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Vanuatu Parliamentarians dialogue on Family PlanningUnwanted pregnancies among high school students and the need to upgrade health facilities in Vanuatu were just two of the many population-related issues which dominated discussions at a two-day Parliamentary retreat in Port Vila this week.
Retreat participants ended the consultation with a draft work plan for 2012 to build on the progress achieved so far in this area, which had included a tour of health centers in rural areas to inform their advocacy role both at parliamentary and grassroots level.
The role of parents, communities, traditional leaders, schools and churches in the communication of reproductive health-related information to children were also passionately discussed at the United Nations Population Fund (UNFPA)-supported retreat.
The retreat was organised primarily for the members of the Parliamentary Standing Committee on Social Policy to dialogue with their stakeholders including state agencies, civil society and traditional and faith-based leadership.
UNFPA Sub-Regional Office Assistant Representative, Virisila Raitamata reminded members of Parliament of the international agreements recognised by the Vanuatu government particularly commitments made to women’s health, reproductive rights and the reduction of maternal and infant mortality.
One of these international agreements is the Millennium Development Goals (MDGs) which 192 United Nations member states including Vanuatu, and at least 23 international organizations, had agreed to achieve by the year 2015. Raitamata said in the case of UNFPA, the MDGs that were concerned with maternal health, gender equality, and poverty reduction were closely linked to the Plan of Action agreed to at the 1994 International Conference on Population and Development (ICPD) held in Cairo. She added it was now widely acknowledged that population dynamics had a significant impact on the achievement of almost all the MDGS.
On contraceptives, Raitamata said the marketing of contraceptives had over the years, narrowed the concept of family planning to its partial and crippled meaning of using contraceptives. She said Family Planning needed to be restored to its original sense of planning for life, for our family, for our culture, for women and men, for young and old. UNFPA promotes and respects the fundamental human right of couples to choose the number and spacing of their children.
Raitamata emphasised the role of legislators in “enhancing financing for health; supporting national health plans; strengthening policies and improving service delivery; addressing structural barriers to and social determinants of women’s and children’s health”. This is in line with the global strategy for mother and child health.
Raitamata said women, men, children, and their families and communities, could not be viewed as passive recipients of services anymore; they needed to be active participants in the realisation of their health and development.
“There is need to promote integrated delivery of health services and life-saving interventions – so men, women and their children, and young people, can access prevention, treatment and care when and where they need them,” she said.
“Strong health systems, with sufficient resources and skilled health workers are core to efficient and effective service delivery. There is need for innovative approaches to financing, and the efficient delivery of health services. Promoting human rights, equity and gender empowerment will assist women to take charge of their health.”
“There is a lot of room to harmonize efforts to avoid duplication and facilitate more efficient use of resources.”
“And more importantly, there is potential to do more to strengthen community systems and participation, with faith-based leaders and the chiefly leadership system, recognizing the essential role communities play in providing health - care, facilitating access to health services, promoting citizen participation and empowerment, advocating for essential interventions and addressing structural barriers to health.”
When officially opening the retreat, the chairman of the Parliamentary Public Accounts Committee Honourable Ioanne Omawa stressed the importance of improving access to modern contraceptives to prevent unwanted pregnancy and related complications.
Omawa acknowledged the challenges of low awareness level, myths and misconceptions about family planning, staff and commodity shortages, service-related costs, long waiting hours, etc.
Omawa said an “all-inclusive” approach was essential, reiterating the central role of policy-makers and legislators in ensuring access to contraceptives. He called upon fellow legislators to “take a leading role in addressing issues that undermine public access to modern contraceptive services”.
Senior policy analyst in the Office of the Prime Minister, Pioni Willie, provided a population profile and socioeconomic situation overview of Vanuatu emphasising the impact of rural-urban migration on population issues.
With the mainly urban-centred service sector contributing 74 per cent to the national GDP, migration to the urban centres would continue to be attractive.
Willie said unless rural health centers services were improved, especially those relating to reproductive health, the high fertility rate in these areas (an average of more than four children per woman) would remain because of the tradition of large families which continue to be encouraged, but also because of inaccessibility to family planning services.
Willie informed the meeting of a new national population policy to be launched soon; another UNFPA financial and technical-supported project. The policy aims to:
*Accelerate the demographic transition and achieve the medium population projection by 2030;
Substantially reduce the unintended teenage fertility rate;
*Reduce maternal mortality and morbidity to where they no longer constitute a public health problem;
*Manage rural-urban migration and urbanisation to better contribute to development;
*Close the population data gap; and
*Further apply analysis of census and survey data to support integrated population-development planning.
Participants heard concerns from state officials and the need to address the issue of a ballooning population growth rate, estimated at 2.4 per cent per year – placing Vanuatu at a higher level than Papua New Guinea and Fiji.
Ministry of Health’s Director Southern Health Care, Morris Amos, attributed the high fertility rate to low contraceptive-use; he added that child-bearing trends were seeing an increasing number of pregnancies in 18-year-olds and below, as opposed to the ideal child-bearing age of at least 21 years.
While the TFR (average number of children born to a woman by the time she ends child-bearing) per women has declined from 6.5 in 1979 to 4.1 in 2009, teenage pregnancy remains high, especially in rural areas at 77 per cent. In Torba for example, it was estimated that out of the 1000 births recorded, 116 were born to women aged between 15 to 19 years.
Vanuatu Family Health Association advocacy and network advisor Julius Ssnabulya spoke of progress since collaborating with developing agencies like the UNFPA.
“More people are becoming vulnerable to unwanted pregnancy and related health and social problems,” he said. “The population is increasing and demand for services is also increasing yet funding for family planning is reducing and men continue to restrict their female partners from using the existing family planning methods.”
“Good progress would benefit individuals, policy-makers and the Government.”
Chief Henden Kalsakau spoke passionately of how he lost a son and twin girls “due to the lack of health resources” reiterating the importance of developing a work plan that would prevent the system failing other parents.
Non-government organisation Wansmolbag spokesperson Norley Jack said most cases of teenage pregnancies recorded at the organisation’s clinic were secondary school students.
Serving an average of 200 clients a month, apart from the 1200 mothers who access contraceptives at their clinics, Wansmolbag uses DVDs and theatre to raise awareness on reproductive health-related issues like sexually-transmitted infections, abortion and teenage pregnancies.
Jack recommended increased targeted sexual reproductive health (SRH) awareness and education, particularly for young men and boys and increased investment in SRH-related training for health workers, especially nurses.
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