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Nigeria Beyond the Headlines: Demography and Health [Part One]
›“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. -
Nabeela Ali on How PAIMAN Is Improving Maternal Health in Pakistan
›“Maternal mortality is a very complex thing – it’s not just patient-doctor relationships, it has so much to do with behaviors, with communities, with the household, with family members,” said Nabeela Ali, chief of party for the Pakistan Initiative for Mothers and Newborns (PAIMAN), which received USAID maternal and child health funding from 2004 to 2010.
Pakistan is the world’s sixth most populous country, yet has long held one of the world’s highest maternal mortality rates. Ali spoke at the Wilson Center last fall about strategies to better engage faith-based organizations on maternal and child health issues. In this interview with ECSP, she stressed that despite Pakistan’s very religious society, these interventions are possible with the right messaging.
PAIMAN aims to reach vulnerable and isolated groups, including poor, rural, or conservative women. “The areas where no one can reach [are] where we targeted,” Ali said.
In these areas, ulama – influential religious leaders and scholars – are highly trusted. “It was not a one-size-fits-all strategy,” Ali emphasized. “Religious leaders are not technical people, but they are experts in their own field. You have to approach them with trust and respect.”
“The first step is establishing rapport with them; then they listen to you,” said Ali. This is best done through another alim, not a technical person. Those ulama that were approachable proved to be valuable allies in the promotion of maternal health. PAIMAN has reached over 35 million people in Pakistan over its now eight-year run.
Projects like PAIMAN are necessary in areas of the world where religious leaders are the most respected community authorities. In Pakistan, Ali believes that now that this strategy has been demonstrated to be viable, the government should help bring it to scale. An NGO-funded project ends, but a government-funded program has much more continuity, which in turn helps build trust with local leaders, she said.
Sources: UN Population Division. -
Richard Matthew: Responsive Peacebuilding Includes the Environment and Natural Resources
›April 30, 2012 // By Stuart Kent“After 20 years of peacebuilding experimentation, one of the good signs is that the countries receiving this [peacebuilding] attention…more and more are shaping the process,” said Professor Richard Matthew, director of the Center for Unconventional Security Affairs at the University of California, Irvine.
Peacebuilding is shifting, he said, from internationals going in with pre-existing conceptions of “what you need for stability and development, what will make you attractive to investors, what will make your people secure,” to instead sitting down and talking with stakeholders about “what types of capacity do you need, and how can we support you in acquiring those.”
Along with the shift towards more responsive peacebuilding has come an elevated interested in the environment and natural resources. For people living in the peacebuilding countries themselves, “there was never any doubt that water and forest and access to minerals and so on were critical to their future,” said Matthew, but Western and Northern countries often thought of it as a “second tier issue that you might get to once people were safe, and the government was functioning, and the economy was up and running again.”
Matthew co-authored the 2009 UNEP report, From Conflict to Peacebuilding: The Role of Natural Resources and the Environment, which examined environmental factors all along the conflict continuum – from inception to peacebuilding. Successful peacebuilding, the report argues, requires that “environmental drivers are managed, that tensions are defused, and that natural assets are used sustainably to support stability and development in the long term.” -
Karen Newman: Rio+20 Should Re-Identify Family Planning As a Core Development Priority
›April 25, 2012 // By Kate DiamondEnergizing people around family planning can be difficult, “because donors, like everyone else, like something that’s new,” said Karen Newman, coordinator for the UK-based Population and Sustainability Network. “There’s nothing new about family planning. The technology is safe, effective, it’s acceptable, and it works. We just need a lot more of it out there to be accessible to a lot more people.”
Newman spoke to ECSP at the 2012 Planet Under Pressure conference about her hopes for the upcoming Rio+20 sustainable development conference, which marks the 20-year anniversary of the UN Earth Summit.
“What we want is increased investment in voluntary family planning services that respect and protect rights,” Newman said, “and I think that Rio represents a fabulous opportunity for us to re-identify family planning as a core development priority.”
Newman also hopes the Rio conference will lead to “an integrated look at sustainable development, so that… it isn’t just about the green economy and institutional framework, it’s looking at sustainable development in the round.”
Government development programs and policymakers need to adapt their bureaucratic processes to the kinds of integrated programming being carried out on the ground, she said. In Madagascar, for example, conservation group Blue Ventures leads an integrated PHE program that cuts across marine conservation, family planning, and healthcare sectors. “Now I defy you to find an EU budget line that would be broad enough to embrace marine conservation and family planning in the same project line,” said Newman.
“The first thing we need is that level of integrated thinking – not just in Rio, but also in the way that we conceptualize the work that needs to be done and we facilitate the availability of funding streams that can fund that kind of integrated program.”
Lastly, Newman hopes that the summit in and of itself is successful because of its implications for future development work. As the world gears up to create the next big framework for global development to follow the Millennium Development Goals, Rio is uniquely positioned to set a baseline for what matters and for what the development community is capable of accomplishing.
