Showing posts from category education.
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Women’s Health: Key to Climate Adaptation Strategies
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The discussion about family planning and reproductive rights “needs to be in a place where we can talk thoughtfully about the fact that yes, more people on this planet – and we’ve just crossed seven billion – does actually put pressure on the planet. And no, it is not just black women or brown women or Chinese women who create that problem,” said Kavita Ramdas, executive director for programs on social entrepreneurship at Stanford University. [Video Below]
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Programming to Address the Health and Livelihood Needs of Adolescent Girls
›“There are 750 million adolescent girls in the world today, and this is by far one of the world’s most marginalized and vulnerable demographics,” said Denise Dunning, the Public Health Institute’s program director for emergency contraception in Latin America during a February 2 panel at the Wilson Center. Dunning, who also leads the Adolescent Girls’ Advocacy and Leadership Initiative (AGALI), was joined by Margaret Greene, director of Greeneworks, and Jennifer Pope, the deputy director of sexual and reproductive health at Population Services International, to discuss how to better reach underserved adolescent girls in developing countries with health and livelihood programs.
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Afghanistan and Pakistan: Demographic Siblings? [Part Two]
›February 15, 2012 // By Elizabeth Leahy MadsenLate last year, Afghanistan’s first-ever nationally representative survey of demographic and health issues was published, providing estimates of indicators that had previously been modeled or inferred from smaller samples. My first post on the survey focused on the methodology and results, which found that Afghanistan is not as much of a demographic outlier as many observers had assumed. But perhaps the most surprising finding is how the results compare to those of Afghanistan’s neighbor, Pakistan.
The political future of each country depends largely on the other and, with Afghanistan making progress on reproductive health issues that remain stalled in Pakistan, their demographic trajectories are heading toward closer synchronization as well. In one key measure – use of contraception among married women – Afghanistan is almost identical to Pakistan. The modern contraceptive prevalence rate is 19.9 percent, slightly lower than the rate of 21.7 percent in Pakistan.
While Pakistan faces its own serious political instability, it is widely regarded as more developed than its neighbor. Afghanistan is included in the UN’s grouping of least developed countries, and Pakistan is not. Pakistan’s GDP per capita is almost twice as high. On the surface, this should suggest lower fertility. There is a general negative relationship between economic development and fertility, though demographers are quick to point out its complexities, and David Shapiro and colleagues have found that countries with larger increases in GDP actually experience slower fertility declines.
Pakistan’s fertility rate of 4.1 children per woman is in fact 20 percent lower than Afghanistan’s, but the similarities in contraceptive use, which is one of the direct determinants of fertility, suggest that this gap could be shrinking. If Afghanistan’s median age at marriage (18 compared to 20 in Pakistan) was higher and more women were educated (76 percent of women have never been to school compared to 65 percent in Pakistan), the two fertility rates might be closer.
Pakistan’s Entrenched Challenge
Why are these indicators closer than might be expected? Relative to the other countries in South Asia, Pakistan has had considerably less success in promoting family planning use. Bangladesh has a per capita income about half that of India and one-quarter that of Sri Lanka, yet the three countries’ fertility rates are identical. Nepal has the lowest income in the region – even slightly below Afghanistan – yet more than 40 percent of married women use modern contraception and fertility is three children per woman. And then there is Pakistan. Despite a per capita income 90 percent that of India, only 22 percent of married women use modern contraception and fertility remains persistently high at over four children per woman.
The weaknesses of Pakistan’s family planning program have been well-documented. Government commitment has been lacking and cultural expectations and gender inequities are a powerful force to promote large family size. The country’s most recent DHS report cited disengagement with the program among local agencies, low levels of outreach into communities, and weak health sector support as likely causes for the stagnation of contraceptive use. In summer 2011, the Pakistani government abolished the federal Ministry of Health and empowered provincial governments with all responsibilities for health services. This transfer of authority could pay dividends by increasing local ownership of health care, but some in and outside Pakistan have raised concerns about the loss of regulatory oversight and information sharing entailed in total decentralization.
