abortion – TheNewsHub

Harris hitting every battleground state, hoping to drive turnout

Aseem — Tue, 29 Oct 2024 00:15:00 +0000

Vice President Kamala Harris will visit every battleground state in the final week before Election Day, with a focus on female voters who she hopes will propel her to the White House.

The campaign has directed several messages to female voters in recent days, reminding them that what happens in the voting booth is a secret.

A Democratic ad released Monday delivers the message: “You can vote any way you want and no one will ever know.”

On Saturday in Kalamazoo, Michigan, former first lady Michelle Obama reminded women that “we are more than just baby making vessels.”

“If you are a woman who lives in a household of men that don’t listen to you or value your opinion, just remember that your vote is a private matter,” Obama said in the battleground state.

A voter CBS News met at the rally said she’s heard from a number of female Republicans who will vote Democrat.

“There’s been kind of a little under campaign going about,” she said. “You can vote and no one knows your vote. And it’s been aiming at women.”

Four first-time female voters all said the top issue for women their age is abortion and reproductive rights.

Harris told CBS News in an interview Saturday that she would restore Roe v. Wade if she wins the election.

“I support Roe v. Wade being put back into law by Congress, and to restore the fundamental right of women to make decisions about their own body. It is that basic,” Harris said.

Harris skirted the question about whether she supports abortion restrictions after fetal viability, generally considered to be between 22 and 24 weeks of pregnancy.

“We would not be debating this if Donald Trump had not hand-selected three members of the United States Supreme Court with the intention they would undo the protections of Roe v. Wade,” she said, noting that women have died because of restrictions that have been enacted since the rollback.

“We have seen women who are experiencing a miscarriage around a pregnancy they prayed for and being denied healthcare because doctors are afraid they’re going to go to prison, and those women developing sepsis,” she said. “We have seen extraordinary harm and pain and suffering happen because of what Donald Trump did in intending and effectuating and overturning of Roe v. Wade. Yes, my first priority is to put back in place those protections and to stop this pain and to stop this injustice that is happening around our country.”

She also urged Americans not to take former President Donald Trump at his word when he denies that he would support a national abortion ban.

“He says everything,” Harris said. “Come on, are we really taking his word for it? He said that women should be punished. He has been all over the place on this.”

With polling showing some of Harris’ early gains have slowed and that the race for the presidency is essentially a dead heat, Harris said she doesn’t put too much stock in the polls.

“I think, certainly, polling is a measure, but to be frank, if I’d listened to polls I would have never run for my first or second office,” she said. “Wouldn’t be here talking with you.”

She pointed to record turnout for early voting in North Carolina and Georgia as a sign of enthusiasm.

Asked if, considering how late in the process she became the Democratic nominee, she felt she had sufficient time to make her case to the American people, Harris responded, “I’m gonna make the most of the time I have.”

Norah O’Donnell

Norah O’Donnell is the anchor and managing editor of the “CBS Evening News,” anchor of CBS News Election Specials and a 60 Minutes contributing correspondent. O’Donnell is a multiple Emmy Award-winning journalist with nearly three decades of experience covering the biggest stories in the world and conducting impactful, news-making interviews.

Drug costs, abortion, Obamacare: How Trump and Harris could change U.S. health care

Harsh — Sat, 19 Oct 2024 12:00:01 +0000

President Donald Trump talks to the press outside the White House, July 19, 2019, left, and Democratic presidential nominee and U.S. Vice President Kamala Harris speaks to mark the one-year anniversary of the Oct. 7 Hamas attacks on Israel, at the vice president’s residence at the U.S. Naval Observatory in Washington, Oct. 7, 2024.

Getty Images (L) | Reuters (R)

Prescription drug costs. Abortion rights. The future of Obamacare.

The fast-approaching presidential election between Vice President Kamala Harris and former President Donald Trump could lead to a huge range of outcomes for patients on those issues and others in the sprawling U.S. health system.

Both candidates are pledging to make care more affordable in the U.S., an outlier in the developed world due to its higher health-care spending, worse patient outcomes and barriers to access. But the candidates appear to have different approaches to doing so if elected.

