The world’s population is projected to hit 8.5 billion by 2030 and 9.7 billion by 2050, according to statistics from United Nations.

And today, July 11, as the world celebrates World Population Day, the spotlight is on the unfinished business of the 1994 International Conference on Population and Development.

Globally, celebrations will be held under the theme ‘25 Years of ICPD: Accelerating the Promise.’

Key players in the health sector ascertain women’s access to family planning and sexual reproductive services as one of the vital tools required in addressing the world’s population’s upsurge.

This is why when different countries met in Cairo 25 years ago, this aspect took centre stage and was highlighted as key in national and global development efforts.

However it’s been over two decades, and the commitments are yet to come to fruition.

Information from World Health Organisation shows that 214 million women of reproductive age in developing countries who want to avoid pregnancy are not using any modern contraceptive method.

These unmet needs in access to family planning are posing a challenge in addressing population issues.

Mark Bryan Schriener, UNFPA Representative to Rwanda, said that monitoring progress towards ICPD contributes directly to core aims of the sustainable development goals.

He observed that Rwanda has made progress over the last two decades on many development fronts, especially health outcomes, including in the area of sexual and reproductive health and rights. 

In particular, gains have been made in family planning and the use of modern contraception.

Figures from Rwanda Demographic and Health Survey (RDHS 2014-15) indicates that use of modern contraceptive methods among married women increased from a mere 4% in 2000 to 45% in 2010.

However the unmet need for family planning is very high and has stagnated at 19% in 2010 and 2014-2015. 

In Rwanda, fertility rate has decreased from 6.1 children per woman in 2005 to 4.2 in 2014-2015.

However, the decline was smaller between 2010 and 2014-15, at only 0.4.

Schriener opined that with more efforts, more success will be registered in population and development issues.

"We appreciate Rwanda’s leadership in creating platforms that convene stakeholders to develop plans to accelerate the program of action accelerating the promise,” he said.

Why rapid population growth is a concern

Joel Serucaca, a reproductive health officer at Rwanda Biomedical Centre, contends that why the population still grows despite remedies, is as a result of policies meant to inhibit population growth, not being exercised by citizens who in this case are the primary beneficiaries.

This, he said, leads to poverty, because as the number of people multiplies, resources tend to be limited and this in turn results in unemployment, lack of medical care and other social amenities.

This is because both facilities and personnel are not enough to accommodate the spur in population, as a result there is an increase in cases like infant mortality rate.

Conversely, more emphasis should be put on family planning methods, easy access to Post-Partum Family Planning (PPFP) toolkits, he said.

"Encouraging the youth to refrain from unprotected sex, and to work towards the sustainable development of the country,” he added.

Why women’s access to family planning matters

Dr Felix Sayinzoga, the head of maternal and child health at the Rwanda Biomedical Centre, highlighted that the fertility rate of women in Rwanda remains high.

In fact, women have on average 4.2 children at the end of their reproductive lives and only one woman out of two aged 15-45 years uses a contraceptive method, he noted.

Unmet family planning needs are high as about two in ten women (2/10) wish to use a contraceptive method but cannot get it.

Gender activist Olive Uwamariya observes that in Rwanda, the biggest unmet need for contraception is among unmarried young women and teenagers.

There is need to improve the quality and access of these services to everyone in need, and with this, she commends the ICPD for initiating a new way of thinking, which is important towards improving the quality of life generally, and more particularly for women.

One of the critical areas for women she noted is accessing comprehensive sexual and reproductive health and rights, including access to family planning.

"One of the major factors contributing to women giving birth to many children is the lack of access to information and services around the use of modern contraceptives, which is still the case in poor or rural communities,” she said.

She notes that as a result, this prevents women from making informed decisions on whether to have children or not, how many to have, and how to space them.

From this end, the idea is to equip women with the knowledge to choose if, when and how many children they wish to have.

Needless to mention, it is factual that as women become more economically, socially independent, empowered and have improved quality of life, the lower the fertility rate, the activist added.

Going forward

Sayinzoga stressed that population growth is a fundamental cause of multiple problems in society and that it has a variety of consequences.

High fertility rates have been strongly associated with poverty, under development and high childhood mortality rates.

Public sensitisation is needed to develop more awareness about population issues like how rapid population growth limits chances for meeting basic needs, he noted.

"Actions to empower women and men is key to a successful solution to many population problems. Increasing the level of education, economic and political decisions particularly for girls and women is vital,” he recommended.

He also noted that it is important to provide general access to health services including family planning for adolescents and adult women and men which will help to reduce family planning unmet needs.

Encouraging various community-based structures and organisations, such as religious communities, nongovernmental organisations and women, men, and youth associations to participate in family planning advocacy activities will strengthen the capacities of family planning service providers.

"Make family planning services available in all health facilities (public and private) and build the facilities’ capacity to provide these services.”

In November this year, health advocates and different organisations will gather for a summit in Kenya which will seek clear commitments to advance the goals of the ICPD and secure the rights and dignity of all.

editor@newtimesrwanda.com