Family Planning: The Elevator Speech

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Family Planning The Elevator Speech

• Global Health Mini-University

Scott Radloff Director, Office of Population and
Reproductive Health October 8, 2009
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• Objective Explain to a policy official why
  family planning programs are important in the
  span of a short elevator ride.

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Basic Challenge

• Family planning is the solution, or part of the
  solution, to a panoply of problems.

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What are the essential messages to include?
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World Population Growth
Micro Macro Messages
Maternal Death/Birth Interval
?10.8
?9.2
?7.8
Source United Nations Population Division, 2006
Source Conde-Agudelo and Belizan, 2000
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More than 380 million women, or nearly 60 of
couples in the developing world want to limit or
space their births, yet more than 200 million of
them do not have access to family planning
services (Singh et al., 2003).

• Enable women/couples to choose the number and
  spacing of children.

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Very short birth intervals (less than 15 months)
are associated with maternal death rates 150
higher than at longer intervals, as well as with
various complications of pregnancy (Conde-Agudelo
and Belizan, 2000).

• Reduce mortality/morbidity risk for mothers
  through healthier timing and spacing of
  pregnancies

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A child born 3 to 5 years after the birth of its
sibling is about 2.5 times more likely to survive
than children born at shorter intervals, less
likely to be malnourished, and suffer less from
stunting (Center for Communication Programs,
2002).

• Reduce mortality/morbidity risk for children
  through healthier timing and spacing of
  pregnancies.

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In Romania, when use of modern contraceptives
more than doubled between 1993 and 1999, the
abortion rate decreased by 35 and
abortion-related maternal mortality dropped by
more than 80 (Westoff, 2003)

• Reduce reliance on abortion.

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A study in Uganda found that HIV incidence rates
were 2.3 per 100 person years during pregnancy,
1.3 per 100 years during breastfeeding and 1.1
per 100 person years in non-pregnant and
non-lactating women (Gray et al., 2005).At the
same level of expenditure, the contraceptive
strategy averts 29 more HIV births than
nevirapine for pevention of mother-to-child
transmision of HIV (Reynolds et al., 2006).

• Reduce HIV/AIDS transmission by reducing
  unintended pregnancy.

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In Africa, between 8-25 of girls who drop out
of school do so because of unintended pregnancy
(All Party, 2007).

• Enable women to complete education and pursue
  careers.

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Smaller families have more opportunities to
increase household savings, to invest more time
and resources in each child, and increase each
family members human capital (UNFPA, 2005).

• Enhance the ability of families to invest in
  children.

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A demographic window opens when the number of
producers in the population grows more rapidly
than the number of dependants. The demographic
bonus in East Asia is estimated to account for
about 1/3 of the regions unprecedented economic
growth during 1965-90 (Bloom and Canning, 2004).

• Mitigate the impact of population dynamics on
  Economic Growth.

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1.1 billion people lack access to safe drinking
water. As population grows, the UN estimates 2/3
of the worlds population will face moderate to
high water shortages by 2025 (All Party, 2007).
The goal of achieving food security will be made
more difficult if population growth rates cannot
be reduced, concluded a 2005 report by the UN
Food and Agriculture Organization (PAI, 2005).
Due both to deforestation and human population
growth, the current ratio of forests to human
beings is less than half what it was in 1960
(PAI, 2000).

• Mitigate the impact of population dynamics on
  Natural Resources.

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Recent studies have shown that a large youth
bulge usually defined as a high proportion of
15-to-29 year olds relative to the adult
population is associated with a high risk of
outbreak of civil conflict (Cincotta, 2005).

• Mitigate the impact of population dynamics on
  State Stability.

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• Why U.S.?
• Largest bilateral donor
• Technical leadership
• Componentry channels
• Why Now?
• High unmet need
• Cost-effectiveness
• Momentum

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• messages could be incorporated
  into an Elevator Speech

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so, which ones to include?
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Answer may depend on

• A. How long is the elevator ride?
• B. Where is the elevator?
• C. Who is on the elevator?

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Family planning could bring more benefits to
more people at less cost than any other single
technology now available to the human race.
But it is not appreciated widely enough that this
would still be true even if there were no such
thing as a population problem.
(James Grant, UNICEF Annual Report
1992).
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Pearl in Haiku-form

• Meet needs of women
• good things happen for her,
• family, others

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Thank you

• For your attention and participation!

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• References
• All Party Parliamentary Group on Population,
  Development and Reproductive Health (2007).
  Return of the Population Growth Factor Its
  Impact Upon the Millennium Development Goals.
• Bloom, D. and Canning, D. (2004). Population,
  Poverty Reduction, and the Cairo Agenda. Paper
  prepared for the Seminar on the Relevance of
  Population Aspects for the Achievement of the
  Millennium Development Goals (17-19 November
  2004). New York United National, Department of
  Economic and Social Affairs, Population Division.
• Center for Communication Programs. (2002). Birth
  Spacing Three to Five Saves Lives. Population
  Reports, XXX (3).
• Cincotta, Richard. (2005). Global Security
  Brief 2 Youth Bulge, Underemployment Raise
  Risks of Civil Conflict. Worldwatch Institute.
• Conde-Agudelo, A., Belizan, J.M. (2000).
  Maternal Morbidity and Mortality Associated with
  Interpregnancy Interval Cross sectoral study.
  British Medical Journal, 321 (7271), 1255-1259.
• Gray, Ronald H. et al. (2005). Increased Risk
  of Incident HIV During Pregnancy in Rakai,
  Uganda a prospective study. The Lancet, 266
  1182-88.
• Population Action International (PAI). (2005).
  How Population Growth Affects Hunger in the
  Developing World.
• Population Action International (PAI). (2000).
  Why Population Growth Matters to the Future of
  Forests.
• Reynolds, Heidi et al. 2006. The value of
  contraception to prevent perinatal HIV
  transmission. Sexually Transmitted Diseases,
  Vol. 33, No. 6 350-356.
• Singh, S., et al. (2003). Adding It Up The
  Benefits of Investing in Sexual and Reproductive
  Health Care. New York The Alan Guttmacher
  Institute and United Nations Population Fund
  (UNFPA).
• UNFPA. (2005). Reducing Poverty and Achieving
  the Millennium Development Goals Arguments for
  Investing in Reproductive Health and Rights
  Reference Notes on Population and Poverty
  Reduction.
• Westoff, Charles. A New Approach to Estimating
  Abortion Rates. 30 June 2008.