Monday, March 22, 2010

Canada "Opens Door" to Family Planning Programs in Global Effort to Reduce Maternal Death

After a firestorm of negative publicity following the Canada government's announcement that it would not fund family planning programs as part of its global contribution toward reducing maternal death and illness, Canadian Prime Minister Stephen Harper appeared to backtrack on the inclusion of contraception as part of his G8 initiative on maternal health reports theGlobe and Mail.

“We are not closing doors against any options including contraception," Harper said. "But we do not want a debate here or elsewhere on abortion.”

Hardly solid reassurance, but it's a step.

As we reported Wednesday, Canadian Foreign Affairs Minister, Lawrence Cannon, told members of parliament that Canada's maternal health initiative was about saving lives and therefore would not include birth control.

“It does not deal in any way, shape or form with family planning,” Mr. Cannon said about the initiative when he met with the committee. “Indeed, the purpose of this is to be able to save lives.”

I called the policy on contraception absurd given the extensive research conducted over 40 years on the contributions of family planning toward reducing maternal, infant, and child death, including through reducing unintended pregnancies, high-risk pregnancies, and the need for unsafe abortion, among other factors in high rates of maternal death and disability among women worldwide.

Reactions to the decision to exclude family planning in Canada and internationally were swift, as noted by the Globe and Mail and Edmunton Sun.

In a statement, Liberal Members of Parliament in Canada said:

By excluding birth control from their maternal and infant health initiative, the Harper Conservatives are going in the opposite direction of its G8 partners and putting women’s lives at risk.

“The Harper Conservatives are setting the stage to embarrass Canada at the G8 with an initiative that turns back the clock on women’s equality and human rights,” said Liberal Status of Women Critic Anita Neville. “Their right-wing ideology should not be allowed to trump the volume of research from around the globe making a solid case for greater international support for sexual and reproductive health programs.”

But Harper was not only out of step with evidence from decades of research on public health and human rights, he also appeared to be out of touch with some of his own government representatives, one of which, according to women's health and rights groups, was responsible for fighting to incorporating language on more comprehensive services into international agreements negotiated at the recently concluded Commission on the Status of Women at the United Nations earlier this month.

Harper's "no contraception" stance was--and his inability to state proactively that contraception is an important part of maternal health programs is-- unequivocally ideological, ignoring a vast body of public health evidence about one of the most effective, least costly prevention interventions in existence. Indeed, as noted by Katherine MacDonald, executive director of Action Canada for Population and Development, "combining family planning with good maternal health services could reduce maternal deaths in the Third World by 70 percent."

Moreover, since a large share of women in many countries continue to have unwanted pregnancies--and therefore a larger completed family size than they ultimately want--providing access to voluntary family planning programs contributes to an expansion of women's rights and power in deciding the future lives of their children, their families and themselves and reduces population pressures where these are of concern...again voluntarily.

Recent research by the Guttmacher Institute and the United Nations Population Fund (UNFPA), for example, states that satisfying the unmet need for contraceptive services in developing countries would avert 52 million unintended pregnancies annually, which, in turn, would save more than 1.5 million lives and prevent 505,000 children from losing their mothers.

So the evidence on the benefits of family planning is clear.

At the same time, whether there is a debate about abortion is more or less out of the control of Harper or others. First of all, contraception is not abortion, but the far right constantly equates the two, blurring lines and ignoring biological science among other things. Indeed the far right in the US and Canada is against contraceptive use, plain and simple.

Second, there should be an informed debate about women's need for access to safe abortion, the effects on women' lives--and hence on the lives of familles, communities, and economies--of unsafe abortion and why governments and the media consistently allow abortion to be stigmatized through mimicking of the misleading messages of the ultra-right. Today, complications of unsafe abortion are one of the leading causes of maternal mortality and disabilty. Unless we address it, we will not resolve the maternal health crisis.

The Edmunton Sun notes that:

Canada is a signatory to several agreements that commit to providing a full range of safe and reliable family planning methods and reproductive health services. The Development Assistance Accountability Act, for example, requires that any assistance provided by Canada be consistent with international human rights standards. In June 2009, a UN Human Rights Council resolution also committed Canada to provide “the effective promotion and protection of the human rights of women and girls” which includes “sexual and reproductive health.”

Whether Canada fully lives up to its agreements remains to be seen.

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