Thursday, 17 February 2011

In defence of family planning

The US House of Representatives is currently considering the Fiscal Year 2011 appropriations bill. One of the things they are apparently considering cutting is international spending on family planning (from the Healthy Lives Blog). By family planning they mean the provision of contraceptives and advice, as well as complementary health services in poor countries.

A thousand times, "no"! There are many kinds of aid projects where results are unclear. Providing free or cost-effective access to contraceptives is not one of those.

Poor women in poor countries face many challenges. One of the largest is the fact that they do not have control over what happens to them. Contraceptives, particularly those contraceptive methods that are woman-controlled and unobtrusive, mean that women can choose the timing and number of their pregnancies. They have control over their bodies. They can choose not to attempt a difficult pregnancy. They can choose only to have children when they have the time and financial security to care for those children. They can choose with whom they wish to have children. They can choose how and when to create their families. How could this possibly be a bad thing?

I'd hazard a guess that this is aimed not at contraceptive provision in the above sense but at condoms (although the two cannot actually be separated). And it is probably premised on the ridiculous but amazingly, annoyingly resilient notion that providing condoms encourages irresponsible (or extra-marital) sex. Basically, the idea that giving people condoms means children will have sex. The trigger for this paranoia is generally HIV prevention campaigns that tell people about sex and encourage safe sex, which is, frankly, unavoidable when teaching about a sexually-transmitted disease. The myth that teaching people about safe sex and providing access to condoms encourages sex has been debunked. Repeatedly. Kids (and adults) will have sex whether you tell them about sex and provide them with condoms or not. If you give them contraceptives and information, there is a better chance that the sex will be protected. But some people would rather cling to their ideas than accept scientific evidence.

Whether, because they think kids might have sex or because they think poor women shouldn't have the option to choose when they become pregnant, the move to limit or eliminate funding for family planning is a bad idea. Of all the things it is a good idea to fund, family planning seems (along with vaccinations, WASH and medical care in crisis situations) a pretty obvious "yes".

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