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Seven billion and counting

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Cambodia’s women still lack access to good family planning advice with almost one quarter of the Kingdom’s women saying their needs have not been met.

Opinion from Population Services International

Seven billion, the number that the world’s population surpassed last month, has been the topic of much discussion lately. But there’s another, more stagnant figure that deserves our attention: 215 million.

That’s how many women around the world today lack access to family planning, and the implications of this figure are far-reaching.

Every year, more than 360,000 women die from pregnancy-related causes. And maternal health is not the only concern. For many couples, unintended pregnancies carry heavy burdens, exposing children and families to a myriad of economic, food, health and environmental risks.

Family planning, therefore, is not just a women’s issue. It is about protecting the rights and health of men and women, adults and young people alike. It is about the future – giving all members of a family and a community the chance to live productive lives and plan their futures on their own terms. And that work needs to start right here in Cambodia.

Progress on family planning across Southeast Asia has been uneven, and while Cambodia has made progress in recent years, many Cambodian couples still lack access to the contraception they want, need and deserve. The total fertility rate in Cambodia is relatively low, with each Cambodian woman bearing approximately three children.

And over the past decade, contraceptive use among married women increased significantly, from 19 per cent in 2000 to 35 per cent in 2010. However, that number falls dramatically short of both the Millennium Development Goal of 60 per cent use by 2015 and the regional rate within East Asia of 80 per cent. Beyond that, nearly a quarter of all Cambodian women continue to report an unmet need for family planning tools and services.

Population Services International (PSI) has been working to expand access to family planning in Cambodia since 1993, when we launched a social media campaign to promote the use of condoms. Since then, we have expanded our work here through a “total market approach” that aims to improve coordination between the public, commercial and social marketing sectors, which ultimately increases access to family planning services.

Each sector has a role to play in achieving this goal – the public sector provides free products to the poor; the social marketing sector offers subsidised products to those who can afford a small fee; and the commercial sector addresses the needs of those who can pay full price. Only by working in collaboration can we effectively support the family planning needs of our population and improve the long-term sustainability of the market.

At the end of this month, the 2011 International Conference on Family Planning will convene nearly 2,000 policymakers, researchers and donors from around the world in Dakar, Senegal, for the largest family planning conference in history.

Now, more than ever, policymakers, donors and advocates in our region have a momentous opportunity to demonstrate the impact of our financial and political commitment to this issue and set the bar high for the rest of the world.

We can do better at delivering the solutions we have, and be more innovative in developing new approaches to meet contraceptive needs. PSI’s total market approach is a prime example of that. But family planning should also be integrated into the broader network of health services – including maternal and child health and HIV/AIDS care – to strengthen health systems, increase efficiency and access and reduce costs.

Investing in family planning today will not only pay dividends now, but will also help the most populous generation of young people in history forge a brighter future. We must not forget that family planning is not a woman’s issue – it is a human issue, and a global one at that.

It is inextricably tied to human rights, public health and development – and the time to take action is now.

Yasmin Madan is the PSI Country Representative – Cambodia.

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