Compared to the Afghanistan survey, the most recent Pakistan Demographic and Health Survey provides more detail on women’s motivations and preferences regarding fertility and family planning. Overall, 55 percent of married women in Pakistan have a “demand” for family planning; that is, they wish to avoid pregnancy or report that their most recent pregnancy or birth was mistimed or unwanted. More than half of these women are using family planning, while the remaining 25 percent of married women have an “unmet need.”
Unintended pregnancies and births play a major role in shaping Pakistan’s demographic trajectory. The DHS survey finds that 24 percent of births occur earlier than women would like or were not wanted at all. If unwanted births were prevented, Pakistan’s fertility rate would be 3.1 children per woman rather than 4.1. Yet 30 percent of married women are using no contraceptive method and do not intend to in the future. The most common reasons for not intending to use family planning are that fertility is “up to God” and that the woman or her husband is opposed to it.
Linked Destinies
Just as Afghanistan and Pakistan’s political circumstances have become more entwined, their demographic paths are more closely in parallel than we might have expected. For Afghanistan, given the myriad challenges in the socioeconomic, political, cultural, and geographic environments, this is good news; for Pakistan, where efforts to meet family planning needs have fallen short of capacity, it is not. While Afghanistan is doing better than expected, Pakistan should be doing better.
Regardless, both countries are at an important juncture. With very young age structures and the attendant pressures on employment and government stability, each government must reduce unmet need for family planning or face mounting difficulties to providing for their populations in the future. In addition to rolling out health services, turning the share of women without education from a majority into zero would be an excellent way to start.
Elizabeth Leahy Madsen is a consultant on political demography for the Wilson Center’s Environmental Change and Security Program and senior technical advisor at Futures Group.
Sources: Afghanistan Ministry of Public Health, Bongaarts (2008, 1978), Cincotta (2009), Embassy of Afghanistan, Haub (2009), International Monetary Fund, MEASURE DHS, Nishtar (2011), Population Action International, Savedoff (2011), Shapiro et al. (2011), UN-OHRLLS, UN Population Division, U.S. Census Bureau, The Washington Post.
Image Credit: Chart arranged by Elizabeth Leahy Madsen, data from MEASURE DHS. -
Kim Lovell, Sierra Club
Pop at COP: Population and Family Planning at the UN Climate Negotiations
›February 8, 2012 // By Wilson Center StaffThe original version of this article, by Kim Lovell, appeared on the Sierra Club’s activist network.
“Population, development, and climate should be a single discussion,” explained Jacques van Zuydam of South Africa’s National Population Unit. Van Zuydam, speaking to a sparsely filled room at the United Nations Framework Convention on Climate Change (UNFCCC) in Durban last month, centers his work around the concept that climate matters because people matter.
Given the focus on the Green Climate Fund, climate change adaptation, and the effects of sea-level rise and changing weather patterns on some of the world’s most vulnerable populations, it would have made sense for discussions about population to play a central role at the 17th Conference of Parties (COP-17). Yet despite these obvious links – and lead negotiator Jonathan Pershing’s admission to the U.S. youth delegation that population plays a central role when discussing climate impacts – the issue gained little traction in the formal negotiations.
Pershing said he considers population “too controversial” to play a role in the international climate talks, and recommended raising the issue elsewhere. But where better to talk about the need for increased access to voluntary family planning services than among a group of world leaders considering solutions to mitigate and adapt to climate change?
As Brian O’Neill and his colleagues at the National Center for Atmospheric Research explained in a 2010 paper, meeting the unmet need for contraceptive services worldwide could reduce emissions in 2050 by 1.4 to 2.5 billion tons of carbon per year, or 16 to 29 percent of the emissions reductions necessary to avoid dangerous changes to our climate. And beyond the potential effects on carbon, increasing access to education and family planning resources will have a huge impact on the ability of women and families to adapt to the effects of climate change that are already altering weather patterns, water availability, and agricultural production around the globe.
Continue reading at Sierra Club.
Sources: Amplify.
