Despite substantial progress, use of modern family planning is still low in Malawi—resulting in a high level of unintended pregnancy that, in turn, leads to a broad range of negative consequences for women, their families and the country’s health care system. The findings come in a new report released today by the Guttmacher Institute and the Centre for Social Research in Zomba, Malawi, entitled "Benefits of Meeting the Contraceptive Needs of Malawian Women," which also documents the considerable financial and health benefits that would accrue from expanding access to family planning services.

Over the past decade, Malawi has made impressive progress in expanding access to modern contraception. Yet, despite more widespread use of family planning in Malawi than in many other Sub-Saharan African countries, more than four in 10 Malawian women who want to avoid pregnancy still are not using a modern method of contraception. As a result, 54 % of all pregnancies in Malawi are unintended, and women there often have more children than they desire.

The new analysis shows that if women’s need for modern contraception was fully met, the benefits would be substantial:

• Nearly 426,000 fewer unintended pregnancies would occur each year, which would reduce unplanned births and unsafe abortions by 87%;
• maternal deaths would drop by 43%, with 1,500 fewer women dying from pregnancy and childbirth per year;
• and there would be 68,000 fewer abortions annually.

Meeting just half of Malawian women’s need for modern contraceptives would still result in tangible health benefits. It would prevent 213,000 unintended pregnancies per year, which would mean 146,000 fewer unplanned births, 34,000 fewer unsafe abortions and 800 fewer maternal deaths than currently occur annually.

"High levels of unintended pregnancy are fueling the country’s alarmingly high levels of maternal death and illness," said Maxton Tsoka of the Centre for Social Research and coauthor of the study. "When women and couples struggle to limit family size, it makes it that much harder for families to lift themselves out of poverty."

Meeting women’s needs for modern contraception would also save money for Malawi’s already strained public health system. And although increasing family planning services would require increased spending, the costs would be more than compensated by the resulting health care savings from avoiding unintended pregnancies and their consequences. Fully meeting women’s need for modern contraception would generate an annual net savings of US$11 million (4.1 billion Malawi kwachas), while meeting just half of the need would result in a net savings of US$5.5 million (2.0 billion kwachas).

"Investing in family planning would not only improve the health and well-being of Malawian women and their families, it would also represent a considerable saving for the country’s public health system," noted Michael Vlassoff, Senior Research Associate at the Guttmacher Institute.

The full report and a detailed appendix are available at www.guttmacher.org. The high rate of return on investments in contraceptive services documented in "Benefits of Meeting the Contraceptive Needs of Malawian Women" echoes findings from similar analyses conducted by the Guttmacher Institute and partners in Uganda, Ethiopia, Burkina Faso and Cameroon.