Showing posts from category PHE.
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Eric Zuehlke, Population Reference Bureau
Democratic Republic of Congo and Madagascar Connect Family Planning With Environmental Health
›February 10, 2012 // By Wilson Center StaffRemote rural communities in developing countries typically face the related challenges of extreme poverty, poor health, and environmental degradation. And population growth often exacerbates these challenges. In communities that face environmental challenges along with high fertility and high maternal and child mortality, health programs that include family planning can have great benefits for the health and well-being of women and families, with positive influences on the local environment. Meeting the reproductive health needs of women and ensuring environmental sustainability by connecting family planning with environment programs has proven to be a “win-win” strategy. Yet this connection has often been seen as controversial or irrelevant to environmental policymaking.
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What Would It Take To Help People ‘and’ the Planet?
›February 1, 2012 // By Geoffrey D. DabelkoThe original version of this article first appeared in the “Scientist’s Soapbox” column of Momentum magazine’s special issue on “what would it take” to craft solutions to some of the Earth’s toughest challenges.
People living in the most biodiverse areas of the world tend to be poor, isolated, and dependent on natural resources. They often lack reliable access to alternative livelihoods and health services and thus can place stress on these ecologically unique regions.
Conservation efforts will merely slow habitat loss if they don’t fundamentally address the living conditions of the human residents as well as the flora and fauna. But programs to assist these communities have commonly focused on one problem at a time, reflecting the interests of the funders: Environmental groups focus on conservation, while health organizations concentrate on disease. We must ask whether investments to protect biologically rich areas are effective and sustainable if they don’t respond to the many needs of the people who live there.
But the problems faced by people in these remote areas don’t fit our traditional sectors. The way we disburse our funds, divide our bureaucracies, demarcate our disciplines, and measure success ignores the reality of intersecting needs. Such stovepiping can disrespect the communities’ scarce resources, especially their time. It can waste development aid on duplicate supplies and staff. And it can lead us to miss how the solution to one problem (e.g., providing antiretroviral drugs to treat HIV/AIDS) can be undercut by another (e.g., lacking access to safe water with which to take the pills).
So, what would it take to help particularly vulnerable populations while protecting particularly important ecological systems?
We need to strategically target our help by addressing HELP – health, environment, livelihoods, and population – through a truly integrated approach to sustainable development in these areas. Evidence suggests tackling problems concurrently can be more efficient and effective. Key donors such as the U.S. Agency for International Development are increasingly prioritizing integrated responses, providing some funding for sustainable development innovators and supporting evaluation of the results. But we need more evidence that these efforts can achieve results that match or exceed the outcomes of single-sector projects. To rigorously test this approach, more projects must be funded, implemented and analyzed, over longer periods of time and at bigger scales.
To date, some promising projects and research in diverse locations – Ethiopia, Nepal, Madagascar, Rwanda, the Philippines, and Uganda – suggest that the HELP approach offers greater benefits than traditional programs.
In the Philippines, for example, the PATH Foundation Philippines’ Integrated Population and Coastal Resource Management (IPOPCORM) program addresses pressing needs for both family planning services and sustainable environmental stewardship in densely populated coastal communities, where local fisheries have been depleted because of increased demand for food. IPOPCORM helps create marine protected areas and promotes alternative economic livelihoods such as seaweed harvesting, thus allowing critical local fish stocks to recover. Concurrently, the initiative mitigates human-induced pressures on the environment and lowers the vulnerability of this underserved population by providing voluntary family planning services. Since its launch in 2001, the IPOPCORM program’s approach has yielded measurable benefits, simultaneously reducing program costs and improving health and environmental outcomes – and outperforming compartmentalized, side-by-side sector interventions.
How can we bring HELP to biodiversity-rich communities? First, we can encourage scholars, practitioners, and policy-makers to step outside their stovepipes by producing and distributing manuals, for example, based on lessons learned from existing cross-disciplinary projects. Second, we must bridge the gap between analysis and field-based programs by developing new metrics that better assess the impact of integrated programs. Third, we must open up bureaucratic funding structures by demonstrating not only the short-term savings but also the synergies that bolster long-term sustainability.
