'Meeting the Unmet Needs': Family Planning as a Fundamental Human Right

The United Nations Population Fund (UNFPA) made headlines in November when its annual report referred to family planning as a "universal human right." The report came in conjunction with two recent General Assembly votes calling for a global ban on female genital mutilation and supporting universal health coverage, thus signaling major strides toward achieving Millennium Development Goals regarding gender equality, female empowerment and maternal health.

According to Dr. Babatunde Osotimehin, UNFPA's Executive Director, "Not only does the ability for a couple to choose when and how many children to have help lift nations out of poverty, but it is also one of the most effective means of empowering women." What's more, Osotimehin said that the "legal, cultural, and financial barriers to accessing contraception and other family planning measures" violate the inherent rights of women everywhere.

UNFPA's report revealed that 645 million women of childbearing age in developing nations now have access to modern contraceptives. However, a shocking 222 million who want and would use family planning services still lack vital access. These are women who do not have the opportunities to postpone pregnancies or childbearing, and who routinely face discrimination, intimidation and violence regarding reproduction. And this extends to developing nations as well, where the report found that millions of women lack sufficient access to education and counseling services, and may face similar gender-based oppression.

"This is about meeting the unmet needs," Richard Kollodge, editor of UNFPA's report, told The InterDependent, "and that family planning is here to stay." Yet while a rights-based approach to family planning is certainly noteworthy, Kollodge claimed that what is particularly significant about the report is the link between human rights and sustainable economic growth.

A Rights-based Approach

Family planning has always been a key component of human rights discussions. UNFPA is guided by the Programme of Action, which 179 nations agreed to at the International Conference on Population and Development in 1994. That mandate held that "the aim of family planning programmes must be to enable couples and individuals to decide freely and responsibly the number and spacing of their children and to have the information and means to do so."

A rights-based approach to family planning, however, existed well before the 1994 conference. For instance, UNFPA's report mentioned the Tehran Conference on Human Rights from 1968, which resulted in "the right of individuals and couples to information, access, and choice to determine the number and spacing of their children." For that matter, elements of UNFPA's current stance on family planning can be traced to the 1948 Universal Declaration on Human Rights.

However, Kollodge suggested that while this discussion has become more explicit in recent years, it continues to exclude women in developing nations. "If it really is a human right," Kollodge said, "the poor, marginalized and disenfranchised simply don't have access."

According to UNFPA's report, of the 1.52 billion women of reproductive age in the developing world, approximately 867 million need contraception, but only 645 million have access to modern contraceptive methods. Among the 222 million remaining women, there were 80 million unintended pregnancies in 2012 alone; half of those resulted in abortions -- a significant portion of which were unsafe. (Kollodge said that while UNFPA does not delve into the abortion debate, "where contraception is widely available, abortion rates will decrease dramatically. And where abortion is legal, it should be safe.")

Inadequate health systems and a dearth of family planning services contribute to these overwhelming statistics. Of course, the primary reason for such high unmet needs involves gross income disparities. As the report noted, "In virtually all developing countries, poor women have more children and lower contraceptive use than wealthier women, underscoring the need for programming in resource-poor communities." In sub-Sahara Africa, for example, the wealthiest women are three times as likely to use contraception as the most indigent.

The Economic Ripple Effects

Kollodge maintained that for the first time, we are seeing human rights arguments for family planning inextricably linked to economic arguments. UNFPA's report concluded that spending an additional $4.1 billion on funding for family planning would save an estimated $11.3 billion annually for new mothers and newborns in developing nations. "Research now shows convincingly," Kollodge asserted, "that family planning yields all sorts of returns on investments."

Overall, UNFPA's report illustrated the enormous economic ripple effects of enhancing family planning services. Improving such services, including enabling women to make their own decisions about spacing pregnancies, will result in healthier pregnancies and safer deliveries, drastically reducing risks of mortality for mothers and children. Healthier mothers and children will then yield healthier educational achievements, and ultimately healthier labor markets, thereby alleviating poverty.

As Osotimehin explained, "Women who use contraception are generally healthier, better educated, more empowered in their households and communities and more economically productive. Women's increased labor-force participation boosts nations' economies." This economic argument is key to overcoming persistent cultural barriers that hinder gender equality in developing nations.

Enhancing Access

Maureen Greenwood-Basken, Executive Director of the Universal Access Project, told The InterDependent that of all of the Millennium Development Goals, the least progress has been made on MDG 5 -- improving maternal health. She highlighted the significance of UNFPA's report for framing the family planning discussion, connecting human rights with economic development.

Although the report is non-binding and has no legal impact on national laws, the UN Common Understanding on a Human Rights-Based Approach makes explicit recommendations for women to attain reproductive rights, as well as for governments to fulfill obligations to provide access to family planning services. The next steps include increasing supplies of contraceptives and making a full range of family planning options available to all women everywhere.

"Contraception has to be made available in the form that is suitable to the person who wants to use it," Kollodge concluded. The other measure to remove lingering obstacles would be for nations to create and enforce laws that foster gender equality.

Both Greenwood-Basken and Kollodge also noted the importance of the London Summit on Family Planning, which took place earlier this year. UNFPA, the United Kingdom, the Bill and Melinda Gates Foundation and partnering organizations gathered to support the rights of 120 million women and girls in developing nations access family planning services safely. The result was the creation of Family Planning 2020 (FP2020), which will monitor financial and policy progress, helping to remove lingering obstacles and ensure the achievement of universal access.

Together with Secretary General's Every Woman Every Child initiative, FP2020 is not only rectifying the lack of substantial MDG progress, but it is also creating a post-2015 agenda and a paradigm shift on this issue.

(Cross-posted on The InterDependent)