The candidates have not yet released detailed proposals on health policy, which ranks slightly lower than other issues at the top of voters’ minds, such as the economy. But each candidate’s track record provides a glimpse of what drug costs, health care and reproductive rights could look like over the next several years.

“A Trump administration will try to slash federal health spending to pay for tax cuts and reduce the role of the federal government in health,” Drew Altman, CEO and president of health policy research organization KFF, told CNBC. He said a Harris administration “will build on existing programs, increasing federal spending to make health care more affordable for people.”

It wouldn’t be easy for either administration to make sweeping changes: The U.S. has a complicated and entrenched health-care system of doctors, insurers, drug manufacturers and other middlemen, which costs the nation more than $4 trillion a year. Any overhaul of the U.S. health-care system would also depend on which party controls Congress, and on the policies state lawmakers pass.

Despite spending more on health care than any other high-income country, the U.S. has the lowest life expectancy at birth, the highest rate of people with multiple chronic diseases and the highest maternal and infant death rate among those nations, according to a 2023 report published by The Commonwealth Fund, an independent research group.

Around half of American adults say it is difficult to afford health care, which can drive some patients into debt or lead them to put off necessary care, according to a May poll conducted by KFF.

Here’s how Harris and Trump differ in their approaches to key health-care issues.

nearly three times higher than those in other countries, according to the nonprofit research firm RAND.

About 1 in 5 adults say they have not filled a prescription in the last year because of the cost, while roughly 1 in 10 say they have cut pills in half or skipped doses, according to the March KFF survey.

Activists protest the price of prescription drug costs in front of the U.S. Department of Health and Human Services building in Washington, D.C., on Oct. 6, 2022.

Anna Moneymaker | Getty Images

Many of Trump’s efforts to rein in drug prices have either been temporary or not immediately effective, according to some health policy experts. On the campaign trail, the former president has also provided few specifics about his plans for lowering those costs.

Some of Harris’ proposals are not fully fleshed out, but if elected she can build on the Biden administration’s efforts to save patients more money, experts said.

Harris plans to expand certain provisions of President Joe Biden’s Inflation Reduction Act, part of which aims to lower health-care costs for seniors enrolled in Medicare. In 2022, she cast the tie-breaking Senate vote to pass the legislation.

Harris’ campaign says she intends to extend two provisions to all Americans, not just older adults in Medicare: a $35 limit on monthly insulin costs and a $2,000 annual cap on out-of-pocket drug spending.

She also plans to expand and speed up the pace of Medicare drug price negotiations with manufacturers to cover more expensive drugs. The landmark policy, passed as part of the IRA, has faced fierce opposition from the pharmaceutical industry, as some companies have challenged its constitutionality in court.

Trump has not indicated what he intends to do about IRA provisions.

Many Republicans have been vocal critics of the drug pricing negotiations, claiming they harm innovation and will lead to fewer cures, according to Dr. Mariana Socal, a health policy professor at the Johns Hopkins Bloomberg School of Public Health. Trump made a similar argument in 2020 when he opposed a separate Democratic bill that would allow Medicare to negotiate drug prices.

Still, Socal said a Trump administration wouldn’t have much flexibility to dismantle or scale back the law without change from Congress.

Some of Trump’s efforts to lower drug prices during his presidency “didn’t really come into fruition,” Socal added.

In 2020, he signed an executive order to ensure Medicare didn’t pay more than the lowest price that select other developed countries pay for drugs. But the Biden administration ultimately rescinded that policy following a court order that blocked it.

The Trump campaign this month said the former president would not try to renew the plan if reelected.

Also in 2020, Trump issued a rule setting up a path to import prescription drugs from Canada, where medication prices are 44% of those in the U.S. But it took years for the measure to gain momentum. The Biden administration only in January approved Florida’s plan to import some prescription treatments from Canada.

Trump also set a $35-per-month cap on some insulin products for seniors through a temporary program that Medicare prescription drug plans, also known as Part D plans, could choose to join. The program was in effect from 2021 to 2023, and less than half of all Part D plans opted to participate each year, according to KFF.

