Showing posts from category global health.
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Celebrating Ordinary Women Doing Extraordinary Things to Improve Gender Equality and Maternal Health Worldwide
›As coordinator of one of the few forums dedicated solely to maternal and reproductive health in Washington, D.C., I am particularly excited about this year’s 100th anniversary of International Women’s Day. This day commemorates ordinary women doing extraordinary things and acknowledges both the progress made and barriers still faced by women worldwide.
“When it comes to the boardroom meetings, government sessions, peace negotiations, and other assemblies where crucial decisions are made in the world, women are too often absent,” said Secretary of State Hillary Clinton during her remarks for International Women’s Day. “It is clear that more work needs to be done to consolidate our gains and to keep momentum moving forward.” [Video Below]
For mothers worldwide, some momentum has indeed been gained: Maternal mortality rates dropped from 526,000 a year in 1980 to 342,900 in 2008, according to a report by the Institute of Health Metrics and Evaluation at the University of Washington. In September of last year, a group of international leaders – including the UN and other multilateral institutions, donors, the business community, and NGOs – launched the “Global Strategy for Women and Children’s Health” and committed $40 billion to save the lives of 16 million women and children in developing countries.
At the sixth meeting of the Wilson Center’s Advancing Policy Dialogue on Maternal Health Series, Mayra Buvinic, sector director of the World Bank’s gender and development group, said: “Investing in women and girls is the right thing to do. It is not only fair for gender equality, but it is smart economics.” She said the World Bank has found that empowering women allows families to better endure economic crises and leads to better futures for their children as well.“When women have better education and health, mothers have greater household decision-making power and prioritize the well-being of their children,” said Buvinic. “In return, children have better educational attainment and are productive adults, building long-term economic growth.”
However, increased investment will only pay off when money is translated into action and stakeholders are held accountable for empowering women.
Since the inauguration of International Women’s Day 100 years ago, the low status of women in many parts of the world has remained relatively unchanged. Many women are still subject to male-dominated values that preclude them from making basic decisions about “who to marry, when to marry, when to have children, and how many children to have,” said Nafis Sadik, special envoy of the UN Secretary-General for HIV/AIDS, in an interview with the Population Reference Bureau. To change this, international development strategies need to prioritize improving gender equality, women’s status, and women’s voice in the political process.
I am grateful to be working in collaboration with extraordinary institutions such as the Maternal Health Task Force (MHTF) and United Nations Population Fund (UNFPA) who take real steps every day to help improve the lives of women and girls. In collaboration with these institutions, the Wilson Center’s Global Health Initiative is please to announce that it will partner with the African Population Health Research Center in Kenya to co-host a three-part dialogue series with local, regional, and national decision-makers on effective maternal health policies and programs. These in-country dialogue meetings will create a platform for field workers, policymakers, program managers, media, and donors to share research, disseminate lessons learned, and address concerns related to policy, institutional, and organizational capacity building for improved maternal health outcomes.
It is our goal that programs like these will continue to highlight neglected maternal health and issues and galvanize the community everyday – and not just on International Women’s Day.
Sources: Population Reference Bureau, UN, UN Population Fund, U.S. State Department.
Photo Credit: Afghan girl, courtesy of flickr user U.S Embassy Kabul Afghanistan, and Secretary Clinton’s video address courtesy of the U.S. State Department. -
What’s Behind Iraq’s Day of Rage? It’s Pretty Basic
›March 4, 2011 // By Schuyler NullIraq’s “Day of Rage” – a phenomenon that has swept the Middle East since Tunisia’s “Jasmine Revolution” – reportedly claimed the lives of nearly 20 people last week. But though the protests may have been inspired by the current broader movement in the region, they are also a symptom of long-standing grievances ordinary Iraqis have had with their government since the American invasion, including lack of public services like access to clean water and especially, reliable electricity.
While these protests alone are unlikely to lead to revolution, they reveal basic livelihood challenges that neither the United States nor the Maliki government have effectively addressed.
