Showing posts from category maternal health.
-
Robert Walker on Family Planning Promotion and Global Population Growth
›
“Expanding voluntary family planning access and ensuring that all women have access to reproductive health services is, to me at least, a no brainer,” said the Population Institute’s Robert Walker in this interview with ECSP. “I think it’s a win for women, for their health, for their welfare, the welfare of their families, for their communities, for the environment, and for the planet at large.”
While China and India dominate much of the global headlines about population growth, other parts of South Asia – namely Afghanistan and Pakistan – and sub-Saharan Africa receive comparatively little attention. For Walker, a renewed global effort to boost the quality and quantity of reproductive healthcare tools and services in these areas of the developing world is essential.
“This is very, very doable. We face a lot of really incredible challenges in the world today, particularly with respect to food, energy, water, and poverty. But if we can increase what we spend on international family planning assistance by three or four billion dollars a year, we can literally change the world,” Walker said. “And I think we desperately need to.”
The “Pop Audio” series is also available as podcasts on iTunes. -
What’s Good for Women Is Good for the Planet
›Ammi, my mother-in-law, was 16 years old when her marriage was arranged. Before she was 18, she had borne her first child, who died within the year, and by 30, she had given birth to six more. She had a fourth-grade education, and like other women in the new state of Pakistan, she knew little about contraceptive choices.
More than 50 years later, contraception still remains inaccessible for millions of women in Pakistan, such as Rani, the young woman who cleans Ammi’s Karachi home. Illiterate and married off to a cousin at age 15, Rani already has three children, and, like the majority of married Pakistani women who have never used modern contraception, will most likely have at least one more.Giving women the ability to determine whether and when to become pregnant is fundamental to the realization of their basic human rights. It is also a proven health and development strategy, substantially reducing maternal and infant mortality by allowing women to space their pregnancies. And now, for the first time, two studies offer compelling evidence that it has another benefit: What is good for women is also good for our planet.
These groundbreaking studies have rigorously quantified the effect on the environment of helping women and girls control their reproductive destinies. The studies – “The World Population Prospects and Unmet Need for Family Planning,” by the Futures Group, and, “Global Demographic Trends and Future Carbon Emissions,” by the National Center for Atmospheric Research and the International Institute for Applied Systems Analysis – demonstrate that giving women and girls access to contraception offers a precious co-benefit: a substantial reduction in carbon emissions.
The logic is simple: When women have the power to plan their families, populations grow more slowly, as do greenhouse gas emissions. The cost of providing these needed family planning services worldwide is minimal compared with other development and emissions reductions strategies – roughly $3.7 billion per year.
More than 200 million women in the United States and developing countries are sexually active and do not want to become pregnant, yet are not using modern contraception. The results are staggering: One in four births worldwide is unplanned, leading to 42 million abortions each year (half of them clandestine) and 68,000 women’s deaths.
Moreover, the large number of women who become pregnant when they do not want to is a significant source of population growth. Read in tandem, the studies show that a reduction of 8-15 percent of essential carbon emissions can be obtained simply by providing modern contraception to all women who want it. This reduction would be equivalent to stopping all deforestation or increasing the world’s use of wind power 40-fold. Although this is just one piece of the emissions reduction puzzle, it is a substantial piece.
The world is now facing multi-layered challenges of economic distress, rising inequality, and environmental devastation caused by climate change. International climate negotiations have repeatedly stalled as powerful nations play the blame game and block progress. Meanwhile, a series of severe weather events has buffeted the earth from Moscow to Iowa to Pakistan, each one hitting women and children hardest. This is the reality that rich nations must reckon with – and commit to changing – today.
In my 14 years at the Global Fund for Women, I have observed the wave of change that comes from empowering women – what some call the “girl effect.” Making information, education, and contraception easily available offers us an affordable, no-regrets strategy that can be implemented now.
Meeting the need for family planning services is not a complex challenge. We know how to provide the commodities, services, and education that women and their families want. There are thousands of programs around the world with successful track records in every conceivable religious, cultural, and political setting.
Investing in family planning has already been proven as an essential strategy to ensure the health, safety, and development of societies. Now we know that it is also an effective way to safely steward Mother Earth through one of her most challenging crises.
Kavita N. Ramdas is chair of the Expert Working Group of the Aspen Institute’s Global Leaders Council for Reproductive Health and senior adviser and former president and CEO of the Global Fund for Women.
Sources: Futures Group, National Center for Atmospheric Research and the International Institute for Applied Systems, Science, UNFPA, WHO.
