Population control: Women, girls health rights as panacea




Health rights of women and girls, especially right to reproductive health, is believed be a sure way of curbing the burden of unwanted pregnancies as well as controlling rapid population growth, ENE OSHABA writes.

Nigeria’s population is projected at about 214 million people due to a high population growth rate of 3.2 per cent and a high total fertility rate of 5.3 children per woman.

According to the Minister of Health Dr. Osagie Ehanire, the rapid population growth has an adverse effect on quality of life and hinders the achievement of socio-economic development goals of the country.

The minister made this know while speaking during the launch of the 2022 State of the World Population Report (SWOP), held in Abuja by the National Population Commission (NPC) with theme: “Seeing The Unseen: The Case for Action in the Crisis of Unintended Pregnancy”

He posited that rapid population growth as a result of unwanted pregnancy was further compounded by unfavourable family planning indices which measure the unmet need for contraception among married women at about 19 per cent and as high as 48 per cent among unmarried sexually active women.

Ehanire disclosed that the modern contraceptive prevalence rate stands at a low 12 per cent of currently married women.

Spate of unwanted pregnancies

The rapid population growth as well as scarce resources to adequately cater for citizens has been a great concern to all, this is one of the reasons the National Population Commission (NPC) is committing towards a successful census exercise in 2023, while advocating the improvement of the health and well-being of Nigerians, especially women, girls, and children.

Executive Chairman, NPC, Hon. Nasir Isa Kwarra, during the SWOP launch emphasized the importance of ensuring women and girls exercise their fundamental rights and have access to adequate and timely information and health services irrespective of the space they exist to prevent the occurrence of unwanted/unplanned pregnancies.

He stressed on collective responsibility and commitments by all towards the elimination of incidences of unintended pregnancy in Nigeria, adding that achieving zero unmet need for family planning (FP) through expanded access to full range of Family Planning commodities is key.

“Most often, women and girls find themselves in situations that inhibit them from exercising their fundamental rights and having opportunities to take decisions on issues that affect their reproductive lives.

“These inhibitions have consequences on their health, well-being, dreams, income/earnings, job security, aspirations, educational attainment/achievements, disposition and potential in life.

“Women lack access to health care services, information and counselling that could enhance their ability to take informed positive decisions that could avert occurrence of unintended pregnancy, particularly for the sexually active unmarried women, leading to alteration in their reproductive choices and timing,” Kwarra said.

The commission boss, who stressed the importance of population control to enable faster development, expressed worry over the consequences of unwanted pregnancies especially on women.

He noted that, “Only 11 per cent of women were reported to have the opportunity to make decisions about their own health care; while 33 percent do it jointly with their husband.”

Also, in her remark the Minister of Women Affairs, Dame Pauline Tallen, lamented the increasing number of unwanted babies and orphanage homes as a result of Sexual and Gender Based Violence (SGBV) especially during the Covid-19 pandemic.

“Orphanages are on the increase with children picked from the streets or dustbins. Children should be loved and not maltreated in such manner.

“The federal and state governments declared a state of emergency yet GBV persisted because perpetrators are walking around freely,” she lamented.

Unwanted pregnancy demography

The NPC boss noted that women and girls represent almost half of the entire population of Nigeria and out of which half of them are in their reproductive years (age 15-49 years); those aged 10 -14 years, represent 12 per cent and 14 per cent are adolescents.

He explained that these population groups constitute the groups of interest in this year’s SWOP report.

According to him, 19 per cent of teenagers aged 15-19 years have given birth or are pregnant with their first child, which showed a decline from 28 per cent prevalence in 1990.

Kwarra pointed out that 27 per cent of teenagers in rural areas were likely to commence childbearing compared to 8 per cent in the urban centres.

“The centrality of concerns and attention is the circumstances that facilitates incidence of an Unintended Pregnancy, those mostly affected and the consequences thereafter, which results in unwanted babies or happy accidents.

“Unintended pregnancy connects with age at first marriage. Early/Child/Forced marriage constitute a huge challenge, where 43 per cent of girls marry before their 18th birthday; while 8 per cent marry before their 15th birthday.

“This experience is contributory to prevalence of teenage childbearing currently at 19 per cent. Much more, 27 per cent of rural girls have commenced motherhood compared to 8 per cent in the urban areas.

“Also, 29 per cent of teenagers in the North-west have begun childbearing as well, which is highest amongst all the regions in Nigeria,” he added.

Speaking further the agency boss stated, “Women lack access to health care services, information and counselling that could enhance their ability to take informed positive decisions that could avert occurrence of unintended pregnancy, particularly for the sexually active unmarried women, leading to alteration in their reproductive choices and timing.

“Accordingly, 19 per cent of currently married women and 48 per cent of sexually active unmarried women, have unmet need for family planning, exposing them to unintended pregnancy and denying them opportunity for self actualisation, consequent on insignificant progress in family planning practice with only 12 percent Contraceptive Prevalence Rate (CPR).”

Similarly, the minister of health stated that the 2018 NDHS Report, 3 per cent and 8 per cent of pregnancies in Nigeria were unwanted and mistimed respectively, attributable to non-use, inconsistent use, or incorrect use of effective family planning methods.

Ehanire added that unintended pregnancies induce serious consequences such as abortion, although illegal in Nigeria, which is often unsafe; as well as mental illness, malnutrition, vesico-vaginal fistula(VVF), and maternal death.

Consequences

Speaking on the consequences and impacts of unintended pregnancy, are numerous and affects all facets of development efforts and progress of nations, the NPC boss said, “Rape constitutes a societal outcome that affects the bodily autonomy of women and girls leading to unwanted pregnancies which has negative effects on women and girls.