The protests in Baghdad and more than 10 other cities were the largest since last summer, when demonstrations over access to electricity led to the death of two protestors in Basra. The New Security Beat spoke to Iraq’s first Minister of the Environment, Mishkat Al Moumin, after those protests to ask her about the lack of services and Iraq’s other non-security challenges, including water security, women’s empowerment, and demographics. She said that decentralizing decision-making power might help alleviate pressure on the government and provide more effective local services:Enacting policies at the local level establishes a sense of ownership among local communities and provides them with an incentive to protect their environmental resources. Moreover, it provides a better opportunity to involve the main stakeholders in policymaking.
Frederick Burkle, senior public policy scholar at the Wilson Center and a senior fellow of the Harvard Humanitarian Initiative at the Harvard School of Public Health, recently cited the military’s failure to restore services, specifically public health services in Iraq, as something the State Department and USAID should seize on to justify the end of “militarized aid.” He pointed out that a 2004 joint report by the Iraqi Ministry of Health and Red Cross found more death and illness was due to the country’s decimated public health infrastructure and social protections than to the violence of war:These indirect deaths from war are preventable but require attention from the occupying powers to the invaded country’s declining public health, social, and physical protections. Iraqis were well aware of this deficiency, and the United States’ lack of attention to the matter led to the loss of lasting trust.
For more on Iraq, be sure to also check out The New Security Beat’s interview with Steve Lonergan, former head of Canada-Iraq Marshlands Initiative, on the state of the southern marshes and their potential for peacemaking.
Sources: Foreign Affairs, The New York Times.
Photo Credit: Adapted from “Tangle of electrical wires in Baghdad,” courtesy of flickr user News Hour (PBS News Hour – Larisa Epatko). -
Joan Castro on Integrated Population and Coastal Resource Management in the Southern Philippines
›In the southern Philippines, the innovative IPOPCORM program “worked in areas where there is high…marine biodiversity, high population, and high population momentum, which means…about 40 percent of the population are 15 years and below,” Joan Castro told ECSP in this interview. Castro, the executive vice president of PATH Foundation Philippines, Inc., recently spoke at the Wilson Center on the state of integrated development efforts in her country and elsewhere.
From 2000-2006, IPOPCORM (which stands for “integrated population and coastal resource management”) sought to integrate population, health, and environment (PHE) development efforts in Philippine communities. They had four primary objectives, said Castro: 1) improve the reproductive health of the community members; 2) improve management of the coastal resources; 3) increase knowledge of the linkages between population, health, and the environment; and 4) increase the capacity of community leaders to advocate for these links.
“The aspect of livelihoods was very essential,” said Castro, especially for empowering women in the communities. Through family planning services and micro-credit finance initiatives, women were able to better space their pregnancies and contribute to household incomes, she said. In addition, by establishing locally managed, marine protected areas, IPOPCORM increased the protection of high biodiversity zones and improved the likelihood that there will be enough fish to feed future generations.
The “Pop Audio” series is also available as podcasts on iTunes. -
QDDR Coverage Wrap-up: Institutional Shifts, Development-as-Security, Women’s Empowerment, and Complex New Threats
›February 23, 2011 // By Schuyler NullSomewhat lost in the wake of turmoil in the Middle East and the budget battle in Congress has been the State Department’s most aggressive attempt yet to reshape itself for the dynamic foreign policy challenges of the 21st century.
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USAID’s Role in National Security: Development Matters and It’s Cheaper Than You Think
›February 22, 2011 // By Ramona Godbole“Development is not and cannot be a sideshow,” said U.S. Agency for International Development (USAID) head Rajiv Shah, in a speech at the Center for Global Development on January 19. This year marks the 50th anniversary of USAID, and there are some promising changes in the works for the agency as it transforms itself into a “modern development enterprise.”
