Family Planning says better contraceptive services in Kiribati could save the country millions of dollars, in addition to improving sexual and reproductive health.
The organisation has just completed a cost-benefit analysis of increasing access to family planning in Kiribati for a project funded by the New Zealand aid programme.
Amelia Langford reports:
Family Planning researcher, Jacob Daube, says the analysis shows there is likely to be a substantial return on every dollar spent on family planning in Kiribati and fertility rates would also fall. Mr Daube says that would mean public sector savings of about US$23 for every dollar spent or the equivalent of $17 million over 15 years.
"JACOB DAUBE: What we have costed is the direct cost of providing contraception, so that's the cost of the commodity, the shipping to get it to Kiribati, the handling, the distribution, any other equipment you might need to provide that contraception and also the staff costs like administration and the nurses' time."
Jacob Daube says better access to family planning services would improve sexual and reproductive health by reducing unplanned pregnancies and maternal and infant mortality rates. He says Family Planning has run similar studies in Solomon Islands and Vanuatu.
JACOB DAUBE: We wanted to do it in Kiribati because it has some of the highest unmet need for family planning, so that's married women who want to space or limit their children but are not using contraceptives. And it is also has a very, very low use of contraception overall - it sits at about 18 percent of married women use modern methods.
Mr Daube says the project has support from the director of public-health in Kiribati and a reference group. Population Action International is a privately-funded organisation working to increase women's access to contraception around the world. Its president, Suzanne Ehlers, says when it comes to sexual and reproductive health, the Pacific is often overlooked and underfunded. She's impressed by Family Planning's cost-benefit work.
SUZANNE EHLERS: Here we have this very sort of small place with this burgeoning population and yet we know it is imminently achievable to do what we need to do in that particular place and that the savings that could be realised in really the near term - I'm not talking 50 years out - in the near to medium term, are incredible.
Family Planning's national medical adviser, Christine Roke, has recently returned from Kiribati after teaching nurses how to provide long-term contraception such as implants and intra-uterine devices or IUDs. She says attitudes are changing in Kiribati towards contraception.
CHRISTINE ROKE: It's been downplayed over the years and now there is a really keen interest in it and their resources are such and the island is such that it's really important for them to make sure they're having children when they want - spacing them.
Christine Roke says Kiribati women she met welcomed the option of long-term contraception.
CHRISTINE ROKE: Occasionally we came upon a woman who we couldn't clearly make sure they weren't pregnant at the time we were going to put the method in so we had to wait and they were really disappointed that we couldn't do it then.
Family Planning says Kiribati has some of the poorest access to family planning services in the Pacific. In August, the Catholic Church in Kiribati restated its opposition to contraception. But other churches in Kiribati are backing the Ministry of Health's calls to improve access to services.
