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John M. Pile, Roy Jacobstein, Jan Kumar, Alyson Smith, Jane Wickstrom The ACQUIRE Project

Workshop on Investing in Family Planning The Case for LAPMs A family planning forecasting tool for evidence based advocacy and planning. John M. Pile, Roy Jacobstein, Jan Kumar, Alyson Smith, Jane Wickstrom The ACQUIRE Project Kampala, Uganda January 29-31, 2007.

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John M. Pile, Roy Jacobstein, Jan Kumar, Alyson Smith, Jane Wickstrom The ACQUIRE Project

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  1. Workshop on Investing in Family PlanningThe Case for LAPMsA family planning forecasting tool for evidence based advocacy and planning John M. Pile, Roy Jacobstein, Jan Kumar, Alyson Smith, Jane Wickstrom The ACQUIRE Project Kampala, Uganda January 29-31, 2007

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

  3. Demand for family planning is high, yet…. • Globally ~716 million women use FP • In Sub-Saharan Africa ~26 million women use FP • In Uganda ~ 1 million women use FP

  4. Significant unmet need for family planning • Globally over 120 million women have unmet need for FP • In Sub-Saharan Africa ~30 million women have an unmet need for FP. • In Uganda ~ 1.8 million have unmet need

  5. Family planning saves lives—addressing unmet need in Uganda Meeting the unmet need for family planning by 2015 would result in an estimated • 4.6 million fewer unintended pregnancies • 1.2 million fewer abortions • 2.8 million fewer unintended births • ~17,000 maternal lives saved • ~1.1 million children lives saved

  6. Reducing unmet need for FP can help countries to meet the MD Goals by reducing the cost of meeting the MD Goals. Family Planning and the Millennium Development Goals Liz Gilbert, the David & Lucile Packard Foundation Chamberlain Diala, JHU/CCP Chamberlain Diala, JHU/CCP

  7. Focus on 5 of 8 Millennium Development Goals: • Achieve universal primary education • Reduce child mortality • Improve maternal health • Ensure environmental sustainability • Combat HIV/AIDS, malaria and other diseases

  8. Social Sector Cost Savings and Family Planning Costs in Uganda Total Savings: $408 M Malaria, $13 M Maternal Health,$126 M Water & Sanitation, $59 M US$ (million) Immunization,$52 M Total Costs: $97 M Education,$158 M Family Planning,$97 M Source: Moreland and Talbird 2006.

  9. Family planning can have a significant and cost-effective impact in HIV/AIDS prevention efforts

  10. Benefits of PMTCT Services and Family Planning Added to PMTCT Services in 14 High-Prevalence Countries in 2007 Source: USAID. Adding Family Planning to PMTCT Sites Increases PMTCT Benefits. Global Health Issue Brief. July 2006.

  11. The Case for LAPMs IUCDs Implants Minilap Vasectomy

  12. The case for LAPMs:LAPMs address the full range of women’s and couples’ needs • LAPMs are an important and attractive method option for women and men who wish • to delay a first birth, • to space births, and • to limit family size once they decide that they want to have no more children. • LAPMs are equally suitable for • young and older women, • women who have been pregnant and those who have not, • people living with HIV, • as well as postpartum and post-abortion women

  13. The case for LAPMs:LAPMs are especially effective Pregnancy Rates by Method

  14. The case for LAPMs:LAPMs have lower discontinuation rates than short-acting methods % Women and men using FP methods at one year Source: 2003 Kenya DHS

  15. The case for LAPMs:LAPMs are cost effective Commodity Cost (US$) to Health Care System Per Year ofProtection, by Method Source: UNFPA 2005. Achieving the ICPD Goals: Reproductive Health Commodity Requirements 2000-2015. Assumes IUD Norplant and Jadelle used for 3.5 years; Implanon for 2.5 years; and female sterilization and vasectomy for 10 years.

  16. Comparison of Annual Contraceptive Commodity Costs for Short- and Long-acting ContraceptivesOver 1 to 5 Years Source: UNFPA 2005. Achieving the ICPD Goals: Reproductive Health Commodity Requirements 2000-2015. .

  17. LAPMs Needed, Wanted and Crucial • The health and cost benefits of investing in family planning are well known, well documented and substantial. • LAPMs have clear advantages among methods of family planning to both clients and health systems.

  18. LAPMs Needed, Wanted and Crucial • The unmet need for family planning in Uganda is great—1 million Ugandan couples have an unmet need to space, 700,000 have an unmet need to limit. • An investment of less than $100 million to address this unmet need will avert more than 1.1 million maternal and child deaths, 4.6 million unintended pregnancies and is more than offset by the resulting savings in achieving millennium development goals of universal primary education and environmental sustainability.

  19. Call to Action • In the absence of widespread availability and use of LAPMs, a country’s fertility will generally stay high, and national development will be low and slow. • Despite other compelling public health and development challenges Uganda faces, the need to make LAPM services more widely available, accessible and used is pressing and should be given even higher priority.

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