Achieving the Achieving the Millennium Millennium

Development GoalsDevelopment GoalsThe contribution of fulfilling The contribution of fulfilling the unmet need for family the unmet need for family

planningplanning

Scott Moreland, The Futures Group/POLICY ProjectJean-Pierre Guengant, Institut de Recherche pour le

Developpement

The number of women of reproductive The number of women of reproductive age is large and growing.age is large and growing.

Projected Women of Reproductive Age, Nigeria

0

10,000,000

20,000,000

30,000,000

40,000,000

50,000,000

60,000,000

2000

2002

2004

2006

2008

2010

2012

2014

2016

2018

2020

2022

2024

Projected Women of Reproductive Age, Mali

0

1,000,000

2,000,000

3,000,000

4,000,000

5,000,000

6,000,000

7,000,000

2001

2003

2005

2007

2009

2011

2013

2015

2017

2019

2021

2023

2025

The number of pregnancies will on The number of pregnancies will on average double in the next 25 years.average double in the next 25 years.

Pregnancies Nigeria

0

2,000,000

4,000,000

6,000,000

8,000,000

10,000,000

12,000,000

14,000,000

Pregnancies Mali

0

500,000

1,000,000

1,500,000

2,000,000

2,500,000

A significant percentage of A significant percentage of these pregnancies are these pregnancies are unintended.unintended.

% Pregnancies Unintended-Nigeria

Intended53%

Unintended47%

% Pregnancies Unintended -Mali

Intended40%

Unintended60%

Many women want to space or limit Many women want to space or limit births, but do not use family planning.births, but do not use family planning.

Number of Women Using or Wanting to Use FP

1,317,056180,0001,067,621

3,614,4371,776,980

764,901947,212

4,592,781

0

1000000

2000000

3000000

4000000

5000000

6000000

7000000

8000000

9000000

Nigeria Madagascar Mali Ghana

Users Don't Use but Want

TraditionalTraditional ModernModern

NigeriaNigeria 32%32% 68%68%

MaliMali 28.4%28.4% 71.6%71.6%

GhanaGhana 25.8%25.8% 74.2%74.2%

MadagascarMadagascar 38.5%38.5% 61.5%61.5%

Percentage Distribution of Users by Traditional or Modern Family Planning Methods

Use of less effective, traditional contraceptive methods is high.

Meeting the unmet need for family Meeting the unmet need for family planning will increase the percentage of planning will increase the percentage of women practicing family planning.women practicing family planning.

CPR - Nigeria

0

5

10

15

20

25

30

35

%

CPR - Mali

05

10152025303540

2001

2003

2005

2007

2009

2011

2013

2015

%

The The numbernumber of women using family of women using family planning will increase when unmet need planning will increase when unmet need is met.is met.

FP Users- Nigeria

01,000,0002,000,0003,000,0004,000,0005,000,0006,000,0007,000,0008,000,0009,000,000

2,00

02,

001

2,00

22,

003

2,00

420

0520

0620

0720

0820

0920

1020

1120

1220

1320

1420

15

Need Met Base

FP Users- Mali

0

500,000

1,000,000

1,500,000

Need Met Base

Meeting the unmet need for family Meeting the unmet need for family planning will reduce unintended planning will reduce unintended pregnancies.pregnancies.

0

1,000,000

2,000,000

3,000,000

4,000,000

5,000,000

2,000 2,002 2,004 2006 2008 2010 2012 2015

UnintendedPregnancies Nigeria

Need Met Base

0

200,000

400,000

600,000

800,000

1,000,000

2001 2004 2007 2010 2013 2015

Unintended pregnancies Mali

Need Met Base

……as well as reduce the number of abortions.as well as reduce the number of abortions.

0

200,000

400,000

600,000

800,000

1,000,000

1,200,000

1,400,000

2,000 2,003 2006 2009 2012 2015

Abortions Nigeria

Need Met Base

0

50,000

100,000

150,000

200,000

250,000

300,000

2,001 2,004 2007 2010 2013 2015

Abortions Mali

Need Met Base

……and therefore reduce the number of and therefore reduce the number of unintended births.unintended births.

0

500,000

1,000,000

1,500,000

2,000,000

2,500,000

3,000,000

2000 2002 2004 2006 2008 2010 2012 2015

Unintended Births Nigeria

Need Met Base

0

100,000

200,000

300,000

400,000

500,000

2001 2004 2007 2010 2013 2015

Unintended Births Mali

Need Met Base

1. Eradicate extreme poverty and hunger2. Achieve universal primary education3. Promote gender equality ad empower women4. Reduce child mortality5. Improve maternal health6. Combat HIV/AIDS, malaria and other diseases7. Ensure environmental sustainability8. Develop a global partnership for development

Reducing unmet need for FP can help Reducing unmet need for FP can help countries to meet the MD Goals by countries to meet the MD Goals by reducing the cost of meeting the MD reducing the cost of meeting the MD Goals.Goals.

Liz Gilbert, the David & Lucile Liz Gilbert, the David & Lucile Packard FoundationPackard Foundation Chamberlain Diala, JHU/CCPChamberlain Diala, JHU/CCP Chamberlain Diala, JHU/CCPChamberlain Diala, JHU/CCP

Focus on 4 Millennium Development Focus on 4 Millennium Development Goals:Goals:

Achieve universal primary Achieve universal primary educationeducation

Reduce child mortalityReduce child mortality Improve maternal healthImprove maternal health Ensure environmental sustainabilityEnsure environmental sustainability

MDGs- Education- Ghana

0

20

40

60

80

100

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

2015

Gro

ss E

nro

lment

Rate

Millennium Development Goals and Targets

MDG

Ensure that by 2015, children everywhere, boys and girls alike, will be able to complete the course of primary schooling.

