The family planning and Birth Spacing clinic has been open in Khanaqin hospital for years to provide awareness and guidance on public health, pregnancy, and childbirth spacing, but the number of women who visit it does not exceed a handful, according to hospital director.
Dr. Shiwan Shakir, the hospital's director, said the clinic is not part of Iraq's strategic plan to organize families and maintain childbirth spacing, but their own initiative to provide necessary services and awareness to women and families in Khanaqin district of Diyala province.
The Iraqi Federal Government has a national strategy for family planning and childbirth spacing for 2020-2025 and is currently in the final stages of implementation to increase the childbearing interval to at least two to three years by providing health services and contraceptives.
The project was launched in late 2020, under the supervision of the Iraqi Ministry of Health and in coordination with the United Nations Population Fund (UNFPA), as a roadmap to improve maternal and child health, reduce mortality, fight poverty, and achieve the Sustainable Development Goals.
"The Iraqi national strategy for family planning is not being implemented in reality, but we have a clinic called family planning in our hospital. We register women who visit us and give them medicine free of charge," he told Kirkuk Now.
The United Nations has set 15 sustainable development goals, with the third and fifth focusing on the Iraqi Ministry of Health’s five-year strategy, which includes family planning and birth spacing as a human right. This commitment enables couples and individuals to freely and responsibly decide on the number and spacing of their children.
The Arabic version of the strategy published by the Ministry of Health emphasizes the commitment to improving maternal health and recognizing family planning and birth spacing.
Regarding family planning efforts, the Ministry of Planning explained that Iraq is not ready to issue a law on birth control due to social traditions governing the Iraqi society. However, they have recommendations and procedures related to family planning, such as spacing and reducing births to ensure children's well-being and mothers' health.
I don't want to have too many children that I can't raise well
Since the announcement of the strategy, the Iraqi government has been encouraging citizens to increase the interval between childbirth to two to three years through the media and social media.
Avan Ismail, 30, a mother of two children, one three years old and the other a few days old, and her husband agreed to organize their family structure, including maintaining the distance between childbirth. She graduated from high school and is a housewife. Her husband is in the ranks of the Peshmerga.
Avan and her husband have set up their family reorganization and childbirth planning, without any health advice, and when they tried, they did not have access to pregnancy and family services.
Avan is not aware of Iraq's family reorganization strategy, and neither her neighbors or family members.
"Anyone who is educated can reorganize their family. If not, then every year give birth to a child and later can’t provide for him," she added.
Iraq still has the highest fertility rate in the region, with only 36% of couples relying on modern contraception methods, indicating a need for more accessible family planning services.
Past surveys revealed that the country’s Total Fertility Rate varied between 3.67 to 4.2 children/women. Another statistic in Iraq indicates that over 50 percent of women aged 15 to 49 do not want more children or want to space out their births.
Globally, out of 1.9 billion women of reproductive age, 1.1 billion need family planning, with almost 900 million using modern contraceptives.
As emphasized more than once throughout the five-year strategy, among the main objectives of family planning and maintaining the interval between childbirth, two or three years, is to fight poverty, protect the lives of mothers and babies, provide more appropriate health services, and better education for children.
The director of Khanaqin hospital said that health awareness in Iraq is at a low level and people are not aware of their clinic “to visit and organize their families. Number of visitors is limited. So far only 20 women visited us.”
Dr. Shakir explained that they have another department called the health institution, which is responsible for providing awareness and guidance to pregnant women, in order to maintain the distance between childbirth and maternal health and prevention of seasonal diseases. "We are against contraception, especially delaying the first child, until the mother is ill or old enough to have a child, but for the second, third and fourth children we enlighten them of child distance and family planning.”
If the interval between childbirths were increased to just two years, the mortality rate of children aged one to four would be reduced by 21 percent and infant mortality by 10 percent, according to the strategy.
“We organize awareness seminars on family planning and intervals for pregnant women.”
Musana Khalis, an assistant physician at Jabara health center in Jalawla sub-district of Khanaqin district, told KirkukNow that the center is implementing a national strategy for family planning through posters and seminars for women and men.
"For pregnant women, we organize awareness seminars on family planning every two months but most of the women are rural residents, so our awareness campaings have not been useful and they are having many children," Khalis said.
Last year, 1,194 children were born in Khanaqin General Hospital, of which six infants died and no mother died during childbirth, according to official statistics for (KirkukNow).
Dr. Shakir urged mothers to visit hospitals and get vaccinated, all other tests, to avoid sick and deformed children, because the diseases related to the fetus have increased, as mothers take medicines without medical advice.
"It is really important to develop the Iraqi national strategy for family planning to reorganize the Iraqi family and the interval between childbirth of two years is better for children, mothers, economy and housing.”
The Family Planning and Spacing Strategy emphasizes in its principles that the state is primarily responsible for it, by providing family planning services as part of the pregnancy health package according to international standards.
The strategy's vision aims for every woman of reproductive age to realize her rights to physical and mental health and well-being related to reproduction by the end of 2025, emphasizing access to family planning services for all in Iraq.
The strategy's guiding principles include nine points, with a focus on human rights, ensuring families can determine the size of family, number of children, and spacing between them, as well as access to information and family planning methods.
