Minister Bangura speaks at a press conference (R) while Dr. Amy Tsui (L) listens

What happens when a developing country has limited funds for health care? Where does family planning fit as a priority? This question came to the forefront at a press conference today during the International Conference on Family Planning (ICFP).

Advocates of family planning constantly promote family planning policies to governments as ‘best buys.’ By investing in family planning and preventing unwanted births and related mortalities and morbidities, family planning can yield a cost savings of $1.5 billion, said Monica Kerrigan of the Bill and Melinda Gates Foundation. This savings can be invested in future generations.

But Sierra Leone’s Minister of Health and Sanitation, Zainab Hawa Bangura, said that it’s not such a clear-cut matter. One journalist asked her if the benefits of family planning are so obvious, why aren’t governments investing more in it.

Minister Bangura responded with a question of her own: “When you only have 5 percent or 10 percent of the money you need to run a health sector, where do you want to spend it? Where do you want to spend the limited amount of money that you have?”

She urged the room of journalists to imagine over-crowded health facilities full of sick women and children. Should you not save them? Should you not spend money to give them life-saving medicines, surgeries, and vaccines? Or should you spend that money instead on family planning to prevent future generations from experiencing the same health outcome?

Family planning is no doubt an effective, long-term solution, Bangura said, but Sierra Leone’s priority now is building enough health facilities across the country. Currently Sierra Leone only has half the facilities it needs, and she said it’s extremely important to build more clinics and hire more staff.

“Once maternal and child mortality rates are stabilized, then we can focus on long-term prevention like family planning,” Bangura said.

The choice is difficult, and Bangura said she wished she had more funds.

“If I had all the money I needed, I would make sure all women in Sierra Leone would have family planning,” she said. “Until then, I have to choose and prioritize.”