Better family planning in South Asia is needed to address the issues of child mortality and maternal health, highlights a new paper presented at the 9th International Scientific Meeting of the Royal College of Obstetricians and Gynaecologists (RCOG)in Athens last week.
The commentary paper is part of an International Reviews Supplement published in BJOG: An International Journal of Obstetrics and Gynaecology, focusing on South Asia, the most densely populated region in the world.
The supplement focuses on five countries, India, Pakistan, Bangladesh, Nepal and Sri Lanka and looks at how far each country has come since 2000 and the launch of the Millennium Development Goals on reducing child mortality and improving maternal health.
It is estimated that family planning could prevent one in every three maternal deaths and one in 11 child deaths, states the paper.
One of the main challenges facing the area is population growth caused by early pregnancy, high fertility and frequent childbearing. As the population rises, so does the number of women and children needing basic health and education.
The paper also looks at the need for educating the population about the advantages of having a smaller family which can improve neonatal survival.
A further problem is access to family planning services with many couples wishing to delay or stop childbearing but unable to as they are not using any contraception.
Birth spacing is also important states the paper. Closely spaced pregnancies and poorly timed pregnancies contribute to mortality rates.
Despite the enormous challenges facing South Asia, there have been significant successes in some countries, in particular Sri Lanka where the maternal mortality ratio is amongst the lowest in the region despite a third of the population living below the national poverty line. The Government there is committed to improving education and healthcare and women have a relatively high status and high literacy rates. In addition there has been a significant reduction in family size and delayed
For each of these five countries covered in the Supplement, authors have reviewed the maternal and newborn health indicators for the country and looked at antenatal, intrapartum and postpartum care, family planning, newborn care and care for children under 5 years.
Causes of maternal and newborn mortality are reviewed, followed by an outline of the country’s strategy, policy and programmes that are in place to address the challenges of meeting MDGs 4 and 5.
Furthermore, the authors highlight both the challenges and opportunities that each country faces and make an estimation of likelihood that the 2015 targets will be met.
Devender Roberts, Guest Editor of the International Reviews Supplement, said:
“This International Supplement has provided a unique opportunity to document comprehensively where each country is at in 2011, the challenges faced five years from the Millennium Development Goals target, and to share lessons learnt across South Asia.”
The Supplement was jointly funded by the International Office at the RCOG and the Department for International Development (DFID).
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Howarth LA, Walker JJ. The role of family planning in South Asia. BJOG 2011; 118 (Suppl. 2): 31-35