Image Credit: UNFCCC/Climate Change Information Center of Armenia. -
Iran: A Seemingly Unlikely Setting for World’s Fastest Demographic Transition
›January 11, 2012 // By Elizabeth Leahy MadsenThis is the second post in a series profiling the process of building political commitment in countries whose governments have made strong investments in family planning. Read the first post, on Rwanda’s recent rapid demographic changes, here.
To date, only 11 countries outside of the developed world, China, and a handful of small island states have reached the end of the demographic transition, with fertility rates declining from more than four children per woman to replacement level or lower.* Of these, only two countries have completed the transition in 15 years or less – and both might surprise you. One is Cuba, whose government dispensed family planning services to its relatively small population in the 1970s through accessible primary health care facilities and legalized safe abortion eight years before the United States did. The other: Iran.
Following the 1979 revolution, Iran’s new theocracy adopted a socially conservative, pro-natalist outlook. Half of the population lived in rural areas, which typically constrains access to health services. In addition, abortion was illegal in most circumstances. According to the UN, Iranian women had an average of 6.5 children each in the early 1980s and the population was growing nearly four percent annually, a rate high enough for it to double in 19 years.
But, by the early 2000s, Iran’s fertility rate had dropped below two children per woman. The swift changes can be attributed to the efforts of government officials concerned about meeting the employment needs of a growing population, supported by public health experts who wanted to rebuild the eroded family planning program.
A Dramatic Policy ShiftThe turning point came after the end of Iran’s eight-year war with Iraq in 1988. With military demands high – several hundred thousand people were killed during the war – population growth was viewed positively. But as the war ended, policy directives did an about-face.
Although public health officials had framed the need for reinvigorated family planning programs in health-related terms for years, the motivation for government officials to change policy appears to have been economic. The national budget agency informed the prime minister that after nearly a decade of conflict, the country lacked adequate funding to both rebuild and to meet the needs of its people. The prime minister responded quickly, directing that demographic factors be integrated into the new development plan and stating that “Iranians’ standard of living was being eroded by the growth of the country’s population.”
“Pragmatism Has Prevailed Over Pure Ideology”
After convincing their superiors, Iranian government officials who supported family planning faced the added challenge of garnering the backing of the influential religious establishment. Shortly after the revolution, Ayatollah Khomeini officially sanctioned the use of contraception, though his perspective was not universal among clerics. Once the prime minister decided to introduce a national family planning program, officials sought support from additional religious authorities. Opposition was minimal after two key institutions offered endorsements. The High Judicial Council determined that there was “no Islamic barrier to family planning” in late 1988, and the Expediency Council approved the government’s plans soon after.
By late 1989, a new family planning program had been officially introduced. The program’s aims were to lengthen spacing between births; limit pregnancies in the early and late reproductive years; and lower fertility by educating the population and ensuring access to free and diverse contraceptive methods. By the mid-1990s, the government had fully integrated family planning into the existing primary health system.
Iran thus followed the example of other majority-Muslim countries where religion was not an impediment to family planning, including Egypt, Indonesia, Jordan, and Oman. Just as in countries where highly Catholic populations have low fertility rates (Italy, Poland, Spain, and many others), religious guidance has been interpreted in varying ways in different settings and is not necessarily a central factor in individual fertility decisions. As Akbar Aghajanian and Amir H. Merhyar write in a summary of Iran’s family planning program, “Pragmatism has prevailed over pure ideology when necessary.”
The Contributions of Women’s Education and a Strong Health System
A new policy orientation was the critical first step, but successful implementation was necessary for Iran’s demographic trajectory to change in response. Fortunately, the government had some advantages in rolling out its new program, namely a strong existing health system, a history of past efforts to promote family planning, and an educated female population among whom demand for contraception was high.Rural development became a priority of the government after the revolution and resulted in improved access to an array of services. In rural areas, community health workers receive two years of training to provide family planning services along with other preventative care and treatment. Services are also available at rural health “houses,” urban clinics, and higher-level centers around the country.
The status of women has also played a major role. A research exercise conducted by IIASA estimated that improvements in educational attainment among women were responsible for about one-third of Iran’s fertility decline between 1980 and 2005. Women’s literacy was already rising during the period of the revolution and reached 74 percent by 1996, while attitudes toward female employment became more supportive. By the late 1990s, new classes of university students included more women than men. The response to the 1989 program indicated that women clearly had an unmet demand for family planning. Use of modern contraception jumped from 31 percent in 1989 to 51 percent just five years later, then rose more slowly over the subsequent decade.
