Showing posts from category development.
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The Future of Family Planning Funding
›November 3, 2009 // By Kayly Ober“Family planning is one of the biggest success stories of development cooperation,” said Bert Koenders, Dutch Minister for Development Cooperation, via video at a Wilson Center roundtable discussion on the future of family planning funding. Koenders was followed by representatives of three of the field’s largest donors, Musimbi Kanyoro, director of the David and Lucile Packard Foundation’s Population and Reproductive Health Program; José “Oying” Rimon, senior program officer for Global Health Policy and Advocacy at the Bill and Melinda Gates Foundation; and Scott Radloff, director of USAID’s Office of Population and Reproductive Health.
Celebrating Family Planning Success
Radloff said his organization has “success stories in every region of the world.” USAID’s family planning and reproductive health programs have shown positive gains over the last few years, especially in Latin America where “most countries have graduated from bilateral assistance or are in the process of graduating,” he added.
Rimon lauded the strides made within developing societies where contraceptive use has become the norm. Since the 1960s, the contraceptive prevalence rate in developing countries has increased from ten per cent to about 55 per cent; which, in turn, has prompted the total fertility rate to fall from fall from six children to about three in the same time frame, he said.
Rimon was even more hopeful about the future of the field, as he claimed that “the decline for family planning/reproductive health resources, which has been happening since the mid 1990s, has been reversed.” Since 2006, the amount of resources allocated to family planning has steadily risen.
Facing Current Challenges
While funding for family planning has been gaining momentum in recent years, it still faces enormous obstacles. “The biggest challenge,” said Koenders, is investing in youth—more than half the world’s population. “We should acknowledge the needs and rights of adolescents and young people—married and unmarried—in the field of sexual and reproductive health,” he said.
Koenders also stressed the need to find common strategies to “counterbalance…growing opposition to sexual and reproductive health and rights,” as it is “not only about abortion.” The reproductive rights of women and girls are “closely linked to the deeply rooted imbalance in power relations between women and men, and the increasing sexual violence against women.”
Nowhere is this challenge more acutely observed than in “the poorest countries of the world, in Africa and South Asia,” said Radloff. If “you look across the countries of Africa, the countries that are lagging behind in terms of increasing contraceptive use and availability of contraceptives, it’s largely Francophone West Africa.”
By 2050, Africa’s population is projected to double. “India would be around 1.7 billion and stabilizing. China would be around 1.5 billion stabilized. And Africa would be at two billion and still growing, in some of the most fragile countries which have very serious economic and development issues,” said Rimon.
Kanyoro said the Packard Foundation will “take a good look at what is happening in sub-Saharan Africa so that we can be able to address some of those areas that are the weakest in the link.” The foundation’s plans include high-level advocacy “to make sure that these messages go across not just one country but several countries and even, if possible, benefit from inter-regional work.”
Opportunities in the Obama Era“I’m an optimist,” said Rimon, who sees opportunities amid these myriad challenges. Not only has the long decline in funding being reversed, but there is a “major trend towards more effective and better policies, and I think here in the U.S. we have seen that: rescission of the Mexico City policy, the new guidelines in PEPFAR, and some with the new changes and policies that are also seen in Europe.”
Radloff agreed that USAID has seen “positive engagement of the administration on reaffirming U.S. support for the MDGs, including MDG 5b and improving access to reproductive health information and services and reaffirming support for the ICPD [International Conference on Population and Development] program of action.” He also found it encouraging that “many bilateral donors, multilateral donors, and foundations are now very interested in working closely with USAID in advancing these programs…the environment, in general, is much better than it’s been at least since 1992, and perhaps even ever.”
“We have, in addition to having strong support in our administration, both a president and a secretary of state that speak out passionately about the need to reduce unintended pregnancies and to make family planning more widely available,” Radloff continued.
“We have family planning and reproductive health included as a priority under the Global Health Initiative which was announced by the President back in May. That initiative encompasses family planning, reproductive health, maternal-child health, and various infectious diseases, including HIV, TB, and malaria. The fact that he placed these under a single initiative, rather than creating two new initiatives for family planning and maternal-child health signals his interest in ensuring that we integrate these programs to the extent practical.”
Sustaining Progress Over the Long Term“I come from Africa, and I know that we can literally grow anything. We can have every small project. But the really big difference is when those problems are brought to big scale,” said Kanyoro. Developing the capacity of local leaders—particularly women—is necessary to make sustainable gains in the field, she said, as well as collaboration between government donors and private funders to drive innovation. “I think private money is really good for paving the way, but I think that private money and government money [are] really what makes the biggest difference in scale.”
