Unintended pregnancies, unsafe abortions and maternal and child mortality are critical areas of the sexual and reproductive health that need immediate attention to prevent the overwhelming cases.
A Guttmacher Institute research in 2020 reported that 218 women in low and middle-income countries (LMIC) including Ghana have an unmet need for modern contraception despite the contributions and support that continue to pour in from international aid.
It is, however, indicated that a complete response and focus to the sexual and reproductive health needs to this challenge could result in immense health gains, including a reduction of about two-thirds unintended pregnancies, unsafe abortions and maternal deaths.
Each year, 111 million unintended pregnancies occur in LMICs, accounting for 49 percent of all pregnancies in those countries. Millions of people who give birth lack adequate pregnancy-related and newborn care, including 16 million women who do not receive necessary services to treat major obstetric complications.
More than 35 million women have abortions in unsafe conditions and 133 million women need but do not receive treatment for one of the four major curable STIs.
Unfortunately for Africa, these statistics were recorded despite the support the continent was receiving from foreign aid through the UN and non-governmental organisations, an indication that more needs to be done to support sexual and reproductive health services.
It is, therefore, worrying that the UK, one of the major sponsors for sexual and reproductive healthcare through the United Nations Population Fund has cut budget funding from £154million to £23million which represents 85 percent cut in contraceptive and reproductive health supplies to the UNFPA, a move that has been described as devastating.
The cut forms part of Britain’s plans to reduce the foreign aid budget from 0.7 percent to 0.5 percent of gross national income.
The Foreign, Commonwealth and Development Office (FCDO) in the UK explained they were forced to take a decision on temporarily reducing the amount spent on aid.
Meanwhile, more than £10billion has been apportioned to fight poverty, tackle climate change, and improve global health.
In Ghana alone, it is estimated that the cut could cause more than 280,000 unintended pregnancies, 99,000 unsafe abortions, and 600 maternal deaths in 2021.
This, as indicated by the Country Director of UNFPA, Niyi Ojuolape, could in the long run increase economic losses as some workers would also have to be laid off due to the cut which has already been precipitated by the COVID-19.
In 2020, statistics from the Ghana Health Service indicated that the country recorded 109,888 teenage pregnancies, a figure corroborated by the UNFPA and an increase from previous cases recorded between 70,000 to 80,000.
Mr. Ojuolape said the funding from the UK has been of immense benefit to the organisation and even though the terms are still not clear, the negative impact on the country would be huge as there would be rippling effects.
“Last year, among teenagers alone, there were more than a 100,000 pregnancies which are not only because of the unavailability of it but low education on the use of contraceptives,” he explained.
He added, “If one person is educated, the person tends to share that information with others so it increases the awareness and the numbers double but once there is no education, the number of people who are ignorant about sexual and reproductive health will also double.”
Sharing his view on the budget cut and its impact, Dr. Henry Bruce, the Head of Social Marketing at Marie stopes, a non-governmental organisation that has been championing sexual and reproductive health, said this cut might affect supply and even cause contraceptive prices to soar.
He lamented the ongoing unsafe abortions would only become worse due to the cut as a result of low or no education on sexual and reproductive health rights.
“Some women even insert something called ‘Chorkor bomber’ to get rid of pregnancies which are needless as these pregnancies could have been prevented with the right knowledge,” he emphasised.
The Director of the Family Health Division at Ghana Health Service, Dr.Kofi Issah, said teenage pregnancies cannot be attributed to only the poor access to family planning resources alone.
“Statistics from previous years on teenage pregnancies were far higher than 2020 but the numbers have hovered around that figure for a long time. With teenage pregnancies, the problems are much complex than we think. If a 19-year-old is considered old enough to marry then such a person cannot be classified under the group of teenage pregnancy contrary to what is currently being practiced,” he lamented.
He was, however, quick to add that the budget cut will still cause a huge gap in sexual and reproductive health in Ghana especially with the Ghana Health Service supply to the public health facilities like the Planned Parenthood Association of Ghana.
Mr. Ojuolape said the UK has been a major partner in the supply of sexual and reproductive health materials including support for the education and awareness of such and was hopeful that an intervention from politicians from affected countries such as Ghana could help change the minds of the decision-makers in the UK for a positive turnaround.
The UNFPA has in the past consulted and sought for help from other countries to help fill the vacuum created whenever there is a drop in budget and that, the country director said, would be adopted to help reduce the impact of the budget cut.
He was worried about the failure of the implementation of the Comprehensive Sexual Education which was met with stiff opposition by parents when the government decided to add it to the curriculum for basic education and entreated government to consider its implementation since it could be a solution to the sexual and reproductive health challenges in the country.
He encouraged parents not to shy away from the topic but continue to educate their wards.
Dr. Bruce on the other hand called on the government to support sexual and reproductive health care through the National Health Insurance Policy.
“I believe that if the clinical contraceptive which is currently a meagre amount is embedded in the National Health Insurance, a large number of people will patronise it and help avoid not just unintended pregnancies but Sexually Transmitted Infections,” he said.
The Ghana Health Service, according to Dr. Issah, is currently in talks with the government to diversify the commodities used in the family planning and education to help ensure the gap created by the cut would be filled and to ensure that the sustainable development goal on sexual and reproductive health is achieved.
From all indications, ensuring universal access to sexual and reproductive health care services, including family planning, information and education and the integration of reproductive health into national strategies and programmes cannot be possible without access to modern contraception, knowledge about sexual and reproductive health rights and improved quality of care.
It is, therefore, imperative that individuals, non-governmental organisations and government join hands to achieve improved and quality health care without foreign aid.
By Adwoa Adobea-Owusu