Changing Rural Maternal and Child Health Through Access to Contraception
Goal 10 of the Sustainable Development Goals (SDGs) is to reduce inequality within and among countries. There are large disparities in the basic standard of living, life expectancy and livelihood opportunities available to people in low- and middle-income countries (LMICs) compared to those in high-income countries. For instance, the proportion of mothers who do not survive childbirth is 14 times higher in developing countries than in developed regions, and four out of every five deaths of children under age five occur in sub-Saharan Africa and Southern Asia. In a global opinion survey commissioned by the United Nations Development Programme, policymakers from around the world acknowledged that inequality in their countries is generally high and a potential threat to long-term social and economic development.
In LMICs including Nigeria, women in rural areas are still up to three times more likely to die while giving birth than women living in urban centers. I remember one of my experiences during a medical outreach to a particular village in my country where I met a woman who was seven months pregnant with her fourth child. She had not been to an antenatal clinic and planned to deliver her baby at home without any medical care. This woman is just one of many women in rural communities who do not access quality health information and services during pregnancy, sometimes resulting in life-threatening complications.
While some underlying factors such as poverty and illiteracy adversely affect the health and economic outcomes of people living in rural areas, other challenges to women’s and children’s survival in these communities include lack of access to comprehensive sexual education and contraception. In many of these communities, discussing sex is taboo, and some girls are still forced to marry shortly after onset of menstruation. Often women are not empowered to negotiate sex with their partners, families have poor child-spacing practices and parents lack knowledge of appropriate vaccination schedules for their newborns. These factors added to economic and geographic vulnerabilities have led to negative maternal and child survival narratives in rural communities.
As a proactive measure to improve lives in vulnerable populations, especially women and girls in rural and slum areas, I provide leadership for a non-governmental organization called Lighthouse Global Health Initiative (LGHI). Through the LGHI platform, we implemented a program called the Rural Empowerment and Health Promotion Project and a number of medical outreach programs to rural communities within Nigeria. More recently, we started a digital storytelling project called the Rural Contraceptives Access Campaign to showcase levels of knowledge, uptake, access to and quality of family planning services available to adolescent mothers living in a rural community in Nigeria. The ultimate goal is to use the findings from this campaign to mobilize necessary support and commitments to ensure that people living in hard-to-reach communities in Nigeria and other developing countries have equal access to contraception.
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Photo credit: David Alexander