Massive investment needed in women’s health

Organisation: Position: Deadline Date: Location:

The Bill and Melinda Gates Foundation will invest about R1.2bn in the next three years to enable countries to count women and girls, and generate crucial data on hundreds of thousands of women around the world. Health-e News reports that foundation co-chair Melinda Gates announced the investment at the Women Deliver 2016 Conference in Copenhagen – with more than 5,000 attendees, the meeting is being billed as the largest international conference on the health and rights of women and girls in the last decade.

According to Gates, better data will mean better policymaking that will respond to the needs of women and children, many of whom currently remain uncounted in official statistics. “We need to know where and when women are born,” she is quoted in the report as saying. “We need to know how many hours they work (and) we need to know whether they get paid.” “We need to collect the data if we’re going to know how to act on the data,” Gates said. “We cannot close the gender gap if we don’t first close the data gap.”

In 2015, the world introduced its latest round of international development targets, the Sustainable Development Goals, which include goals like expanding access to education, health, and water and sanitation. According to Gates, the lack of data on women and girls means the world has no real way of knowing how far it has to go to achieve Sustainable Development Goal 5 on gender equality.

Australia Ambassador for Women and Girls Natasha Stott Despoja said that without a significant investment in collecting data on women and girls, the world had little hope of realising the 17 Sustainable Development Goals.

US Ambassador-at-Large for Global Women’s Issues Cathy Russell congratulated Gates on the announcement. “There’s a clear call in the gender community that we need more data,” Russell said. “We need more refined data (and) we need more disaggregated data.”

“If advocacy for women and girls is about giving voice to the voiceless then gathering and analysing data is about bringing visibility to the invisible,” Gates added.


A study released at the conference showed that preventing unintended pregnancy is essential to improving sexual and reproductive health and social and economic well-being among adolescent women, yet it found that many who want to avoid pregnancy are not receiving the services they need to protect their health and delay childbearing. The study released by the Guttmacher Institute finds that an estimated 38m of the 252m adolescent women aged 15–19 in developing regions are sexually active and want to avoid pregnancy. Yet 23m of these adolescents have an unmet need for modern contraception: they are sexually active and want to avoid having a baby within the next two years but are not using modern contraceptives. Most adolescents with unmet need are using no contraceptive method (84%); the remaining 16% rely on traditional methods, primarily withdrawal and periodic abstinence, which are less effective than modern methods.

Currently, 15m adolescent women use modern contraceptives, thereby preventing 5.4m unintended pregnancies each year. Of these pregnancies, an estimated 2.9m would have ended in abortion, many of which would have been unsafe. Current use of modern contraceptives also averts 3,000 adolescent maternal deaths annually in developing countries.

“Making it possible for young women to avoid unintended pregnancy and childbearing until they feel ready to become mothers can have a profound impact. It allows them to achieve healthier lives for themselves and their children, more education and better job opportunities,” says lead author Jacqueline E Darroch. “The positive impact of investing in sexual and reproductive health services for adolescent women is undeniable.”

The researchers estimate the total cost of providing modern contraceptives to the 15m adolescent women currently using them is $222m per year. Improving existing services to better serve current users (including increasing young people’s access to accurate information and education and ensuring they have a range of modern methods from which to choose) would increase the cost to $313m per year.

Expanding contraceptive services to also address the needs of the 23m adolescent women who currently have an unmet need for modern contraception would increase the total cost to $770m annually. Regionally, costs would be $351m in Africa, $222m in Asia, and $196m in Latin America and the Caribbean.

On average, providing high-quality contraceptive services to all adolescent women aged 15–19 who are sexually active and want to avoid becoming pregnant would cost just $21 per user each year.

The impact of this investment would be dramatic. Meeting the need for modern contraception for all adolescent women who want to avoid pregnancy would result in 6.0m fewer unintended pregnancies (a decline of 59%); 2.1m fewer unplanned births (a decline of 62%); 3.2m fewer abortions (a decline of 57%), including 2.4m fewer unsafe abortions; 700,000 fewer miscarriages of unintended pregnancies (a decline of 60%); and 5,600 fewer maternal deaths related to unintended pregnancies (a decline of 71%).

Based on the study’s findings, the authors suggest that programme planners and policymakers must work on several fronts to meet adolescents’ needs: prevent human rights violations such as child marriage, coerced sex and sexual abuse, which underlie some sexual activity among young women; promote adolescent women’s education and advance the status of girls and women in society; and provide high-quality sex education and contraceptive counselling and services to help young women overcome barriers to contraceptive use and to protect their rights to voluntary, informed and confidential contraceptive choice.

For this report, researchers analysed data from a wide range of sources, including survey data from women aged 15–19 in developing countries, to document the number of adolescent women who lack contraceptive services, what it would cost to meet their needs, benefits of meeting these needs and the obstacles to providing adolescents with necessary services.


Health experts at the conference say that self-injectable contraceptives, which are being trialled in Uganda and Senegal, could revolutionise women’s lives in rural Africa and dramatically cut maternal and newborn deaths, reports Reuters Africa. The disposable $1 device consists of a small needle connected to a plastic bubble containing the contraceptive Depo-Provera which can be squeezed to inject a dose that lasts three months.

Self-injectables could have a major impact on the lives of women who cannot access clinics or who face opposition to contraceptive use from their partners, said the global health organisation PATH which has designed the device called Sayana Press. “This is a life-saver. This is a game-changer for family planning,” PATH’s Emmanuel Mugisha is quoted as saying.

About a third of maternal deaths could be avoided by delaying motherhood, spacing births, preventing unintended pregnancies, and avoiding unsafe abortions, according to PATH. Unwanted pregnancies also cut short girls’ education and stop them reaching their potential.

Mugisha, PATH’s Uganda director, said women in rural areas could spend an entire day trekking to a clinic and queuing for contraceptives only to discover they were out of stock. “In Africa, one of the hindrances with family planning is access. The second hindrance is us men,” he said. “Most men don’t want family planning. Some want more children, but others think it interferes with their sex life. “With Sayana Press a woman has the freedom to decide when she wants children and when she doesn’t, and the man will have no control; the man will not know, which is very good.”

Mugisha said self-injectable contraceptives would also reduce the high numbers of women dying during botched abortions in Uganda.

Trials with Sayana Press, which is manufactured by Pfizer, are being carried out to ensure women can remember to take it, administer it correctly and dispose of the device safely so that it does not get picked up by children. Nomi Fuchs-Montgomery, an expert on contraceptive technology at the Bill and Melinda Gates Foundation which is helping support the trials, said early indications were very positive. “We see so much promise with this,” she added. “This is really the future.”

Fuchs-Montgomery said increasing the availability of contraception had a major role to play in meeting many of the Sustainable Developing Goals. Access to contraception allows women to complete their education, follow careers and participate economically which has “an incredible knock-on effect” on their wider communities and national development, she added.

PATH is also conducting trials in Burkina Faso and Niger where community health workers are using the device to deliver contraceptives to women.

Health-e News material
Guttmacher Institute material
Full Reuters Africa report

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