Achieving the Achieving the Millennium Millennium
Development GoalsDevelopment GoalsThe contribution of fulfilling The contribution of fulfilling the unmet need for family the unmet need for family
planningplanning
Scott Moreland, The Futures Group/POLICY ProjectJean-Pierre Guengant, Institut de Recherche pour le
Developpement
The number of women of reproductive The number of women of reproductive age is large and growing.age is large and growing.
Projected Women of Reproductive Age, Nigeria
0
10,000,000
20,000,000
30,000,000
40,000,000
50,000,000
60,000,000
2000
2002
2004
2006
2008
2010
2012
2014
2016
2018
2020
2022
2024
Projected Women of Reproductive Age, Mali
0
1,000,000
2,000,000
3,000,000
4,000,000
5,000,000
6,000,000
7,000,000
2001
2003
2005
2007
2009
2011
2013
2015
2017
2019
2021
2023
2025
The number of pregnancies will on The number of pregnancies will on average double in the next 25 years.average double in the next 25 years.
Pregnancies Nigeria
0
2,000,000
4,000,000
6,000,000
8,000,000
10,000,000
12,000,000
14,000,000
Pregnancies Mali
0
500,000
1,000,000
1,500,000
2,000,000
2,500,000
A significant percentage of A significant percentage of these pregnancies are these pregnancies are unintended.unintended.
% Pregnancies Unintended-Nigeria
Intended53%
Unintended47%
% Pregnancies Unintended -Mali
Intended40%
Unintended60%
Many women want to space or limit Many women want to space or limit births, but do not use family planning.births, but do not use family planning.
Number of Women Using or Wanting to Use FP
1,317,056180,0001,067,621
3,614,4371,776,980
764,901947,212
4,592,781
0
1000000
2000000
3000000
4000000
5000000
6000000
7000000
8000000
9000000
Nigeria Madagascar Mali Ghana
Users Don't Use but Want
TraditionalTraditional ModernModern
NigeriaNigeria 32%32% 68%68%
MaliMali 28.4%28.4% 71.6%71.6%
GhanaGhana 25.8%25.8% 74.2%74.2%
MadagascarMadagascar 38.5%38.5% 61.5%61.5%
Percentage Distribution of Users by Traditional or Modern Family Planning Methods
Use of less effective, traditional contraceptive methods is high.
Meeting the unmet need for family Meeting the unmet need for family planning will increase the percentage of planning will increase the percentage of women practicing family planning.women practicing family planning.
CPR - Nigeria
0
5
10
15
20
25
30
35
%
CPR - Mali
05
10152025303540
2001
2003
2005
2007
2009
2011
2013
2015
%
The The numbernumber of women using family of women using family planning will increase when unmet need planning will increase when unmet need is met.is met.
FP Users- Nigeria
01,000,0002,000,0003,000,0004,000,0005,000,0006,000,0007,000,0008,000,0009,000,000
2,00
02,
001
2,00
22,
003
2,00
420
0520
0620
0720
0820
0920
1020
1120
1220
1320
1420
15
Need Met Base
FP Users- Mali
0
500,000
1,000,000
1,500,000
Need Met Base
Meeting the unmet need for family Meeting the unmet need for family planning will reduce unintended planning will reduce unintended pregnancies.pregnancies.
0
1,000,000
2,000,000
3,000,000
4,000,000
5,000,000
2,000 2,002 2,004 2006 2008 2010 2012 2015
UnintendedPregnancies Nigeria
Need Met Base
0
200,000
400,000
600,000
800,000
1,000,000
2001 2004 2007 2010 2013 2015
Unintended pregnancies Mali
Need Met Base
……as well as reduce the number of abortions.as well as reduce the number of abortions.
0
200,000
400,000
600,000
800,000
1,000,000
1,200,000
1,400,000
2,000 2,003 2006 2009 2012 2015
Abortions Nigeria
Need Met Base
0
50,000
100,000
150,000
200,000
250,000
300,000
2,001 2,004 2007 2010 2013 2015
Abortions Mali
Need Met Base
……and therefore reduce the number of and therefore reduce the number of unintended births.unintended births.
0
500,000
1,000,000
1,500,000
2,000,000
2,500,000
3,000,000
2000 2002 2004 2006 2008 2010 2012 2015
Unintended Births Nigeria
Need Met Base
0
100,000
200,000
300,000
400,000
500,000
2001 2004 2007 2010 2013 2015
Unintended Births Mali
Need Met Base
1. Eradicate extreme poverty and hunger2. Achieve universal primary education3. Promote gender equality ad empower women4. Reduce child mortality5. Improve maternal health6. Combat HIV/AIDS, malaria and other diseases7. Ensure environmental sustainability8. Develop a global partnership for development
Reducing unmet need for FP can help Reducing unmet need for FP can help countries to meet the MD Goals by countries to meet the MD Goals by reducing the cost of meeting the MD reducing the cost of meeting the MD Goals.Goals.
Liz Gilbert, the David & Lucile Liz Gilbert, the David & Lucile Packard FoundationPackard Foundation Chamberlain Diala, JHU/CCPChamberlain Diala, JHU/CCP Chamberlain Diala, JHU/CCPChamberlain Diala, JHU/CCP
Focus on 4 Millennium Development Focus on 4 Millennium Development Goals:Goals:
Achieve universal primary Achieve universal primary educationeducation
Reduce child mortalityReduce child mortality Improve maternal healthImprove maternal health Ensure environmental sustainabilityEnsure environmental sustainability
MDGs- Education- Ghana
0
20
40
60
80
100
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
Gro
ss E
nro
lment
Rate
Millennium Development Goals and Targets
MDG
Ensure that by 2015, children everywhere, boys and girls alike, will be able to complete the course of primary schooling.