Over the past year, the Obama administration launched the Quadrennial Diplomacy and Development Review (the QDDR – see our full set of reviews on this first-of-its-kind document), Feed the Future, and the Global Health Initiative. In accordance with these new strategic initiatives, USAID has launched USAID Forward to implement a series of reforms to strengthen its capacity to meet the world’s development challenges effectively and efficiently. The agency has tried to foster a “spirit of innovation, science, technology, and smarter strategic thinking to each of [its] areas of core focus: gender, education, water, and climate,” said Shah. In his speech at CGD, he announced a new, re-worked evaluation policy and outlined a number of cost-saving actions, including graduating countries that no longer need aid, promoting procurement and contracting reform, and eliminating some costly senior positions in the agency.
Value to Shareholders
Moving forward, USAID is working to further reduce inefficiencies and increase transparency, said Shah, and is “focused on delivering the highest possible value for our shareholders – the American people and the congressional leaders who represent them.” He added that “like an enterprise, we’re relentlessly focused on delivering results and learning from success and failure.”
These are exciting changes for the development community. But, if Congress significantly cuts funding, by, for example, passing a plan similar to one endorsed by 165 Republican representatives a few weeks ago, these changes might not see the light of day – the plan proposed to save $1.39 billion by eliminating agency operating expenses. Putting that in perspective, the USAID operating budget for the past fiscal year was $1.69 billion. (Strangely, while the plan all but eliminates the agency that administers them, it does little to cut actual outgoing foreign assistance monies.)
The plan, however, may reflect the views of much of the American public. A World Public Opinion poll showed that Americans believe the government spends up to 25 percent of its budget on foreign aid and want to cut back to 10 percent, while in fact, aid represents just one percent of the federal budget (compared with more than 20 percent for defense).
What the proposed plan fails to take into account is development’s role in promoting peace, security, and prosperity globally. Said Shah at CGD, “as the President and the Secretaries of State, Treasury, and Defense have all made abundantly clear, development is as critical to our economic prospects and our national security as diplomacy and defense.”
A More Efficient Investment
Shah elaborated on this idea in an interview with Foreign Policy last month: “In the military they call us a high-value, low-density partner because we are of high value to the national security mission but there aren’t enough of us and we don’t have enough capability,” he said. “This is actually a much, much, much more efficient investment than sending in our troops, not even counting the tremendous risk to American lives when we have to do that.”
Chad Briggs, a professor for the USAF Air University, pointed out the multiple benefits to the military that increased State and USAID agency in the field could provide in his review of the QDDR:Considering the existing responsibilities of the United States overseas and the potential for future risks and crises that will need to be addressed, the QDDR’s recommendations to strengthen engagement abroad can only be a positive step for U.S. interests. If the various hurdles enumerated above and elsewhere can be addressed, the QDDR’s focus on emerging risks may also ease the burden on DOD resources and force deployments, recognizing that not every engagement abroad should be resolved by the military alone.
If done right, development can provide both economic growth and democratic governance and help stabilize countries before, during, and after conflict or crisis in a cost-effective way while simultaneously addressing transnational human and environmental security issues like hunger, poverty, disease, and climate change (see Yemen for an example where the application of soft power now could reduce the chance of deploying more hard power later).
Policymakers should support USAID’s current efforts to make smarter investments, “which over time will save hundreds of millions of dollars, as opposed to trying to save a little bit now by cutting our capacity to do oversight and monitoring,” said Shah in Foreign Policy.
Sources: Center for Global Development, The Economist, Foreign Policy, USAID, U.S. Department of State, World Public Opinion.