“What I want to see is a really sophisticated look at sustainable development, coming up with sustainable development goals in a world that makes sense of seven billion, where there are still millions of women without access to the family planning services that we take for granted,” said Newman, “and taking that concept to the job of developing the post-MDG framework that will frame development for the next 20 years.” -
John Donnelly, Global Post
Aspen Institute on Women, Population, and Access to Safe Water
›April 24, 2012 // By Wilson Center StaffLoading the player…The original version of this article, by John Donnelly, appeared on the Global Post.
The U.S. Census Bureau’s World Clock says that the population of the world today is estimated at 7.008 billion people, while projections show that the world could reach the 9 billion marker by 2050.
In the last of its series called “7 Billion: Conversations That Matter,” Aspen Institute’s Global Health and Development hosted a panel of experts based in Africa and the United States on the interconnectedness of gender issues, family planning, population, and access to safe water.
The point of the series was to ask questions about why it mattered that the world was passing the seven billion mark, and the questions today in Washington were appropriately big: Will water wars replace oil wars? What are the solutions to expand water and sanitation to the 2.5 billion people who don’t have it? And just how many people can the world support in an equitable fashion?
An answer to the last question: You need a bigger pie, better manners, and fewer forks.
Borrowing from a book by Joel Cohen called How Many People can the Earth Support? (written in 1996 when the world supported a 5.7 billion population), Laurie Mazur, director of the Population Justice Project, said that the answer was “it depends on how we use resources.”
Continue reading on the Global Post.
Sources: U.S. Census Bureau. -
Karen Newman: Population and Sustainable Development Links Are Complex, Controversial, and Critical
›April 23, 2012 // By Kate Diamond“The one child family norm in China has fixed the global imagination around population to be around doing something which constricts people’s and women’s choices, rather than expands women’s possibilities to take control of their lives,” said Karen Newman, the coordinator for the UK-based Population and Sustainability Network. But contemporary population programs are about educating people on and providing access to voluntary reproductive, sexual, and maternal health services.
Newman spoke to ECSP, during the Planet Under Pressure conference this year, about family planning efforts and the connection between population dynamics and the environment.
“You have what I would describe as a sort of kaleidoscope of complexity” between climate change and population dynamics – not just growth, said Newman, but urbanization and migration.
For example, China recently overtook the United States as the world’s largest emitter of carbon, and although China has 1.3 billion people compared to the United States’ 310 million, population can hardly be credited as the most important driver for the country’s emissions. “How fair is it [to credit population growth] without in the same nanosecond saying, ‘but most of the carbon that was emitted in China was to manufacture the goods that will of course be consumed in the West?” said Newman.
“It makes it more difficult to say in a sound bite that ‘OK, population and sustainable development, it’s the same conversation,’ which I believe it to be.”
The Population and Sustainability Network, working through the Population and Climate Change Alliance, collaborates with international organizations from North America, Europe, Ethiopia, and Madagascar to support on-the-ground groups working on integrated population, health, and environment programming. These programs address environmental issues, like marine conservation and deforestation, while also providing reproductive health services, including different methods of contraception, diagnosis and treatment of sexually-transmitted diseases, antenatal and postnatal care, and emergency obstetric care.
“As a result of people wanting to place a distance between those coercive family planning programs in the ‘60s and the way that we do reproductive health now…because it’s such a large package, there is a sense that…this reproductive health thing is too much, we can’t really get ahold of this,” said Newman.
“What I think we need to do is keep people focused on the fact that these are women’s rights,” she said. “But we at the same time have to say ‘this is relevant if you care about sustainable development and the world’s non-renewable resources.’”
Sources: United Nations Population Division. -
‘Earth Focus’ Talks to PAI About Bringing Out Women’s Voices on Climate Change
›“We have got to build an increased desire for [and] interest in what happens outside of the United States,” said Suzanne Ehlers, CEO of Population Action International (PAI). She was joined by Vice President of Research, Roger-Mark De Souza, in an episode of Link TV’s Earth Focus, “Women and the Changing Environment,” to discuss the interconnections between women’s reproductive health and climate change.
The episode, built around PAI’s Weathering Change documentary, draws together footage from Ethiopia, Peru, and Nepal to construct messages about the role that reproductive health services can play in responding to the burden that climate change places upon women in the developing world.
“Women are at the forefront of climate change impacts [and] they are disproportionately affected by the negative impacts,” said De Souza. Empowering women by increasing access to voluntary family planning services that allow them to make choices about the timing and the spacing of their births is a way to help ensure that women have the resilience required to react to climate impacts, he continued.
“I want the American people to get out of their borders more often,” said Ehlers. “The U.S. is an unbelievable global leader on reproductive health,” but fluctuations in funding due to domestic politics have sometimes “forced closures of clinics throughout the world.” By listening to those voices that are too often marginalized in international decision making, especially women, we can build a desire for international engagement, she suggests.
“It’s got to be something that the American people see as development…how it links to diplomacy and it absolutely supports defense – that those three D’s are interchangeable,” she said.
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