A global congress on fertility health in Hong Kong this week will hear of disturbing gaps in access to female contraception across the Asia Pacific region with the poor and young most vulnerable.
Assistant Professor Susan Logan, a Singapore-based specialist in sexual and reproductive health, said public access to contraception and broader reproductive health services increasingly had to compete for funding support against other human rights and health-related priorities including management of infectious diseases, such as HIV, and chronic conditions.
“Unmet contraceptive need has plateaued over the past two decades and funding for contraceptive provision has not increased in recent years,” she said.
“An initial increase in access to contraception has tailed off because of lack of prioritisation and the decline in funding support.
“With the global population projected to increase from around 6 billion people in 2000 to 9.8 billion by 2050, the implications of this access gap are very concerning. Over this period, the population in Asia is expected to increase by 41 per cent and across the wider Oceania region by 84 per cent.
“Around 85,000 women across the Asia Pacific region die each year from conditions related to pregnancy and childbirth, and up to 90 per cent of these deaths are preventable.
“National surveys have reported improvement in access to contraceptives among married women and those in long-term relationships, but the data among unmarried women and sexually active adolescent females is extremely limited.”
Assistant Professor Logan, Senior Consultant in the Division of Reproductive Endocrinology and Infertility at Singapore’s National University, will highlight concerning access gaps to contraception at the ASPIRE 2019 Congress at the Hong Kong Convention and Exhibition Centre.
The Asia Pacific Initiative on Reproduction (ASPIRE) embraces 21 countries across the region with a mission to enhance competencies in assisted reproduction while improving access to and quality of fertility-related health services.
Assistant Professor Logan said the benefits of contraception were huge in terms of advancing the sustainability development goals regarding planet, people, prosperity, peace and partnerships.
However, she highlighted problems related to “Six As” – awareness, availability, accessibility, accommodation, acceptability and affordability – of contraception and other reproductive health services including safe abortion care, maternal and new born care, prevention and control of sexually transmitted infections and gender based violence and treatment for infertility.
At the ASPIRE Congress, Assistant Professor Logan will highlight data on access and use of traditional and modern contraceptive methods.
She said out of 1,000 women per year, the expected failure rate of the withdrawal method is 250; condom use 180 and the pill 90. In contrast, long-acting reversible methods have rates comparable to or better than female sterilization, with 8 and 0.5 failures expected with IUCD and implant use respectively.
Assistant Professor Logan will present case studies including a Myanmar woman aged 35 who had an unsuccessful abortion resulting in a disabled child. She was subsequently prescribed the contraceptive pill, but received no advice on how and when to take the medication.
She will highlight the case of a Timor-Leste woman who became pregnant at 16 years of age, ultimately giving birth to six children with two miscarriages and one stillbirth, and who practices the withdrawal method with her husband, who is often drunk and violent.
Assistant Professor Logan said there were often with specific location-based barriers to accessing reproductive health information and services.
About 1,600 delegates including scientists, clinicians, embryologists, nurses and fertility counsellors will attend the ASPIRE 2019 Congress from today until Sunday.
For further information, go to the Congress website www.aspire2019.com
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