Colombia launches large-scale birth control effort

Since a law was passed guaranteeing all citizens access to free birth control drugs and procedures, clinics have opened, especially in impoverished areas where teen pregnancy rates are high.

Reporting from Cali, Colombia — When 80 women from the poor Agua Blanca district of Cali got free contraceptive implants last week, they became the first local beneficiaries of one of Latin America's most liberal reproductive rights laws.

Colombia's Congress this fall passed a law guaranteeing all citizens access to free contraceptive drugs and surgical procedures, including vasectomies and tubal ligations.

The benefits are only now filtering down to shanty neighborhoods such as this one in northeast Cali, where birthrates are among the nation's highest, particularly among teenagers, health officials here said.

"The law is a real accomplishment and is already creating a lot of demand," psychologist Maribel Murillo said in her office at the Diamante health clinic, not far from shacks made of boards and plastic sheeting. "It will advance the sexual rights of women of little means, many of whom already have several children."

The law, which had been proposed for years, got a decisive push from new President Juan Manuel Santos, who after taking office in August put it at the top of his legislative agenda.

Activists hail the legislation as a progressive measure for reproductive rights, part of a general liberalizing trend in this largely Roman Catholic nation that has included recent rulings by the constitutional court removing penalties for performing abortions.

But Santos may have had pressing social and economic problems in mind in pushing for the new law.

Colombia's healthcare system is on the verge of collapse because of the constitutional guarantees of universal care, as funding from tax and other government revenue falls short. Because maternity and neonatal care are among the healthcare system's fastest-growing costs, free contraceptive medicine and surgeries could end up saving the government money.

Moreover, Colombia's birthrate, which overall has dropped by nearly two-thirds since 1950, has risen recently among teenagers, said Diva Moreno, an advisor to the Social Protection Ministry in Bogota, the capital. Studies show that adolescent pregnancies feed a vicious cycle of social problems, including poverty, violence and low levels of education.