Showing posts from category From the Wilson Center.
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Nigeria Beyond the Headlines: Demography and Health [Part One]
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“Nigeria is a country of marginalized people. Every group you talk to, from the Ijaws to the Hausas, will tell you they are marginalized,” said Peter Lewis, director of the African Studies Program at the Johns Hopkins University School of Advanced International Studies. Lewis spoke at an April 25 conference on Nigeria, co-hosted by ECSP and the Wilson Center’s Africa Program, assessing the country’s opportunities for development given its demographic, governance, natural resource, health, and security challenges. [Video Below]
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Learning From Success: Ministers of Health Discuss Accelerating Progress in Maternal Survival
›“The gains we have made [in reducing maternal mortality rates] are remarkable; however, gains are fragile and donor resources are declining. Substantial investments must be maintained to safeguard these hard-wins,” said Afghan Minister of Health Suraya Dail at the Wilson Center on April 23. [Video Below]
As part of the Wilson Center’s Global Health Initiative, the Advancing Dialogue to Improve Maternal Health series partnered with the U.S. Agency for International Development to co-host Minister Dail, along with Honorable Dr. Mam Bunheng, Minister of Health, Cambodia; Honorable Dr. Bautista Rojas Gómez, Minister of Health, Dominican Republic; and Dr. Fidele Ngabo, Director of Maternal and Child Health, Ministry of Health, Rwanda.
These ministers spoke about the lessons learned in countries where there has been tremendous progress under challenging circumstances.
In the Dominican Republic, Bautista Rojas Gomez said the first challenge was to address the “Dominican paradox,” where maternal mortality rates were high despite the fact that 97 percent of women received prenatal care and delivered in hospitals. The government created a zero tolerance policy that included a comprehensive surveillance system, mandatory maternal death audits, and community oversight of services, which assured better quality services.
Similar political commitment improved indicators in Cambodia, where maternal mortality rates dropped from 472 to 206 per year from 2005 to 2010. “It takes a village…and the prime minister has inspired the country to act,” said Mam Bunheng. Through increased access to contraception the number of children per woman went from seven to three and commitment to family planning, education, technology, infrastructure, and community have been the key drivers of success.
“In Rwanda, the big challenge we are having is education,” said Fidele Ngabo. “Many of the maternal health indicators depend on education.” When women and girls are educated they are twice as likely to utilize modern contraception. The efforts of Rwanda’s government have been instrumental in facilitating positive change, he said, particularly the efforts of First Lady Jeannette Kagame, who he called a “champion” for women and girl’s health.
As witnessed throughout the Advancing Dialogue to Improve Maternal Health series – and reiterated by the ministers of health – the interventions to improve maternal mortality rates exist, what’s left is to generate the needed political willpower.
Event Resources
Photo Credit: David Hawxhurst/Wilson Center. -
Nicholas Eberstadt, Wilson Quarterly
Population Changes Set to Remake Japanese Society
›The original version of this article, by Nicholas Eberstadt, appeared in the Wilson Quarterly.
In 2006, Japan reached a demographic and social turning point. According to Tokyo’s official statistics, deaths that year very slightly outnumbered births. Nothing like this had been recorded since 1945, the year of Japan’s catastrophic defeat in World War II. But 2006 was not a curious perturbation. Rather, it was the harbinger of a new national norm.
Japan is now a “net mortality society.” Death rates today are routinely higher than birthrates, and the imbalance is growing. The nation is set to commence a prolonged period of depopulation. Within just a few decades, the number of people living in Japan will likely decline 20 percent. The Germans, who saw their numbers drop by an estimated 700,000 in just the years from 2002 to 2009, have a term for this new phenomenon: schrumpfende Gesellschaft, or “shrinking society.” Implicit in the phrase is the understanding that a progressive peacetime depopulation will entail much more than a lowered head count. It will inescapably mean a transformation of family life, social relationships, hopes and expectations – and much more.
