Achieving the Millennium Development Goals (MDGs): The Contribution of Fulfilling the Unmet Need for Family Planning
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The Millennium Development Goals (MDGs) - a set of eight, time-bound goals ranging from reducing poverty by half to providing universal primary education - present a major and important challenge to developing countries. The MDGs are set to be met by 2015, but current reports show that many countries are not "on track" to meet the goals by the deadline. If progress continues at the current rate, only the safe water and sanitation MDG will be met by all countries by 2015 (Vandemoortele, 2002).
This report is about one strategy that will make the MDGs easier and more affordable for countries to meet. It shows how meeting unmet need for family planning can help countries achieve the MDGs by reducing the size of the target population groups for the MDGs and therefore lowering the costs of meeting the MDGs. A benefit-cost analysis was applied to 16 sub-Saharan African countries: Burkina Faso, Cameroon, Chad, Ethiopia, Ghana, Guinea, Kenya, Madagascar, Mali, Niger, Nigeria, Rwanda, Senegal, Tanzania, Uganda, and Zambia. Analyses were included for selected targets and indicators of five of the eight MDGs:
" Achieve universal primary education " Reduce child mortality " Improve maternal health " Ensure environmental sustainability " Combat HIV/AIDS, malaria and other diseases
Given past high rates of fertility, the number of women expected to enter the reproductive age group in the next 10 years will increase by some 35 percent resulting in a 33 percent increase in the annual number of pregnancies. A significant percentage of these pregnancies are either mistimed or unintended. For example, in five of the 16 countries that were studied more than half of the pregnancies were mistimed or unintended. One reason for this is the low use of family planning and the high rates of unmet need for family planning. In Rwanda, for example, 35 percent of women have an unmet need for family planning, suggesting a high level of latent demand and presenting a potential opportunity for increased provision of family planning services.
For each country, two population scenarios were created: one when current unmet need for family planning is met and one when unmet need is not met. The costs of family planning and of meeting selected targets of each of the five MDGs were estimated under both scenarios for each country. Next, the difference in cost between the two scenarios was calculated over the 10-year period from 2005 to 2015. The additional cost of family planning was then compared with the savings that family planning will generate in each of the selected MDG sectors to calculate benefit-cost ratios for each sector and for the country overall.
The analysis shows that the benefits (measured by savings in meeting MDG targets) from meeting unmet need outweigh the extra costs of meeting the unmet need in all countries. Overall, we found that benefit-cost ratios ranged from 2.03 in Ethiopia to 6.22 in Senegal. The greatest potential for cost savings in most countries is in education and maternal heath.
Health benefits for children and mothers were also analyzed. The analysis shows that meeting unmet need can help avert maternal deaths during childbirth by reducing the number of pregnancies and induced abortions. For example in Tanzania, 18,688 mothers' lives could be saved. Reducing unmet need for family planning can also reduce the number of infant and child deaths by reducing the percent of high-risk births. In Ethiopia and Nigeria, more than one million children's lives would be saved.
Thus, while increasing family planning use is not one of the MDGs, a strategy to increase contraceptive use by reducing the unmet need for family planning can play a valuable complementary role and help countries to move closer to achieving their MDGs by freeing up resources to meet these goals while at the same time saving lives.
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|Document Type:||Technical Reports: Global|
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|Keywords:||Advocacy, Malaria, HIV/AIDS, Maternal Health, FP/RH, MDGs, Unmet Need|