Photo Credit: “Pallets of food, water and supplies staged to be delivered,” courtesy of flickr user USAID_Images. -
Health, Demographics, and the Environment in Southeast Asia
›“Health and Health-Care Systems in Southeast Asia: Diversity and Transitions,” launches a series in The Lancet on health in Southeast Asia. While social, political, and economic development have paved the way for substantial health improvements in some countries, demographic transitions are taking place at among the fastest rates in the world, including reductions in fertility, population aging, and rural-to-urban migration. An epidemiological shift is occurring as well, from infectious to chronic diseases. Rapid urbanization and population movement can not only affect the emergence and spread of new infectious diseases directly, but can also exacerbate environmental changes that indirectly contribute to the burden of waterborne and vector-borne diseases. The series, available early online, addresses these concerns in more detail. Moving forward, the authors advocate for “enhanced regional cooperation in the health sector to share knowledge and rationalize health systems operations, leading to further public health gains for the region’s diverse populations.”In “A Stormy Future for Population Health in Southeast Asia,” author Colin D. Butler responds to the series, stressing that the health of the future generation is dependent on actions today. Environmental change will likely bring sea-level rise that threatens urban centers and food bowls, causing regional food scarcity, exacerbating diseases like dengue fever, increasing the number of extreme weather events, and contributing to resource scarcity throughout the region. With increasing need for sustainable development in the region, Butler concludes that “stronger human factors will be essential to counter the increased physical stresses that seem to be the inevitable destiny of Southeast Asia, largely as a result of the actions of people who have never seen its shores.” -
Eliya Zulu on Population Growth, Family Planning, and Urbanization in Africa
›“The whole push for population control or to stabilize populations in Africa in the ’70s and the ’80s mostly came out of the West,” said Eliya Zulu of the African Institute for Development Policy (AFIDEP) in this interview with ECSP. Then new research brought to light the fact that many women in Africa actually wanted to control their fertility themselves, but they didn’t have access to family planning.
“It kind of put the African leaders who really didn’t want to talk anything about fertility control and so on in a fix,” Zulu said. “Because all of sudden now it was the African women themselves who are saying we need these services – it was not an imposition from the West.”
Based in Nairobi, Kenya, Zulu said that part of what he does at AFIDEP is “try to get African countries to think about the future.” Current economic growth in parts of Africa simply can’t match population growth, but improving access to family planning and child/maternal health infrastructure can greatly reduce fertility rates – and quickly.
“The question for Africa is: Are we going to be ready? And we need to prepare,” said Zulu. “For that to happen it’s not just about saying ‘let’s have fewer children.’ I think we also need to do this from a social developmental perspective where we also look at ways in which we can improve the quality of the population, empower women, invest in education, and so on.”
Four Factors of Success
There are several factors that are critical for successful family planning and child/maternal health efforts, said Zulu: strong political leadership, sustained commitment over time, financial investment (research has shown that over 90 percent of women in sub-Saharan Africa cannot afford contraceptives), and strong accountability mechanisms for monitoring performance of programs and use of resources.
“There are a number of countries that have shown that, even with the limited resources that Africa has, that with all the problems that Africa has, if you really emphasize those four factors that I mentioned, you can actually achieve very, very positive results,” Zulu said.
Rapid Urbanization and the Growth of Urban Poverty
Rapid urbanization is one of Africa’s biggest challenges, said Zulu. “Africa is the least urbanized region of the world now, but it’s growing at the highest rate.” If you look at historical examples from the West and Asia, “urbanization is supposed to be a good thing; urbanization has been a driver of economic development,” he said, but “the major characteristic of urbanization in Africa has been the rapid growth of urban poverty.”
“If the economies are not going to develop the capacity to absorb this population and create enough jobs for them, there’s going to be chaos, because you can’t have all these young people without having jobs for them,” said Zulu. “The challenge for many African governments is how to have sustainable urbanization and how to transform our cities into agents of development.”
The “Pop Audio” series is also available as podcasts on iTunes. -
Reality Check: Challenges and Innovations in Addressing Postpartum Hemorrhage
›Heavy bleeding after childbirth, also known as postpartum hemorrhage (PPH), is one of the leading causes of maternal deaths worldwide. Globally, approximately 25 percent of all maternal deaths are caused by postpartum hemorrhage, and many mothers bleed to death due to delays in seeking health care services. On January 25th, 100 representatives from the maternal health community – a majority working directly in developing countries – convened for an all-day meeting at the Wilson Center to discuss experiences in the field and perform “reality checks” on the challenges and successes of PPH programs.
