Malaysia - Access to reproductive health services the key

I REFER to your interesting AFP report “How many is too many?” (Oct 24) on issues relating to the world’s population explosion estimated to reach seven billion by end October 2011.

Indeed, it is clear that while climate change and environmental degradation has taken the spotlight over the last decade, very little attention has been given to the population problem which is itself one of the prime causes of these two looming catastrophies, whatever we might say about consumption by the West.

This is particularly pertinent in relation to the spiralling population growth in the world’s poorest countries which cannot provide food security to their younger generation, let alone the cost of basic healthcare and education.

Since the landmark International Conference on Population and Development in Cairo 1994 (ICPD), the international community has recognised the need to enable all women access to information and services to regulate their family size as a prerequiste to achieving optimum social and economic development.

Subsequently UN members have also committed their countries to the Milennium Development Goals 2000 which include recognition of universal access to reproductive health services (RH) as one of the key factors to reduce both maternal mortality as well as poverty. This would include all modern contraceptive methods and safe abortions when needed.

The recently completed 6th Asia Pacific Conference on Reproductive and Sexual Health and Rights in Jogjakarta (Oct 19-22) has once again highlighted the obstacles that continue to prevent this aim of universal access to RH services to women in many countries in the Asia Pacific Region since ICPD.

Voluntary family planning and safe abortions using modern medical technology, if made universally accessible, would be the most effective solution. This is borne out by worldwide surveys conducted on women’s intended family size which indicate that on average, only two out of every five pregnancies are intended, and of the three unintended pregnancies, two are continued but one is intentionally aborted. In other words, only half the babies brought into the world are the result of a planned intended pregnancy!

So what are the obstacles faced in applying this strategy to curb population growth? Most significantly, this is certainly not due to lack of financial resources or reliable medical technology of RH which has made great strides the last 60 years. Methods of contraception are now safer and cheaper than any time in our history, as are methods of abortion especially with the discovery of the abortion pill almost 20 years ago.

These newer technologies have also made it possible for services to be safely provided by non-doctors such as midwives, nurses, pharmacists and even via the internet without needing expensive facilities. Sufficient studies have been conducted by women’s health advocates to refute claims that such delivery systems are less efficient than those provided by doctors in traditional clinic settings. But unfortunately, despite all these advances, delivery of these services continues to be hampered by non-medical factors.

The range of obstacles to women’s access to RH services include archaic cultural attitudes and practices, irrational religious dogma, backed by policies and laws reflecting both cultural and religious bias. Often the purported reasons are to protect the moral values of society. Thus policies and laws are often used to oppose sex education in schools, and freer and cheaper access to contraception and safe abortions, all in the name of morality.

The medical profession, which as the leader of the healthcare community, is supposed to apply medical technology in healthcare programmes, has not been particularly prominent in adopting new strategies to expand access to RH services to the needy; some suspect their motivation has been to protect their financial interests by denying non-doctors the opportunity to provide RH services on the pretext of protecting patient safety. Politicians fearing the short-term loss of conservative religious voters are no better at protecting women’s right to health.

Sadly, it does not seem that we can overcome these irrational obstacles any time soon to put a break on the inexorable population explosion with all its dire consequences to us and future generations. Hopefully, reaching the 7 billion mark may make us pause for thought on whether we can continue to tolerate these obstacles to progress on an issue that has serious implications for the survival of the human race.

Dr S.P. Choong

Chair, Steering Committee

Asia Safe Abortion Partnership

The Sun Daily

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