The challenges are significant, but I see promising new opportunities for overcoming them. For example, the new Pathfinder International-led projects around Lake Victoria in Uganda and Kenya mark the entry of a respected health organization into the environmental arena and the return of a leading private funder – the MacArthur Foundation – to HELP programs. With some of Africa’s highest population densities, poverty, ethnic diversity, and biodiversity, the Great Lakes region is one of the most volatile intersections of human development and environmental change.
Through these and other community-based, integrated projects, we can truly help people and the planet at the same time.
Photo Credit: “Boy on road east of Addis,” courtesy of Geoff Dabelko/Wilson Center. -
From Dakar: Explaining Population Growth and Family Planning to Environmentalists
›December 19, 2011 // By Sandeep Bathala“There is a growing recognition that population is a key driver of environmental, development, governance, and security challenges; however, family planning is not a traditional tool, nor is it often considered an ‘appropriate’ one, for responding to food, water, climate, or conflict,” said Roger-Mark De Souza at a November 30 panel discussion at the 2011 International Conference on Family Planning in Dakar, Senegal. “This presents a challenge for us: How can we change perceptions of family planning so that it becomes part of the solution to wider problems, including natural resource scarcity, lack of economic development, gender inequity, and instability?”
De Souza, vice president of research and director of the climate program at Population Action International (PAI), was joined by Sandeep Bathala, program associate with the Wilson Center’s Environmental Change and Security Program; Robert Engelman, president of Worldwatch Institute; and Daisy Magaña, fellow with the GoJoven Program, for a session on “Reaching Out at Rio: Explaining Population Growth and Family Planning to Environmentalists.”
Population Dynamics Part of Climate Vulnerability
“Advocates…need to communicate that empowering women to make their own reproductive choices will improve both their individual well-being and our collective environment,” said Engelman. According to research conducted on behalf of Americans for UNFPA, messages that focus on women – their health or empowerment – resonate well with American environmentalists, as they do with broader audiences.
PAI’s interactive mapping website shows that high levels of unmet need for family planning and rapid population growth rates are common in countries with low levels of resilience to climate change and high levels of projected decline in agricultural production, said De Souza. “Family planning services can be one element of a multi-pronged strategy to reduce especially women’s vulnerability to these interlocking vulnerabilities,” he said.
“Currently, population growth is viewed as a challenge to addressing climate change-related vulnerabilities, but family planning services are commonly left out of conversations about ways to reduce these vulnerabilities.” This is a lost opportunity, said De Souza: “We can integrate family planning into wider environmental, development, and peace-building efforts.”
At the recent UN Climate Change Conference in Durban, a side event on reproductive health and climate was well-attended. However, as panelist Esther Agbarakwe of the Africa Youth Initiative on Climate Change noted, population was not part of the conference‘s official discussion, due to lack of knowledge and fears of population control. PAI is currently working with UNFPA to produce a series of training modules on population and climate change that will help environmentalists, climate change activists, and researchers better understand and explore these connections.
Tapping the Youth Base
Bathala, formerly the Sierra Club’s Global Population and Environment Program director, discussed how the Sierra Club, one of the only major grassroots conservation organizations with a population program, uses youth outreach to raise awareness on the links between the environment, reproductive health, and women’s rights.
Because young people constitute over half of the world’s population, the Sierra Club focuses on empowering youth leaders to make the connection between environmental issues and sexual and reproductive health and rights. The Population and Environment Program reaches youth directly by organizing summits and multi-state campus tours featuring young people from around the world sharing compelling stories with their peers.
“The program provides youth and adult activists with materials, communication strategies, and leadership training,” Bathala said. “With these tools, the activists then educate their community members, campus, and decision-makers about the need for measures that increase access to family planning while addressing poverty, women’s empowerment, and environmental protection.”
In April, fellow panel member and Belize-native Daisy Magaña joined one of the Sierra Club’s U.S. tours to discuss the GoJoven program, which convenes and support youth reproductive health champions throughout Latin America. Through GoJoven, Magaña has worked to expand adolescent reproductive and sexual health choices, services, policies, and programs in Belize.
