The Pill Photo: BELGAIMAGE, Source: De Standaard
Thought Babble

European Nations Named and Shamed for Failing Citizens’ Sexual Health Needs

April marked 50 years of family planning being declared a basic human right. This is a timely milestone considering that just a few weeks prior, an intriguing official report called the “Contraception Atlas” was released, comparing 46 countries in the greater European community in terms of their provision of contraceptive services. But how did these nations compare? And how might a box of chocolates help spread awareness of this issue?

You would think, considering half a century has passed since this human right got official recognition, that by now this would have been put into practice by governments. However, depending on where you live, the results just may come as a bit of a shock.

The Contraception Atlas tracks and compares national government policies on access to contraceptive methods, family planning counselling and the provision of public information about contraception in 46 European states.

This is the initiative of the European Parliamentary Forum on Population and Development (EPF), which reiterate repeatedly on their social networks that adequate contraceptive tools are a ‘basic human right’ which ‘allow women to take control not only of their bodies, but of their entire lives.’ According to this parliamentary network – specialised in policies surrounding sexual and reproductive health and rights (SRHR) – the importance of accessible contraception cannot be overlooked, and yet many governments still fail to provide their citizens with the tools that they need.

Shockingly, the report states that 43% of pregnancies in Europe are unplanned, and yet a third of fertile European women are currently not using contraception. This means that Europe disappointingly lags behind when compared with North America, Latin America and the Caribbean. When it comes to European women’s ability to take control of their own fertility, our national governments certainly have left plenty of room for improvement.

The Atlas also shows that Belgium, France and the UK are currently leading the way in this area. A major factor pushing these states to the top spot is their implementation of general reimbursement schemes covering a range of contraceptive supplies, including long acting and reversible methods, also known as “LARCs”. These methods include subdermal contraceptive implants and IUDs, which are not only more cost-effective, but also boast higher success and satisfaction rates than other forms of contraception.

Regarding the financial burden which unintended pregnancies place on national governments – due to both the limitation on the number of fertile women in the workforce, and in some cases leading to government-funded abortion procedures – on top of the relatively small cost of such reimbursement schemes – it is baffling that most national governments are yet to catch onto this crowd-pleasing solution.

How does your country score? Source: https://www.contraceptioninfo.eu/node/7
How does your country score? Source: https://www.contraceptioninfo.eu/node/7

The Atlas displays each country in colour, according to their score. Note that the red category – indicating a very poor performance contains 14 countries, making it bigger than all the other groups. As the map reveals, much of Eastern Europe, as well as Andorra, fall into this category. Czechia, Lithuania, and Iceland, among others, also have a long way to go.

Overall, schemes offering reimbursement for these LARCs are not only powerful in increasing access – especially since one appointment will provide protection for several months or even years – but such schemes also equate to long-term economic benefits for governments, as more women are able to contribute to the workforce while less require the costly repeated appointments and prescriptions that come along with other methods.

Official Contraception Atlas infographic. Source: https://www.contraceptioninfo.eu
Official Contraception Atlas infographic. Source: https://www.contraceptioninfo.eu

Official government-run websites explaining contraception options are a negligible expense, but can make a huge difference for citizens seeking reliable information – and the handful of countries which already boast these scored much better overall. An elite 11 of the 46 countries assessed had a “very good” or “excellent” government-supported website.

MEP Sophie in’t Veld brandishing the atlas at its European Parliament launch on 11th April.
MEP Sophie in’t Veld brandishing the atlas at its European Parliament launch on 11th April.

EPF have certainly gone to rather imaginative lengths in order to spread awareness of this issue: along with the Atlas, the organisation also released a line of “contraception chocolates,” where each chocolate had an intricate design of one of the various contraception methods promoted by the campaign, accompanied with an enticing booklet to inform you of your selection.

That’s one way to get people's’ attention...
That’s one way to get people’s’ attention…

But of course – this booklet sheds no light on the flavour of each chocolate, but focuses rather on the contraception method which it represents. (This would certainly make for an innovative valentines gift.)

EPF Secretary Neil Datta presenting the Atlas and chocolate accompaniment.
EPF Secretary Neil Datta presenting the Atlas and chocolate accompaniment.

But in all seriousness, access to contraception should perhaps be a more pressing concern for governments striving to empower their citizens. And if chocolate is the vessel for which to convey this important message, then so be it! The consensus at the parliamentary launch was that regrettably, every single country analysed in this report has room for improvement. The findings show that for many European countries, sexual and reproductive rights are simply not a priority for the authorities.

Co-chairs of the sexual and reproductive rights think tank, the Guttmacher Institute (Ann M. Starrs and Dr. Alex Ezeh) released the following official statement on Twitter to mark this 50-year milestone:  ‘A broader vision of sexual and reproductive rights is essential to achieving the world’s human rights and development goals.’

But how have governments reacted to this criticism? Andorra scored last place, since contraception is reportedly so hard to come by over there. Especially the emergency contraceptive pill, which was only available with a doctor’s prescription. (As most will realise, this can delay a situation where truly every second counts…) However, since being branded the worst country for family planning care in Europe, the national government has responded positively, and the “morning-after” pill is now available over the counter, in line with the majority of Europe.
Furthermore, in response to this report, Members of Parliament at the Parliamentary Assembly of the Council of Europe tabled the Motion for a Resolution last week, entitled: “Empowering women: promoting access to contraception in Europe”. The process will could take up to 2 years – so it’s no quick fix – but this is definitely a huge step in the right direction.

Let the cold hard truth in this Contraception Atlas be ample motivation for European governments to improve contraception access  – and act a stark reminder that their citizens deserve better when it comes to their reproductive rights!

Check out the complete Contraception Atlas HERE

EPF on Twitter: EPF_Pop_Dev

Contraception Info on Twitter: ContraceptionInfo.eu

Roxanna Azimy
Roxanna is a European affairs writer and communications professional of British and Iranian descent. Having studied French and Spanish at King’s College London, with an MSc in European Studies from LSE, and currently working at the European Parliamentary Forum on Population and Development in the field of human rights and international development, she strives to increase the visibility of ethical and sociocultural issues in Europe. Twitter: @RoxannaYasmin

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