“This evil act escalated during the COVID-19 pandemic lock-downs resulting in unintended pregnancies. It is an act that all societies should condemn in the strongest terms to demonstrate the upholding of the rights to protect women and girls in every space.

“Education, particularly of girls, out of the 10.3 million currently reported as out-of-school children in Nigeria, 6.34 million are girls, Minister of Education in 2021.

“Poverty puts women and girls at disadvantage to negotiate and exercise their rights regarding reproductive issues.

“Conflicts and insecurity disrupts access to education, health care services and contraceptives, thereby escalating sexual violence including rape.

“Unintended pregnancy particularly among teenagers/ adolescent girls is a major health concern, as it is associated with high morbidity and mortality of both mother and child, including outcomes of malnutrition.

“Experience of pregnancy during adolescence has adverse social consequence, particularly on their educational attainment; Constitute proximate determinant of high fertility rates (currently at 5.3 per woman) and rapid population growth; Contributes to high preventable maternal death, (512/100,000 live births).”

He added that it also contributes to high child mortality rates and malnourishment, particularly among the under-five; Contributes to high rates of out-of-school and drop-outs among girls; and Promotes and sustains extreme poverty at household level as it interrupts women’s jobs and earnings.

UNFPA report

The United Nation Population Fund (UNFPA) report showed that, “Nigeria cards about 2.5 million cases of unintended pregnancy annually with 90 per cent of married women and 48 per cent of unmarried women seek to postpone or delayed childbearing.

“Almost 60 per cent of unintended pregnancies, more than three in five and in abortion, many are unsafe abortion, one of the leading causes of maternal death and cause of millions of hospitalisation per year.”

Resident Representative of the UNFPA in Nigeria, Ms. Ulla Elizabeth Muller, drew attention to how much the world values women and girls beyond their reproductive capacities, noting that what happens before a pregnancy the information not received, the contraceptive not used, the conversation occur between partners.

It is about costs, hostility to and misinformation about contraception use that undermines women’s ownership of their own bodies. “Unwanted pregnancy takes place in the bodies of people who did not affirmatively choose pregnancy or motherhood, were not open to the prospect of having a child at the time and with that partner, or in those circumstances, for those women, the most life altering reproductive choice whether to become pregnant or not, is no choice at all. So it becomes a very personal issue.

“Globally, nearly half of all pregnancies are unintended. I started 121 million each year throughout the world. This is an unseen crisis unfolding right before our eyes.

“Unwanted pregnancy takes place in the bodies of people who did not affirmatively choose pregnancy or motherhood. Were not open to the prospect of having a child at the time and with that partner, or in those circumstances, for those women, the most life altering reproductive choice whether to become pregnant or not, is no choice at all.

“So it becomes a very personal issue. But this is not a report about abortion. This is not a report about motherhood,” she said.

‘World where every pregnancy is wanted’

This aptly connects with more of right than ability of women and girls to make choices about whether, when and with whom to become pregnant; including the right to determine freely and responsibly the number and spacing of their children according to Kwarra.

“The central reflection of the report shows that almost a quarter of all women across the globe are unable to say no to sex and equally unable to make decisions about their own health care.

“Also, recent World Health Organization (WHO) report, March, 2022, showed that sub-Saharan Africa, has a range of 49 to 145 women per 1,000 unintended pregnancy, being the highest globally,” he added.

Government’s effort

Continuing, Kwarra noted various efforts by the government in recognition of the dominant role of women and girls in the unity, progress and development of Nigeria, stating that government has shown demonstrated commitments to ensure their fundamental rights are exercised through the launching of a national strategy to end child marriage in 2016.

He said that there are provisions for funds to access free family planning information, counselling and services in all public health facilities since 2011.

The commission boss added that with the support of UNICEF government is implementing the Girls for Girls Initiative to promote girls’ education in terms of enrolment, retention and completion.

He said government pledged to increase the annual domestic education expenditure by 50 per cent over the next two-years and 100 per cent by 2025; encouraged women’s participation in decisions that affects their lives and well-being; Launched and commenced implementation of the Revised National Policy on Population for Sustainable Development (NPP) and the Roadmap for harnessing the demographic dividend through investment in youth, both emphasize investments in compulsory and free quality education for every Nigerian child with attention for girls’ education to the completion of the minimum of senior secondary school.

Call to action

Amidst efforts by the government stakeholders are called to expediently and urgently commit to eliminate incidences of unintended pregnancy in Nigeria to enable the achievement of zero unmet need for family planning (FP) through expanded access to full range of FP commodities.

“I emphasize the importance of ensuring women and girls exercise their fundamental rights and have access to adequate and timely information and services irrespective of the space they exist to prevent occurrence of unintended/unwanted/unplanned pregnancy as our collective responsibility and commitments.

Abolish child marriage through legislation with penalties for defaulters/perpetrators.

“There is the need to promote and emphasize quality, compulsory and continuing education of girls to complete a minimum of secondary schooling; Deploy a holistic engagement and advocacy through the platform of the National Population Policy (NPP) implementation to promote Family Life Education; Ensure effective and sustained media engagements and campaign at all level to mitigate unintended pregnancies; and Invest in health systems strengthening at the sub-national,” the NPC boss stressed.

However, the women affairs minister said until there is a full implementation of the Violence Against Persons Prohibition (VAPP) Act and the Child’s Rights Act the country would keep going in circles looking for solutions to ending the menace.

She called on stakeholders to be ambassadors of family planning to support the sanitisation of all families to enable a saner society, stating that unplanned pregnancy is capable of causing rejection and stigmatisation for women and girls.

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