With a population of approximately 220,000 (the second-smallest in Africa) but with a high fertility rate of 93 births per 1,000 young women 15 to 19 years of age, the island country of Sao Tome and Principe recognized that empowering women and families through increased access to modern birth control and family planning support could be instrumental in helping it to meet its commitments to the Sustainable Development Goals while at the same time ensuring the health and well-being of its citizens. and family planning support could be instrumental in helping it to meet its commitments to the Sustainable Development Goals while at the same time ensuring the health and well-being of its citizens.
The Government, with an investment of $350,000 from the India-UN Fund, thus partnered with UNFPA to launch a nationwide effort to increase the use of modern family planning among the childbearing- age population. Part of the National Family Planning Plan (2018–2021), the project also fed into the National Reproductive, Maternal, Neonatal, Child, Adolescent and Nutrition Health Plan (2019–2023), an integral component of the Government’s commitments concerning SDG 3 on good health and well- being.
In three years, the project achieved its goals. All 38 health units (hospitals, centres and posts) throughout the country were equipped with the medical equipment needed to provide high- quality family planning, including long-acting contraceptives. Residents in six districts participated in health clinics that provided family planning guidance, general clinic services, HIV screening and civil registration of births. More than 140 health-care providers received training in the delivery of contraceptive methods, and, through three mobile clinics, family planning services expanded to remote communities in the northern, southern and central regions of the country.
Most importantly, almost 50 per cent of women of childbearing age – more than 50,480 women and adolescents ages 15 to 49 years – are now using contraception, 46 per cent of whom opted for long- lasting modern methods; this is up from 37.4 per cent prior to the launch of the programme.
“The implant is the most popular method, especially for teenagers and young girls. It helps them study and make their dreams come true.”
Nurse Sortiana Lima.
“This mobile clinic is a reinforcement for our team that travels to the field with pregnancy maintenance services, child deworming, vaccination, care for pregnant mothers, among others. The service provided is integrated.”
Health Delegate Bonanza Aragao stated.
“There are stages of a journey where the aspect of information and communication for behaviour change is fundamental. We have a very young population, and it is important that the structures linked to sexual and reproductive health are very well leveraged not only by the Ministry of Health but by all those involved in the process.”
Dr. Edgar Neves, Minister of Health, commented while attending one of the health fairs.
The decision as to whether and when to have children is at the heart of family planning programmes but like a pebble in a pond, the ripple effects on the health and well-being of a woman, a family and even a country are much greater.
Certainly, contraceptives prevent unwanted pregnancies and reduce the number of abortions and sexually transmitted diseases and HIV/AIDS but they also save lives by significantly reducing the number of maternal deaths. This is especially important among adolescent girls ages 15 to 19 years for whom complications with pregnancy and childbirth are a leading cause of death. Studies show that by strengthening a woman’s household autonomy, the family’s economic security is similarly strengthened. Countries also benefit through the realization of a demographic dividend and improved economic productivity as a result of increasing the workforce coupled with a falling number of dependents.
“I advise women like me to do family planning. This way you avoid having too many children, which brings benefits to women’s health and children’s education.”
Djamila, a mother of three living in the Lobata District, who does not wish to have more children for the time being.
