The dire consequences of inaction in family planning are starkly illustrated in a recent report presented by Dr. Jacob Novignon and his team from the Kwame Nkrumah University of Science and Technology. Without increased investment and scaling up of modern family planning services, projections suggest a staggering 1.4 million unintended pregnancies, 2,500 maternal deaths, and 450,000 unsafe abortions. However, the report also highlights the significant return on investment in family planning, with every dollar spent yielding between US$2.6 and US$6.9 in averted costs related to these adverse outcomes. This emphasizes the economic prudence, beyond the ethical imperative, of prioritizing family planning initiatives. The report, presented at a stakeholder validation meeting organized by the UNFPA in Accra, underscored the critical interconnectedness of family planning with other crucial social issues, including maternal health, child marriage, and gender-based violence.
Addressing the pervasive issue of gender-based violence (GBV), the report outlined the potential impact of targeted interventions. Investing in GBV prevention and support services is projected to reduce the prevalence of GBV from 33% in 2024 to varying levels by 2030, depending on the ambition of the intervention. A “business as usual” approach would see a reduction to 27.1%, while achievable and ambitious interventions could further lower the rate to 25.8% and 24.5%, respectively. The estimated cost of these interventions by 2030 ranges from $1,417.64 million to $1,958.61 million, representing a significant investment but one with potentially transformative societal benefits. Reducing GBV not only protects individuals from harm but also contributes to a more equitable and just society.
Child marriage, another critical issue addressed in the report, can be significantly mitigated through a combination of interventions. These include expanding access to education, particularly in rural areas, through improved infrastructure and pedagogical changes, providing cash transfers to support families of poor students, strengthening malaria prevention programs, and implementing community-based interventions to change social norms. Scaling up these interventions is projected to avert between 114,000 and 146,000 cases of child marriage in Ghana between 2024 and 2030. The total investment required for these interventions is estimated between $103.53 million and $142.45 million, highlighting the need for strategic allocation of resources to maximize impact. Dr. Novignon emphasized the importance of community engagement in these efforts, noting that the most cost-effective interventions involve active participation from local communities.
Dr. Emmily Naphambo, the UNFPA Country Deputy Representative, underscored the report’s findings by highlighting the urgent need for sustainable investment in sexual and reproductive health, particularly for women and girls. She stressed the importance of moving beyond “business as usual” approaches and embracing innovative strategies to achieve lasting improvements in family planning uptake, maternal health, GBV reduction, and the elimination of child marriage. Dr. Naphambo acknowledged the changing landscape of development assistance, with Ghana’s graduation to lower-middle-income status necessitating a shift from a primarily donor-funded model to a more balanced approach incorporating domestic financing. This transition requires a “funding and financing model” that leverages both domestic resources and international partnerships.
The transition in development assistance presents both challenges and opportunities. Dr. Naphambo highlighted the move by development partners, including UNFPA, towards mandatory co-financing arrangements, similar to those employed by the Global Fund and GAVI. This approach encourages greater ownership and sustainability by requiring recipient governments to contribute financially to health programs. However, she cautioned that poor transitions by governments to this new model could lead to financial shortfalls, medical product and supply stock-outs, service disruptions, and ultimately, negative health outcomes. To mitigate these risks, Dr. Naphambo emphasized the need for strong government commitment, strategic planning, and effective coordination with development partners.
Ghana’s aspiration to “go beyond aid,” achieving greater self-reliance in development financing, necessitates a fundamental shift in mindset, attitudes, and behaviors, according to Dr. Naphambo. This includes fostering a culture of data-driven decision-making and presenting compelling evidence on the return on investment in health programs. This evidence can be instrumental in attracting investment from governments, the private sector, and non-traditional partners, broadening the base of support for essential health services. By demonstrating the significant economic and social benefits of investing in family planning, maternal health, GBV prevention, and the elimination of child marriage, Ghana can build a stronger, more sustainable health system and pave the way for a healthier and more prosperous future. This collaborative approach, involving diverse stakeholders and underpinned by robust evidence, is crucial to achieving long-term positive change and improving the lives of women, girls, and communities across Ghana.