Radloff agreed that we should not view the sectors “as independent of each other, but interrelated.” Governments should partner with the private sector to “develop strategies that incorporate the contributions of private sector and public sector, and acts in ways that improves the environment for private sector investments and involvement,” he said. Such collaboration will lead to success: “Almost uniformly, where we graduate countries, is where there is a strong private sector providing services to those who can pay.” -
VIDEO: Scott Radloff on Family Planning Under the Obama Administration
›November 3, 2009 // By Wilson Center Staff“We have a new administration that places a priority on family planning and reproductive health,” Scott Radloff, director of the Office of Population and Reproductive Health at the U.S. Agency for International Development (USAID), tells ECSP Director Geoff Dabelko after a discussion on the future of family planning at the Woodrow Wilson Center.
The Obama administration has rescinded the Mexico City Policy and announced an expanded Global Health Initiative. Radloff credits these new policies with opening opportunities “to work with key organizations in international family planning.”
The new family planning and reproductive health programs will address the large unmet need for family planning services in the developing world, particularly in Africa and South Asia. New programs will focus on reaching people in rural communities far from health clinics. “We expect to have great success,” he said. -
Missives From Marrakech: Growing and Slowing, and a Letter From the King
›October 5, 2009 // By Gib ClarkeHere in Morocco, where I am attending the IUSSP conference on population, if you never went to elementary school or if you married at a young age, you are likely to have more children.
A Bangladeshi couple is more likely to have a third child if they have 0-1 sons, but a European couple is increasingly likely to prefer daughters because they take better care of their aging parents.
Globally, a forthcoming Harvard study shows that the “Reproductive Health Laws Index”—which includes the legal framework governing abortion, condoms, IUDs, and birth control pills—can predict fertility (more liberal laws = fewer children) and potentially increase female participation in the labor force.
Such causes of population growth are favorite topics for demographers and family planning experts here at the conference, and were quite well attended. However, perhaps due to the large number of European attendees, the panels on this popular topic were empty in comparison to those examining aging, fertility decline, and migration—issues at the forefront of European policymakers’ agendas.
A Message From His Majesty
“One of the characteristic features of our population policy stems from our firm belief that [its] impact … cannot be determined in isolation from economic, social, cultural and political factors,” wrote Morocco’s King Mohammed VI in a welcome letter delivered to the conference, which also discussed aging, climate change, food security,natural resource scarcity, the economic crisis, and growing levels of income inequality.
Morocco is taking steps to tackle this complicated set of problems. The government has launched a National Initiative for Human Development to fight poverty and social inequalities, and help Morocco meet the Millennium Development Goals (MDGs). He also notes that the country’s “political and social reforms aimed at increasing the scope of democratic participation and ensuring the advancement of women.”
Like all leaders, Morocco’s will be measured not by his words—eloquent as these may be—but by his deeds and the country’s progress. Morocco has some work to do to reach the MDGs and other social and economic goals. -
Dutch Minister for Development Cooperation Bert Koenders on the Future of Family Planning
›September 22, 2009 // By Gib Clarke“I think everybody…will agree that family planning is one of the biggest success stories of development cooperation. I also consider the paradigm shift in this field from top-down family planning (FP) to programs of reproductive health (RH) and rights for couples and individuals adopted in Cairo in 1994 to be a success story,” said Bert Koenders, the Dutch Minister for Development Cooperation, in a statement prepared for a roundtable discussion at the Wilson Center on future strategies in FP and RH.
Looking beyond the successes of the past, Koenders identifies a series of opportunities and challenges facing the RH community. He cites as the first opportunity the potential to “join forces” with the United States to meet Millennium Development Goal #5 (which focuses on maternal, sexual, and reproductive health, and family planning). He calls MDG 5 “the mother of all MDGs” and says that if it is not met, “then the other MDGs will not be attained either. It is smart economics to invest in MDG 5.” Other opportunities include public-private partnerships and the “growing awareness” in developed and developing countries alike.
The challenges, however, are significant. Youth, he notes, account for half of the world’s population and face barriers in access to reproductive health information and commodities. To overcome these barriers, we must first identify what adolescents and unmarried women and couples need, and recognize their rights to the same quality services as older and married women and couples. Koenders also says there is a growing opposition in many parts of the world to sexual and reproductive health and rights, and that programs must address this in order to be successful.
