Contraceptives among best anti-poverty innovations

“For the last 50 years, no country has emerged from poverty without expanding access to contraceptives. They are the greatest anti-poverty innovations in history,” the foundation’s annual report released yesterday by Africa Director for Bill and Melinda Gates Foundation Dr Ayo Ajayi revealed to the continent yesterday said.

Dr Ajayi leads the foundation’s work on policy, advocacy and government relations across the continent, as well as the foundation’s offices in Ethiopia, South Africa and Nigeria.

It said contraceptives are one of the greatest antipoverty innovations in history because when women are able to time and space their pregnancies, they are more likely to advance their education and earn an income—and more likely to have healthy children they can support.

“This leads to fewer dependents that need government services, a growing workforce that includes more women, and more resources for sending children to school,” it says.
If a country sends a generation of healthy, well-educated young people into the workforce, it’s on its way out of poverty, the report says.

When we started the foundation, I underestimated the power of contraceptives to lift families out of poverty. I began to see it because Melinda is a great storyteller—and that includes getting the story. When I was still full-time at Microsoft, she’d go out in the field and come back and tell me what she saw.

At one time when the data said family planning clinics were “stocked,” Melinda learned they had only condoms, which most women will not ask their partners to use, Bill Gates was quoted as saying in the statement.

Melinda Gates said in the report that most of the women she talked to in the field brought up contraceptives.

“I remember visiting the home of a mother in Niger named Sadi, whose six children were competing for her attention as we talked. She told me, ‘It wouldn’t be fair for me to have another child. I can’t afford to feed the ones I have,” the report quoted her as saying.

She went on, “In a Kenyan slum, I met a young mother named Mary who had a business selling backpacks from scraps of blue-jean fabric. She invited me into her home, where she was sewing and watching her two small children. She used contraceptives because, she said, “Life is tough.” I asked if her husband supported her decision. She said, “He knows life is tough, too.’”

The report says right now, there are still more than 225 million women in the developing world who don’t want to get pregnant but don’t have access to contraceptives. A recent youth survey in the Indian state of Uttar Pradesh showed that 64 percent of married teenage girls wanted to postpone their first pregnancy, but only nine percent practiced a modern method of contraception.

Family Planning 2020, a global partnership that Bill and Melinda Gates are a part of, has set a goal of providing 120 million more women access to contraceptives by 2020.

“We’re focusing on South Asia, where contraceptives are used by only a third of the women, and on Africa—where they’re used by fewer than one in five,” it said, adding that the latest is an injectable that lasts for three months and combines the drug and needle in a tiny device one can hold in a palm which is so easy to use that the design itself expands access to contraceptives.

“These changes are rolling out now, and that’s encouraging. But we still face one of the biggest and oldest challenges: making sure people understand the lifesaving, poverty-ending power of contraceptives,” it said.

For the first time in history, more than 300 million women in developing countries are using modern methods of contraception. It took decades to reach 200 million women. It has taken only another 13 years to reach 300 million—and the impact in saving lives is fantastic.

When women in developing countries space their births by at least three years, their babies are almost twice as likely to reach their first birthday. Over time, the ability of women to use contraceptives and space their pregnancies will become one of the largest contributors in cutting childhood deaths.

Progress in increasing the childhood mortality for children under five coverage for the basic childhood vaccines is now the highest it’s ever been, at 86 percent. This is the biggest reason for the drop in childhood deaths. While the progress has been good, there is still more to do. 19 million children - most of them living in conflict zones or remote areas – are still not immunized.

One million infants die on the day they’re born. A total of nearly 3 million die in their first month of life. Most newborn deaths fall into one of three categories -- sepsis and other infections; asphyxia, which means the new-born isn’t getting enough oxygen; and prematurity, which means the baby was born early. Some of the interventions that address this are easily available but need more support and evangelism.

One of the important gaps we are looking to fill is better understanding of why children die. It has been difficult generating support for doing autopsies on children – but the lack of data on the causes of death prevents Bill and Melinda Gates from addressing key gaps.

Extreme poverty has been cut in half over the last 25 years. But almost no one knows about it.

“Optimism is a strategic asset. Optimism isn’t a belief that things will get better; it’s a conviction we can make things better,” the report which reveals the progress that has been made in child health and the reduction in child mortality that has occurred across the continent.

In 1988, when the global campaign was launched to end polio, the report says there were 350,000 new cases. Last year, there were 34. Those 34 cases were confined to northern Nigeria and parts of Afghanistan and Pakistan.

The report admits that immunizing children in conflict areas is hard – even dangerous stressing that keeping up the fight is vital as eradicating polio will enable the world to dedicate funding and effort to the next disease. The surge of optimism will pull energy and brains and dollars into global health, and that will intensify the fight against measles, malaria, TB, and AIDS.”

Last year, about one million infants died on the day they were born. A total of more than 2.5 million died in their first month of life. As the total number of childhood deaths has dropped, the proportions that are newborn deaths have gone up. Newborn deaths now represent 45 percent of all childhood deaths, up from 40 percent in 1990.

Well over half the newborn deaths fall into one of three categories: sepsis and other infections; asphyxia, which means the newborn isn’t getting enough oxygen; and prematurity, which means the baby was born early.

The Bill and Melinda Gates report said it was encouraging to note that many countries have taken steps to arrest the situation. From 2008 through 2015, Rwanda, one of the poorest countries in Africa, cut its newborn mortality by 30 percent, down to 19 deaths per 1,000 births. By comparison, Mali—with a comparable GDP—has a newborn mortality rate of 38 deaths per 1000, twice as high as Rwanda.

“What were they doing in Rwanda? A few things so cheap that any government can support them: breastfeeding in the first hour and exclusively for the first six months. Cutting the umbilical cord in a hygienic way. And kangaroo care: skin-to-skin contact between mother and baby to raise the baby’s body temperature. These practices led to big drops in newborn deaths,” the report says.

“These changes are rolling out now, and that’s encouraging. But we still face one of the biggest and oldest challenges: making sure people understand the lifesaving, poverty-ending power of contraceptives,” it said.