But Japan is on the cusp of an even more radical demographic makeover than the one now under way in Germany and other countries that are in a similar situation, including Italy, Hungary, and Croatia. (The United States is also aging, but its population is still growing.) Within barely a generation, demographic trends promise to turn Japan into a dramatically – in some ways almost unimaginably – different place from the country we know today. If we go by U.S. Census Bureau projections for Japan, for example, there will be so many people over 100 years of age in 2040, and so few babies, that there could almost be one centenarian on hand to welcome each Japanese newborn. Population decline and extreme population aging will profoundly alter the realm of the possible for Japan – and will have major reverberations for the nation’s social life, economic performance, and foreign relations. Gradually but relentlessly, Japan is evolving into a type of society whose contours and workings have only been contemplated in science fiction. It is not clear that Japan’s path will be a harbinger of what lies ahead in other aging societies. Over the past century, modernization has markedly increased the economic, educational, technological, and social similarities between Japan and other affluent countries. However, Japan has remained distinctive in important respects – and in the years ahead it may become increasingly unlike other rich countries, as population change accentuates some of its all-but-unique attitudes and proclivities.
Continue reading in the Wilson Quarterly.
Sources: U.S. Census Bureau.
Photo Credit: Japanese woman enjoying some free soup for breakfast, courtesy of flickr user USAFA87. -
Megacities, Global Security, and the Map of the Future
›“We’re in an urban century, there is no doubt,” said Peter H. Liotta, visiting scholar at the U.S. Military Academy West Point and co-author of The Real Population Bomb: Megacities, Global Security, and the Map of the Future, during a March 20 event at the Wilson Center. Liotta’s book focuses on the geopolitical impacts of poorly managed urbanization on the most vulnerable as well as the security issues such urbanization might create. He was joined by Jaana Remes of the McKinsey Global Institute, who painted a more promising picture of a globally rising, economically prosperous urban middle class, and Stimson Center visiting fellow Peter Engelke, who grappled with the contradictions between these alternative urban realities. [Video Below]
“Urbanization is key to economic development, but it has been, is now, and will continue to be into the future beset by a very large shadow side, wherein the marginalized face grinding poverty, squalor, and despair,” explained Engelke.
Although Liotta and Remes laid out very different “maps of the future,” Engelke suggested three commonalities. First, they both highlight the “unprecedented scale and speed of global change.” Second, they acknowledge that “a global demographic shift is well underway, and has been for some time.” And third, they accept that we have yet to fully integrate cities into the physical and mental maps by which we navigate the world, he said. Despite the economic dynamism of cities, “we live in a world that, I submit, has not yet grasped this reality even in conceptual terms, much less political and policy ones.”
The City as a Source of Vulnerability
People come to megacities “because there’s a chance,” said Liotta. “It looks like a nightmare to us, but people come because they’re waiting for a future.” This chance, however, is often slim, according to Liotta.
The sheer scale of modern urbanization (approximately 200,000 people move every day from rural to urban areas) produces myriad sources of vulnerability for the poorest and most marginalized, said Liotta. “World population growth will occur in the poorest, youngest, and often heavily Muslim states, which lack education, capital, and employment. And for the first time in history the world will be primarily urbanized, with most megacities in the poor states where you don’t have policing, sanitation, and health care.”
This urban shift concentrates young populations presumed to be unstable, exacerbates the risk of disease and climate change, and increases the threat of declining resource availability and food production, Liotta said. In states where “the lights are out” – that is, where urbanization is not met with sufficient economic development – our new urban century may feature significant security challenges, he argued. “Every single security problem we have today, and in the future – whether it’s human security, environmental security, or national security – is [in] the places where the lights are out.”
In The Real Population Bomb, Liotta links these sorts of security issues to what he terms “entangled vulnerability scenarios,” such as scarcity of water for drinking and irrigation, outbreak and rapid spread of disease, or lack of sufficient warning systems for natural disasters or environmental impacts. These scenarios, he argues, deserve a greater showing next to the traditional focus on hard security “threats.”
Fertility rates are generally declining, which will eventually dissipate the youth bulges being experienced by many countries, but the challenge is how to “manage that glide path,” said Liotta. It is about “doing it well collectively, because we are not thinking collectively well about how to do this and places in the world are in serious trouble.”
The City as a Center of Growth
Jaana Remes presented both a broader scale of analysis and a more positive outlook. Urbanization is “the most powerful positive economic force in today’s environment,” she asserted, drawing on the McKinsey Global Institute report, Urban World: Mapping the Economic Power of Cities.
Compared to the historical experiences of the Western world, change in the most rapidly urbanizing of today’s developing states is occurring at “100 times the scale, in one tenth of the time,” said Remes. This change is fundamentally shifting the economic profiles of states such as India and China, which are projected to account for approximately one third of global GDP by 2050.
This growth in economic prominence can be accounted for by the rise of urban populations of middle class consumers not just in megacities, but also in the rapidly growing “middleweight” cities (from 200,000 to 10 million people) explained Remes. The path that these cities take will be “very significant for…how our world is going to look like in the next few decades,” she said. They are where “the lion’s share of global investment is going to be made.”
