This week, the World Bank reported that Latin America and Africa are the only two regions that have not met the Millennium Development Goal to reduce extreme poverty. Latin America may be the wealthiest region in the developing world on a per capita basis, but it also has one of the most unequal income distributions in the world. Statistical averages across the region mask the existence of the significant inequality within it that hinders access to sexual and reproductive health services for the region’s most vulnerable — in particular, rural, poor, indigenous, and youth populations.
Sexual and reproductive health is fundamental to our overall well-being, and investment in sexual and reproductive health care holds enormous benefits for individuals and societies. The right of women and men to control their fertility and have reliable access to quality health services is at the center of contemporary reproductive health and sustainable development policies. Still, nearly half of sexually active young women in Latin America and the Caribbean have an unmet need for contraception.
Improving access to sexual and reproductive health services is necessary to advance the Millennium Development Goals. At this critical moment, funding priorities for family planning are being shifted away from Latin America and the Caribbean. This move may undermine the substantial gains that have been made in the region and overlook the tremendous need that still remains.
Withdrawing funding by “graduating” countries before they are capable of independently maintaining and improving access to reproductive health care will have a negative impact that could reverse the progress that has already been made through decades of sustained investment. The costs of failing to do so will be turning back substantial advances in health, economic development, and women’s equality.
The need for expanded sexual and reproductive health services and commodities is often linked to poverty reduction. Indeed, common sense supports the notion that poor reproductive health outcomes, such as unintended pregnancy, excess fertility, or complications associated with pregnancy or unsafe abortion, undermine the ability of the poor to escape poverty. Economically vulnerable communities in rural areas often do not have access to sexual and reproductive health education and services. As a result, fertility rates are considerably higher in rural areas.
Investing in sexual and reproductive health can have a considerable impact on achieving wider health-related, social, and economic development goals. For example, a study in Mexico showed that for every peso spent on family planning services between 1972 and 1984, nine pesos were saved on unrealized expenses of treating complications of unsafe abortions and in providing maternal and post-natal care. Broader gains for development can be achieved through better sexual and reproductive health for men and women across the region.
Latin America and the Caribbean has the highest contraceptive prevalence rate in the developing world, and fertility rates have declined substantially over the last four decades. In spite of this, over half of all pregnancies of women between 15 and 44 are unintended, maternal mortality rates are stagnating, and adolescent pregnancies are on the rise. In 2008, approximately 1 in 4 women in Latin American and the Caribbean who wanted to avoid getting pregnant were not using contraceptives or family planning services. These same women accounted for three-quarters of all unintended pregnancies across the region. The unsatisfied demand for contraceptives is not only the second highest in the world (after Sub-Saharan Africa), but unequal access to sexual and reproductive health services reflects the prevalence of social inequalities in the region.
The cost of providing adequate sexual and reproductive health services to women in Latin America and the Caribbean is relatively small ($880 million). Fulfilling this unmet need would reduce the number of unintended pregnancies by 67%, substantially decrease the number of unsafe abortions, and make maternal and newborn care more affordable. In addition, an estimated 70,000 lives — 10,000 mothers and 60,000 infants — would be saved each year as maternal and infant mortality rates would be cut in half, making the benefits of continued investment in the region clear.
Providing financial support to sexual and reproductive health programs remains necessary in order to reach the neediest populations across Latin America and the Caribbean. And it is crucial to closing the massive inequality gaps that prevent access to these services across the region.