But that measure was much more limited than the Biden administration’s insulin price cap, which requires all Part D plans to charge no more than $35 per month for all covered insulin products. It also limits cost-sharing for insulin covered by Medicare Part B plans.

Both administrations would likely continue to scrutinize pharmacy benefit managers, the drug supply chain middlemen who negotiate rebates with manufacturers on behalf of insurance plans, according to Dr. Stephen Patrick, chair of the health policy and management department at Emory University.

Lawmakers and the Biden administration have recently ramped up pressure on PBMs, accusing them of raking in profits while inflating prescription medication prices and harming U.S. patients and pharmacies.

she would not back the program as president.

But Harris has supported the Affordable Care Act, also known as Obamacare, since she was a senator, consistently voting against bills to repeal the plan and reasserting her commitment to strengthen it during the presidential debate on Sept. 10.

The ACA was designed to extend health coverage to millions of uninsured Americans and implement reforms to the insurance market. The law expanded Medicaid eligibility, mandated that Americans purchase or otherwise obtain health insurance, and prohibited insurance companies from denying coverage due to preexisting conditions, among other provisions.

The IRA extended enhanced subsidies that made ACA health plans more affordable for millions of households through 2025 — a provision Harris plans to make permanent if elected, her campaign said.

Harris may also work with Congress to try to extend Medicaid coverage in the 10 states that haven’t expanded it under the ACA, some experts said. Medicaid provides coverage for 81 million people, or more than 1 in 5 Americans, according to KFF.

The program is the largest source of federal funding to states. It covers low-income patients and families, as well as those with complex and costly needs, such as people with disabilities and individuals experiencing homelessness.

But if Republicans control even one branch of Congress, boosting Medicaid coverage will “be much tougher, if not impossible to do,” KFF’s Altman said.

Democrats face a difficult path to retaining their slim Senate majority, while Republicans are trying to cling to narrow control of the House.

Vice President Kamala Harris greets guests after speaking at an event celebrating the 13th anniversary of the Affordable Care Act in the East Room of the White House in Washington, D.C., March 23, 2023.

Nathan Posner | Anadolu | Getty Images

Meanwhile, Trump led multiple failed crusades to repeal the ACA during his first term. In a campaign video in April, Trump said he was not running on terminating the law and would rather make it “much, much better and far less money,” though he has provided no specific plans. Many Republicans have abandoned their promises to repeal the law after it grew more popular in recent years.

During the Sept. 10 debate, Trump reiterated his belief that the ACA was “lousy health care.” But he did not offer a replacement for the law when asked, saying only that he has “concepts of a plan.”

KFF noted that Trump’s previous replacement proposals would have made the ACA less expensive for the federal government but raise out-of-pocket premiums for patients, lead to more uninsured Americans and increase risks for states.

A Trump administration would likely have major implications for Medicaid, Altman said.

Notably, Trump has said he would not cut spending for Medicare and Social Security. But that makes Medicaid, which costs the federal government more than $600 billion a year, a target for severe cuts, Altman noted.

He said Trump could make fundamental changes to the program to curtail enrollment, such as lifetime limits on how many years people can get Medicaid coverage.

A rally against Medicaid cuts in front of the U.S. Capitol on June 6, 2017.

Bill Clark | CQ-Roll Call, Inc. | Getty Images

Trump could also revisit some of his earlier attempts to reduce spending on Medicaid. As president, he approved eligibility restrictions such as work requirements, and proposed changing the way the federal government gives money to states for Medicaid into a “block grant” program.

That refers to the government providing states with a fixed amount of money to administer and provide Medicaid services in exchange for more flexibility and less oversight.

The Biden administration withdrew some of those restrictions and encouraged waivers that would expand Medicaid coverage and reduce health disparities, which Harris would likely pursue if elected, experts said.

A Democratic House or Senate would likely block any of Trump’s sweeping changes to Medicaid, according to Altman.

“My theory is that if the Democrats hold even one house in Congress, all of that will fail,” he said. “There’ll be a big debate, but it will fail. Medicaid is too big.”

a late August poll by The New York Times and Siena College.