Engaging Global Urbanization
“That we are seeing cities rise in their profile is nothing new in history,” said Remes, “in fact you can argue that cities are actually some of the longest-lasting assets in the world.” Today, 600 urban centers generate more than 60 percent of global GDP; 400 of these are in emerging markets. So, “even though the scale of the change we expect to see is very dramatic, from the cities perspective, it is probably going to be more evolution than revolution.”
Taking advantage of this growth will require some significant global re-posturing. In terms of commercial diplomacy for instance, most nations continue to distribute their people more according to the “geopolitical power of the 20th century than the economic opportunity of the 21st,” said Remes. She points out, for example, that the city of Wuhan in China is expected to generate 10 times the GDP growth of Auckland, New Zealand, yet the number of foreign service officials stationed in each city is in the opposite proportion.
Policymakers looking to adapt should also look more closely at opportunities to re-develop existing, or “brownfield,” infrastructure. The challenge of accommodating the tremendous pace of urbanization may be great, she said, but “we have not yet seen one piece of infrastructure where you can’t make substantial improvements.”
Summing up the need to work on what he argued has been a shortfall in policy engagement, Engelke concluded that, “we are indeed quite a ways from acknowledging the enormous challenges, but also the opportunities, that global urbanization presents to us.”
Event ResourcesSources: UN Population Division.
Photo Credit: David Hawxhurst/Wilson Center. -
After the Disaster: Rebuilding Communities
›Recent history has shown that no country, developed or developing, is immune to the effects of a natural disaster. The catastrophic tsunami that struck Indonesia in 2004, the earthquake and subsequent tsunami that struck Japan in 2011, the 2010 earthquake in Haiti, and Hurricane Katrina in the United States in 2005, are all reminders of the deep and long-lasting impacts that disasters can have from the local neighborhood all the way up to the national level. Each of these disasters also garnered international attention and response, showing that globalization is a game-changer in the worldwide response to community or regional-level crises.
And yet, as evidenced by the continued challenges faced by each of the places above, the disaster response community still struggles with how to contribute most effectively to local level recovery. Recognizing this, the Wilson Center’s Comparative Urban Studies Project and Environmental Change and Security Program, and the Fetzer Institute recently brought together an international group of practitioners, policymakers, community leaders, and scholars to identify best practices and policy in disaster response that are based on community engagement. A subsequent publication, After the Disaster: Rebuilding Communities, highlights the complex nature of disaster response and explores ways to overcome the inherent tension between those responding to disasters and the local community.
Voice, Space, Safety, and Time
A key theme that emerged during the workshop was the importance of identifying the strengths of the post-disaster community and building responses based on those. So how can one identify the strengths of a community? In a previous Wilson Center/Fetzer Institute workshop on community resilience, participants emphasized the importance of civil society voice; the creation of space, both physical and political; and the assurance of safety and time.
Not surprisingly, all of these aspects of resilience emerged in the post-disaster response discussion as avenues to access the strengths of a community. Finding and listening to the voices of the community, identifying the physical spaces or “centers of gravity” around which the community operates (often spiritual and cultural activities, or gatherings that bring women together), and providing safe and sustained support for healing, are necessary steps to engage with and meet the needs of communities.
Having a voice means that people “feel that they have some way to participate meaningfully in decisions that are being made about their lives…[that] they have access, points of influence, and conversation,” explained John Paul Lederach, professor of international peacebuilding at the University of Notre Dame.
Key to listening to the voices of the local community is acknowledging them as first responders. “An involvement and control of the relief and rehabilitation process empowers communities,” wrote Arif Hasan, founder and chairperson of the Urban Resource Centre in Karachi, Pakistan. “It improves their relationship with each other, makes it more equitable with state organizations, and highlights aspects of injustice and deprivation that have been invisible.”
Technology is playing a growing role in giving local communities voice and helping relief workers to identify those centers of gravity. “Whether in conflict or even post-conflict reconstruction, technology gives us a possibility of having a collective history but also collective memory,” noted Philip Thigo, a program associate at Social Development Network in Nairobi. “I spoke in a conference where communities were able to map what was important for them and bring it to the public domain: This is who we are and what we are saying, therefore you, the government, have to interact with us within this space. In that sense technology begins to enable communities to say we exist.”
