Iran: the health cost of a political order
This summer, the Iranian parliament began to pass laws for a U turn from a successful birth control policy1 (figure) to a birth encouragement policy that bans permanent sterilisation for the general population and punishes those who prepare or encourage contraception, even in the media. This decision has important sociomedical implications and needs careful planning-no pilot study exists on the effects of the new policy on the diverse population of Iran of 77 million people.
Differences in population growth between states or ethnic groups can affect the balance of power between political actors nationally and internationally.2, 3 Although the political effects of a birth encouragement policy is the main concern of Iranian politicians, the policy will have many sociomedical effects. First, the new policy will increase unintended pregnancies, which are a threat to the physical and mental health of women and children. Results of a meta-analysis4 show that one third of pregnancies in Iran are unwanted. This fact shows the necessity of education and contraceptive use. Second, if present family planning services are stopped or changed, including education and free condom distribution, HIV and other sexually transmitted diseases could more easily spread, especially between young people.5 Third, the cost of contraceptives-which is already high because of international sanctions that target the Iranian economy-will increase. This increased cost could lead to a rise in birth rates, particularly in rural and poor populations, which form a large part of Iran’s population. The country’s economic situation might therefore worsen, adding to existing issues of high inflation and unemployment rates, at 39% and 15% in 2013, respectively.
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