In a blog post, Magaña discussed how her message was simple: Don’t give up. “If you think being active on environmental and sexual rights issues is hard to do here, imagine doing it in a deeply conservative [Catholic] country like mine,” she told U.S. students.
Sierra Club also leads story tours to functioning population, health, and environment programs in the field, including a 2009 trip to Guatemala and Belize in conjunction with GoJoven. Through visits to 10 project sites, two U.S.-based youth advocates witnessed first-hand the challenges and opportunities associated with community-based sexual and reproductive health programs, significantly enhancing their ability to be pro-active messengers in their own communities. The tour helped the Sierra Club build an international network of young people committed to social and policy change in their countries.
Looking Forward: Finding Ways To Highlight Integration
While recognition of the connections between population growth and environmental impacts is growing, the experience of the panelists shows that it takes innovative methods to reach both the environmental and family planning communities. A similar panel later this winter at the Wilson Center will include representatives of Americans for UNFPA discussing their research on talking to environmentalists about reproductive health and population growth.
With the UN Conference on Sustainable Development (Rio+20) coming in June of next year, highlighting successful strategies is crucial in order to pave the way for better integration in the future.
Event ResourcesImage Credit: Roger-Mark De Souza/Population Action International. -
Watch: Dr. Vik Mohan on Integrating Family Planning and Conservation in Madagascar
›The integration of population, health, and environment programming “enables us to create synergies that mean we are more effective at achieving both health and conservation goals,” said Dr. Vik Mohan, director of sexual and reproductive health programming for Blue Ventures, in an interview with ECSP at the 2011 International Conference on Family Planning.
After Blue Ventures established their first clinic in 2007 in the village of Andavadoaka, on Madagascar’s southwest coast, “we felt immense pressure to scale up our intervention,” said Mohan. “We started with one clinic in one village, and now we have a multi-site service covering all 40 villages that we partner with for our community-based conservation work,” he said.
According to data compiled by Blue Ventures, the average total fertility rate in the region is 6.7 children per woman. The London-based eco-tourism-turned health and environment NGO offers a variety of family planning services to meet local demand, including mobile outreach clinics and community-based distribution of contraceptives. They also partner with Marie Stopes International to offer long-acting and permanent methods of contraception for those that want it.
“This Model Can Be Taken to Scale”
By integrating conservation and reproductive health messaging and service delivery, “we are getting greater buy-in from the community because they all see the added value of the breadth of things that we offer them,” Mohan said. “Men who came to hear about fisheries management get to hear about family planning technologies, practically for the first time in their lives.”
The fishermen are able to see the links between food security and population growth through their own experience, he added. “We believe very passionately this model can be taken to scale,” Mohan said. “This is something that could be easily replicated in other regions. Definitely in other coastal regions, but almost certainly in other remote areas – perhaps areas of high biodiversity where there are existing projects, perhaps conservation projects – but where there is an unmet need for healthcare and family planning in particular.”
“My advice to other organizations, whether you are doing healthcare or whether you are doing conservation, is just think holistically,” said Mohan. “If you are a conservation organization that recognizes that there is an unmet healthcare need for the communities that you work with, then…don’t be afraid to ask those questions, and don’t be afraid to build capacity to meet the need, if you find one. Or, don’t be afraid to partner with health NGOs to enable that need to be met.”
For more on Blue Ventures’ integrated efforts, see also ECSP FOCUS Issue 23, “To Live With the Sea: Reproductive Health Care and Marine Conservation in Madagascar,” co-authored by Vik Mohan. -
Jason Bremner, Behind the Numbers
PHE Champions Bring Their Experiences From the Field to the International Family Planning Conference in Senegal
›December 8, 2011 // By Wilson Center StaffThe original version of this article, by Jason Bremner, appeared on the Population Reference Bureau’s Behind the Numbers blog.