This is the first presidential election held since the Supreme Court overturned Roe v. Wade, the landmark ruling that established the constitutional right to abortion in the U.S. in 1973.

Abortion access in the U.S. has been in a state of flux in the roughly two years since the court’s decision, which has given conservative governors and legislatures the power to limit the procedure in their states. As of last year, more than 25 million women ages 15 to 44 lived in states where there are more restrictions on abortion than before the court’s ruling in 2022, PBS reported.

Vice President Kamala Harris speaks about Florida’s new 6-week abortion ban during an event at the Prime Osborn Convention Center in Jacksonville, Florida, May 1, 2024.

Joe Raedle | Getty Images

The future of abortion rights could look starkly different depending on which candidate holds office, according to Stacey Lee, professor of health law and ethics at the Johns Hopkins Carey Business School. That leaves the reproductive well-being of many women, especially lower-income people and people of color, hanging in the balance.

Harris has long been a staunch advocate of abortion access and has seized the opportunity to highlight what some health policy experts and voters consider the extreme and often inconsistent views of Trump and the broader Republican Party.

She has blamed Trump, who appointed three members of the Supreme Court’s conservative majority, for the reversal of Roe v. Wade, and urged Congress to pass a national law codifying abortion rights. Democrats have not had enough votes in Congress to pass such protections under Biden.

Last month, Harris also said she supports eliminating the filibuster in the U.S. Senate to restore federal abortion protections as they existed under Roe v. Wade. The filibuster rule requires a 60-vote threshold for most legislation to pass, which makes it difficult for lawmakers to approve bills in a closely divided Senate.

Harris has also “been a firm proponent” of defending the availability of the abortion pill mifepristone, Lee said. Anti-abortion physicians squared off with the Food and Drug Administration in 2023 in an unprecedented legal battle over the agency’s more than two-decade-old approval of the medication.

In June, the Supreme Court unanimously dismissed the challenge to mifepristone and sided with the Biden administration, meaning the commonly used medication could remain widely available. The administration’s FDA also revised restrictions on medication abortion, allowing certain certified retail pharmacies to dispense the pills.

Meanwhile, Trump vaguely suggested in August that he would not rule out directing the FDA to revoke access to mifepristone. Just days later, his running mate, Sen. JD Vance, of Ohio, attempted to walk back those remarks.

Trump’s comments appear to be a shift from his stance in June, when the former president said during a CNN debate that he “will not block” access to mifepristone.

During his time in office, Trump introduced several anti-abortion measures. That includes a “gag rule” that would have made clinics, such as Planned Parenthood, ineligible for federal health funds if they provided abortions or referrals for them.

Vance this month also said a future Trump administration would defund Planned Parenthood.

But Trump has also waffled over the last few years on abortion policy, appearing to soften his stance on the issue to appeal to more moderate and independent voters.

He takes credit for Roe v. Wade’s demise since he reshaped the court, and his latest stance is that abortion policy should be set by the states. Earlier this year, however, Trump lamented that certain state laws go “too far.”

During a radio interview in March, Trump said he would consider a national ban on abortions around 15 weeks of pregnancy.

But earlier this month, he said he would not support a federal abortion ban, writing in a post on X he would veto one. He added that he supports exceptions in cases of rape and incest and to save the life of a pregnant woman.

“It is difficult to find consistency within his policies, but that lack of consistency should amplify that perhaps anything is possible in terms of a more restrictive stance to abortion and reproductive rights,” Lee said.

President Donald Trump arrives to speak at the 47th annual anti-abortion “March for Life” in Washington, D.C., Jan. 24, 2020.

Nicholas Kamm | Afp | Getty Images

Meanwhile, both Harris and Trump have recently expressed their support for in vitro fertilization, a type of fertility treatment performed outside of the body in a lab. It accounts for roughly 2% of births in the U.S. but is extremely costly for many low- and middle-income people who need the technology to start families.

It became a campaign issue after the Alabama Supreme Court ruled in February that frozen embryos created during the IVF process could be considered children, which threatened the availability of those services in the state.

