FAMILY PLANNING: A PATHWAY TO A HEALTH AND PROSPEROUS NATION

…As experts say contraceptive pills, injectables, implants are safe with no any harm to humans’ health

By SIMON MUNTEMBA

JESSICA Mubanga, a hairdresser in Lusaka’s Emmasdale residential area, sits idly on a bench outside a salon with three of her workmates while having an informal conversation as they patiently wait for clients.
“Contraceptives are dangerous to women’s health and they can harm your womb. In fact, most of my female friends have gained weight as a result of contraceptive pills use. I will never use them,” Mubanga told her friends.
In agreement, one of Mubanga’s workmates only identified as Lydia chipped in: “Yes, you are absolutely right boi (my friend), my neighbour has lost shape ever since she started using contraceptive pills. Besides, I hear family planning methods such as injectables and implants cause cancer and infertility.”
Mubanga and her workmate’s conversation mirrors what is obtaining across certain communities where negative myths and misconceptions about family planning are a barrier to modern contraceptive use.
According to statistics by the World Health Organisation (WHO), about 214 million women in developing countries such as Zambia wish to avoid pregnancy but are not using modern contraceptives due to negative myths and misconceptions about them.
In fact, rumours and misconceptions about contraceptives are spread by and among women themselves, often through their informal social networks.
The family planning myths most prevalent at the individual and community levels are that people who use modern contraceptives end up with health problems.
THE TRUTH ABOUT FAMILY PLANNING/ THE BENEFITS
Family planning is simply the process that allows individuals and couples to control the number and timing of their children through various contraceptive methods and the treatment of infertility.
Methods of contraception include oral contraceptive pills, implants, injectables, patches, vaginal rings, intrauterine devices, condoms, male and female sterilization, lactational amenorrhea methods, withdrawal, and fertility awareness-based methods. Of course, these methods have different mechanisms of action and effectiveness in preventing unintended pregnancy.
Maternal health experts say that family planning is not only safe but has a positive influence on reducing the incidence of unintended pregnancies, unplanned births, and maternal mortality.
In an interview, consultant obstetrician and gynaecologist Dr. Annabel Mulonda explained that contrary to the negative myths and misconceptions, family planning such oral contraceptive pills and implants are very safe with no scientific evidence of causing cancer.
“Family planning such as hormonal methods or even permanent methods such as tubal ligation and vasectomy are very safe. They do not cause any harm to humans’ health,” Dr. Mulonda said.
The consultant obstetrician and gynaecologist stated that in fact, access to family planning information and services prevents unnecessary maternal death or illness due to an unintended pregnancy.
Dr. Mulonda emphasized that women who choose family planning are healthier and face a lower risk of dying during pregnancy and childbirth.
She also reiterated that contrary to the negative myths and misconceptions, women do not gain or lose weight as a result of contraceptive pills use.
“A woman’s weight may fluctuate naturally due to changes in age or lifestyle. But because changes in weight are common, women wrongly attribute their natural weight gain or loss to the use of pills,” Dr. Mulonda said
She further explained that after contraceptive pills are swallowed, they dissolve in the digestive system just like any food or medicine without accumulating anywhere in the body.
“After they produce their contraceptive effect, the hormones in the pills are metabolised in the liver and gut and are then eliminated from the body. In fact, each pill lasts for about 24 hours in the woman’s body and does not get stuck anywhere. That is why pills are taken every day, preferably at the same time, to be effective,” she explained.
Dr. Mulonda has however urged those experiencing weight gain to be active and control their diets.
“Maintaining shape and avoiding gaining weight can be achieved through exercising regularly and controlling diets. Otherwise, the benefits of family planning are many for women, men and children,” Dr. Mulonda said.
On rumours that contraceptives cause infertility, an accomplished Professor of public health and medicine Wilbroad Mutale said family planning does not make a person infertile but rather it works in a way that stops them from getting pregnant until that desired time when they are ready.
Prof. Mutale who is also chief executive officer and founder of Teledoctor Zambia said contraceptives do not cause infertility regardless of how long they are taken.
He stated that women who stop using contraceptives or any other family planning method can become pregnant again as long as they have not reached their menopause.
Prof. Mutale has however advised those who are not comfortable with the use hormonal methods to choose from the various types of family planning methods that suit them.
He said there are many different types of contraception available to choose from depending on an individual’s desire to have children in future.
“Family planning is not just about taking pills or injections, there are various types of family planning methods. Depending on their choice, couples or women can decide the type of family planning methods they intend to use. If they are not comfortable to use hormonal methods, they can for example, use natural method,” Prof. Mutale said.
Prof. Mutale said with family planning, women can have children by choice and not by chance, thereby reducing the rate of unintended pregnancies and the need for unsafe abortions.
He also noted that family planning gives women enough space between pregnancies for their body to completely recover from the effects of pregnancy, labour and childbirth.
Prof. Mutale further said several couples in the developing world like European countries are using a modern method of contraception for healthy timing, spacing, and limiting of births to achieve their desired family size.
