"All women should have pregnancies they want and the antenatal care they need."
As we mark World Contraception Day on September 26th, this may seem like a lofty goal. Similar ambitious and hopeful statements are being made right now at the United Nations as the Sustainable Development Goal process moves forward. But this is a specific target. This is Laura Razaka's hope for the communities that she serves over the coming year. And it can be realised.
Laura is a 25 year-old Malagasy midwife who works in rural southwest Madagascar for marine conservation organisation Blue Ventures. This may seem like an unusual workplace for a midwife, but it offers Laura a unique opportunity to reach isolated communities with vital health services.
Laura (centre) with her colleagues Balbine (left) and Caroline (right)
Collaborative approaches for extending access to voluntary family planning services are desperately needed. An estimated 222 million women in developing countries would like to be able to space or limit their births, yet are not currently using modern contraceptives. Upholding their reproductive rights would prevent an estimated 79,000 maternal deaths, 1.1 million infant deaths and 54 million unintended pregnancies.
"Women who come to me often have a pregnancy every year," says Laura. "This leads to maternal and child deaths - I want to see that decrease as unmet family planning needs also decrease."
Laura is part of a dedicated team working closely with government and health partners to ensure that all pregnant women in her service area have access to the antenatal and postnatal care they need, and that each of their pregnancies is wanted. She supports the work of local community-based distributors of short-term contraceptive methods, who also provide health education to women in their villages.
After recently being trained by Marie Stopes Madagascar as an "MS Lady", Laura is now able to offer long-acting reversible contraceptives as well as antenatal and postnatal care. This means that women in the 40 communities that she serves now have access to a full range of contraceptive options, where previously they had to walk up to the length of a marathon in dry heat to reach the nearest family planning clinic.
Through this community-based service delivery model, and thanks to strong partnerships with Marie Stopes Madagascar, Population Services International and the Madagascar Ministry of Health, we now have the mechanisms in place to achieve Laura's goal.
The message of World Contraception Day is empowering: "It's your life; it's your future; know your options." But let's take this to the next level. Let's come together to ensure that no one stops at knowing their options but that all of us, no matter where in the world we live, can act on this knowledge and freely choose when we have children and how many children we have.
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In collaboration with Caroline Savitzky, Community Health Programme Coordinator for Blue Ventures Conservation
Blue Ventures uses an integrated Population-Health-Environment (PHE) approach to improve human and ecosystem health together; recognising the links between unmet family planning needs, food insecurity, environmental degradation and vulnerability to climate change. This approach capitalises on the frequent presence of conservation organisations in very remote and under-served areas, addresses community needs in a holistic way, and creates synergies through the sharing of opportunities and resources across projects. Blue Ventures recently brought together numerous conservation and health organisations to establish a national PHE network in Madagascar.