Prof Mola is candidly worried about the poor state of women's health in his country. He shared that contraceptive prevalence rates in Papua New Guinea are stuck at mid to high 20%. It also has very high rates of chlamydia, gonorrhoea and syphilis infections. Chlamydia rates are about 25% in antenatal populations in community surveys though these rates are much higher in STI clinics at 30-40%. Syphilis rates vary from 1-2% in coastal areas to 5-10% in the highlands. HIV infections too have climbed from 2% to 3% during the last few years.
In Papua New Guinea even getting condoms is not easy. "People are embarrassed about requesting a condom especially as most of the healthcare workers are women. So it is difficult for young men to go to a female health worker and request condoms. Also there is an undercurrent in healthcare workers that condoms are bad as they promote promiscuity. They forget that condoms are for safety and risk mitigation" said Prof Mola.
He rightly suggests that condoms should be kept in an open box at the front reception desk of every health facility so that those who want them can take as many as they need without asking or feeling embarrassed. And nurses should record the total number of condoms taken away (and not record names of clients and how many each took).
One success story he cites is that recently Papua New Guinea has instituted immediate postpartum family planning, mainly with contraceptive implants as well as postpartum sterilisation.
"Counselling for implants is done antenatally so that when the woman comes for supervised birth she is mentally prepared for it. Our demographic health survey shows clearly that the family size in Papua New Guinea is always about one more than what they want. The main problem is misinformation and misconceptions around family planning- like 'implants cause cancer' and/or 'interfere with sexual activity'. So we have to counsel and re-counsel women when they request for removal of their implants after just a couple of months because of rumours they hear in the community" shared Prof Mola.
He called for "integrating family planning services with general healthcare - and not confine it to maternal healthcare only - in order to improve the situation. Access to general healthcare is vital to have effective family planning services. If we do better on other social fronts, family planning will come along with it".
In the words of Tomoko Fukuda, International Planned Parenthood Federation (IPPF)'s Regional Director for East and South-East Asia and Oceania Region, "The main challenge is reaching out to all the diverse groups of women - single women, young women, women with disabilities, women living in remote areas. Family planning is not just about the family but about a woman's choices and rights to control her life, and how to prevent STIs and unplanned pregnancies. It is about young girls and women to lead a full and productive life".
Sustainable development can only be achieved if women have autonomy over their bodies. It is only when women and girls across the region can make informed decisions about their sexual and reproductive health, will they be able to lead a healthy and productive life.
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