MDGs- Measles Immunization- Mali

0

20

40

60

80

100

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

2015

% V

acc

inate

dMillennium Development Goals and Targets

Reduce by two thirds, between 1990 and 2015, the under five mortality rate.

MDG

MDGs- MMR Nigeria

0100200300400500600700800900

100011001200

MM

RMillennium Development Goals and Targets

MDG

Reduce by three quarters, between 1990 and 2015, the under maternal mortality ratio.

MDGs- Water and Sanitation- Nigeria

0102030405060708090

100

% P

op w

ithout

Wate

r &

Sanit

ati

on

Millennium Development Goals and TargetsBy 2015, reduce by half the proportion of people without sustainable access to safe drinking water and sanitation.

MDG

Calculating the savings in the Calculating the savings in the costs of meeting the MD goals due costs of meeting the MD goals due to increased contraceptive use.to increased contraceptive use.

1.1. Project the population with constant FP Project the population with constant FP use and with unmet need fulfilled.use and with unmet need fulfilled.

2.2. Calculate the costs of meeting MD Calculate the costs of meeting MD goals for each projection.goals for each projection.

3.3. Compare the costs projections and Compare the costs projections and calculate the difference.calculate the difference.

Achieve universal primary education

Fulfilling unmet need generates savings by Fulfilling unmet need generates savings by reducing the costs of meeting MD primary reducing the costs of meeting MD primary education goals.education goals.

Cumulative Primary Education Cost Savings- Ghana

$0$5

$10

$15$20$25$30$35

$40$45$50

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Mill

ion

s

$284

Cumulative Primary Education Cost Savings- Mali

$0

$10

$20

$30

$40

$50

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Achieve universal primary educationAchieve universal primary education

$43m $52 m

Reduce child Reduce child mortalitymortality

Fulfilling unmet need generates savings Fulfilling unmet need generates savings by reducing the costs of child vaccination by reducing the costs of child vaccination MD goals.MD goals.

Cumulative Measles Vaccination Cost Savings- Nigeria

$0$5,000,000

$10,000,000$15,000,000$20,000,000$25,000,000$30,000,000$35,000,000

Cumulative Measles Vaccination Cost Savings- Madagascar

$0

$2,000,000

$4,000,000

$6,000,000

$8,000,000

$10,000,000

Reduce child mortality

$9.5m$32m

Improve maternal mortality

Fulfilling unmet need reduces Fulfilling unmet need reduces the number of maternal the number of maternal deaths.deaths.

Maternal Deaths Averted due to Reduced Pregnancies (2000-2015)

16947

36764908 4419

$0

$5,000

$10,000

$15,000

$20,000

Nigeria Madagascar Mali Ghana

Improve maternal healthImprove maternal health

Ensure Ensure Environmental Environmental SustainabilitySustainability

The costs of achieving safe water and The costs of achieving safe water and sanitation goals are reduced by sanitation goals are reduced by fulfilling unmet need.fulfilling unmet need.

Cumulative Cost Savings to Provide Water and Sanitation- Nigeria

$0$500,000

$1,000,000$1,500,000$2,000,000$2,500,000$3,000,000$3,500,000$4,000,000$4,500,000$5,000,000

Cumulative Cost Savings to Provide Water and Sanitation- Ghana

$0$200,000$400,000$600,000$800,000

$1,000,000$1,200,000$1,400,000

2000

4

2000

5

2000

6

2000

7

2000

8

2000

9

2001

0

2001

1

2001

2

2001

3

2001

4

2001

5

Ensure environmental sustainabilityEnsure environmental sustainability

Weighing the Benefits and Costs of Weighing the Benefits and Costs of Meeting the MD Goals by fulfilling Meeting the MD Goals by fulfilling Unmet Need for Family PlanningUnmet Need for Family Planning

The additional costs of reducing unmet need The additional costs of reducing unmet need for FP are (partially) offset by MDG cost for FP are (partially) offset by MDG cost savings by 2015.savings by 2015.

0

50

100

150

200

250

300

Millions

$

Nigeria Mali

Ghana

Madag

asca

r

Addional FP Costs MDG Cost Savings

In conclusion:In conclusion: Low level of contraceptive useLow level of contraceptive use

– Very slow increase in useVery slow increase in use– High proportion of traditional methodsHigh proportion of traditional methods– High levels of unmet needsHigh levels of unmet needs

Resulting in:Resulting in:– Many Unintended pregnanciesMany Unintended pregnancies– Many abortionsMany abortions– Many unintended birthsMany unintended births

Eliminating unmet need will allow couples to Eliminating unmet need will allow couples to achieve their reproductive rights by reducing :achieve their reproductive rights by reducing :– Unintended pregnanciesUnintended pregnancies– AbortionsAbortions– Unintended birthsUnintended births

Achieving the Millennium Development Achieving the Millennium Development Goals will be a major challenge.Goals will be a major challenge.

These goals will be easier and cheaper to These goals will be easier and cheaper to achieve if contraceptive use increases as a achieve if contraceptive use increases as a result of fulfilling unmet need.result of fulfilling unmet need.

The additional costs of reducing unmet need for FP are (partially) offset by MDG cost savings by 2015

The time has come to reposition family planning in West Africa so as to help reach the Millennium Development Goals.

POLICY Project