Trump has called for the government or private insurers to pay for IVF treatment. Harris has said she would defend the right to both IVF and contraception, but has not specified how she would do so.

They Were Loyal Republicans — Until Trump and Abortion Bans

Aseem — Fri, 11 Oct 2024 09:02:03 +0000

“I consider myself an original Republican. We used to refer to Biden and Kamala in our house as the ‘corpse and the cackler.’” “I am a lifelong Republican — of smaller government, lower taxes, not intervening in our lives.” “I grew up in the Reagan era, and Reagan was a hero in my home. So he was my hero.” “I think in this day and age, you really can’t say that if someone is pro-choice, they must be liberal.” Abortion is changing the Republican Party this election. Here in Arizona, almost one-third of Republicans say they’ll support Proposition 139, a state ballot measure that would make abortion legal until about 24 weeks. “I would say 20 years ago, that definitely would not have been the case.” We spoke to three longtime supporters of the Republican Party about how the end of Roe v. Wade is changing their vote. “I grew up very Catholic. I never knew anybody who had an abortion. I don’t think I said the word out loud until after I’d been married.” “When I heard about Roe being overturned, I was not terribly surprised. Our state law reverted back to the previous law, which was from 1864.” “No one could quite believe it. I mean, it really came so quickly.” Passed during the Civil War when Arizona was still a territory, the 1864 law was a near-total ban on abortion. “Even conservatives in Arizona thought that it didn’t make a lot of sense.” The law was overturned in May, and a ban after 15 weeks was put into place. But it made some Arizonans rethink their stance on abortion. “I had to stop and think: Well, how do I feel about it? What could the potential repercussions be? And the more I read, the more news stories I saw, the more afraid I got for women. I’m a member of the Church of Jesus Christ of Latter-day Saints. I am a mother of 10 and a grandmother. I do believe in the sanctity of life, but I just don’t believe it’s my right to choose for someone else.” “I think when people go through this, it is probably the most painful decision they’ve ever made. I was a delegate to the 2016 convention, and the day that we had the vote in Arizona to go to the convention, I realized that I was bleeding. Turns out that I somehow was pregnant and it had released. I went to the doctor, and I had to have a D&C. Let’s say the 1864 law was in place. Would they have allowed me to have a D&C? Would they have investigated me? 2016, I voted for Trump; in 2020, voted for Trump, but I won’t vote for him again.” “President Trump prides himself in the fact that he dismantled Roe v. Wade. It doesn’t serve women well. It doesn’t serve the country well. And so I can’t support and would say to friends of mine, if Prop 139 is your issue, I don’t see how you could support candidate Trump.” “I will always be a Republican. I listen to NPR in the morning, it reminds me every day why I’m a Republican, but I can’t see myself voting for either of them, for either party at this point.” “I will be voting for Kamala Harris. I have done phone banking on one occasion and I’ll be doing it again. This time, I think that a lot of Arizonans feel, and I feel like our vote actually counts.”

Beyond choice

Harsh — Sat, 07 Sep 2024 18:54:29 +0000

Hina*, a 22-year-old mother of two from rural Sindh, tragically lost her third child due to complications during childbirth. Her story is one of the many heart-wrenching reminders of the devastating consequences of inadequate access to reproductive health services and family planning education in Pakistan. Millions of women in the country face risks due to a lack of knowledge and resources, leading to unplanned pregnancies, unsafe abortions, and maternal mortality.

The absence of reproductive health education and family planning services has far-reaching consequences, affecting not only the health and well-being of women but also the economic prosperity of families and communities. When women are unable to plan their families, they are more likely to experience poverty, malnutrition, and poor health outcomes, perpetuating cycles of disadvantage.

Educating females about reproductive health and family planning is crucial for preventing such tragedies and empowering women to make informed decisions about their lives. In Pakistan, where only 34% of women use family planning methods and 40% lack access to female healthcare, the need for awareness and education is dire. The statistics are alarming: 4.2 million unplanned pregnancies and 2.2 million abortions annually, with young women desiring an average of four children but having only two due to lack of access to family planning services.

