26-year-old Marie operates a small home décor business in Buea. She has a beautiful seven-month old baby girl and is engaged to the father of her baby. She has been away from her shop for months due the birth of her baby and has only just restarted her business. These days, when she goes to work, her baby girl is with her. You may think her baby is the result of an unplanned pregnancy because she is not yet officially married, but you would be wrong.
“I planned for my baby,” she says with a bright smile. “When I first told my fiancé I wanted to have a child, he said it was not a good idea at the time because I had dropped out of school and had nothing doing. He helped me start this business and then we decided to have the baby.”
Generally, twenty two out of every one hundred pregnancies in Cameroon are unintended, going by figures from a 2004 demographic and health survey. Still, public health officials and activists who promote family planning want every woman to always be able to make the conscious decision to get pregnant, like in Marie’s case, as unintended pregnancies may have negative effects on a woman’s health.
“When there are unmet needs for family planning, women of reproductive age get pregnant against their wish, bear more children than their strength and get pregnant more frequently than their systems can resist”, says Numfor Alenwi, the director of Cameroon Agenda for Sustainable Development (CASD), a nonprofit organization that promotes maternal and reproductive health. “These lead to maternal complications, which can take away the life of the mother and/or the child.” In Cameroon, it is estimated that one in 31 women die during child birth.
Aside from the risk to the mother’s health, unplanned pregnancies will usually have significant financial implications. Marie is very aware of that. Even she who planned for her pregnancy says it’s not been easy on the financial side. “My baby was born two month before its due date and I had to spend more on medical bills. Also since the baby came, I have hardly bought a thing for myself. Every time I look at something in the market, it end up being for the baby. If I didn’t plan for this baby, it would have really terrible.”
It is therefore, for both health and economic reasons that family planning is encouraged. Public health officials estimate that only about 12.5 percent of women in Cameroon use a family planning option. This is quite low when compared to other sub-Saharan African countries like Namibia and Rwanda, which have a family planning rate of 53.4% and 46.1% respectively.
For years, family planning and women’s health in Cameroon took a backseat to epidemics like HIV/AIDS and malaria. Funding for family planning activities dropped and family planning units in health centres did not come with trained staff. During this time, many women did not get the necessary education to help them decide whether or not they needed a family planning option while myths associated with contraception grew. Nonprofit organizations that proved to be invaluable partners in the response to other health concerns like HIV/AIDS and malaria where more or less absent from the scene. CASD Director, Alenwi, explains. “The poor attention on women health started during the adoption of the millennium development goals, MDGs, in 2000. Sexual and reproductive health was omitted and was only added as MDG5 B in 2007. Very little investment internationally and nationally, is put into women health. Since the nonprofit organization often than not seek funds than think of the pressing needs of the communities, they all shift to areas like HIV and Malaria where funding is available.”
International organizations have recently tried to fix the situation. In November 2011, Britain announced a donation of 35 million pounds (about FCFA 262.5 billion) to the United Nations Population Fund, UNFPA, for urgently needed contraceptive supplies in low and middle income countries like Cameroon. In March, maternal and reproductive health experts, African policy makers were hosted by the international women’s health advocacy group, Women Deliver, in Uganda to discuss how maternal and reproductive health in sub-Saharan Africa could be improved.
The government of Cameroon has also been making an effort to train staff to work in family planning units, improve access to modern contraception methods and in so doing, help reduce maternal mortality. However, education remains a major problem as many women still don’t know or have fears about contraceptives like pills and implants. On this issue, Alenwi, says it is “advisable for girls and women to forget about the myths and go for contraception. If your religion cannot prevent you from having an unintended child, then go for a condom (male or female), insert Inter-uterine device (IUD), inject or swallow contraception.”
Marie who plans to have her next baby in three years admits she knows very little about other forms of contraception and will opt for condoms, which is the contraception method she knows best. She remains determined, however, and says “I will talk seriously to my husband because sometimes men may be a little relaxed about planning for babies but I will insist we take measures so that the baby comes only after three years.”