A Dividend Squandered?
The rapid changes in Iran’s age structure, thanks to declining fertility, have opened a window of opportunity for the country to boost economic growth through lower dependency ratios – a phenomenon called the demographic dividend. However, the dividend is not an automatic bonus, and Iran’s capacity to capitalize on its demographic change is questionable.
The unemployment rate among young people today is over 20 percent, indicating that the economy is not generating sufficient jobs, which is a prerequisite to improving productivity. This inopportune climate may even contribute to a further decline in the fertility rate: Some observers have suggested that the country’s economic troubles and rising costs of living have motivated young people to delay marriage and have smaller families. “Unemployment and high costs of living, coupled with social and political restrictions, have made [life] increasingly difficult for young Iranians,” Farzaneh Roudi of the Population Reference Bureau (PRB) explained in a blog post last year.
Given Iran’s challenges in producing adequate jobs and other economic benefits for its population, President Mahmoud Ahmadinejad’s recent unusual pronouncements on population issues are especially puzzling. Last year, Ahmadinejad introduced a pro-natalist policy offering direct payments to each child born, continuing until they reach adulthood, and later suggested that girls should marry at age 16 or 17.
But despite a high level of international media attention, most observers expect the policy to have little impact. Widespread adoption of family planning has become entrenched in society: 60 percent of Iranian women now use a modern contraceptive method. As PRB’s Roudi wrote in response to Ahmadinejad’s proposal, “Iranian women and men have gotten used to exercising their reproductive rights and would expect to be able to continue to do so.”
*The 11 countries that have achieved replacement fertility or lower outside of developed regions, China, and small island states are Brazil, Chile, Costa Rica, Cuba, Iran, Lebanon, Myanmar, Thailand, Tunisia, and the United Arab Emirates.
Elizabeth Leahy Madsen is a consultant on political demography for the Wilson Center’s Environmental Change and Security Program and senior technical advisor at Futures Group.
Look for related analysis on the political implications of Iran’s changing age structure by Richard Cincotta on New Security Beat soon.
Sources: Abbasi-Shavazi, Lutz, Hosseini-Chavoshi and Samir (2008), Abbasi-Shavazi (2002), Aghajanian and Merhyar (1999), Christian Science Monitor, GlobalSecurity.org, The New York Times, Noble and Potts (1996), Population Reference Bureau, Roudi-Fahimi (2002), UN Population Division, World Bank.
Image Credit: “بیست و پنجم خرداد ۸,” courtesy of flickr user Recovering Sick Soul (Nima Fatemi); charts arranged by Sean Peoples and Elizabeth Leahy Madsen. -
Jon Barnett: Climate Adaptation Not Just Building Infrastructure, But Expanding Options
›“I think it’s appropriate to think about [climate change] adaptation or investments in adaptation as investments to open up the range of choices available to people to deal with an uncertain future,” said Jon Barnett, associate professor of geography at the University of Melbourne, in an interview with ECSP. “In some circumstances it might be appropriate to build infrastructure and hard options where we’re very certain about the nature of the risk…but in other cases, expanding the range of choices and freedoms and opportunities that people have to deal with climate change in the future is perhaps the better strategy.”
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Three New Reports Highlight Ongoing Significance of Youth Demographics in Global Trends
›January 2, 2012 // By Elizabeth Leahy MadsenAmidst world population reaching seven billion and last year’s Arab Spring, which in some nations is continuing into this winter, it can be easy to miss emerging pieces of research that tell us something relatively objective about youth and instability. Three new studies give practitioners and policymakers a stronger foundation of evidence to highlight the challenges and opportunities facing the world’s largest generation of young people.
Results of a recent UNICEF staff survey indicate that the people responsible for the UN’s efforts targeting children and youth are seriously concerned about demographic and economic dynamics. Asked to review a list of 20 “global trends,” UNICEF staff rated “growing disparities” and “youth bulge and youth unemployment” as the most significant to children. The results, which the agency will soon publish in a paper on “The Next Generation and Global Trends,” also indicate that staff members feel that UNICEF has a strong capacity to influence the future of these trends.
