Unmet need increasing population in Malawi

Maria Phiri, 36, of Kawale in Lilongwe had been using Depo Provera, an injectable family planning method, for over a year.

However, she happened to lose a family member and travelled to the Northern part of Malawi for the funeral and missed her day for getting her next injection. She ended up having a 12-day lag.

When she returned home, she could not immediately make it to Kawale Family Planning Association Clinic for her injection and slept with her husband. The following day, she finally got her injection. However, a month later, she was confirmed to be pregnant and her husband dumped her at the clinic, claiming that she was given expired medicine.

The husband said the five children they had were enough, and he was not ready for another child.

Family Planning Association of Malawi (Fpam) district manager for Lilongwe, Thokozani Njoloma, says the issue was settled after Phiri showed her health passport which showed she had missed her injection for two weeks.

“We agreed to see her for antenatal care, but she only showed up once and never came again. When we followed up with her, it was discovered that she was chased from her husband’s home because of her pregnancy,” says Njolomole.

She says women usually think they will not get pregnant when they have been using the injectable for some time, even though there’s room for them to get pregnant when they have sex at a time they are due for another injection.

Another woman, Charity Kunje, also fell victim to an accidental pregnancy. With two children aged 14 and 9, she discovered that she was pregnant after missing her time for her injectable.

When time for delivery came, she was so scared of having a normal birth that she could have lost her child had it not been for an emergency Caesarean section. Looking after her new baby is now a burden on her as her other children have already grown.

Unmet need for family planning is one of the issues that came up at the National Leader’s Conference on Family Planning held in Lilongwe on Tuesday and Wednesday this week. It is partly to blame for the country’s rising population.

Some delegates felt that Malawi’s current population boom could be controlled by setting a policy on family size. In a break-out session on Tuesday, the topic became the centre of debate as leaders discussed the best way forward in slowing down Malawi’s population growth.

UNFPA programme manager for Population and Development Dr Thomas Chataghalala Munthali said in an interview that government realises that family planning is about people’s rights and that the right to choose family sizes rests with couples.

“What government has been encouraging is giving people the information and the access to contraceptives when they make the choice to plan their family sizes. This is the spirit that was adopted, particularly under the International Conference for Population and Development (ICPD) in Cairo in 1994. Governments are never encouraged to prescribe the number of children that couples should have,” said Munthali.

To this end, UNFPA has been supporting governments by creating awareness on the pros and cons of certain family planning decisions as well as making available the means for planning families, including in remote areas.

Munthali said putting forward a policy that explicitly defines the number of children each couple should have would be an infringement of people’s rights as enshrined in the various conventions and declarations of the United Nations to which Malawi is party.

At the conference, it was revealed that Malawi has been a shining example in family planning over the past decade. Contraceptive prevalence rate has increased from about 28 percent in 2004 to 42 percent in 2010 and the Malawi Growth Development Strategy (MDGS) has for the first time prioritised population and development as a stand-alone sub-theme under social development.

Therefore, both at policy and programming levels, Malawi is making strides such that it has been awarded this year the Resolve Award by the Global Leaders Council for Reproductive Health.

Munthali explained that a managed population will lead to better quality of life as economic resources are able to cover for people’s basic needs. And if the population grows uncontrollably, most of the resources are infinite like land so there has to be a way of ensuring that there is a proper balance between resources and population growth.

Malawi’s population growth rate is currently at three percent which means 400 000 people are added each year. At this rate, the country will grow to four times its size by 2050.

Challenges such as the unmet need in family planning are increasing the number of children born, according to Nissily Mushani of the Ministry of Economic Planning and Development.

“One in four women says that she does not want another child now or at all, but is not using family planning. Nearly half of pregnancies in Malawi are unplanned,” says Mushani, adding that this leads to unsafe abortion, among other health hazards.

“In Malawi, one woman dies every two hours from causes related to pregnancy or childbirth,” she says.

If the unmet need for family planning were met by the year 2020, Malawi could prevent 7 000 maternal deaths and 354 000 child deaths.

Senior Chief Lukwa of Kasungu suggests that family planning be introduced to people in the grass roots using the village development committees and encouraging parents to talk to their children about sex.

“Using the Ministry of Education and dismissing the culture that we can’t talk to our children about sex can help reduce teen pregnancies and delay birth of children, therefore, reducing fertility rate per woman,” said Lukwa.

Countries like Norway, Japan, Germany, China are reeling with challenges of an ageing population and are now encouraging their citizens to have more children.

“It helps to match resources with the number of people. Population growth on its own is not bad, but when it out-paces resources then something needs to be done. Family planning is an important tool for achieving sustainable development. It offers the youth with hope for the future as they would have time to attend school than reproduce at a tender age.

“It offers hope to the nation as an educated population ensures a productive nation. The reposition of family planning in Malawi, therefore, from a health issue to an indispensable sustainable development issue would not have come at any better time than this,” says Munthali.

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