Pakistan is the sixth most populous country in the world with 208 million people and a population growth rate of 2.4% per year. The population dynamics pose challenges to national development, economic growth, and security. To address these challenges, it's essential to take the conversation to the parliamentarian level, ensuring policies and programs support reproductive health and family planning initiatives. Parliamentarians have a critical role in championing women's rights and advocating for enhanced access to reproductive health services, particularly in underserved areas.

Recently, the Sustainable Development Policy Institute (SDPI) and United Nations Population Fund (UNFPA) organised a seminar for Sindh's parliamentarians, a crucial step towards mobilising political will and action. However, this is just the beginning. Many more efforts are needed to educate individuals and policymakers about the importance of reproductive health and family planning. The consequences of inaction are too severe to ignore – we must act now to ensure a brighter future for Pakistan's women and girls.

The alarming reality

Pakistan faces a reproductive health crisis, with staggering numbers of unplanned pregnancies and abortions. According to a report by the Guttmacher Institute, ‘Unplanned Pregnancy and Abortion in Pakistan’, 50% of pregnancies in Pakistan are unplanned, while the World Health Organization reports that one in five pregnancies end in abortion. This translates to approximately 2.2 million abortions annually, with a devastating 80% being unsafe, leading to serious health complications and even death. In fact, unsafe abortions account for 12% of maternal deaths in Pakistan, as per the Pakistan Demographic and Health Survey.

The root cause of this crisis lies in the lack of access to family planning services. According to the Pakistan Demographic and Health Survey by National Institute of Population Studies, only 35% of married women use modern contraceptive methods, while 20% have an unmet need for family planning. This means millions of women are unable to make informed decisions about their reproductive health, leading to a cycle of unplanned pregnancies and unsafe abortions.

The situation is exacerbated by a lack of access to female healthcare, with 40% of the population unable to access essential services. Improved supply chains and involvement of the private sector in underserved areas are crucial to address this gap.

The power of family planning

Family planning is a fundamental aspect of reproductive health, enabling individuals to make informed decisions about their fertility and plan their families. In Pakistan, where one in every five women desire to use contraceptives but lack access, family planning is crucial for preventing unwanted pregnancies, reducing unsafe abortions, and saving lives.

Family planning was declared a basic human right at the United Nations International Conference on Human Rights in 1968. This rights-based approach ensures that individuals have the right to determine freely and responsibly the number and timing of their children, with access to quality information and services, free from discrimination and coercion.

It prevents maternal deaths, saves children's lives, and ensures that every pregnancy is intended. Unfortunately, Pakistan has lower use of modern contraceptives compared to other countries in the region, with only 26% of women aged 15-49 years using a modern method. This highlights the need for improved access to family planning services, which is imperative for saving lives.

The UNFPA works closely with the Government of Pakistan to increase the uptake of family planning information and services. The goal is to enable an estimated 5.8 million women to become additional users of modern contraception.

Access to contraceptive information and services is central to achieving gender equality. When women are empowered to plan their families, they are better enabled to complete their education, have more autonomy within their household, and improve their earning power. This strengthens their economic security, education, health, and well-being, as well as that of their children and family.

By recognising the importance of family planning, we can ensure that individuals have the freedom to make informed decisions about their reproductive health, saving lives, empowering women, and building a brighter future for all.

Steps taken to address the crisis

Pakistani authorities have taken various steps to address the country's reproductive health challenges, recognising the critical need to improve access to family planning information and services. In collaboration with the UNFPA, the government aimed to enable an estimated 5.8 million additional women to use modern contraception by 2022, a significant step towards reducing the unmet need for family planning.

Pakistan has also committed to the Family Planning 2020 (FP2020) initiative, pledged to add 6.7 million new users of modern contraception by 2020 and achieve a contraceptive prevalence rate of 50%. This commitment demonstrates the government's dedication to addressing the country's high population growth rate and improving the health and well-being of its citizens.