Connecting to Community Points of Power
At the same time, new technology isn’t paramount to connecting with a community, and just having the technology is not sufficient. Leonard Doyle, country spokesperson for the International Organization for Migration (IOM), shared the story of a simple but effective effort to encourage a national conversation in Haiti by enabling “a flow of information between affected communities, humanitarian actors, and local service providers.”
IOM set up more than 140 information booths, complete with suggestion boxes, among the 1,300 camps where more than 1.5 million homeless people were housed after the 2010 earthquake. There was some doubt that the suggestion boxes would attract letters in a country with just a 50 percent literacy rate, but it didn’t take long for the letterboxes to fill up. In just three days, 900 letters were dropped into a booth in one of the poorest communities, Cité Soleil.
“Amid the flotsam of emails and text messages that dominate modern life,” wrote Doyle, “these poignant letters had an authenticity that is hard to ignore….Urgent cases received a quick response; others became part of a ‘crowd-voicing’ effort to listen to those who had been displaced by the earthquake.”
In the end, “the problem is when we NGOs [or other outside bodies] try to create new systems,” observed Thigo. “We do not look at what exists in the community as knowledge. We do not see how to plug our formal thinking into a structure that we may not understand but that we could perhaps simply try to enhance, to provide better services. We think power doesn’t exist in those communities. But there’s a structure of power. It could be leadership that is not necessarily within the formal context that we understand. The fundamental point is: How can we, even during disasters, connect to these points of power?”
Download After the Disaster: Rebuilding Communities from the Wilson Center. -
One Country, Two Stories: Marc Sommers on Rwandan Youth’s Struggle for Adulthood
›Almost an entire generation of Rwandans is confronting the prospect that they are going to be failed adults, said Marc Sommers, a fellow with Woodrow Wilson Center’s Africa Program and visiting researcher at Boston University’s African Studies Center.
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Hotspots: Population Growth in Areas of High Biodiversity
›More than one-fifth of the world’s population lives in biodiversity hotspots – “areas that are particularly rich in biodiversity and endemic species,” said John Williams of the University of California, Davis, at the Wilson Center on February 29. And those populations are growing faster than the global average. Add to that the fact that “biodiversity continues to decline globally, despite increasing investments in conservation,” said David Lopez-Carr of the University of California, Santa Barbara, and the need for new approaches to conservation becomes evident. [Video Below]
Williams and Lopez-Carr were joined by Dr. Vik Mohan, director of the sexual and reproductive health program for Blue Ventures, a London-based conservation nongovernment organization that works with communities on the remote western coast of Madagascar.
To respond to the demands of the communities and to better protect biodiversity hotspots, the speakers argued that conservation efforts need to incorporate health and livelihood services directed at the growing populations living nearby.
A Complex Relationship
“The relationship between population and biodiversity loss or conservation is a pretty complex relationship,” said Williams.
He offered Latin America and the Caribbean as an example of the multiple factors that can affect how population and biodiversity interact. Population growth in the region has slowed, and agricultural expansion is driving habitat loss as the population ages and urbanizes and as increasing per capita GDP contributes to higher levels of consumption.
In the Indo-Pacific region, stretching from East Asia to Australia, high population growth coupled with economic growth has coincided with an increase in the exploitation of rare species for illegal trade, according to Williams. And in Africa, where the population is growing quickly but without comparable economic growth and amid high levels of instability, subsistence drives ecological exploitation.
Biodiversity and Family Planning in Madagascar
“People who live in the biodiversity hotspots are typically poorer, typically have poorer access to healthcare than their counterparts in the cities or in the world at large, and typically have poorer health than those counterparts,” said Mohan.
Blue Ventures has been working in Madagascar since 2003. The island is one of the most biodiverse areas in the world; 80 percent of its plant and animal life is endemic, meaning it exists there and nowhere else, said Mohan. At the same time, Madagascar is one of sub-Saharan Africa’s fastest growing countries, with a population growth rate of 2.9 percent and an average total fertility rate of 4.6 children per woman.
Blue Ventures initially came to the country to improve conservation in the island’s coastal villages, where residents survive largely on subsistence fishing. But once there, the group quickly found that the population was “growing so rapidly that in spite of our best conservation efforts, the demand for those finite coastal resources [was] outstripping supply,” said Mohan.
“The number of people who are going out to catch fish to feed their to feed their families is going up exponentially, and those fisherman are having to work harder and harder to catch smaller fish that are farther and farther down the food web.”