Photo Credit: “Chaco: Madre pilagá,” courtesy of flickr user Ostrosky Photos, and Kavita Ramdas, courtesy of Global Fund for Women. -
John Bongaarts on the Impacts of Demographic Change in the Developing World
›“The UN projects about 9.1 billion people by 2050, and then population growth will likely level off around 9.5 billion later in the century. Can the planet handle 9 billion? The answer is probably yes. Is it a desirable trajectory? The answer is no,” said John Bongaarts, vice president of the Policy Research Division at the Population Council, in this interview with ECSP.
Although family planning was largely brushed aside by international policymakers following the 1994 UN International Conference on Population and Development in Cairo, Bongaarts said he is hopeful because it is now enjoying a higher profile globally – and receiving greater funding.
“I am optimistic about the understanding now, both in developing and developed world, and in the donor community, that [family planning] is an important issue that should be getting more attention,” Bongaarts said. “And therefore I think the chances of ending up with a positive demographic outlook are now larger than they were a few years ago.”
The “Pop Audio” series is also available as podcasts on iTunes. -
Tamara Kreinin on Women’s Empowerment, Population Growth, and Sustainability
›“We know that when that when we empower women – whether it’s giving them control over their bodies and access to family planning or whether it’s by including them in planning around climate change – their agency can make huge leaps for us,” said Tamara Kreinin, executive director of women and population at the UN Foundation, in this interview with ECSP.
Seventy percent of the world’s poor are women and they’re also the members of the household most likely to be responsible for food, water, and firewood collection.
“At the same time, we know that women are often not at the table,” she said. “They’re not at the table in country when countries are creating aid to adaptation strategies around the environment and climate change, and they’re not at the table at places like Copenhagen and some of the big climate change meetings.”
The “Pop Audio” series is also available as podcasts on iTunes. -
Mobile Phones for Maternal Health in the Developing World
›With rising use in the developing world, cell phones and mobile technologies can create “connected and coordinated health systems that save more lives,” said Josh Nesbit at the GHI event “New Applications for Existing Technologies to Improve Maternal Health,” on October 27. Capitalizing on these new technologies could increase efficiency, cost-effectiveness, and efficacy of public health programs. Nesbit, executive director of FrontlineSMS: Medic, was joined by Alain Labrique, assistant professor at the Johns Hopkins School of Public Health, and David Aylward, executive director of the mHealth Alliance at the United Nations Foundation, to discuss the role of Information and Communication Technologies (ICTs) in the prevention of maternal mortality.
Collaborations for mHealthWhile “cell phones can’t save lives, the lack of information does kill,” said Aylward. Using technology that many people already own and use, mobile technology is an appropriate tool for disseminating health data and information. Existing technologies such as mobile phones and SMS text messaging can revolutionize healthcare by improving data collection and disease tracking, expanding patient diagnostics, and advancing education and awareness among health workers and patients.
With 64 percent of all mobile phone users located in the developing world, the use of mobile devices to improve health services in low-income countries is especially promising.
Aylward hopes that mobile health technology (mHealth) will help combat maternal mortality in the developing world. With approximately 350,000 women dying in childbirth each year, and only marginal progresses towards achieving Millennium Development Goal 5, finding such innovative solutions to improve maternal health is crucial.
Public-private partnerships are particularly important when considering the long-term sustainability of mHealth programs. “This didn’t happen because of the World Bank, it happened because people who are very poor voted with their very limited funds to have access to information,” said Aylward.
Aylward is hopeful that government and donor support will continue to become more supportive of mobile technology and coordinated in their implementation of mHealth programs globally.
Mobile Health Solutions in the Developing World
“Through mobile tools, we can act as quickly as possible to improve access to skilled birth attendants, emergency obstetric care, and access to reproductive health commodities,” said Nesbit.Nesbit’s organization, FrontlineSMS: Medic, is working to eliminate barriers created by the lack of resources and infrastructure in the developing world using mobile health technology. Now working in 20 countries, the organization uses free software “that enables large-scale, two-way text messaging using only a laptop, a GSM modem, and inexpensive cell phones,” explained Nesbit.
“One of the best measures is whether people continue to use your tools, and they will if it impacts their lives positively and they won’t if it doesn’t—sometimes it’s as simple as that,” said Nesbit on why communities in the developing world are eagerly embracing mobile technology.
Moving forward, Nesbit hopes to “scale and replicate, both vertically and horizontally, models that we’ve shown can work, but also to build new tools” and work with the health community “to help identify the needs and the gaps in these systems.”
However, Nesbit stresses that “these are very much tools and not solutions; they become solutions when they are paired with people on the ground who use them.”
Compressing the Time Between Crisis and Care
“The opportunities for mobile phones to act synergistically with existing health systems in low- to middle-income countries are many,” said Labrique. The current challenge is to harness this technology to improve health outcomes in the developing world, where disease burden is disproportionately high.