This past week at the 2011 International Conference on Family Planning, four practitioners from the field traveled from remote parts of the Democratic Republic of Congo, Ethiopia, Madagascar, and Tanzania to Dakar, Senegal, to share their successes and challenges in reaching remote communities with an integrated package of health, livelihood, and environment services. Together they made up the panel, “Reaching the Hardly Reached: Delivering Family Planning Through Population, Health, and Environment Integration.”
The panelists came from four environmental organizations whose starting point for working in these remote places was the protection of the biodiversity and natural resources upon which all life depends. Dr. Vik Mohan, physician and medical director for Blue Ventures, talked about how he and his organization transitioned from focusing initially on the conservation of coastal marine reserves and coral reefs to now working to improve health care, including access to family planning.
Blue Ventures, in response to community and women’s needs, opened a family planning clinic, and on the opening day, 20 percent of the women of reproductive age in the community came out to request contraceptives. Today they offer a whole spectrum of short- and long-acting contraceptive methods through partnerships with Marie Stopes International, Population Services International, and various funders. Blue Ventures reported that contraceptive prevalence had risen from 8 percent when they began in 2007 to 35 percent today.
Continue reading on Behind the Numbers.
Photo used with permission courtesy of PRB. Left to right: Didier Mazongo, WWF; Vik Mohan, Blue Ventures; Baraka Kalangahe, Tanzania Coastal Management Partnership; and Jason Bremner, PRB. -
New Population, Health, and Environment Program for Lake Victoria
›With some of Africa’s highest population densities, ethnic diversity, and biodiversity, the Great Lakes region is one of the most volatile intersections of human development and the environment. A new population, health, and environment (PHE) initiative from Pathfinder International, announced Monday at the International Conference on Family Planning in Senegal, aims to help address these issues by supporting sustainable resource management and women’s right to choose when and how often they have children.
Jointly funded by the David and Lucile Packard Foundation and the John D. and Catherine T. MacArthur Foundation, with additional support from USAID’s Office of Population and Reproductive Health, the project will focus on Ugandan and Kenyan sections of the Lake Victoria basin.
Lake Victoria is the second largest freshwater source in the world, a biodiversity hotspot, and an important regional waterway, but regional population growth among the highest in Africa and economic development have led to declining water quality, reduced fish stocks, and industrial pollution. The basin as a whole supports upwards of 35 million people.
“This new project is a welcome development for many reasons,” said ECSP Director Geoff Dabelko. “It brings the integrated PHE approach to one of the world’s greatest lakes, it enables respected health NGO Pathfinder to pursue PHE efforts, and marks the return of a leading private donor, the MacArthur Foundation, to a group of foundations willing to support this innovative approach.”
Sono Aibe, senior advisor for strategic initiatives at Pathfinder emphasized the integrated challenges facing the region. “In these remote, resource dependent areas of the world, the interconnectedness between the health of people and the health of the environment is undeniable,” she said in a press release. “When women are empowered to participate in the sustainable management of natural resources alongside men and youth, as well as have access to sexual and reproductive health care services, their lives will improve and so will the condition of the ecosystems that they depend on.”
The project’s objective, according to Pathfinder, is to reduce threats to biodiversity, conservation, and ecosystem degradation by increasing access to family planning and sexual/reproductive health services. The project plans to develop scalable approaches that can be adopted by communities, local governments, and national governments. Technical support is to be provided by the BALANCED Project, ExpandNet, and the Population Reference Bureau.
“Lessons learned from this new project will help us better develop and design projects for vulnerable communities in fragile ecosystems, while simultaneously advocating for increased government support for integrated programs throughout the Lake Victoria Basin,” said Lucy Shillingi, Pathfinder’s country representative for Uganda.
The Lake Victoria effort will build upon the experiences of other integrated PHE efforts in the region, such as Rwanda’s SPREAD Project, Uganda’s Conservation Through Public Health, and Tanzania’s TACARE and Coastal Management Partnership.
Sources: Lake Victoria Basin Commission, Pathfinder International, UNEP. -
Jeanne Nyirakamana, PHE Champion
Reaching Rural Rwandans With Integrated Health and Livelihood Messages
›This PHE Champion profile was produced by the BALANCED Project.
