Voices from the Field features contributions from scholars and practitioners highlighting new research, thinking, and approaches to development challenges. This article is authored by Ellen Starbird, director of the Office of Population and Reproductive Health at the U.S. Agency for International Development.
The sustainable development goals (SDGs) articulate seventeen goals for the world to collectively meet by 2030. The SDG document organizes the goals into five themes—people, planet, prosperity, peace, and partnership—but it’s still a lot to grasp, so finding lynchpins that connect the themes and goals will be important to their success. Voluntary family planning is one of those lynchpins, with clear connections across all five themes.
First, family planning affects people in myriad ways. It advances human rights, and saves lives. The 1968 International Conference on Human Rights proclaimed that “parents have a basic human right to decide freely and responsibly the number and spacing of their children.” However, in 2014, estimates indicated that 225 million women in low- and middle-income countries had unmet needs for modern contraceptive methods, meaning they want to stop or delay childbearing but are not using modern contraceptive methods.
The ability to access and use family planning can influence outcomes ranging from health and education to women’s empowerment. Family planning helps women time and space their pregnancies, so they can bear children at the healthiest times of their lives. This lowers the number of unintended and high-risk pregnancies, and reduces women’s exposure to pregnancy-related health risks.
Helping women time and space their pregnancies also contributes to reduced child malnutrition, healthy birth weight for newborns, and increased breastfeeding. Analyses indicate that by 2020, family planning could help prevent approximately seven million under-five deaths and 450,000 maternal deaths in USAID’s priority countries. Correct use of male or female condoms has dual benefits—preventing both transmission of the HIV virus and unintended pregnancy in HIV-positive women, thus preventing HIV transmission to the newborn.
Family planning also advances gender equality and strongly supports the empowerment of women and girls by helping them stay in school, become literate, learn a trade, or start a business. Women cannot take advantage of opportunities and resources equally with men if they cannot plan their families. A wealth of country-level studies document the impact of family planning programs, and provide guidance on how to reach all women, as well as marginalized and underserved populations.
Second, family planning use affects the planet. Population dynamics, including human population size, growth, density, and migration, are important drivers of environmental and natural resource degradation, including land, forests, biodiversity, water, and climate change. Population growth affects water scarcity, erodes renewable energy gains, and influences the development of sustainable urban infrastructure. In many countries, populations are growing so quickly that they are overwhelming governments’ abilities to provide education, health services, housing, drinking water, electricity, and waste disposal, contributing to the spread of urban slums. Slower population growth enables building a resilient infrastructure for health and economic development, where fewer government health and education services, including water, are required, and more land, electricity, and energy are available per person.
A 2015 report concluded that improving access to family planning can “slow global climate change by providing 16 to 29 percent of the needed emissions reductions.” And a 2015 review of integrated population, health, and environment (PHE) projects concluded “it is clear that PHE projects are having an impact…improving the health, well-being and environment of households and communities across diverse settings and landscapes.”
Third, family planning can facilitate economic prosperity. Rapid fertility decline, a result of increased family planning use, lowers the ratio of young people (dependents) to wage earners. With supportive socio-economic policies and attention to equity, countries can experience a “demographic dividend” of rapid economic growth. Family planning also contributes to economic growth by increasing the economic participation of women, and research has shown that having fewer children per family leads to increased household savings and increased investments in each child. Korea and Thailand, both demographic dividend success stories, represent strong examples of countries aligning population policy and family planning services with human capital development policies to accelerate economic growth.
Fourth, family planning can contribute to peace—to the development of stable, democratic societies. Studies have shown that a large “youth bulge” (defined as a high proportion of 15 to 29 year-olds relative to the older adult population) is associated with a high risk of civil conflict. The political impact of fertility decline can be significant: studies show that, as a country and its population age, the probability of attaining and maintaining a liberal democracy is increased.
Fifth, family planning progress requires new and continued partnerships. Despite recent increased donor and country-level attention to family planning and the potential contribution of family planning to the SDGs, family planning services continue to fall short of need in all developing regions. As we map out the global plan for tackling the SDGs, family planning partnerships at the global level, such as Family Planning 2020, the UN Commission on Life Saving Commodities, the Ouagadougou Partnership, and at the country level, with the public and private commercial sectors, foundations, civil society organizations, and non-health sector groups, will continue to be critical. Empowering women to choose the number, timing, and spacing of their pregnancies is not only a matter of health and human rights, but can hasten progress across the five themes of the new sustainable development goals.
Quite simply, family planning is a best buy, and can help make the world a better place for all of us.