Background Although efforts to reduce high maternal mortality in countries such as Indonesia tend to focus on addressing health risks among pregnant women, family planning has been shown globally to reduce maternal mortality by reducing both total and higher-risk pregnancies. This article assesses past contributions of family planning to the reduction of maternal mortality in Indonesia and the potential future contribution toward achieving the 2030 SDG maternal mortality goal. Methods The study takes advantage of data from long series of population censuses and large-scale surveys that are available in few other low- and middle-income countries. We use the decomposition method suggested by (Matern Child Health J, 16:456–463, 2012) and regression-based policy simulations to estimate the number of maternal deaths averted during 1970–2017 due to contraceptive use and project potential future contributions to the year 2030. Results It is estimated that between 523,885 and 663,146 maternal deaths were averted from 1970 to 2017 due to contraceptive use, a 37.5–43.1% reduction. If the contraceptive prevalence rate (CPR) were to rise from 63% in 2017 to 70% in 2030 and unmet need for family planning were to fall to from 10 to 7%, an additional 34,621–37,186 maternal deaths would be averted, an 18.9–20.0% reduction. A 2030 CPR of 75% and unmet need for family planning of 5% would result in 51,971–54,536 maternal deaths being averted, a 28.4–29.4% reduction. However, the CPR growth rate would have to nearly double the 2000–2017 rate to reach 70% CPR by 2030 and more than triple to reach 75%. Achieving the most ambitious target would still leave the maternal mortality ratio at 125 in 2030 without corresponding improvements in maternal health services. Conclusions Although substantial reductions in maternal mortality between 1970 and 2017 can be attributed to contraceptive use and further contributions to the year 2030 are probable, smaller contributions are likely due to the already relatively high CPR and the challenges that must be overcome to move the CPR significantly higher. The ability of Indonesia to reach the 2030 SDG maternal mortality target of 70 maternal deaths per 100,000 live births will depend primarily upon health system effectiveness in addressing health risks to women once they are pregnant.

BackgroundUnmet need for family planning in the Pacific is among the highest in the world. Better understanding of required investments and associated benefits of increased access to family planning in the Pacific may assist prioritisation and funding.MethodsWe modelled the costs and associated health, demographic and economic impacts of reducing unmet need for family planning between 2010–2025 in Vanuatu and the Solomon Islands. Baseline data were obtained from census reports, Demographic and Health Surveys, and UN agency reports. Using a demographic modelling program we compared a scenario of “no change in unmet need” with two distinct scenarios: 1) all family planning needs met by 2020; and, 2) all needs met by 2050.ResultsMeeting family planning needs by 2020 would increase prevalence of modern contraception in 2025 from 36.8 to 65.5% in Vanuatu and 28.5 to 37.6% in the Solomon Islands. Between 2010–2025 the average annual number of unintended pregnancies would decline by 68% in Vanuatu and 50% in the Solomon Islands, and high-risk births would fall by more than 20%, averting 2,573 maternal and infant deaths. Total fertility rates would fall from 4.1 to 2.2 in Vanuatu and 3.5 in the Solomon Islands, contributing to slowed population growth and lower dependency ratios. The direct cost of reducing unmet need by 2020 was estimated to be $5.19 million for Vanuatu and $3.36 million for the Solomon Islands between 2010–2025. Preventing unintended pregnancies would save $112 million in health and education expenditure.ConclusionsIn small island developing states such as Vanuatu and the Solomon Islands, increasing investment in family planning would contribute to improved maternal and infant outcomes and substantial public sector savings.

The COVID-19 pandemic presents unprecedented scenarios and challenges for programme managers. Health systems have been overwhelmed with the increasing number of cases, and the focus has shifted to saving lives. Furthermore, lockdowns have adversely affected the production and distribution of products and availability of commodities, while the restrictions in movement have limited individuals’ access to services. This article analyses the possible consequences of the pandemic on the rights of individuals and couples and endeavours to provide justifications for continued national commitment and investments in family planning, especially during these challenging times. As sexual and reproductive health and reproductive rights are fundamental to achieving the Sustainable Development Goals, it is critical to focus on ensuring rights-based family planning, because it is intimately associated with fundamental human rights, addresses the issue of equity, equality and universality and provides valid and practical solutions to the vital economic quagmire that has unfolded as a consequence of this global crisis.

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Procedures for selecting students who are most likely to succeed academically in the initial year at an innovative medical school deserve further study and probably should include both academic performance and non-academic attributes.