Family Planning: Francophone West Africa on the Move. A Call to Action

Family Planning, Ouagadougou Partnership.

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Résumé :

Ce rapport présente des axes ciblés d’investissement dans la planification familiale pour stimuler les progrès en Afrique de l’Ouest. Des recommandations y sont formulées pour faire progresser la planification familiale, mobiliser l’engagement politique et les ressources et coordonner les ressources et les actions.

Although family planning is one of the most cost-effective, high-yield interventions to improve health and to accelerate development, West Africa is lagging behind all other regions in family planning use. With an average of 5.5 children per woman, the region has one of the highest fertility rates and fastest growing populations in the world. High fertility results in many unplanned pregnancies that pose serious health risks for mothers and children.

In francophone West Africa, approximately three women die from maternal causes every hour, and one child under age 5 dies every minute. By reducing unplanned pregnancies and enabling healthy timing and spacing of pregnancies, contraception could save the lives of thousands of mothers, infants, and children each year.

In addition to saving lives, family planning also helps raise the status of women. Fewer, well-spaced children enable women to participate more in household income-generating tasks and community activities, promoting women’s empowerment and gender equity. Reproductive choice is a basic right, essential for improving the quality of life for women, couples, youth, families, and communities. But without access to relevant information and high-quality services, that right cannot be exercised.

In February 2011, representatives from eight francophone West African countries attended the “Population, Development, and Family Planning in West Africa: An Urgency for Action” Conference in Ouagadougou to discuss how to accelerate progress. Participating countries included Benin, Burkina Faso, Guinea, Mali, Mauritania, Niger, Senegal, and Togo, with Ivory Coast joining the initiative later. Country delegations arrived at an important consensus, all agreeing to take concrete actions to increase the uptake of family planning in their respective countries.

A similar commitment formed among the donors at the conference, who came together to pledge unprecedented cooperation and coordination in support of family planning in West Africa. This report presents targeted areas of investments in family planning to spur progress in West Africa. It provides recommendations for advancing family planning, mobilizing political commitment and resources, and coordinating resources and actions.

Family planning can and should play a much larger role in the region’s development. The returns on investment are enormous. For example, in francophone West Africa, investing in family planning to meet the unmet needs expressed by women to space or limit births would avert 7,400 maternal deaths and 500,000 child deaths in the next 10 years. Cumulative savings of the costs of maternal and child health care will be US$182 million for the next 10 years and US$1.9 billion by 2040.Moreover, a regional analysis indicates that every $1 invested in family planning saves $3 in other development sectors that contribute to achieving the MDGs (education, vaccinations, water and sanitation, maternal health, and malaria treatment)—a high return on investments!

Research is also shedding new light on innovative models that increase family planning demand and access to services. One new concept originating in Senegal, Democratize, Demedicalize, and Decentralize—“the 3 Ds”—provides an innovative framework for structuring family planning interventions. “Democratization” focuses on expanding commitment for family planning through a multi-sectorial, participatory approach.

The “demedicalization” of family planning means removing policy barriers to enable nonmedical and lower-level health care workers to provide a broad range of family planning services. These legal reforms are crucial for providing greater access to vulnerable populations (rural, urban poor, youth, displaced, refugees) through community-based distribution programs. And finally, “Decentralization” aims to strengthen health systems at the regional, district, and community levels to be able to effectively manage quality FP services while improving governance, accountability, and cross-sectorial collaboration.

How do we move forward with the commitments made at Ouagadougou? The Ouagadougou Initiative seeks to mobilize the many skills available in West Africa by pooling resources and by coordinating objectives and strategies. Governments and their partners need to use existing resources more strategically, but also expand and diversify funding sources: increasing public funding, attracting new funding partners for the region, and finding ways to better involve the private sector and civil society organizations. Ultimately, these actions should keep family planning visible and a high priority on government and donor agendas, and, consequently, help sustain the movement to improve and expand services in the region.

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