Indeed, as rightly stated by both Dr. Mulonda and Prof. Mutale, family planning allows people to attain their desired number of children and determine the spacing of pregnancies without affecting their health.
For instance, Mrs. Getrude Nyambe, a mother of four testified that before having access to family planning information and services, her life was not stable as she suffered from the physical and mental toll of pregnancies.
Mrs. Nyambe, 42, a resident of Lusaka’s Matero Township however said her life took a positive turn when she embraced modern contraceptives.
Mrs. Nyambe narrated that she was initially hesitant to use family planning methods such as contraceptives because of the myths and misconceptions surrounding their use.
Sharing her experience, Mrs. Nyambe recounted: “I initially never wanted to use contraceptives because of the strong rumour that they cause cancer. I was also scared that I would gain a lot of weight and experience heavy menstruation. But here I am, my shape has not changed.”
She said one of her cousins who is a nurse at Matero Level One Hospital encouraged her to practice family planning after explaining the benefits.
Mrs. Nyambe said contrary to the negative myths and misconceptions about the use of contraceptives, embracing family planning has paid off as it has helped ensure the wellbeing of her family.
She explained that by using contraceptives she and her husband have managed to maintain a small family, especially with the current economic situation in the country.
“Had it not been for embracing family planning, I would have about seven children by now and fail to take good care of them. Using contraceptive injection has been a game changer for me in the sense that it has helped my husband and I to give our four children the best in life, especially good education and nutrition because we have a manageable number of children.” Mrs. Nyambe said.
Mrs. Judith Tembo, 30, is another mother enjoying family planning.
The Matero resident who is using the implant family planning method disclosed that it has helped her to avoid a mistimed pregnancy, thereby allowing her to further upgrade herself in terms of education.
“For me, I have never experienced any health challenge ever since I started using implant family planning method some three years ago when my son was two years and he is now five years. I even enrolled pursuing my Master’s degree at the university last year and will be finishing my programme end of this year,” Mrs. Tembo said.
The soft-spoken Mrs. Tembo encouraged her fellow women to ignore the negative myths and misconceptions about family planning, and embrace it if they are to live a health and fulfilling life.
Indeed, family planning is one of the most cost-effective and powerful strategies to empower women and improve their lives. It is a high impact intervention for both improved health outcomes and economic prosperity for the country.
This is because women who are empowered to make choices about childbearing are more likely to get better education and job experience, and are more likely to contribute to the economic health of their families and communities.
Moreover, embracing family planning can results in smaller, healthier families that are better able to care for themselves.
It is against this background that the Zambian government has a dedicated family planning policy that includes integrating family planning services into the national health system.
GOVERNMENT’S INTEVENTION
According to the Ministry of Health in Zambia, family planning is a key component of national development, with a focus on increasing access to a wide range of contraceptive methods through an integrated family planning costed implementation plan (CIP) aiming to significantly raise the contraceptive prevalence rate (CPR) from the 49 percent to 80 percent by the year 2026.
The goal is to ensure all citizens have access to quality family planning services and information to make informed choices about their reproductive health.
Minister of Health, Dr Elijah Muchima said the Zambian government is committed to improving family planning services through strategic initiatives, including expanding service delivery points, introducing new contraceptive methods, and enhancing education and counselling programmes.
Speaking during the opening of the Sexual Reproductive Health Alliance Conference in Lusaka recently, Dr. Muchima acknowledged the progress made in increasing contraceptive prevalence rates, reducing unintended pregnancies, and improving maternal health outcomes.
He, however, noted that challenges in accessing contraceptives remained a significant barrier in the country.
To promote family planning, the Zambian government also works with international organisations and Non-Governmental Organisations such as the USAID Zambia Accessible Markets for Health (ZAM-Health) Project.
The ZAM-Health project is designed to expand the availability and accessibility of high quality health products and services in the private sector. It supports community outreach for family planning, and mother to child services.
As a result of such partnerships, according to the latest Zambia Demographic and Health Survey Contraceptive use in Zambia (ZDHS) report, contraceptive prevalence is 55 percent among currently married women and 50 percent among sexually active unmarried women.
The 2024 ZDHS report indicates that 53 percent of currently married women in Zambia use modern contraceptives, with injectables at 28 percent, implants 11 percent and pills at 6 percent being the most commonly used.
The 2024 ZDHS report further reveals that 34 percent of sexually active unmarried women have an unmet need for family planning.
WAY FORWARD
Education programmes are needed to dispel common myths and misconceptions about modern contraceptives.
There is a need for the provision accurate and reassuring information to women and couples about family planning. Effectively promoting family planning will help people to start using contraception and motivate them to continue.
In turn, communities and nations will benefit from stronger, healthier, more productive citizens who can better care for themselves, educate their children, and put less strain on limited resources.
As evidenced by Mrs. Nyambe and Mrs. Tembo’s success stories, embracing family planning is a sure way of promoting a health and prosperous families in that when couples have only the number of children they want, their financial strain is reduced.