The case for investing in family planning in
the Pacific: costs and benefits of reducing
unmet need in Vanuatu and Solomon Islands
Dr Elissa Kennedy
Principal for Maternal and Child Health
Centre for International Health, Burnet Institute
Acknowledgments:
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Sean Mackesy-Buckley, Family Planning International
Sumi Subramaniam, Family Planning International
Apisai Tokon, Vanuatu Ministry of Health
Judith Seke, Solomon Islands Ministry of Health
Annette Sachs Robertson, UNFPA
Rufina Latu, WHO
Arthur Jorari, Statistics and Demography Programme, SPC
Kabwea Tiban, IPPF ESEAOR
Andreas Demmke, population specialist
The ability to decide freely the number, spacing and timing of
children is a fundamental human right
It is also one of the most cost-effective global health and
development interventions
Prevalence of modern contraception is lower than the average for
less developed regions
Source: Demographic and Health Surveys Marshall Islands, Solomon Islands, Nauru, Tuvalu, Kiribati, Papua New
Guinea, and Samoa; UNFPA KAP study Vanuatu; UNFPA State of World Population 2012.
Unmet need for family planning is among the highest in the world
Source: Demographic and Health Surveys Marshall Islands, Solomon Islands, Nauru, Tuvalu, Kiribati, Papua New
Guinea, and Samoa; UNFPA KAP study Vanuatu; UNFPA State of World Population 2012.
A significant proportion of pregnancies are unintended
Source: Demographic and Health Surveys Marshall Islands, Solomon Islands, Nauru, Tuvalu, Kiribati, Papua New
Guinea, and Samoa; UNFPA KAP study Vanuatu; UNFPA State of World Population 2012.
Aims and objectives
To estimate the costs and health, demographic and economic impacts of
reducing unmet need for family planning in Vanuatu and Solomon Islands
• Assist Ministries of Health, NGOs, service providers and other
stakeholders to advocate for increased funding for family planning
• Assist governments to develop reproductive health and population
policies and resource these adequately
• Contribute to the evidence-base for family planning in the Pacific
Methods
Three scenarios:
1.
2.
3.
No change in unmet need for family planning
All family planning needs met by 2020
All family planning needs met by 2050
Population models were created for 2010-2025, using Spectrum, to
estimate:
– Contraceptive prevalence and number of users
– Family planning costs and commodities required
– Health outcomes for women and children (unintended pregnancies, births,
induced abortions, births with any risk, and maternal and infant deaths)
– Total fertility rate and population growth
– Health and education expenditure and required resources (infrastructure
and human resources)
Meeting all the need for family planning by 2020 would result in
25,000 more women using a modern method of contraception
Contraceptive prevalence rate (modern methods) 2025
The average annual number of unintended pregnancies would fall
by 69% on Vanuatu and 50% in Solomon Islands
Average number of unintended pregnancies per year 2010-2025
The number of avoidable high risk births, including births to
adolescent girls, would decrease by 54% in Vanuatu
High risk
births:
4,049
Total births:
7,298
No change in unmet need
High risk
births:
1,940
Total births:
4,542
All needs met by 2020
… and by 20% in Solomon Islands
High risk
births:
8,922
Total births:
16,280
No change in unmet need
High risk
births:
7,185
Total births:
14,402
All needs met by 2020
More than 2,500 maternal and infant deaths would be averted
between 2010-2025
Vanuatu
Solomon Islands
Satisfying the demand for family planning would reduce TFR and
slow population growth
Vanuatu
Satisfying the demand for family planning would reduce TFR and
slow population growth
Solomon Islands
Preventing unwanted fertility would result in less demand on scarce
public sector resources
Vanuatu:
projected health
and education
resources required
by 2025
Preventing unwanted fertility would result in less demand on scarce
public sector resources
Solomon Islands:
projected health
and education
resources required
by 2025
Preventing unwanted fertility would reduce the youth dependency
ratio, resulting in less demand on household resources
Vanuatu population 2025: constant unmet need
-30000
-20000
-10000
Female
0
Population
10000
20000
Male
30000
Preventing unwanted fertility would reduce the youth dependency
ratio, resulting in less demand on household resources
Vanuatu population 2025: need met by 2020
-30,000
-20,000
-10,000
0
Female
Population
10,000
20,000
Male
30,000
US$8.6 million would be required over the next 16 years to meet all
family planning needs
Cumulative family planning costs (direct costs) between 2010-2025
• Vanuatu:
• Solomon Islands:
– $1.47 per capita to meet all
needs by 2020
– $0.40 per capita to meet all
needs by 2020
– $104 to prevent an
unintended pregnancy
– $101 to prevent an
unintended pregnancy
– $3,928 to avert a maternal or
infant death
– $2,762 to avert a maternal or
infant death
Reducing unintended pregnancies would result in US$112 million in
public sector savings between 2010-2025
Total family planning costs and public sector savings (US$ millions) between 2010 and 2025
For every $1 spent to reduce unmet need by 2020,
$9-16 would be saved in health and education expenditure making
other development goals more attainable and more affordable
Conclusions
• Reducing unmet need for family
planning in Vanuatu and the Solomon
Islands would have substantial
benefits for the health of women and
children
• It would also have considerable
economic benefits, reducing the
demand on household and national
resources and saving $112 million in
public sector spending between 20102025
Recommendations
• Reducing unmet need for family planning should be given greater
priority in reproductive, maternal and child health, and population and
development policies
• Increased and long term financial commitment is required to meet the
needs of women and couples (at least $1.5 million for Vanuatu and $1
million for Solomon Islands over the next 5 years)
• Improved information systems are needed to support planning and
monitor progress towards universal access to reproductive health
Resources
• Full reports and summary reports
available at:
www.wchknowledgehub.com.au
• Contact: elissa@burnet.edu.au