UNICEF’s recent “Child Outlook” report on global trends discusses the issues highlighted in the survey. The report notes that although many countries are moving toward middle-income status, poverty rates remain stubbornly high, indicating that economic development does not benefit all equally. Income and consumption in such countries tend to be concentrated among the wealthiest households. “While many families will prosper, others are being left behind,” the report explains.
“Tensions and discouragement arising from youth unemployment, combined with higher food prices and fiscal contractions, may have contributed to increased civil unrest, protests, and political instability,” UNICEF asserts. In many developing countries, the number of young people entering the labor market far surpasses the number of available jobs. Although some youth are not working because they are enrolled in secondary or tertiary education, low rates of youth participation in the workforce often are not a matter of choice. Young people, especially those with low levels of education and from poorer families, are often unable to find secure, decent jobs. More than one-quarter of all young people with jobs worldwide live below the poverty line of $1.25 per day.
Economic Pressures on Youth in East Africa
Two other research projects – one published, one still underway – provide additional context to the combination of demographic and economic challenges that face the world’s young people. In the first, part of a recent special U.S. Institute of Peace series on South Sudan, Stephanie Schwartz and Wilson Center fellow Marc Sommers probe the expectations of and obstacles faced by youth in the newly created country.
According to the incipient government’s statistics agency, 72 percent of South Sudan’s population is younger than 30, which places it among the 20 youngest age structures in the world. Only 40 percent of youth ages 15 to 24 are literate, and nearly 80 percent of households depend on agriculture for their income. Based on interviews conducted with urban and rural youth in three areas of South Sudan, the authors find that the pressure of paying rising dowry costs is the most salient issue facing young men, while young women are treated as economic assets with no influence in their own future. The authors’ research suggests that “some young men join armed gangs, at least in part, because they believe it will help them pay dowries.”
Although many young people in South Sudan aspire to the stability of government work, the limited number of jobs and shortage of relevant skills inhibit their aspirations. With an underdeveloped private sector, few opportunities for training, and nepotistic practices in hiring, there is little work for those living in towns and urban areas beyond manual labor and selling goods. The authors recommend that education and job training be expanded, with a focus on equitable access among young people from varied geographic backgrounds.
Across the border in northern Uganda, Chris Blattman, an associate professor of political science at Yale, has been studying the social effects of the government’s youth employment program started in 2007. The program offered grants to small groups of young people for vocational training or to fund the costs of starting a new business. Although a full paper has not yet been published, preliminary findings indicate strong economic benefits of the program which in turn improve social cohesion and community participation while diminishing aggression and “disputes with authorities” among young men. If they bear out, the results may well confirm the oft-repeated policy recommendation that focusing on youth employment is critical to improving national development as well as reducing the likelihood of instability and conflict.
In the year of seven billion, we heard much about the need to invest in young people and the tremendous potential they embody, for demographic dividends as well as overall development. Yet 2011 was also a year of tremendous upheaval, much of which was driven by young people – and their older counterparts – seeking representative and democratic governance. This should serve as a reminder that youth can be a remarkable force for positive change, but in too many places – South Sudan among them – their opportunities, prospects, and contributions are constrained. As the UNICEF survey results reiterate how important this issue is to development programming, the Uganda research may be another important piece of evidence that direct investment in young people reaps tangible results not only for them, but also for society.
Elizabeth Leahy Madsen is a consultant on political demography for the Wilson Center’s Environmental Change and Security Program and senior technical advisor at Futures Group. She was previously a senior research associate at Population Action International.
Sources: Bill and Melinda Gates Institute for Population and Reproductive Health, Chris Blattman, ILO, Sommers and Schwartz (2011), South Sudan National Bureau of Statistics, UNICEF, World Bank.
Photo Credit: “UNAMID Peacekeeper Speaks with Sudanese Youth,” courtesy of UN Photo/Albert Gonzalez Farran. -
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.
