The Family Planning 2020 (FP2020) Annual Progress Report revealed the use of modern contraceptives in Family Planning (FP2020) focus countries prevented 84 million unintended pregnancies and 26 million unsafe abortions from July 2016 to July 2017. The usage of modern contraceptives also averted 125,000 maternal deaths in the focus countries.
According to the report 38.8 million more users than those who were using contraceptives in 2012, when FP2020 was launched; this is an increase that is approximately 30 percent above the historical trend. Through the dedicated efforts of governments, policymakers, programme implementers, service providers and donors, the health systems in FP2020 countries are becoming better aligned to meet the needs of an ever-increasing number of women and girls.
Pakistan is also a part of this global partnership along with other countries which include Bangladesh, Benin, Burkina Faso, Burundi, Côte d’Ivoire, DR Congo, Ethiopia, Ghana, Guinea, India, Indonesia, Kenya, Liberia, Madagascar, Malawi, Mali, Mauritania, Mozambique, Myanmar, Nepal, Niger, Nigeria, Philippines, Rwanda, Senegal, Sierra Leone, Somalia, Tanzania, Togo, Uganda, Zambia and Zimbabwe.
FP2020 is a global partnership that supports the rights of women and girls to decide freely whether they should have children, when and how many children they should to have. The Population Council report shows nearly 700,000 women in Pakistan went to health facilities for treatment of complications resulting from spontaneous abortions or induced abortions using unsafe methods or with the assistance of an unskilled provider.
While safe procedures for post-abortion care were found to be more widely used in 2012 than they were in 2002, health facilities still rely on unnecessarily invasive procedures such as dilation and curettage (D&C). Additionally, many facilities do not have adequate equipment and supplies to provide quality care for complications and a majority are not equipped to provide around-the-clock services to manage severe complications. Lastly, the private sector plays an important role in the provision of care, as more than 60 percent of all cases were treated by private sector providers.
Women in our society are not given the right to make decisions about their own bodies. It is the husband who decides how many children she will deliver. Women should be given this right in order to save their lives and the government should ensure contraceptives are easily available in rural areas
25 percent of women like to avoid or delay pregnancy, but are not using contraception, and therefore are at risk for unintended pregnancy. As a result, many women resort to induced abortion to end unintended pregnancies. Unfortunately, most doctors are not clear about the legal status of an abortion in Pakistan. Abortions are not legal in this country. The law permits an abortion only to save a woman’s life or to provide her with ‘necessary treatment’. It is then left to the doctor to interpret the appropriate treatment for the patient.
Due to legal restrictions and the lack of clarity among women and healthcare providers in interpreting the law, women may be forced to seek abortion by untrained providers. The resulting morbidity and mortality places a heavy burden on women, their families, communities and the national health system. Women in our society are not given the right to make decisions about their own bodies. It is the husband who decides how many children she will deliver. Women should be given this right in order to save their lives and the government should ensure contraceptives are easily available in rural areas.
There is a need to improve the quality of post-abortion care and expand the use of safer, World Health Organisation-recommended treatment methods, such as manual vacuum aspiration and medication abortion. Besides, to ensure that health facilities in the public and private sectors were equipped with technologies they needed to provide full range of post-abortion care. The government needs to ensure healthcare provider training, capacity-building and promoting continued advocacy and guaranteeing facilities that provided post-abortion care which are prepared to offer a full range of contraceptive services onsite or in their immediate vicinity 24 hours a day and seven days a week.
Lack of well-trained staff, stigma and financial constraints also pose inherent barriers to the delivery of good service. Coordinated efforts of Health and Population Welfare Departments must augment other actors together as a community to address these issues that threaten the lives of women in Pakistan each and every day. A pool of nurses, LHVs and other midlevel providers need to be trained and specialised in the provision of post abortion care and family planning services. Lady health workers should also be used for raising awareness about the use of contraceptives and the consequences of unsafe abortions, which is primarily their responsibility.
The writer is a freelance journalist and is associated with the development sector. He can be reached on [email protected] & twitter: @mqesar
Published in Daily Times, December 13th 2017.