In the developing world, “decisions influenced by the lack of resources, such as poverty, or lack of information have led to highly convoluted patterns of care-seeking,” said Labrique.“Delayed decision-making compounded by delayed transport can have tragic consequences for maternal mortality,” said Labrique, and the most immediate use of mobile technology is “getting the necessary care, on time, to where these deaths are taking place.” Cell phones can help women, their families, and local health workers to seek timely, appropriate medical help for an obstetric emergency.
“Addressing equity and access to phones when evaluating the impact or success of mHealth interventions is critical,” Labrique said. Although cell phone use is high and steadily increasing, social and cultural norms in some countries might prevent women from using them. Further, Labrique notes, in Bangladesh, cell phone use among the poorest families is noticeably less than those with higher socioeconomic status.
“ICT and mHealth solutions have tremendous promise to improve maternal health in resource limited settings; however, it’s important not to let the technology guide the public health agenda,” said Labrique. More data is needed to determine how these tools might strengthen and enhance health systems and a clearer research agenda can help ensure evidence-based solutions guide programming.
For more from David Aylward and mHealth, be sure to see “Watch: David Aylward on How Wireless Technology is Changing Global Health and Empowering Women.”
Sources: Lancet, United Nations Foundation.
Photo Credit: “‘SMS till you drop’ — mobile phone ad on van in Kampala, Uganda,” courtesy of flickr user futureatlas.com. -
Watch: David Aylward on How Wireless Technology is Changing Global Health and Empowering Women
›“We have millions of young children, babies, dying unnecessarily, hundreds of thousands of women dying in childbirth – most of them unnecessarily – in large part for lack of access to health, lack of access to health information,” said David Aylward, executive director of the UN Foundation’s mHealth Alliance. “And while wireless doesn’t solve any of those problems by itself, it is a conduit, a pathway to solve those problems.”
We spoke to Aylward before the Global Health Initiative (GHI) event “New Applications for Existing Technologies to Improve Maternal Health,” at the Wilson Center earlier this week.
“We’ve gone from a billion subscribers to five billion subscribers in the last six years, and 70 percent of those are in the developing world,” he said. “So almost everywhere you go a woman has a cellphone or has access to a cellphone.”
This access allows women in the developing world to do basic things those in the developed world take for granted, like call for help or set up reminders. The most important thing to think about in the future is to continue empowering women with the tools and knowledge to understand their own healthcare and supporting them with better care.
“All of which are possible in the very near term if we can get the different parties to get together and work on them together,” said Aylward, “and that’s what our mission is.”
Check out the the full event summary from GHI here. -
Watch: Population, Health, and Environment in Ethiopia
›Severely eroded and deforested, Ethiopia’s land is increasingly turning to desert, due to the country’s high population growth, unsustainable land use, and lack of land ownership. Featuring footage from my trip to Ethiopia last year, this video looks at the efforts of two projects to combat these devastating trends by meeting the country’s complex challenges with integrated solutions.
Ethiopia’s population is estimated at 85 million. Since 1900, the country has grown by nearly 74 million people, and the United Nations predicts this rapid growth will continue, reaching nearly 120 million people by 2025.
“Family planning is very crucial” to sustainable development, said Gebrehiwot Hailu of the Relief Society of Tigray (REST), located in the northern region of Tigray. “If the family has more children… he can’t feed them properly, he can’t send the children to school, because there is a food gap in the household.” REST uses a watershed planning model jointly developed by the community, health workers, and government agencies.
Realizing there is no silver bullet to development, projects like REST integrate population, health, and environment (PHE) programs to engage these challenges from all angles.
The Ethio Wetlands and Natural Resource Association (EWNRA), located in Ethiopia’s Wichi watershed, uses a combination of techniques to restore the watershed, create alternative livelihoods, strengthen health systems, and improve reproductive health.
“Through this integrated watershed intervention, the wetland is regaining its natural situation,” Shewaye Deribe of EWNRA told me. “The communities with their own bylaws, with their own watershed committee, with their own organization… are protecting these remaining forest patches.”
Sources: Population Reference Bureau. -
Barbara Crossette on UNFPA State of the World Population 2010 Report
›“Particularly when you go into a society that’s been broken by war or conflict or is so impoverished that is has nowhere to start climbing up, there have to be integrated programs and they have to work with people in mind,” said former New York Times foreign correspondent Barbara Crossette in an interview with The New Security Beat. “The people themselves will solve a lot of the problems around them if they’re just given the tools to do so.”
Crossette is one of the lead authors of the UN Population Fund’s latest State of the World Population Report, “From Conflict and Crisis to Renewal: Generations of Change,” set to launch this Wednesday, October 20th. She spoke to us particularly about the challenges of women around the world and the unique storytelling aspect of this year’s report.
The “Pop Audio” series offers brief clips from ECSP’s conversations with experts around the world, sharing analysis and promoting dialogue on population-related issues. Also available on iTunes.
