by Carolyn Miles, President & CEO of Save the Children. Miles traveled to Uganda in February.
Around the world, an estimated 222 million women who don’t want to get pregnant cannot access contraception. I was surprised to learn Namutebi was one of them.
On the way to the Ugandan hospital where I met Namutebi, I saw several clinics advertising family planning services. The services were free and there for the asking. But despite her deep desire to control her family size, Namutebi told me she didn’t go to the clinics. Her husband didn’t want her to use contraceptives, she said. It just wasn’t a decision she could make.
Namutebi was in her early 20s, but she had just given birth to her fifth child. She was lucky, really, because she escaped serious complications for her baby or herself—even though she was unable to plan and space her pregnancies at least two years apart as medically recommended. In fact, empowering women to delay conception for three years after giving birth could save up to 1.8 million children’s lives each year, as explained in Save the Children’s new report, Every Woman’s Right: How family planning saves children’s lives.
But Namutebi hardly felt like celebrating. She told me she felt worried. How would she and her husband provide for their growing family? Would there be enough money for food? For school fees? And what if she kept having babies? She probably would, she knew. The average Ugandan woman has seven children, a figure that has barely budged for several decades.
In Namutebi’s community and others around the world, large family size is equated with status and even a perception of wealth. In some Ugandan tribes, for example, a man may receive cows for every daughter he marries off. He’ll need these when it comes time for his sons to marry. The whole thing can end in a wash, but the pressures remain. Women like Namutebi and their children often pay the price, sometimes with their lives.
In many places where men have the upper hand, husbands may insist their wives keep having children and become angry or even abusive if women choose to use contraception. It makes sense, then, that when we talk about making family planning more accessible for women, we include men in the conversation. The Ugandan government has started to do that now with a campaign aimed at engaging men around the benefits of having smaller families.
Save the Children also includes men in our global efforts by helping train male “motivators” to talk to their peers with messages on the importance of healthy timing and spacing of births. At the same time, we must ensure that women themselves can access family planning methods that are acceptable to them. That’s one of the many reasons Save the Children puts great emphasis on training frontline health workers to reach out directly to mothers in their own communities. These health workers are a critical link to lifesaving maternal, newborn and child health services—including family planning—for women who cannot access hospitals or sometimes even a clinic.
This week, world leaders are congregating in London for a family planning summit hosted by the British government and the Bill & Melinda Gates Foundation. The summit will be a great opportunity to address the barriers to improved access and use of contraception, and we hope to see commitments that will boost supplies, improve delivery and focus on the critical role of frontline health workers. This comes on the heels of a global “Child Survival Call to Action” hosted by the U.S., Indian and Ethiopian governments in Washington last month. Save the Children is calling on policymakers to endorse that forum’s goal of ending preventable child deaths within a generation.
The United States has helped lead the way to cutting child deaths by nearly half in the last 20 years. We need to keep investing in girls’ education and health and nutrition programs that we know save children’s lives. Family planning is a key part of the solution.
To learn more, visit savethechildren.org/child-survival
Photo credit: Save the Children. After suffering anemia while pregnant with her son, community health workers counseled Sobia on the importance of birth spacing. She delayed her next pregnancy and then gave birth to a healthy baby girl.