Ask most people about the greatest healthcare and societal challenges facing our region and they’ll point to Covid-19. Fighting the pandemic must naturally be our first health priority, but we should not neglect the urgent issues of our demographic development.
We can do that while simultaneously addressing the widespread problem of unplanned pregnancies, fighting both challenges with the same means.
Southeast Asia nations are undergoing varying stages of population ageing. The World Bank estimates that by 2030, most countries in the region, including Vietnam, Malaysia and Indonesia, will become ageing societies, while Singapore and Thailand will even become aged ones. Intensifying this challenge is the falling fertility rates over the past 50 years.
While many countries in the region have birth rates fluctuating around 2.1 children, it is expected the birth rate will continue to decline. For example, Thailand’s rate today has dropped to 1.5, while Singapore has an even lower rate of 1.1, far below the 2.1 required to maintain a stable population.
Low fertility rates have an economic and societal impact, not least in terms of public spending on healthcare and retirement pensions as fewer hands must do the work to support a growing population of older people.
Covid-19 has only exacerbated decades of slow population growth. Some analysts predicted a baby boom when the pandemic started, and while this has happened in some corners of the world, the opposite has been the case for others, including Southeast Asia. Largely due to uncertainty and anxieties, people have delayed or cancelled plans to start or expand their families. Many fertility clinics either postponed treatment cycles or closed altogether to slow the virus spread. A study found patients across age brackets, from under 30 to 42, experienced delays of six to 12 months.
Some Southeast Asia countries have experienced a large number of unintended or unplanned pregnancies, especially among teenagers and young adults. In Malaysia, almost half (42.9%) of pregnancies are unplanned. Similarly, NGO MSI Reproductive Choices reports it helped prevent more than 860,000 unintended pregnancies in Vietnam in 2020.
an estimated 12 million women may have been unable to access family planning supplies and services, especially in low- and middle-income countries
New data from the United Nations Population Fund show that as a result of measures arising from Covid-19 such as social distancing, lockdown strategies and mobility restrictions, as well as fear of travelling to health facilities, an estimated 12 million women may have been unable to access family planning supplies and services, especially in low- and middle-income countries.
As a result of these disruptions, as many as 1.4 million unintended pregnancies may have occurred in these countries before women were able to resume use of family planning services. These unplanned pregnancies can impact women and society in many ways, including physical and mental health implications and longer-term financial difficulties.
While neither demographic development nor unintended pregnancies can be solved easily, there is a commonality in the solution. Through innovative partnerships, healthcare professionals should provide support and access to information and services for women across Southeast Asia so they are empowered and able to plan pregnancies at the right time for them.
While sexual and reproductive health remains challenging to address, especially unplanned pregnancies among young women, we must first acknowledge the issue exists
Knowledge and awareness around the risk of unintended or unplanned pregnancies can play an important role in contraceptive behaviour and adherence. Underestimation of pregnancy risk has been found to lead to low use of contraceptives and, subsequently, unintended pregnancy. For people who want children, having the right family planning education and information is equally important.
While sexual and reproductive health remains challenging to address, especially unplanned pregnancies among young women, we must first acknowledge the issue exists. While raising reproductive health awareness and education may seem like a straightforward solution, there can be societal reasons why these topics are avoided. Providing women with trusted and reliable information to make informed decisions should be prioritised.
The UN Economic and Social Council explains sexual and reproductive health and rights investment not only saves lives and improves health and wellbeing, but also helps women obtain quality education and find work. This in turn helps increase productivity and household income, subsequently contributing to broader development goals.
As the proverb goes, ‘It takes a village to raise a child.’ The same applies to finding approaches to better family planning. It takes a partnership approach from all sectors – government, healthcare providers, NGOs, educators and even the family unit – to find solutions addressing all elements of reproductive health.
Women are the foundation of family, community and society. When women rise, we all rise together. When women are healthier and empowered, so too are their families and communities. By empowering and supporting women to look after themselves and their health, we can create a brighter future for everyone.
World Contraception Day is 26 September, an opportunity for us to take a step in the right direction and make family planning a priority conversation in Southeast Asia.
Andreas Jorgensen is the managing director for South, East and Southeast Asia at global healthcare company Organon.
