[Full Text] Gov’t Must Increase Investment In Sexual And Reproductive Health And Rights Of Adolescents And Young People—Dr Rashid Pelpuo

Gov’t Must Increase Investment In The Sexual And Reproductive Health And Rights Of The Adolescents And Young People

Let me begin my address with a quotation and a commitment. First the quotation:

“Perhaps the greatest threat to Africa’s peace and security is the very rapid rate of population growth.” ––John Dramani Mahama, former president of Ghana, April 20, 2018 (In, Africa’s Population Challenge, 2018)

Now the commitment. Two weeks ago, Ghana was the centre of the world, in hosting the 3^rd Africa-China Conference on Population and Development under the theme ‘Population Data Management and Universal Access to Reproductive Health as Key Drivers of Sustainable Development.’ The conference was hosted by the government of Ghana and coordinated by the National Population Council in collaboration with the Ministry of Planning and the UNFPA. Part of the conference period and discussions was devoted to celebrations of the United Nations Population Fund as an organisation. It is 50 years this year, 2019. The International Conference on Population and Development was held in 1994 in Cairo and that was 25 years ago, which developed the programme of action on population (PoA). These milestones are worth celebration and the highest of them is the celebration that would take place in Nairobi, Kenya in November 2019, with commitment and strategies for the future. Last year UNFPA, the AU, ECA and African countries took stock of the past 25 years of the PoA and 50 years of UNFPA existence. This year, all roads lead to Nairobi, Kenya to make a commitment for the future to continue with the unfinished business and Ghana must be there.

Africa, has a great potential for rapid economic development, and this is a fact we all attest to unequivocally. We clearly have the capacity to expedite our economic transformation. Africa is also at this same time, threatened by rapid population growth rate, which has already outstripped our economic growth rate, and threaten to continue to do so unless drastic measures are taken to curb the situation. Since 1950, Africa’s population has increased by 450%, from 226million to 1.26billion by 2017 (Population Reference Bureau, 2017). Our high fertility rate of 4.6 is currently an outlier on the world fertility graph, according to the World Population Data Sheet. Africa’s population momentum has been driven largely by two main factors: early initiation of childbearing and high fertility rates, and any attempts to slow down the continent’s population growth rate must therefore take cognizance of these two factors (Speidel 2018)

Ghana’s population growth rate is not far removed from that of the continent. Our current 2.5% annual population growth rate means that, on the average, we are adding not less than 700,000 new souls to the population of the country every year. Quite significantly, major contributors to this statistic are adolescents and young people, mainly through adolescent pregnancies and unintended births. With 10-24year olds forming 32% of our population, the country is currently witnessing the highest number of young people in our history (GSS 2012), and the implications in terms of sexual and reproductive health cannot be so easily ignored by us as a country.

The risk of population explosion is high and also real for Ghana. Even if every Ghanaian couple decides today to have two children, we would still experience high population growth rate, given the huge numbers of sexually active young people and the proportion of the population in their reproductive ages. Our recent Maternal Health Survey of 2017 shows that 49% of our girls are sexually active by 18years and 73% by 20yrs (GSS et al, 2018) Quite disturbingly, however, our adolescents are among the least users of contraception in Ghana; just about 50% of them use any form of modern contraception (GSS et al, 2015)

Already, 14% of all pregnancies in Ghana are recorded amongst 15-19yrs olds. This ranks against 10% teenage pregnancy rate across sub-Saharan Africa and 1.5% in high income countries (Telegraph 2019). A disturbing 26% of our girls are also married off before their 18^th birthday (GSS et al, 2018). This exposes them to early childbearing and repeated pregnancies. We are therefore in real danger of high population growth rate, which may not be matched with corresponding expansion in the economy, infrastructure, education, healthcare, security among others.

Evidence gathered by a 2015 UK All Party Parliamentary Committee on Population and Sexual and Reproductive Health report showed that for every 1 person added to the population of the UK, an investment of 165,000 pounds was required to expand services, infrastructure and training (All Party Parliamentary Group 2015). This is even in the UK where the basic services are already available, and this investment only represents expansion. It is clear that the figure would be higher in our context, where basic services are still not available in many parts of the country.

Estimates from expert economists suggest that, at 1% annual population growth rate of a country, there needs to be a corresponding 6% -7% annual growth in the GDP of that country in order for that country to maintain the same quality of life for its people. In our context as a country therefore, at our current 2.5% annual population growth rate, we will need between 15-17% annual expansion in our GDP in order to keep our people at this same quality of life, and if we really want to lift our people from poverty, then the rate of economic expansion must seriously outstrip population growth rate.

