Family planning services too reliant on donor funding

By The Standard | Nov. 1, 2017 | 5 Min read

ZIMBABWE’s family planning and reproductive health services have been largely bankrolled by donors since government support is so measly, with an allocation of $200 000 to the Zimbabwe National Family Planning Council (ZNFPC) in 2017, which translates to 1,7% of the Ministry of Health budget.

By VENERANDA LANGA

Due to donor dependence on family planning funding, some Zimbabweans, including MPs, have developed myths that the different contraceptive methods supplied by donors such as the contraceptive pill, implants like jadelle and implanon, injectables and other methods are dumped in Africa, so as to deliberately reduce African populations.

During a recent workshop for legislators from eight Parliamentary Portfolio Committees which was organised by the Population Services Zimbabwe (PSZ) and ZNFPC on family planning and reproductive health, the MPs raised different issues pertaining to side effects of modern family planning methods and different myths associated with it.

“Western countries do not have land and that is why they are introducing family planning, so that they can weaken us, and hence massive donations from the United States and European Union,” alleged Marondera East MP Jeremiah Chiwetu (Zanu PF) as he sought an explanation to such myths from PSZ and ZNFPC officials.

“We also hear that children born of mothers on modern contraceptives have a low intelligence quotient (IQ).”

Another MP, Sarah Mahoka (Hurungwe East, Zanu PF) suggested that Zimbabwe’s population must increase.

“We should bear more children in Zimbabwe, but I am not necessarily saying that every year women should be getting pregnant We only need child spacing,” Mahoka said.

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Chairperson of the Parliamentary Portfolio Committee on Finance David Chapfika said there is need to debate the issue of family planning extensively.

“We need to debate on whether we need reduced families because we are poor, whether families can afford children and such issues because if one looks at European countries, they are overpopulated with tens of millions of people,” Chapfika said.

PSZ country director, Abebe Shibru said family planning has advantages in that it improves the health, education, and well-being of women, as well as allowing countries to invest in economic development.

“By investing a $1 in family planning in a country, governments can save $6 that can be spent on improving health, housing, water, sanitation and other public services. It is one entry point for socio-economic development of a country,” Shibru said.

The PSZ has been supporting family planning and reproductive health services through partnering with 134 private doctors and nurses under the Blue Star health network model. The model also reaches out to underprivileged rural areas through its nine mobile outreach programmes, serving women in 63 districts and in 2017 the PSZ plans to reach out to more than 400 000 people in terms of offering family planning and reproductive health services. In 2016, the PSZ offered services to 335 400 users.

While different myths are associated with modern family planning methods, ZNFPC executive director Munyaradzi Murwira, who is a medical doctor, dismissed them saying family planning has several advantages, but it also has side effects like any other medication such as painkillers.

Murwira said the country’s family planning strategy is actually to increase contraceptive prevalence rate from 59% to 68% by 2020, and in the process reducing teenage pregnancies from 24% to 12% by 2020.

He said contrary to the myths about family planning, some of its advantages include preventing unwanted pregnancies, preventing infection by diseases such as sexually transmitted diseases and HIV, and unsafe backyard abortions among several other reasons.

This is amid statistical evidence by the ZNFPC that in 2015, 22% of young women aged between 15 and 19 years had already begun child bearing, while 17% of youths are already mothers and an additional 5% are pregnant with their first child. He said this prevents the girl child from accessing further education and exposes them to danger while giving birth.

Murwiwa said it is, therefore, imperative to spread information about family planning and reproductive health through youth centres, school-based programmes, youth corners, youth interact centres, youth community centres, e-technology, taking into cognisance the different kinds of messages to be disseminated to those who are not sexually active so that they abstain, and those already sexually active, so that they take preventative measures against contracting sexually transmitted infections.

He said it is also imperative for men to accompany their wives to family planning sessions so that they get information on the method that can best suit their spouse, the advantages and disadvantages.

On allegations by Chiwetu that children born of women taking modern contraceptives have a lower IQ, Murwira dismissed the myth, saying children nowadays are actually getting 15 points at ‘A’ Level, a situation that points to that they are actually intelligent.

While government dithers in budgetary support towards family planning services, there is fear that if donors decide to withdraw their support, Zimbabwe will be plagued by sexually transmitted infections, unplanned pregnancies, and even unsafe abortions. Brighton Muzavazi, a Ministry of Health and Child Care official, said the government is committed to supporting family planning and reproductive health and averting more than 600 000 unplanned pregnancies by 2020.

“Budgetary support to family planning and commodities remains a challenge, but services are free at local health institutions with others charging a minimal fee,” Muzavazi said.

Chairperson of the Parliamentary Portfolio Committee on Health and Child Care Ruth Labode said it is disturbing that a country should depend on donors for family planning services, adding Parliament will push that in the 2018 National Budget, the ZNFPC gets allocated 3% of the Health Ministry budget to go towards family planning.

ZNFPC technical director Nonhlanhla Zwangobani said they have come up with the Zimbabwe National Family Planning Costed Implementation Plan for 2016 to 2020 to enable an environment for policy, financing, service delivery, and advocacy programmes for family planning and reproductive health activities.

“Some of the results to be achieved are to increase the proportion of the national health budget allocated to family planning from 1,7% to 3%, to reduce the unmet need for family planning services from 13% to 6,5% by 2020, to increase availability, access and utilisation of HIV and other sexual and reproductive health services for young people, to increase the knowledge of long acting and permanent methods among all women and men from 46% to 51% by 2020, and to maintain stock-out levels of family planning commodities below 5% from 2016 to 2020,” Zwangobani said.

She said full implementation of the plan will avert more than three million unintended pregnancies, more than 900 000 abortions, more than 7 000 maternal deaths, and over 33 000 child deaths between 2016 and 2020.

Ministry of Health and Child Care chief accountant Edward Zvidzayi Mutyambizi, said the problem is under-allocation of the Ministry of Health by Treasury.

Mutyambizi said every year they bid for amounts above $1 billion, but in 2017 the ministry was only allocated $350 million. In 2017, the ZNFPC was supposed to get $281 976, but only $59 000 was disbursed, leaving the organisation relying on donor support.

Chairperson of the Women Affairs and Gender Parliamentary Portfolio Committee Biata Nyamupinga expressed shock that a measly $40 000 was allocated towards reproductive health.

“Women are on national duty when they fall pregnant and give birth and so government must ensure they support family planning and reproductive health issues,” she said.