Realizing that trend, Mohan said that “just by asking a few very basic questions, we unearthed a huge unmet need for healthcare and a huge unmet need for family planning in particular.”
In response, Mohan and his colleagues opened up a family planning clinic in Andavadoaka, one of the villages Blue Ventures serves. On the clinic’s first day, Mohan said, “20 percent of all women of reproductive age came asking for contraception.” Following that opening, they “rapidly found [that] this unmet need was mirrored in every single village along the coast that we worked in,” he said. Since then, modern contraceptive prevalence, initially about seven percent, has increased four-fold, while birth rates have fallen by about one-third. All in all, Mohan said, the population of the Velondriake region, where Blue Ventures operates, is five percent smaller now than it would have been without the group’s family planning services.
Rural Areas Driving Population Growth
Across the developing world, Lopez-Carr said that unmet need for family planning “remains significantly higher” in biodiversity hotspots. Given that high unmet need, especially in Africa, it is easy to infer that “conservation may be less sustainable…if it does not consider health,” he said.
In his ongoing research on population and biodiversity, Lopez-Carr looks at how fertility rates compare in and out of hotspot areas and between regional and local levels. At the country and province level, “high-value conservation areas do not have unusually high total fertility rates (TFRs),” he said. But at more localized levels, “in the most remote rural areas, TFRs remain high, and in many cases, in the most remote rural areas, the demand for family planning is still very low,” indicating that these areas are still in the early stages of their demographic transitions.
The fact that the sub-state picture can look so different from the state-level picture means that there is more work for researchers to do, said Lopez-Carr. “Where the fertility rates are highest is where we have the least data,” he said, and that has significant implications for understanding future population growth.
Looking at UN population projections, the world’s net population gains will be in its poorest cities, he said, but “virtually all this growth is going to be from migration, fueled by remaining high fertility in rural areas.” And “virtually all of that growth will be predicated upon the timing, magnitude, [and] pace of the fertility transition in rural areas.”
Better understanding the demographic picture in rural areas is therefore critical – not just to improving health and preserving biodiversity in the world’s hotspots, but to honing down more accurate global population projections as well.
Event ResourcesPhoto Credit: “Fisherman Carries Day’s Catch,” courtesy of United Nations Photo. -
The Middle East Program
Reflections on Women in the Arab Spring
›The Arab Spring has fascinating and powerful demographic and gender undercurrents. Last year, demographer Richard Cincotta counseled observers to pay close attention to the demonstrations: if they featured young women – as opposed to being dominated by young men and boys – it’s a sign that democracy may be on its way. To mark the occasion of International Women’s Day last week, the Wilson Center’s Middle East Program gathered observations from a cross-section of regional voices on how women have fared thus far.
Excerpted below is the entry from Moushira Khattab, former Egyptian ambassador to South Africa and the Czech and Slovak Republics, and former minister of family and population:As the global community celebrates International Women’s Day, we must hail the heroic and pivotal role Egyptian women played to make the January 25th Revolution an inspiration for the world. They joined men and took to Tahrir Square calling for freedom, dignity, and social justice. They rallied around the cause of pushing the train of political change. One year later, Egyptian women find that the train of change has not only left them behind, but has in fact turned against them. It is ironic that the revolution that empowered a country, and made every Egyptian realize the power of their voice, stopped short of women’s rights. Sadly, the only march that was kicked out of Tahrir Square was that of women celebrating 2011 International Women’s Day. Women were beaten, subjected to virginity tests, and stripped of their clothes in the very same Tahrir Square.
Download the full set of reflections from the Wilson Center’s Middle East Program.
Dormant conservative value systems are being manipulated by a religious discourse that denies women their rights. Calls for purging the sins of the old regime necessitate a reminder of the positive outcomes of laws that, although enacted under that old regime, have liberated and enhanced women’s status, including prohibiting female genital mutilation and child marriage. We also need a reminder that such gains are only a step towards these rights, and are the outcome of collective hard work along generations. Against the background of parliamentary elections, defenders of women’s rights have backed down, while young revolutionaries don’t have women’s rights on their agendas. The most telling indicator is the shameful and meager representation of women in Egypt’s post-revolution parliament. Among a handful of elected female MPs, one declared that her top priority is to repeal the law granting women the right to seek divorce.
With religious parties controlling it, the question becomes: Will this parliament be willing and able to produce a constitution that guarantees equal rights to all Egyptians regardless of gender or religion? Dare we dream that Egyptians in 2012 could have a constitution equal to that put in place by South Africans in 1996?
