International Women's Health Coalition - Investing in Sexual and Reproductive Health

Investing in Sexual and Reproductive Health

As Congress works to finish funding bills for the current fiscal year as well as for FY2012, some are calling for deep cuts in every aspect of sexual and reproductive health - around the world an in the United States. You can stay up to date on this every changing process by reading Capitol Critiques.

As debates about cuts continue, one note to consider is that for every $100 million cut from the international family planning/reproductive health budget, estimates are that it will lead to:

5,000 more maternal deaths;
6,000,000 fewer women and couples receiving contraceptive services and supplies;
1.9 million more unintended pregnancies;
800,000 more abortions (of which 600,000 would be unsafe);
23,000 more children losing their mothers.

International Family Planning

Contraception and family planning services enable women to exercise their basic right to determine if, when, and how many children to have. Investments in family planning services support autonomy and agency in enabling people to take charge of their own lives. It also results in fewer unintended pregnancies and unplanned births, reduces the need for abortion, prevents HIV infections and improves maternal and infant health. The number of women of reproductive age in the developing world has grown by almost 300 million since 1995, yet U.S. funding for international family planning has declined by almost 40% during this same period. Currently, more than 200 million women have an unmet need for contraception and the Obama Administration and Congress are making the necessary changes to continue an upward trajectory in funding for these important services.

After taking charge of setting funding priorities, funding for overseas family planning services grew from $545 million to $648.5 million in fiscal year 2010, which is a 19 percent increase from last year. This funding level will come closer to enabling to meet the family planning needs of those in some of the poorest countries of the world.

Additionally, after seven years of the Bush Administration blocking funds appropriated by Congress from going to UNFPA, the United Nations Population Fund, the Obama Administration joined 180 other countries in funding these programs in 140 countries, supporting programs in many more countries than US bilateral programs currently do. The family planning funding level of $648.5 million includes $55 million for UNFPA.

IWHC is working with a broad based coalition to work with the new Administration and Congress to ensure that U.S. support for international family reflects its fair share of the global needs by appropriating $1 billion for these essential services for women. A request of $63.5 million for UNFPA is included in this funding "ask".

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Reproductive Health in the United States

At a time that 17.5 million women are in need of publicly-supported reproductive health services in the United States, support for and therefore access to family planning services is severely curtailed for those lacking them. Twenty-nine percent (5.1 million) of these women are younger than 20 years old and 71 percent (12.4 million) are poor or low income adult women. Since 2000, the number of women in need of subsidized services increased by more than one million (7%), indicating an increase of need that has not been matched with an increase in funding or access to these vital services.

The program that provides "safety net" reproductive health services - known as Title X - provides preventive health services to nearly 5 million low-income and uninsured women and men each year at more than 4,400 health centers nationwide. Through this program, women can access voluntary contraceptive services, prenatal care, and testing for pregnancy, sexually transmitted infections, breast and cervical cancer, diabetes, high blood pressure, and anemia. For fiscal year 2010, the funding for Title X increased by $10 million to $317.5 million. Yet, had its budget kept up with medical inflation since 1980, program funding would be approximately $759 million. The United States must invest in the health and well-being of women, regardless of their ability to pay for these services. An investment in Title IX of at least $700 million should be made so that the program can provide these "safety net" reproductive health services to a greater number of women.

Those eligible for Medicaid can access voluntary contraceptive services, prenatal care, and testing for pregnancy, sexually transmitted infections, breast and cervical cancer, diabetes, high blood pressure, and anemia. Medicaid provides cost-effective family-planning services for millions of low-income Americans. However, states that have sought to expand access to family planning services must navigate a cumbersome and time-consuming administrative process. Parity between the income level at which a woman is eligible for pregnancy care and the income level at which she is eligible for family planning services under Medicaid should be a priority for the new President. With parity, eligibility for family planning services would increase by more than three million women each year and prevent more than 500,000 unintended pregnancies. Achieving parity will allow both states and the federal government to achieve significant savings.

International Maternal Health

Approximately 550,000 women die each year from complications related to pregnancy and childbirth, and these complications are a leading cause of death and disability among women in their reproductive years (15 to 44) in less developed countries. The leading killers are known—hemorrhage, eclampsia or high blood pressure, unsafe abortion, sepsis or infections, obstructed labor—yet not enough has been done to address them. A more robust investment in international maternal and child health programs would increase efforts to ensure skilled care by nurses, midwives, or doctors during pregnancy and childbirth, including emergency services; care for mothers and newborn babies after delivery; and provide the resources necessary to care for the millions of women and children that experience—and too often die from—pregnancy-related complications.

IWHC is part of advocacy efforts to increase U.S. funding for maternal and child health. We recognize the myriad of benefits that communities and nations accrue when women and their children have access to these essential services. Current U.S. funding for international maternal and child health programs falls short at $549 million for FY 2010, though it does represent a $54 million increase from the previous year.

However, the U.S. needs to invest $1.3 billion annually, to put us on track toward funding the U.S.’s fair share of the global need. Access to the information and services necessary to have a healthy and safe pregnancy and childbirth is a right not a privilege, and the U.S. needs to commit the necessary resources to improve the health and well-being of our world’s mothers and their children.

Maternal Health in the United States

The United States has its own hurdles in ensuring healthy pregnancies and deliveries. As one of the wealthiest countries in the world, the United States still only ranks 27 out of 146 countries in terms of the well-being of mothers and their children. Infant and child mortality rates are higher in the U.S. than almost any other industrialized nation, and unacceptable racial disparities in death rates of women and children are present. In the United States, a black child is 2.3 times more likely to die than a white child, and the maternal mortality rates for black women are 3.7 times higher than for white women.

The Title V Maternal and Child Health (MCH) Services Block Grant is the only federally funded program in the U.S. that focuses solely on improving the health of all mothers and children in the United States. The program is a critical safety-net that serves 33 million women and children. The goals of the program are to improve maternal health and reduce infant mortality by providing direct health services; transportation, translation and family support; and other health screenings and needs assessments.

The Maternal and Child Health Services Block Grant is authorized at $850 million, yet the funding appropriated for this program in FY2010 is only $662 million, the same amount appropriated in FY2009. A nation with the wealth and capacities of the U.S. must recognize the vital importance that the health and well-being of its mothers and children has on the prosperity and security of families and communities across the U.S. and begin to fund this program adequately.

IWHC works with its sister organizations to secure the health care needs of women and youth - in the United States and in some of the world's poorest countries.

What You Can Do

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Read Five Things the World Can Do to Improve Maternal Health

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