Pakistan has also made commitment to the FP2030 with a vision that, “by the end of 2030, Pakistan envisions a society where women and girls are empowered and all couples enjoy basic rights to decide the number of their children freely and responsibly by maintaining a balance between their family size and resources, make informed choices to achieve a prosperous, healthy, and educated society.”

The vision includes adapting and implementing evidence-based progressive policy reforms with political will and enabling an environment at all levels, universal access to services to lower fertility rates and address unmet need for contraception, address information and service needs specially to remote areas, gearing for Uniform Understanding of National Narrative, contraceptive commodity security and efficient supply mechanism, legislative support, institutionalisation of human development and system strengthening to sustain family planning efforts, and monitoring and evaluation for results and effectiveness.

Given due consideration that population is a cross-cutting issue, which has its linkages with the most important issues relating to poverty, health, illiteracy, environment, climate change, economic instability, etc, the Government of Pakistan has developed a New National Narrative under the theme “Tawazin” (meaning middle of the course) and decide the family size according to the resources, enabling to fulfill the fundamental rights of all.

The UNFPA advocates widely at the policy level to ensure that family planning is embraced as a basic human right. This rights-based approach ensures that individuals can determine freely and responsibly the number and timing of their children, with access to quality information and services, free from discrimination and coercion. By empowering individuals, particularly women, to make informed decisions about their fertility, UNFPA works to address the social and cultural barriers that often limit access to family planning services.

Efforts are also being made to improve access to contraceptives, particularly for women who wish to use them but lack access. This includes increasing the availability, accessibility, acceptability, and quality of family planning services, ensuring that individuals can obtain the information and resources they need to plan their families.

By addressing these critical gaps in family planning services, Pakistani authorities and UNFPA aim to reduce the country's high rates of maternal mortality, unsafe abortions, and unintended pregnancies, ultimately improving the health and well-being of women and families across Pakistan.

Progress Made

Significant progress has been made in improving antenatal care in Pakistan, with coverage increasing from 30% in 1990-91 to 77% in 2020. However, despite this achievement, challenges persist in ensuring access to quality reproductive healthcare.

Dr Rubina Ali, Assistant Country Representative for UNFPA, emphasised the need for a rights-based approach to family planning, and said, "Population management transcends mere control. It is about empowering individuals with the right to plan their families and access essential resources."

Dr Rubina urged parliamentarians to advocate for enhanced access to contraceptives and family planning services.

The SDPI plays a crucial role in advocating for reproductive health policies and family planning in Pakistan. According to Syed Ali Wasif Naqvi, Senior Research Associate and Head of Policy Advocacy & Outreach at SDPI, "SDPI provides research-based insights and policy analysis that inform and strengthen the efforts of these organizations." SDPI's collaboration with UNFPA and similar organisations ensures that its research contributes to more effective advocacy and policymaking in healthcare, including reproductive health and family planning.

Looking ahead, SDPI plans to continue its research and policy advocacy efforts in the broader healthcare sector, with a focus on data development for reproductive health. "Future initiatives may include more focused research on reproductive health challenges in Pakistan and developing policy briefs that guide effective interventions. SDPI aims to partner and collaborate with organizations that can drive systemic change and improve health outcomes nationwide,” explained Naqvi.

Persistent challenges

Despite progress made in improving reproductive healthcare in Pakistan, several challenges persist. Accessibility remains a significant issue, particularly for women in rural or remote areas. They face constraints in accessing essential healthcare services, including quality antenatal and postnatal care, reproductive health, breast cancer treatment, and fistula treatment. The biggest gap is in delivery in hospitals, with only 64% of women in rural areas and 85% in urban areas delivering in hospitals. In rural areas, a staggering 66% of women consider distance to health facilities a major problem.

According to Naqvi, the implementation of reproductive health policies in Pakistan faces several challenges, including cultural barriers, lack of awareness, inadequate healthcare infrastructure, and insufficient funding. “Addressing these challenges requires a multifaceted approach that includes increasing public awareness, enhancing healthcare services, and ensuring that policies are culturally sensitive. The importance of community engagement and the need for stronger governance to ensure that policies are effectively translated into practice cannot be ignored,” added Naqvi.