MDGs- Measles Immunization- Mali
0
20
40
60
80
100
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
% V
acc
inate
dMillennium Development Goals and Targets
Reduce by two thirds, between 1990 and 2015, the under five mortality rate.
MDG
MDGs- MMR Nigeria
0100200300400500600700800900
100011001200
MM
RMillennium Development Goals and Targets
MDG
Reduce by three quarters, between 1990 and 2015, the under maternal mortality ratio.
MDGs- Water and Sanitation- Nigeria
0102030405060708090
100
% P
op w
ithout
Wate
r &
Sanit
ati
on
Millennium Development Goals and TargetsBy 2015, reduce by half the proportion of people without sustainable access to safe drinking water and sanitation.
MDG
Calculating the savings in the Calculating the savings in the costs of meeting the MD goals due costs of meeting the MD goals due to increased contraceptive use.to increased contraceptive use.
1.1. Project the population with constant FP Project the population with constant FP use and with unmet need fulfilled.use and with unmet need fulfilled.
2.2. Calculate the costs of meeting MD Calculate the costs of meeting MD goals for each projection.goals for each projection.
3.3. Compare the costs projections and Compare the costs projections and calculate the difference.calculate the difference.
Achieve universal primary education
Fulfilling unmet need generates savings by Fulfilling unmet need generates savings by reducing the costs of meeting MD primary reducing the costs of meeting MD primary education goals.education goals.
Cumulative Primary Education Cost Savings- Ghana
$0$5
$10
$15$20$25$30$35
$40$45$50
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Mill
ion
s
$284
Cumulative Primary Education Cost Savings- Mali
$0
$10
$20
$30
$40
$50
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Achieve universal primary educationAchieve universal primary education
$43m $52 m
Reduce child Reduce child mortalitymortality
Fulfilling unmet need generates savings Fulfilling unmet need generates savings by reducing the costs of child vaccination by reducing the costs of child vaccination MD goals.MD goals.
Cumulative Measles Vaccination Cost Savings- Nigeria
$0$5,000,000
$10,000,000$15,000,000$20,000,000$25,000,000$30,000,000$35,000,000
Cumulative Measles Vaccination Cost Savings- Madagascar
$0
$2,000,000
$4,000,000
$6,000,000
$8,000,000
$10,000,000
Reduce child mortality
$9.5m$32m
Improve maternal mortality
Fulfilling unmet need reduces Fulfilling unmet need reduces the number of maternal the number of maternal deaths.deaths.
Maternal Deaths Averted due to Reduced Pregnancies (2000-2015)
16947
36764908 4419
$0
$5,000
$10,000
$15,000
$20,000
Nigeria Madagascar Mali Ghana
Improve maternal healthImprove maternal health
Ensure Ensure Environmental Environmental SustainabilitySustainability
The costs of achieving safe water and The costs of achieving safe water and sanitation goals are reduced by sanitation goals are reduced by fulfilling unmet need.fulfilling unmet need.
Cumulative Cost Savings to Provide Water and Sanitation- Nigeria
$0$500,000
$1,000,000$1,500,000$2,000,000$2,500,000$3,000,000$3,500,000$4,000,000$4,500,000$5,000,000
Cumulative Cost Savings to Provide Water and Sanitation- Ghana
$0$200,000$400,000$600,000$800,000
$1,000,000$1,200,000$1,400,000
2000
4
2000
5
2000
6
2000
7
2000
8
2000
9
2001
0
2001
1
2001
2
2001
3
2001
4
2001
5
Ensure environmental sustainabilityEnsure environmental sustainability
Weighing the Benefits and Costs of Weighing the Benefits and Costs of Meeting the MD Goals by fulfilling Meeting the MD Goals by fulfilling Unmet Need for Family PlanningUnmet Need for Family Planning
The additional costs of reducing unmet need The additional costs of reducing unmet need for FP are (partially) offset by MDG cost for FP are (partially) offset by MDG cost savings by 2015.savings by 2015.
0
50
100
150
200
250
300
Millions
$
Nigeria Mali
Ghana
Madag
asca
r
Addional FP Costs MDG Cost Savings
In conclusion:In conclusion: Low level of contraceptive useLow level of contraceptive use
– Very slow increase in useVery slow increase in use– High proportion of traditional methodsHigh proportion of traditional methods– High levels of unmet needsHigh levels of unmet needs
Resulting in:Resulting in:– Many Unintended pregnanciesMany Unintended pregnancies– Many abortionsMany abortions– Many unintended birthsMany unintended births
Eliminating unmet need will allow couples to Eliminating unmet need will allow couples to achieve their reproductive rights by reducing :achieve their reproductive rights by reducing :– Unintended pregnanciesUnintended pregnancies– AbortionsAbortions– Unintended birthsUnintended births
Achieving the Millennium Development Achieving the Millennium Development Goals will be a major challenge.Goals will be a major challenge.
These goals will be easier and cheaper to These goals will be easier and cheaper to achieve if contraceptive use increases as a achieve if contraceptive use increases as a result of fulfilling unmet need.result of fulfilling unmet need.
The additional costs of reducing unmet need for FP are (partially) offset by MDG cost savings by 2015
The time has come to reposition family planning in West Africa so as to help reach the Millennium Development Goals.
POLICY Project
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