We have the opportunity to reduce the high adolescent pregnancies through increased investment in their Sexual and Reproductive Health. We already have the policies and strategies in place. We have the Adolescent Reproductive Health Policy developed by the National Population Council, The Adolescent Health Service Policy and Strategy developed by the Ghana Health Service, a 5–year Strategic Plan to Reducing Teenage Pregnancy by the Ministry of Gender Children and Social Protection, among many other wonderful initiatives by partners. What is required now is the adequate funding of these policies and strategies. Then we can be sure to bring down fertility and the high population growth rates, and avoid the Nigerian situation.

Quite recently, the Executive Director of the National Population Council, Dr. Leticia Adelaide Appiah shared some disturbing data on the population crises of Nigeria in an interview she granted, on the issue of the overpopulation of Nigeria. She observed that Nigeria was only 45million at their independence in 1960 from their colonial masters, the UK, which had a 52million population at the time. Fast-track to 2018, and Nigeria’s population has more than quadrupled to 200million, whilst that of the UK is only 66 million. So, even though Britain was more populated than Nigeria at independence, our brother Nigeria today commands three times the population of the UK. The challenges, Mr. Speaker, this high population growth rate has brought to Nigeria is evident for all of us to learn from.

Currently, 32% of our girls are already mothers by age 19yrs, and this is unacceptable (GSS et al, 2017). We need to do everything possible to bring this figure down to the barest minimum, and that requires deliberate prioritization and investment in adolescent/youth SRHR. Anything short of this would be suicidal for our poverty reduction objective, because it is evidential that investments in family planning and universal access to sexual and reproductive health information and services hold some of the greatest returns on investment for any country. Recent evidence from Kohler and Behrman (2014), shows that the value – for - money for universal access to sexual and reproductive health services and family planning was estimated to be US$ 120 in economic benefits for each US$ 1 spent in providing SRHR information and services. When we are investing in adolescent sexual and reproductive health, therefore, we need to appreciate the fact that we are investing for a lifetime of returns; we are investing to reap a lifetime of dividends, and that should be our motivation for increasing budgetary allocation for adolescent and youth SRHR. It holds the greatest returns on investments.

In conclusion, I wish to share with the house a statement Franklin D. Roosevelt, the 32^nd President of the United States of America made; ‘‘We cannot always build the future for our youth, but we can build our youth for the future’’ I pray this becomes a timeless reminder to this honourable house, of our solemn duty to the adolescents and young people of our country, to ensure that we give them a better future than we have lived in. No resource of a nation is as important as its people. In prioritising the health and wellbeing of the people therefore, we secure the future we have always dreamt of. The people are always the instruments and the objective of development, and no priority can be greater than their health and wellbeing. I by this statement issue a clarion call to all arms of government to work together to ensure that our young people are given the future they deserve.

The publication of this statement was supported by the National Population Council and Marie Stopes International Ghana

Hon. Dr. Rashid Pelpuo
Chair, Parliamentary Select Committee on Population and Development

Parliament House, Osu- Accra
Bibliography
Population Reference Bureau (2017): World population data sheet. Washington DC: 2017.

Ghana Statistical Service (2012): Ghana Population and Housing Census 2010. Ghana Statistical Service, Accra.

Ghana Statistical Service (GSS), Ghana Health Service (GHS), and ICF. 2018. Ghana Maternal Health Survey 2017. Accra, Ghana: GSS, GHS, and ICF.

Ghana Statistical Service (GSS), Ghana Health Service (GHS) & ICF Macro (2014) Ghana Demographic and Health Survey 2014, Accra: GSS, GHS and ICF Macro. Pp79-96

The Telegraph (2019): Harnessing Africa’s Baby Boom: Women seize power over their fertility – and future ( https://www.telegraph.co.uk/news/contraception-in-ghana/ )

All Party Parliamentary Group (2015): Population Dynamics and the Sustainable Development Goals: a report by the UK All –Party Parliamentary Group on Population, Development and Reproductive Health. United Kingdom.

Kohler, H., and Behrman (2014): Population and Demography Assessment Papers: benefits and costs of the population and demography targets for the post 2015 development agenda. Copenhagen: Copenhagen Consensus Centre.

Speidel J. J (2018): Africa’s Population Challenge. Bixby Center for Global Reproductive Health, University of California, San Francisco, 3333 California Street, Suite 335, San Francisco, CA 94118