For the remainder of this course, I plan to further examine the issue of maternal health and focus on family planning for women in the country of Benin. As of 2012, contraception prevalence in Benin was at a mere 12.9% (USAID 2012). To help increase the use of modern and traditional contraceptive methods by women ages 15-49 years old to 20% by 2018, the Beninese government has required all its public health facilities to provide family planning services as a part of their minimum package of services; however, these services are not readily available, particularly in rural or impoverished areas (S. Chae and Wilson 2015). Where services are available, facilities suffer from shortages of supplies and trained personnel, as well as a limited range of methods for women to choose from. These gaps leave both married and unmarried women who do not wish to become pregnant with an unmet need for contraception.
Low rates of contraception use places Beninese women at risk for an unplanned pregnancy. From a public health standpoint, this issue also heightens the risk for the contraction of HIV/AIDs, the spread of STIs and other diseases, and higher rates of maternal mortality (i.e. due to unsafe abortions, birth complications, etc.). Adult prevalence of HIV hovers around 1.1% of the population, but the stifling stigma surrounding the disease makes the discussion of (and education about) HIV incredibly taboo, and the pursuit of treatment even more difficult. Unsafe abortions are another direct result of the lack of family planning in Benin. In 2010 alone, the maternal mortality ratio for lifetime risk of maternal death was 1 in 53 (World Health Organization 2015). Despite recent activism and recommendations for advancing the sexual and reproductive health and rights of women and girls, there are still legal restrictions to safe abortions and postabortion care in Benin, even in the case of rape or incest. The Ministry of Health estimates that 15% of maternal deaths are due to unsafe abortions as a result (Ipas 2019). Overall, better utilization of family planning methods, both traditional (i.e. withdrawal, rhythm method, etc.) and modern (i.e. condoms, oral pills, injections, IUDs, etc.), has the potential to decrease a myriad of adverse health effects.
The lack of contraceptive use in Benin is also a very important cultural problem. Research focusing on why women who do not wish to get pregnant choose not to use contraceptives in Benin found that the fear of side effects/health concerns, their inability to afford the cost, opposition from their partners (or the women themselves), or the infrequent nature of their sexual activity motivates their decision (S. Chae and Wilson 2015). Partner refusal and cultural norms about male dominance in decision-making restrict the role of women in sexual relationships. The social stigma that surrounds unmarried women having sex and the practice of modern contraceptive methods also serves as a great deterrent. While a majority of women report hearing about family planning messages from the media and other information channels, many have never had a discussion about it with their families or spouse/partner (i.e. not socially acceptable), and they have not had access to any formal instruction or contraceptive counseling (S. Chae and Wilson 2015). In addition, Benin’s public sex education is often incomplete, and many girls do not have the opportunity to attend school regardless, particularly secondary education. All of these factors put Beninese women at risk and reinforce the importance of family planning and maternal health.
References
Ipas. 2019. Benin strengthens reproductive health and rights for women and girls. February 15. Accessed July 25, 2019. https://ipas.org/news/2019/February/benin-strengthens-reproductive-health-and-rights-for-women-and-girls.
S. Chae, V. Woog, C. Zinsou,, and M. Wilson. 2015. “Barriers to contraceptive use among women in Benin.” Guttermacher Institute. Accessed July 25, 2019. https://www.ncbi.nlm.nih.gov/m/pubmed/26702466/.
USAID. 2012. “Demographic and Health Surveys: Benin.”
World Health Organization. 2015. “Maternal Mortality in 1990-2015.”