life for the attainment of their reproductive, health and socio-economic goals.

54 References UNFPA Fact Sheet. http://www.unfpa.org
ICF Macro Ghana Trend Report: Trends in Demographic, Family Planning, and Health Indicators in Ghana : Trend Analysis of Demographic and Health Surveys Data. Calverton, Maryland, USA: ICF Macro. Report of Hearings by the All Party Parliamentary Group on Population, Development and Reproductive Health. January Return of Population Growth Factor: Its Impact upon the Millennium Development Goals. USAID Health Policy Initiative. July “Achieving the MDGs: The contribution of family planning Ghana.” Futures Group International. Ghana Statistical Service (GSS), Ghana Health Service (GHS), and Macro International Ghana Maternal Health Survey Calverton, Maryland, USA: GSS, GHS, and Macro International. The Case for Including Family Planning on the National Health Insurance Scheme (NHIS) and Increased Budgetary Allocation for Contraceptives by Government. Position Paper. PPAG and Partners Advocacy 2010   Ghana Statistical Service (GSS), Ghana Health Service (GHS), and ICF Macro Ghana Demographic and Health Survey Accra, Ghana. Vice President’s Keynote Address at Launching of Life Choices Campaign, Accra August 2010

55 Thank You for Your Interest!
Presented by: Dr. Gloria Quansah Asare ( Director Family Health Division) Ghana Health Service “Family Planning for a Better Life”


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