When you think of what's needed in a country ravaged by civil war, a food crisis and a cholera outbreak, family planning might not be the first thing to spring to mind - but it's vitally important and its impact will saves lives.
Ahead of the Family Planning Summit in London on 11th July, I caught up with Mary, a wonderful midwife who works with CARE International in South Sudan, the world's youngest country.
Mary Poni Daniel works in Parieng Primary Health Care Centre, Ruweng State in South Sudan. Many of the women Mary works with are refugees who have fled from the war in Sudan. Even in the midst of a refugee camp people still engage in activities that constitute everyday human needs - that includes having sex. In light of this, women who happen to be living in these settings have a more urgent and desperate need for family planning services. Why? Because for them contraception can literally mean the difference between living and dying.
I'd read up on the situation in South Sudan ahead of my call with Mary, and was stunned by the country's maternal mortality rate. The nation has one of the highest mortality rates in the world. Here in the UK, a woman's chances of dying in childbirth are approximately 1 in 39,000. Mary reported that in her hospital, it is higher than 1 in 60. Most of these deaths could be prevented if there were more health professionals, medical supplies (clinics are often looted) and - without doubt - family planning services.
I'd heard that there is a shortage of midwives at Mary's hospital, and I was keen to hear about staffing levels. Mary explained that where she works, a typical day involves two trained midwives looking after around 50 women. What an astonishing contrast to the hospital where I work, where we try to achieve one-to-one care, so that a woman in established labour has one midwife who looks after her throughout her labour and birth.
Mary's daily role is full and much broader than a midwife's role in the UK. Aside from the typical activities, there is a huge emphasis on health education and advice on family planning. Mary's very much involved with advising all women, not just the ones who have just given birth, regarding family planning. In South Sudan families are traditionally large, which is great, but having many children needs to be done safely. Mary speaks to the women she sees about healthy birth-spacing - this has enormous health benefits for the mother and to the babies born to her. Children born 3-5 years apart are twice as likely to make it to age 5 in comparison to those born less than 2 years apart. Another harrowing fact is that a woman who has more than 4 children is at increased risk of maternal mortality so informing her of the risks of increased family size and how contraception may prevent this could potentially save her life.
I felt so heavy hearted after speaking to Mary. The conversation was a real eye opener and it gave me a perspective I didn't have before. The work she does really is life-saving work - but sadly, there's a lack of funding for it. Worldwide it's estimated that there are currently around 214 million women living in developing countries who want to delay or prevent pregnancy, but have an unmet need for effective contraception simply because they don't have access to it. It's so important that women have access to contraception and control over their bodies and this includes women living in areas of conflict, like South Sudan.
At the last Family Planning Summit, in 2012, governments from around the globe made a commitment, to reach an additional 120 million women, with access to family planning by 2020. We need to make sure this becomes reality.