He also emphasised the crucial role of the private sector in expanding access to reproductive health services, particularly in underserved areas. “The private sector has a key role in expanding access to reproductive health services by partnering with public health organizations and supporting public health initiatives, particularly in underserved areas. SDPI suggests that incentivizing private healthcare providers through public-private partnerships could enhance service delivery,” he said, adding that, collaborations with the private sector should focus on capacity building and service expansion, especially in rural and underserved regions. “This will ensure that reproductive health services are accessible to all and help bridge gaps in service provision and improve overall health outcomes.”

The unfinished agenda

Huge disparities persist between young women's desires and their reality when it comes to reproductive health in Pakistan. On average, women desire four children, but the reality is that they have only two. This significant gap has far-reaching implications for reproductive health outcomes and highlights the unfinished agenda in this critical area.

According to Naqvi, "Although SDPI's direct involvement concerning family planning is limited, the organisation recommends integrating reproductive health into broader healthcare and development policies."

He emphasised that SDPI's research in healthcare shows that infrastructure, improving data collection methods, and building a multi-sectoral collaboration can help overcome challenges in reproductive health policy implementation. "SDPI advocates for evidence-based policy that reflects the unique socio-economic context of Pakistan," said Naqvi.

Naqvi also highlighted the crucial role of education, particularly girls' education, in improving reproductive health outcomes. "Education, especially for girls, is crucial in improving reproductive health outcomes. Educated women are more likely to make informed decisions about their health and family planning," he said, adding that SDPI advocates for girls' education and enrollment of out-of-school children.

“Our prime focus is on the policies that promote girls' education as a means to improve reproductive health," said Naqvi. Underscoring the empowering effect of education on women, he said, "Education empowers women to understand and exercise their rights, leading to better health outcomes and more sustainable development."

The role of parliamentarians

Parliamentarians play a vital role in championing women's rights and advocating for enhanced access to reproductive health services. Dr Abid Qaiyum Suleri, Executive Director of SDPI, said, "Access to sexual reproductive health and family planning services is not only a matter of public health but also crucial for promoting sustainable economic growth. Parliamentarians play a key role in policy-making that will lead to a more balanced population growth and a better future for Sindh."

Dr Suleri stressed the importance of mobilising dialogue on political will and enabling environment for the successful implementation of the National Action Plan on Family Planning and the Family Planning 2030 (FP2030).

Shaheena Sher Ali, Sindh Minister for Women Development, reaffirmed the Sindh government's commitment to working on family planning and reproductive health awareness as fundamental rights: "The Sindh government will implement policies in the province that promote reproductive health and underscore the connection between population and sustainable economic growth. As members of the Sindh Assembly, we must ensure that every citizen in Sindh has access to the reproductive health services they need, especially in rural areas."

Dr Jamil Ahmad Chaudhry, Program Specialist at UNFPA, highlighted the urgent need for parliamentary engagement to achieve the Council of Common Interests' goals, addressing key challenges such as lack of access to female healthcare and the need for improved supply chains.

Naqvi highlighted that through policy dialogues, advocacy initiatives, conferences, and collaborative projects, SDPI ensures that its research reaches key decision-makers. “Our partnerships with UN agencies and other international bodies help align national policies with global best practices, including those related to healthcare including our recommendations for female healthcare,” he shared.

What to expect?

The path forward requires sustained efforts and collective action. As Naqvi said, "We plan to maintain our efforts in providing data-driven insights and facilitating multi-stakeholder dialogues. With our research informing policy and practice, we can drive progress towards achieving the goals outlined in the FP2030 framework."

This commitment to evidence-based decision-making will be critical in addressing the complex reproductive health challenges facing Pakistan. “At SDPI, our strategy involves around building stronger networks, engaging in capacity-building initiatives, and ensuring that the focus on SRH and FP remains a priority in the national discourse,” said Naqvi.

The call to action remains: to bridge the gaps, prioritize women's and girls' health, and ensure every individual's right to reproductive health and family planning. The journey ahead is long, but collective efforts can ignite transformative change, empowering individuals, communities, and the nation to thrive.

*Name changed to protect identity