Population management for holistic development
By Dr. Leticia Appiah
Effective population management improves the lives and livelihoods of citizens by making it easier and cheaper to implement all other policies such as education, housing, sanitation, employment and security.
It also helps to balance the population growth rate of the country in line with available resources of the country at any time, focusing on quality life for all. It includes family planning, child marriage, teen pregnancy, gender equality and equity.
Indeed, data shows that the neglect of effective population management accounts for about 30 per cent of population growth in developing countries due to unintended and accidental pregnancies with numerous negative health and socio-economic consequences.
On the other hand, data shows that for the past 50 years, few countries have made significant improvement in the socio-economic development of citizens without focus on effective population management made possible through expanding access to family planning methods and relevant quality education.
As Ellen Starbird et al. (2018) put it: “without universal access to family planning, the impact and effectiveness of other interventions will be less, will cost more and take longer to achieve.”
Self-reliance refers to building of a character needed to live both independently and freely in the community for oneself, with others and for others. Self-reliance is dependent on internal resources (human and natural) to provide life with coherence and fulfilment. (Baumeister 1987:171)
For us to be resilient, we need not only focus on doing good such as offering regular antenatal services, we should also focus on minimising harmful practices such as teen pregnancies and child marriage, mindful of some barriers such as the urge to conform to current situations and reliance on our past, irrespective of the outcome.
Ghana and Africa have all it takes to be self-reliant, we just need to adjust and agree to break certain rules and cultural practices such as child marriage for the purpose of complying with better rules and desired outcomes for sustainable development.
Identifying risk factors
Population management focuses on identifying risk factors affecting a group in society, determining what steps can be taken to improve the health of that group and identify evidence-based preventive care interventions for implementation.
The objective of effective population management is to reduce the rate of the individual and state’s most costly preventable health conditions: risky pregnancies, unintended and accidental pregnancies by increasing healthy sexual behaviours and supporting evidence-based effective preventive programmes.
By preventing unintended pregnancy, family planning averts deaths of mothers and children.
It ultimately reduces the cost of maintaining a healthy population for socio-economic development thereby improving lives and livelihoods.
Effective population management ultimately increases average population health, bridges inequality gaps within the population, improves life expectancy and facilitates accelerated sustainable development of individuals, communities and nations.
It is for this reason Article 37, clause 4 of the 1992 Constitution of Ghana states that: “The state shall maintain a Population Policy consistent with the aspirations and development needs and objectives of the people of Ghana and the establishment of the National Population Council by Act 485,994 as the highest advisory body of the Government.”
Building self-reliant and resilient nations start with nurturing healthy individuals from cradle to the grave in optimal numbers at any particular time.
We need to focus on the importance of supporting mothers and families to plan their births to reduce avoidable high-risk pregnancies with attendant high cost at the individual and national levels.
According to the 2017 Maternal Health Survey Report, 49 per cent of births were in at least one avoidable high-risk category and 17 per cent of pregnancies were in the multiple high-risk categories.
High-risk pregnancies have high probability of ending in preterm births thereby contributing significantly to high maternal and child morbidities and mortalities with its accompanying high cost of health care.
For example, according to researchers, preterm babies’ use of Neonatal Intensive Care Unit (NICU) admissions is 4 to 5 times as high as uncomplicated full-term infants and the average medical cost through the first year of life in the USA is approximately $32,000.00 for preterm infant and $3000.00 for full-term infants.
High-risk pregnancies also contribute to high population growth rate and its attendant high consumption of services from education, health, employment, utilities among others, which is a challenge in a resource constrained setting.
Spending limited resources on many low yielding interventions is at times worse than inefficient because it stifles productivity and at times, it costs lives.
In resource constrained settings, the right health policy such as family planning contributes to improving macroeconomic policies by keeping people healthy and ultimately productive in all spheres of life from education to skill acquisition and employment.
Higher fertility in lower income quintiles limits the ability to take advantage of economic opportunities. Thus, access to family planning is essential to level the playing field.
Consequently, an effective voluntary family planning programme, combined with proper skill development, will be essential to avail these opportunities.
To support effective population management, family planning should be available and accessible, which is ethically and culturally acceptable to all and backed by political will and support.
Political support is the main determinant for an enabling policy and programme environment and facilitates resource mobilisation, which is a factor to successful programmes.
Supported by capable bureaucracies, galvanising political will and commitment for family planning at top leadership and all levels of government increase its profile as a health and development priority through evidence informed advocacy.
Political will positions the population agenda, which includes family planning services at the centre of development planning where it belongs.