Choice, Availability: Leaders Champion Universal Access to Family Planning in Laos

A Lao couple is listening to family planning options. (Photo supplied by UNFPA Laos.)

Joint Op-Ed by H.E Dr. Bounfeng Phoummalaysith, Minister of Health, Dr. Bakhtiyor Kadyrov, UNFPA Representative in Laos, and Ms. Sumita Banerjee, FP2030 Managing Director of the Asia and the Pacific Hub

What women, girls, and young people need and want matters. They want to choose their future and enjoy their rights.

A fundamental human right is making personal, informed choices for bodily autonomy.

A fundamental human right is deciding whether to have children, how many, and the spacing between them.

A fundamental human right is receiving care and counseling no matter where women and youth live and regardless of their ethnicity and gender identity.

Safe and voluntary family planning is a fundamental human right. It is central to gender equality and women’s empowerment. To ensure this right becomes a reality in Laos, the country has a vision to accelerate progress now towards the achievement of universal access to sexual and reproductive health and reproductive rights by 2030.

Rights-based family planning is a best value-for-money investment that delivers a wide range of health, social, and economic benefits for women and girls, their families and communities, and a whole nation.  For instance, an investment case and analysis conducted in Laos estimated that for every dollar invested in family planning, benefits to families and societies are estimated to be around USD 33.6 (“Prioritizing Health Investments for Human Capital Development,” September 2022, UNFPA Laos). The investment case showed that increasing and sustaining budget allocations for family planning information and services and making them available across the country could avert 1,044,888 unintended pregnancies.

This is expected to reduce the cost requirements for other health interventions and lead to economic benefits from increased workforce participation, additional years of education for adolescents, and increased lifetime earnings for women. Thus, family planning helps to keep girls in school, enables women to join the labor force, helps reduce household poverty, improves nutrition, and reduces inequalities.

In 1994, Laos was one of the 179 governments to affirm the Program of Action of the International Conference on Population and Development (ICPD POA) and to recognize sexual and reproductive health and rights – including rights-based family planning – as prerequisites to sustainable development aspirations. The ICPD POA transformed the way the world views population and related issues, creating a paradigm shift from a focus on reaching specific demographic targets to a focus on the needs, aspirations, and rights of individual women, men, girls, and boys. The ICPD POA  is about empowering women and girls to make choices in their lives and ensuring that parents, brothers, spouses, and communities are supportive, understanding, and act as full partners.

Since the adoption of the ICPD POA in 1994, Laos, in partnership with UNFPA, has been working to  advance the people’s health and wellbeing by improving the quality of sexual and reproductive health and family planning services, enhancing women’s and girls’ leadership and agency, empowering adolescents and youth, and investing in data for development to ensure rights and choices and leave no one behind.

Since then, Laos has made significant progress in achieving a decline in the proportion of the population living below the national poverty line from 48 percent in 1990 to 18.3 percent in 2018–2019 and a decline in the maternal mortality ratio from 530 per 100,000 live births in 2000 to 126 per 100,000 live births in 2020. Antenatal care and skilled birth attendance coverage have improved, with 79.8 percent of births attended by skilled personnel in 2023.

It is worth noting that Laos was among the countries that made renewed commitments at the ICPD25 Nairobi Summit in 2019. Through the country’s delegation, progressive and bold commitments were made to accelerate the national sexual reproductive health and rights, family planning, and youth empowerment agendas, promote data for development, and address gender-based violence and harmful practices, including child marriage.

A woman is receiving contraceptive pills. (Photo supplied by UNFPA)

Laos is currently in a rapid demographic transition in which the share of the working-age population is increasing, and the share of the dependent population is decreasing, with 60 percent of the total population under the age of 30. This demographic transition provides a one-time window of opportunity for the country to benefit from higher economic growth over the next two decades. As this demographic dividend is just potential but not a guarantee, sustained investments are required for women’s and girls’ empowerment, education, and health, especially sexual and reproductive health and family planning, as well as adolescents and youth empowerment programs, as part and parcel of human capital development.

Realizing this demographic dividend is possible if we educate, empower, and support adolescents and youth from all backgrounds and ensure that they access equal and equitable education, health, and empowerment opportunities. This involves supporting adolescent girls and boys to delay pregnancy and marriage until adulthood, helping them acquire skills and competencies, and expanding access to comprehensive sexuality education and youth-friendly reproductive health services. These are essential preconditions for adolescent girls and boys and youth to stay in school, combat misconceptions and social norms, say no to dependency and abuse, access decent work, and ultimately realize their full potential in support of the country’s socio-economic development and prosperity.

Accelerating progress towards ending the unmet need for family planning can both contribute to and result from women’s empowerment and gender equality, a valuable result in itself and a critical element of economic development. When women and men, girls and boys, enjoy the dignity and human rights to expand their capabilities, secure their reproductive health, choice, and rights to achieve their potential, Laos will take a significant step towards realizing the benefits of having a solid, young and consequent workforce. 

Addressing the unmet need for family planning involves concerted efforts and focus on improving the quality of family planning care, investing in health workforce skills and data, strengthening the national supply chain system for family planning commodities, enhancing women’s and girls’ leadership and agency, engaging men and boys, family planning integration into universal health care efforts, securing sustained resources,  and reaching adolescents and youth.

Expanding access to sexual and reproductive health, including family planning information and services, is a “quick win,” a cost-effective action towards achieving the Sustainable Development Goals.  A quick win that can produce tangible results in improving the quality of people’s lives in the short and long term.

Laos is reaffirming its commitments to the unfinished ICPD agenda and to the global partnership on Family Planning 2030 (FP2030) to improve access to adolescent and youth-responsive health systems for contraceptive use, ensure the availability of quality and safe youth-friendly services and family planning information and services to reduce the unmet need for family planning among adolescents and young people aged 1524 years to 12 per cent by 2030, increase the availability of contraceptives and reproductive health commodities from 53 to 100 percent, and increase the family planning fund to support the availability of commodities at community and grassroot levels.

The Government of Laos, through the Ministry of Health and with the technical support of FP2030, will focus on reaching the last mile to ensure that remote communities are better served with sexual and reproductive health supplies to reduce the unmet need for family planning among the unmarried group.  Other focus areas include the integration of family planning services into broader maternal, child health, and nutrition activities, including training midwives to provide family planning services, increasing male involvement at the community level, expanding adolescent and youth-friendly services and couples’ counseling, strengthening private sector engagement, and ensuring supplies of reproductive health commodities at all levels, with a focus on health centers. 

We have unfinished business. We must work together with urgency and seize every opportunity to achieve the inclusive, equitable, and sustainable vision of the ICPD, building on the demonstrated benefits of family planning.

Let us work together for every family, every pregnancy to be a result of choice and not chance or coercion, and support women and girls everywhere in Laos to make the right choices for themselves today for a better tomorrow.