The roundtable discussion, to be held on September 22 at the Wilson Center, features Musimbi Kanyoro of the Packard Foundation, José “Oying” Rimon of the Gates Foundation, and Scott Radloff of the U.S. Agency for International Development. -
Combating Climate Change with Condoms
›September 17, 2009 // By Meaghan ParkerMountains of reports and studies have proposed expensive technological responses to climate change. But the scientists and policymakers working to protect the planet may have overlooked one of the easiest, cheapest ways to reduce carbon emissions: contraception.
A recent study commissioned by the Optimum Population Trust estimates contraception would be almost five times cheaper than conventional green technologies. “Each $7 spent on basic family planning would reduce CO2 emissions by more than one ton,” researchers conclude, while low-carbon technologies would add an extra $25 per ton.
Slowing population growth could not only cut emissions, but also help poor families in vulnerable areas adapt to the impacts of climate change, such as land degradation, drought, and loss of food security. However, while governments of the poorest countries often cite population growth as a factor in environmental catastrophes, few address family planning as part of their adaptation strategies, IPS reports from a recent NGO forum in Berlin.
Enabling women to plan their families is not only climate-friendly, it’s also right. Currently, more than 100 million women worldwide want—and can’t get—modern methods of family planning. Better reproductive health care is “an end in itself,” with climate mitigation being the “side effect,” rather than the primary goal, Barbara Crossette writes in The Nation.
While many policymakers shy away from getting population in their environment, Secretary of State Hillary Clinton recently said, “It’s rather odd to talk about climate change and what we must do to stop and prevent the ill effects without talking about population and family planning.” At the Berlin forum, UNDP Administrator Helen Clark linked the goals of education, equality, and environmental sustainability in a “virtuous cycle.”
As the world’s largest per-capita emitter, the United States has a special obligation to examine its growth and consumption patterns. While the lives of Bangladesh’s 140 million people are acutely threatened by climate change, each new U.S. child and its descendants will be responsible for 160 times the carbon emissions of a Bangladeshi infant according to Oregon State University researchers writing in Global Environmental Change.
Unfortunately, condoms are unlikely to become heroes at Copenhagen. Some populous developing countries like India object to bringing population into the climate change debate without more focus on reducing consumption in developed countries. The Washington Post called the connection “unpopular,” and compared its odds to another “long shot”: geoengineering. Anti-contraceptive groups, development “silos,” sexism, and old-fashioned squeamishness are also formidable barriers to an open and nuanced discussion of how family planning can contribute to mitigation and adaptation.
Too bad, because as Suzanne Petroni writes in the latest issue of the Environmental Change and Security Program Report, “A careful discussion of the ways in which voluntary family planning can further individual rights, community development, and, to some extent, climate change mitigation, could increase awareness not only of the outsized contribution of developed nations to global emissions, but also of their appropriate role in the global community.”
A shorter version of this post will appear in the October issue of Centerpoint.
Photo courtesy Flickr user OsakaSteve. -
Weekly Reading
›In an Economist.com debate on population growth between John Seager of Population Connection and Michael Lind of the New America Foundation, Seager argues that rapid population growth is “the source of many of the world’s—especially the poor world’s—woes,” as it accelerates environmental degradation and “undermines both security and development.” On the other hand, Lind counters that “countries are not poor because they have too many people,” and asserts that “technology and increased efficiency have refuted what looks like imminent resource exhaustion.”
In Foreign Policy, David J. Rothkopf contends that actions to mitigate climate change—though necessary to avoid very serious consequences—could subsequently spur trade wars, destabilize petro-states, and exacerbate conflict over water and newly important mineral resources (including lithium).
The International Crisis Group (ICG) reports that “the exploitation of oil has contributed greatly to the deterioration of governance in Chad and to a succession of rebellions and political crises” since construction of the World Bank-financed Chad-Cameroon pipeline was completed in 2003. Chad must reform its management of oil resources in order to avoid further impoverishment and destabilization, ICG advises.
The Royal Society and the Institution of Mechanical Engineers (IME)—both based in the United Kingdom—released independent reports on geoengineering the climate. While calling reduction of greenhouse gas emissions “the safest and most predictable method of moderating climate change,” the Royal Society recommends that governments and international experts look into three techniques with the most potential: CO2 capture from ambient air, enhanced weathering, and land use and afforestation. The IME identified artificial trees, algae-coated buildings, and reflective buildings as the most promising alternatives. “Geo-engineering is no silver bullet, it just buys us time,” IME’s Tim Fox told the Guardian.
In “Securing America’s Future: Enhancing Our National Security by Reducing Oil Dependence and Environmental Damage,” the Center for American Progress (CAP) argues that unless the United States switches to other fuels, it “will become more invested in the volatile Middle East, more dependent on corrupt and unsavory regimes, and more involved with politically unstable countries. In fact, it may be forced to choose between maintaining an effective foreign policy or a consistent energy supply.”