Rwanda is one of the most densely populated countries on the planet, with more than 11 million people in one of Africa’s smallest countries, most of whom depend on the land as subsistence farmers. The country has diverse mountain, lake, and savannah landscapes, and the Virunga Mountain chain in the northwest part of the country is home to one-third of the world’s threatened mountain gorilla population. At the same time, the population throughout the country suffers from high rates of unmet need for contraception, and three percent of the adult population lives with HIV/AIDS. In a land under such intense pressure on natural resources, rural livelihood initiatives are critical to ensuring people have options for meeting their daily health and well-being needs.
For the past three years, Jeanne Nyirakamana has served as head of the health program for the Sustaining Partnerships to Enhance Rural Enterprise and Agribusiness Development (SPREAD) Project. Supported by the U.S. Agency for International Development through Texas A&M; University, the SPREAD Project is integrating a dynamic coffee production and quality improvement program in Rwanda with health outreach to improve community well-being. The health component works to improve the lives of coffee farmers and cooperative members by providing them with health information and services related to family planning, maternal and child health, prevention of sexually-transmitted infections (including HIV), and water and sanitation.
Training Peer Educators
Working closely with the coffee program, Nyirakamana’s team has trained more than 540 men, women, and youth peer educators who have reached more than 95,000 coffee farmers with education and services. Key communication messages highlight the links between sound decision-making and health-seeking behaviors, productive farms and agribusinesses, and strong and healthy families.
The program also leverages and supports local health resources through referrals to existing public health services, organization of mobile clinics, and community-based distribution of a socially marketed water purification solution (Sur Eau) and condoms (Prudence). According to Nyirakamana, one of the project’s greatest successes is the increased acceptance of family planning by farmers and their families and the more than 7,500 farmers who have been tested for HIV. In order to draw in as many coffee farmers as possible, many of the health and livelihood activities take place at the stations where the coffee beans are washed, at other buildings used by the coffee farmer cooperative, or during combined community meetings or home visits. At the washing stations, Nyirakamana’s team supports local health center staff to provide voluntary counseling and testing (VCT) and de-worming services while at the same time SPREAD-trained peer educators and coffee/health extension agents disseminate family planning information.
The cooperatives’ buildings have clean water, hand-washing stations, and small kiosks where condoms and Sur Eau are sold. These community health agents work with SPREAD to ensure that the greater community, not just the coffee farmers, has access to health knowledge and services. They learn how to teach the community about a range of health issues and each month they submit reports showing how many people they reached and with what kinds of messages. They are also becoming increasingly engaged in coffee and agribusiness activities. Through the success of their health activities, these agents are seen as vital community resources.
Integrated Results
By implementing this integrated population, health and environment (PHE) approach, the SPREAD Project staff is ensuring the health of the people and environment and success of the agribusiness. “You cannot care for the environment without first caring for the people who live and use that environment, so when you transmit dual messages [agriculture and health] you are able to hit two birds with one stone,” said Nyirakamana.
According to a 2010 evaluation of the project, farmers and their families reported improvements in personal and household hygiene; an increase in understanding and acceptance of family planning; uptake of HIV and VCT services; and use of condoms and other local health services. As well, they noted shifts in gender norms affecting household revenue use, alcohol, and reproductive health. The agribusiness stakeholders value the integrated approach as a means to more holistically meet farmers’ goals of increased incomes and improved lives and livelihoods.
This PHE Champion profile was produced by the BALANCED Project. A PDF version can be downloaded from the PHE Toolkit. PHE Champion profiles highlight people working on the ground to improve health and conservation in areas where biodiversity is critically endangered.
Photo Credit: BALANCED Project. -
Watch: Geoff Dabelko on Climate Adaptation and Peacebuilding at SXSW
›November 16, 2011 // By Wilson Center StaffThe problems of climate adaptation, poverty alleviation, and peacebuilding are common to many parts of the world. Yet the efforts to address them are often pursued separately or with little coordination. Capturing the co-benefits of building institutional capacity critical to all three areas is an idea that will likely receive little attention at next year’s Rio+20 Earth Summit in Brazil, says ECSP Director Geoff Dabelko.
