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Low Funding Threatens Malawi’s Gains in Family Planning

Dr Dube:  Think the starting point is just the right thing to do. But we are seeing more returns on human development. If we invest. Dr Dube: Think the starting point is just the right thing to do. But we are seeing more returns on human development. If we invest.

Malawi and several other countries have set a target to increase access to the modern contraceptive from 48% to 60% by 2030.This follows the launch of the FP2030 Family Planning Measurement Report for 2023 which shows significant achievements in family planning across the globe, even in the face of what has been described as stagnant funding.

Speaking at the launch, minister of health Khumbize Kandondo Chiponda noted that family planning is one of the most cost-effective health services and a major contributor in the improvement of women’s and girls’ empowerment.

However, health right activists Maziko Matemba has cast doubt on Malawi achieving the target as the government does not put in place deliberate measures to increase financing towards sexual and reproductive health.

According to Matemba, the government has not provided the required funding to the sector over the past years, especially considering that the country has a largely young population.

“Our young people are having sex at a tender age, so if we have low usage of modern family planning methods, it’s a concern which as a country we need to resolve. We cannot have lower use of family planning methods and expect to reach the goals of universal health 2030,” warns Matemba, “Overdependence on foreign aid is counterproductive for the country.”

In the last budget, the government provided only K520 million for family planning commodities but this year it has been slightly increased to K700 million after a campaign by activists, notes Matemba.

He says, “We need to gradually start reducing how Malawi is relying on foreign funding in terms of investing [in the health sector], hence you have seen us, the civil society, deeply involved in health sector financing reforms.

“Currently, financing in the health sector is supposed to be K292, 000 per year per person but we are at K68,000 per person in a year. If you find out, most of those resources, I think 50% to 80% are donor funded. We need to create reforms so that we reach the World Health Organisation threshold for financing for health domestically as well.”

Dr Lilian Chunda, chief of health services [technical] admits that Malawi is far below global requirements in terms of health financing in all sectors including sexual and reproductive health services, but says plans are underway to improve the trends.

“According to WHO, we are supposed to spend almost U$86 per capita in terms of expenditure per patient, but what we have in Malawi is half of that. And, in fact, you only find that only 10 percent of that goes to the actual service or patient care. So, what we want is the private sector to help the public sector, the ministry of health, in terms of financing some of these things. Some of the health services we have are very expensive and as a ministry we cannot manage on our own.

“More than half of our health budget comes from our partners - the donors. Government is only able to give us close to 25% and the other percentage comes from the donors. What we want to do now is to say, instead of us depending on the donors, we want to promote domestic revenue collection, that be via government as well as the private sector, so that come probably five years from now when the partners are pulling out the health system in Malawi should not collapse,” says Chunda.

The director says the government is prioritizing maternal and neonatal health after noticing that it is increasingly becoming an important matter of health concern.

Chunda says in the newly launched Health Sector Strategic Plan, spanning from 2023 to 2030 deliberate efforts have been put in place to encourage local resource mobilization.

“So, in terms of the disease burden, previously the most burden was on infectious diseases, for example HIV, TB etcetera, but now what we have seen so far is that maternal and neonatal issues are now top of the list. Children under one month old are dying the most, according to our research. So, we, as a country, need to start addressing maternal and neonatal issues. In this context, the private sector can help us by providing proper infrastructure, equipment as well as other supplies.

Positive trends

Overall, the report, titled Meeting the Moment: Family Planning and Gender Equality, notes that there has been an improvement in access to modern family planning methods globally. It says, for instance, in Malawi and Zimbabwe, women who gave their first births within marriage had higher modern contraceptive use at 6 months postpartum.

Malawi is currently at around 48 percent in terms of access to family planning and sexual and reproductive health services.

The FP2030 updates show that in six countries — Malawi, Burkina Faso, Mozambique, Madagascar, Sierra Leone, and Uganda — MCP has risen by more than 1 percentage point per year since 2012 despite the reduction in global funding for SRH services.

This is considered a remarkable achievement, taking into account the challenges that include low funding and the disruptions of the COVID-19 pandemic that sparked a socio-economic meltdown for at least three years after 2019.

The decline in funding mainly stems from what is called Mexico City Policy or MCP of the US government which reduces total foreign aid to family planning by 3-6% per year to developing countries, mainly in Africa and Asia, that implement pro-abortion policies.

According to the report, in Malawi and Zimbabwe, women whose first births were within marriage had higher modern contraceptive use at 6 months postpartum.

“This includes more than 80 percent of postpartum women in Ethiopia; more than 60 percent of postpartum women in Angola and Tanzania; more than 40 percent of women in Malawi, Burundi, Uganda, and Madagascar; and more than 20 percent of women in Zimbabwe, Rwanda, Zambia, and Kenya. Only in three countries —Kenya, Rwanda, and Zambia— do the majority of women receive their postnatal checks within 4 hours of delivery,” the report reads in part.

Latest global statistics show that 800 women die every day in childbirth. 218 million women in the global south, where Malawi lies, have unmet needs for modern contraception – in other words they want to avoid a pregnancy but have no access to modern contraceptive methods.

Dr. Samukeliso Dube, Executive Director for FP2030, said during a webinar for the global launch that adequate funding is the solution to reversing the current trends to attain high gender equality and economic growth for low-income countries like Malawi.

“We are seeing more returns on human development if we invest in this foundational human right. According to UNFPA, for every dollar that you invest in family planning, there are benefits to families; there are benefits to society, and that’s estimated to be at least U$8.78 returns – altogether generating about U$680 billion in economic benefit by 2050…Every additional dollar you spent investing in family planning would save U$3 in reproductive, maternal, newborn and healthcare costs,” she said.

Gender dimension

Speaking at the launch of the Malawi commitments minister of health Khumbize Kandondo Chiponda noted that family planning is one of the most cost-effective health services and a major contributor in the improvement of women’s and girls’ empowerment.

Similarly, Dr Sheila Macharia, the FP2030 East Southern Africa Hub Managing Director, added, “The FP2030 East and Southern Africa Hub is looking forward to working even more closely with the Government of Malawi and the civil society and youth focal points to accelerate the use of family planning.”

The movement for rights-based family planning is an integral part of the global push for gender equality. Gender is at the root of every person’s ability to make and carry out decisions about sex, contraception, and sexual and reproductive health, says the report.

Dr. Macharia said FP2030 will continue working with Malawi and other governments in the East and Southern Africa regions to advance the recognition of family planning as central to the agenda for sustainable development.

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Last modified on Friday, 17/05/2024

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