The Chinese government is “drawing up plans to prohibit or restrict exports of rare earth metals that are produced only in China and play a vital role in cutting edge technology, from hybrid cars and catalytic converters, to superconductors, and precision-guided weapons,” The Telegraph relates. The move could send other countries scrambling to find replacement sources.
In studying the vulnerability of South Africa’s agricultural sector to climate change, the International Food Policy Research Institute finds that “the regions most vulnerable to climate change and variability also have a higher capacity to adapt to climate change…[and that] vulnerability to climate change and variability is intrinsically linked with social and economic development.” South African policymakers must “integrate adaptation measures into sustainable development strategies,” the group explains. -
Half the Sky, All the Promise: The Personal is Political in NYT Special Issue
›“The world is awakening to a powerful truth: Women and girls aren’t the problem; they’re the solution,” write Nicholas Kristof and Sheryl WuDunn in the lead article of this Sunday’s The New York Times Magazine.
In this special issue devoted to “Saving the World’s Women,” five articles document global failures and personal horrors, but also offer forward-looking solutions from the individual to the institutional. As the subtitle says—“changing the lives of women and girls in the developing world can change everything”— this vital effort can help us not only improve the lives of women, but meet larger goals including international security, global health, and economic development.
In “The Women’s Crusade,” Pulitzer Prize-winners Kristof and WuDunn, whose new book Half the Sky will be published on September 8, outline the ways in which the world’s women and girls are abused, neglected, and overlooked. They use devastating data to detail how women around the world suffer from lack of education, maternal mortality, sexual violence, trafficking, and economic and political oppression, and then bring these figures to life with women’s personal stories.
They argue that elevating women is not a “soft” issue, but rather has the power to transform economies and address security threats—a point echoed in an interview with Hillary Clinton, in which she calls women and girls “a core factor in our foreign policy.”
“I happen to believe that the transformation of women’s roles is the last great impediment to universal progress,” says Clinton, long an informed and passionate advocate for global women’s issues. She encouraged President Obama to create a new ambassadorship for global women’s issues, and filled the opening with Melanne Verveer, a respected activist and former head of the Vital Voices Global Partnership.
Clinton most strongly emphasizes the connection between women’s issues and national security, calling it “an absolute link”: “If you look at where we are fighting terrorism, there is a connection to groups that are making a stand against modernity, and that is most evident in their treatment of women.” She goes so far as to agree that spending taxpayer money on education and healthcare for girls and women in Pakistan would be more effective than military aid to the country.
“A woman who is safe enough in her own life to invest in her children and see them go to school is not going to have as many children. The resource battles over water and land will be diminished,” she says. “And it’s an issue of how we take hard power and soft power, so called, and use it to advance not just American ends but, in advancing global progress, we are making the world safer for our own children.”
Also in the magazine:
The New York Times’ website adds a slide show of Katy Grannan’s portraits of women in South Asia and Africa, and launches a contest soliciting personal stories from the field. Submit your photos and blog posts to Kristof’s blog by September 19.- Dexter Filkins investigates the acid attacks on girl students in Afghanistan in the horrifyingly vivid storytelling he displayed in his best-seller, The Forever War.
- Lisa Belkin takes note of an emerging generation of female philanthropists using their money to “deliberately and systematically to aid women in need,” spurred by the Hunt sisters’ “Women Moving Millions” campaign.
- Tina Rosenberg describes how sex-selective abortion and inadequate health care for young girls has led to a “daughter deficit” in China and India, where, somewhat paradoxically, “development can worsen, not improve, traditional discrimination.”
- Africa’s first female President, Liberia’s Ellen Johnson-Sirleaf, tells NYT that if women ran the world, it would be “better, safer and more productive.”
To me, such vital voices are the most powerful, proving that the personal is political. The quotes in the lead article from academic studies, local NGO personnel, and women themselves map the way forward:- “When women command greater power, child health and nutrition improves” – Esther Duflo of MIT, on micro-finance.
- “Girls are just as good as boys” – An unidentified man who once beat his wife for not having sons, but changed his mind when a micro-loan turned her into the family breadwinner.
- “Gender inequality hurts economic growth” – Goldman Sachs, Global Economics Paper, 2008
- “I can’t talk about my children’s education when I’m not educated myself … If I educate myself, then I can educate my children” – Terarai Trent, a Zimbabwean woman now completing a PhD in the United States.
