Zainab Usman wrote a thoughtful article on the Gates’ contraception campaign for ThinkAfricaPress.com that got picked up by AllAfrica.com.
Zainab is a Nigerian freelance writer currently working in Brussels and “a budding political economist and political scientist with a keen interest in Current Affairs: Nigerian, African and International affairs.”
In “Nigeria: Family Planning Is No Substitute for Development” she points out:
However, the focus on family-planning as a solution to reproductive health challenges downplays the underlying governance issues which are the root causes: public sector corruption, mediocrity, waste and mismanagement. For instance, in Nigeria these problems helped to establish an inefficient healthcare system where surgeries are sometimes performed by flashlight or lantern, with decaying infrastructure and lack of basic medical equipment and supplies. . .
The Summit fails to consider how developing countries’ deplorable health care systems, still grappling with treating malaria, typhoid and post-partum bleeding, would manage the side effects of long-term usage of hormonal contraceptives such as the birth control pill and especially the contraceptive injection on a large scale. It’s difficult to imagine how rural women, at the bottom rung of the socio-economic ladder, would deal with possible harmful side effects to their hormonal balance – these have been known to include thinning of bones, an increased risk of osteoporosis, an increased risk of STDs, breast and cervical cancer. The many who will require follow up treatment will be left unattended – especially if governments divert funds from a sector they view as being fixed.
Zainab Usman
From her vantage point as an African woman, she also notes the cultural concerns:
This “big push” to bring family planning back onto the global agenda is prescriptive and ignores the dynamics of different societies. It carries with it an overtone of cultural neo-imperialism.
The Gates Foundation have proclaimed that “more than 200 million women and girls in developing countries want to delay, space or avoid becoming pregnant” but do not have access to contraceptives, “resulting in over 75 million unintended pregnancies every year”. However, not every pregnancy in advanced economies is intended. By outwardly seeking to empower women, are they indeed robbing these women of their agency? How faithfully have the views of women in developing countries been represented?
Should the Contraception Prevalence Rates in Nigeria (15%) be equal to France’s 71% or the United Kingdom’s 84%, given the disparity in the levels of development? Do Nigerian women, with an average birth rate of six births, want to have two children given the dynamics of such societies where polygamy and large families are the norm among the urban middle classes or the rural poor? The risk of curtailing a country’s cultural norms looms large.
International examples have not been encouraging. Top-down family planning approaches have led to the coercion of many vulnerable and poor people by governments eager to meet targets of population control in China, Namibia, Peru and India. Setting numeric targets, such as giving 380 million women access to contraceptives by 2020, risks tampering with people’s legitimate reproductive rights. The approach fails to address the genuine concerns raised by those sceptical of the family planning agenda for religious or cultural reasons or for fear of a coercive population control agenda. These groups have genuine reasons to be concerned given the length some governments have gone to achieve targets in reducing population—such as the on-going forced sterilisation in India (an initiative part of a programme funded by the UK’s Department for International Development).
And she nails the problem of the “rights-based” approach:
So how have these risks been glossed over? At the level of semantics, the language employed by birth control discourse presupposes its benefit. By subsuming women’s rights and human rights within its purview, it polarises the debate: pro-family planning advocates are seen as moral champion of women’s rights, other groups with legitimate cultural oppositions – religious and otherwise – are seen as out of touch with them.
Family planning has been framed within a human rights narrative as giving the world “a moral obligation to help ensure that everyone, equally, has the right to access family planning”. At the outset, religious leaders are shown to oppose family planning, without giving the organisations an opportunity to defend their work in development. It is worth noting that well-known abortion providers such as the International Planned Parenthood Federation and Marie Stopes International were partners of the London Summit.
Zainab sums up what African leaders ought to do:
There are no shortcuts to economic and social development. Political leaders should not be given reasons to excuse their governance failures towards citizens – education and health care, employment and economic opportunities—by blaming population growth or a lack of contraceptives. Service delivery rests with reform-minded leaders implementing transformational economic and social policies, not with birth control policies.
Well done, Zainab.
