State of World Population 2012 - UNFPA Haiti

Family planning programmes reinforce thepositive impacts of other programmes thatinvest in human capital. By reducing maternalmortality and increasing life expectancy, suchprogrammes raise the return to schooling andthus increase the returns to investment ineducation, particularly for girls. Governmentsshould regard family planning in the sameway they view and prioritize other humancapitalinvestments in education, labour forceparticipation and political participation.By reducing maternal mortality and increasing life expectancy,such programmes raise the return to schooling and thusincrease the returns to investment in education, particularly forgirls. Governments should regard family planning in the sameway they view and prioritize other human-capital investments ineducation, labour force participation and political participation.The close relationship between declines infertility and improvements in women’s rightssuggests that governments and multilateralinstitutions should not only focus on promotingdirect legislative changes for women’s rights butshould also invest in family planning and otherprogrammes that invest in human capital. Thisis one more way of improving the bargainingposition of women in society.Family planning programmes are not,however, a substitute for other types ofinvestments in human capital. In fact, familyplanning programmes and declines in fertilityhave their maximum impact in societies thatare making complementary investments inincreasing female schooling, expanding labourmarket opportunities, and experiencingeconomic changes that fundamentally changethe cost-benefit tradeoff of high fertility.Programmes have often been most effectivewhen coupled with other types of maternaland child health inputs.3 Ensure the right to family planningof specific excluded groupsAs an essential part of governments’ commitmentsto rectifying inequalities in health,programmes must address the financial,physical, legal, social and cultural factors thatmake it difficult for so many people to seekhealth services and overcome the intersectingforms of discrimination they may face.Poor women who have no access to familyplanning have more children than they intend.Meanwhile, wealthy and educated elites,wherever they are, tend to have access to familyplanning, independent of whether policies orprogrammes support it. In many countries, eventhough efforts have been made to overcomehealth inequities by targeting services for thepoor, the benefits are often accrued mainlyby those who are already better off (Gwatkinand others, 2007). To improve access tocontraceptive information and services for thepoor, programmes must often address not justthe financial obstacles but also the physicalobstacles (such as distance to health facilitiesand the opportunity costs of lost work timeto visit family planning providers) and socialand cultural factors (including disrespectful orjudgmental treatment by health workers, lackof autonomy in making decisions about healthservices or family or community opposition tocontraceptive use).In countries where it is needed, new legislationshould be introduced to ensure universalaccess to family planning; in others, stepsmust be taken to ensure the equitableimplementation of existing legislation, policiesand programming. Government support forfamily planning should include actions thatmake services available to marginalized groups,102 CHAPTER 6: MAKING THE RIGHT TO FAMILY PLANNING UNIVERSAL