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How Family Planning Meets Development Goals
›“Knowing is not enough; you must act and let your government know that family planning is a right and saves lives,” said Maurice Middleberg of the Global Health Council at a recent event in Chapel Hill.
The other panelists at “How Can Family Planning Efforts Help Us Achieve the Millennium Development Goals?” (Dr. Martha Carlough of UNC, Dr. Ward Cates of Family Health International, and Pape Gaye of IntraHealth International) all provided compelling statistics demonstrating the effectiveness of family planning as an intervention that addresses the Millennium Development Goals (MDGs).
MDGs 4, 5, and 6 – reducing child mortality; improving maternal health; and combating HIV/AIDS, malaria, and other diseases, respectively – all have obvious connections to health and woman’s reproductive health. An unmet need for family planning, which is measured as the percentage of women of reproductive age who desire to space or limit their births but are not using contraception, can undermine the achievement of these goals.
For example, very early motherhood not only increases the risk of dying in childbirth, it also jeopardizes the well-being of surviving mothers—and their children, too. A child born to an adolescent mother has a greater risk of dying in infancy or childhood.
“Contraception is the best-kept secret in HIV prevention,” said Dr. Cates, who cited research that found that “current contraceptive use in sub-Saharan Africa prevents an estimated 577,200 unplanned births to HIV-infected mothers” and thus prevents the birth of an estimated 173,000 HIV-infected infants each year.
Family planning can help meet the other MDGs, including ending poverty and hunger (Goal 1); providing universal primary education (Goal 2); and promoting gender equity (Goal 3). Young mothers frequently miss out on education and socio-economic opportunities. Being able to make their own decisions about family planning and reproductive health can empower women and improve gender equity. When women are given equal opportunities for education, health, and employment, they are more likely to invest in the education and care of their children. This helps them break the cycle of poverty, hunger, and disease.
Although the MDGS don’t include any formal targets for sexual and reproductive health, the UN Millennium Project has stated that the MDGs cannot be achieved in low-income countries without access to sexual and reproductive health services, including family planning. The panelists agreed that family planning is a cost-effective intervention that provides broader positive benefits for development.
But the real strength of their presentations lay in the personal stories behind the statistics. Middleberg closed the discussion with a story about a woman in Latin America who told him that she loves her husband but was afraid of him every time he touched her. Now, after having undergone sterilization, she no longer worries and can love her husband with no fear of becoming pregnant.
A mother of six interviewed in a 2009 news article about the Philippines’ new family planning bill said, “How can one keep on having children? We don’t earn enough to feed them, much less send them to school.” New York Times columnist Nicholas Kristof interviews a Haitian woman with 10 children in a dramatic video interview, “Saving Lives with Family Planning.”
Underlying all of these facts and stories is the belief that one’s health and well-being, including access to family planning, is a right. But as Middleberg said, believing is not enough.
EngenderHealth, an international reproductive health organization working to improve the quality of health care in the world’s poorest communities, is asking Americans to create a video explaining why we should care about international family planning. Contribute your thoughts on YouTube’s Video Volunteers project.
Lisa Basalla, MPH, is a research associate with the Carolina Population Center. She graduated from Case Western Reserve University with a MPH focusing on reproductive and adolescent health. She has worked with Johns Hopkins University’s Center for Communications Programs on its reproductive health knowledge management project as well as a HIV-prevention behavior change communication project in Malawi.
Photo: A billboard promoting family planning in Phnom Pehn, Cambodia. Courtesy flickr user olerousing.
Radloff said his organization has “success stories in every region of the world.” USAID’s 
“I’m an optimist,” said Rimon, who sees opportunities amid these myriad challenges. Not only has the long decline in funding being reversed, but there is a “major trend towards more effective and better policies, and I think here in the U.S. we have seen that: 
“I come from Africa, and I know that we can literally grow anything. We can have every small project. But the really big difference is when those problems are brought to big scale,” said Kanyoro. Developing the capacity of local leaders—particularly women—is necessary to make sustainable gains in the field, she said, as well as collaboration between government donors and private funders to drive innovation. “I think private money is really good for paving the way, but I think that private money and government money [are] really what makes the biggest difference in scale.”
Here in Morocco, where I am attending the 
Mountains of reports and studies have proposed expensive technological responses to climate change. But the scientists and policymakers working to protect the planet may have overlooked one of the easiest, cheapest ways to reduce carbon emissions: contraception.
“Knowing is not enough; you must act and let your government know that family planning is a right and saves lives,” said Maurice Middleberg of the Global Health Council at a recent 
