Central Africa has the lowest global contraceptives prevalence rates among women aged 15 to 49 who are married or in a union says the United Nations Population Fund (UNFPA) this week.
Presenting the UNFPA “Worlds Apart – Reproductive health and rights in an age of inequality, State of The World Report 2017” at the UN headquarters in New York yesterday, Mr. Richard Kollodge, Editor of the United Nations Population Fund’s State of the World Population 2017, said the highest contraceptives prevalence in Central and West Africa averages 26% while its lowest medium was just 10%. This was well below the global contraceptive use average of 40%.
The UNFPA says income inequalities tend to feed into the vicious cycle of women having less access to contraceptives. “Poor, uneducated women especially in rural areas of Central Africa are unlikely to get an education. As a result they have less human rights mechanisms to decide when to have a pregnancy or give birth safely in a hospital under the care of trained attendants,” said Mr. Kollodge.
In Nigeria, Cameroon, Guinea and Niger the use of skilled birth care is extremely low among the poorest women, just 20% compared to 70% among the wealthiest women.
The report says poor women in this region have dim prospects of staying healthy even during a pregnancy. “Even when such women seek to exercise their reproductive rights, they face hostile social and institutional obstacles that women elsewhere are less likely to encounter.”
In 13 of the 20 Central and West African countries mapped, women from the richest 20 per cent of households are more twice as likely to have their demand for contraception satisfied as women from the poorest 20 per cent of the households.
This is a complete opposite to regions like South Asia (Bangladesh, Bhutan, Cambodia or Thailand) where contraceptive use prevalence rates are highest among the poorest 20% of the population than they are among the richest 20%.
Place of residence for women too is a key factor why women in Central Africa between the ages of 15 to 45 have the world´s lowest access to contraceptives at 10% lowest and 26 percent. Even in this region where contraception access is dismal – women in urban households are more likely to meet their demand for birth control than their rural counterparts.
He added, “For example in Chad, women from the 20% richest households are four times more likely to have at least four antenatal visits as women from the poorest 20% of households.”
Encouraging as it may seem, this is still 50% below the global average where 40% of all pregnant women are likely to have four antenatal visits before delivery.
However the UNFPA admits that in Central and West Africa itself many countries are working fast to improve their capacity in providing modern contraception for women seeking to avoid or delay pregnancy.
For example, the Democratic Republic of Congo was cited for praise for having achieved the best improvement in coverage of skilled birth care attendance, even though the quality of coverage among the wealth quintiles declined from 2005 to 2011.
The best performers in Africa were Rwanda (East Africa) and Lesotho (Southern Africa). “The two countries made the most progress over about a 10 year period in reducing inequality in meeting the demand for modern methods of contraceptives. Rwanda transformed both access and equality between 2005 and 2015.”
Access to sexual reproductive rights greatly influences health outcomes and economic opportunities. “We have seen this correlation in Senegal, the West African country that recorded the greatest overall neonatal mortality reduction over the recent 10-year period.”
Curiously, in Chad (West Africa) neonatal mortality changed little between 1996 and 2004 and neonatal mortality burdened women in all wealth quintiles.
(About the writer: the writer of this report Ray Mwareya is the editor of Women Taboos Radio Africa and a Dag Hammarskjold Fellow at the UN headquarters in New York)
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