-
Food Security, the Climate-Security Link, and Community-Based Adaptation
›In “The Causality Analysis of Climate Change and Large-Scale Human Crisis,” published in last month’s Proceedings of the National Academy of Sciences, authors David Zhang et al. write that changes in food supply are key indicators for the likelihood of climate change-induced conflict. Adding to the debate on the links between climate and conflict, the authors write that their purpose was to discover the specific causal mechanisms behind the relationship by analyzing various climate- and crisis-related variables across several periods of peace and conflict in pre-industrial Europe. They found that “climate-induced agricultural decline,” as opposed to resource scarcity caused by rapid population growth, was the clearest indicator of impending crises. “Malthusian theory emphasizes increasing demand for food as the cause,” write the authors, “whereas we found the cause to be shrinking food supply” – a distinction with “important implications for industrial and postindustrial societies.”
In “Using Small-Scale Adaptation Actions to Address the Food Crisis in the Horn of Africa: Going beyond Food Aid and Cash Transfers,” published in Sustainability, authors Richard Munang and Johnson Nkem advocate for community-based adaptation programs to increase resilience to food crises in the Horn of Africa. “Given that hunger and poverty are concentrated in rural areas,” the authors write, “targeting local food systems represents the single biggest opportunity to increase food production, boost food security, and reduce vulnerability.” The authors present a joint UNEP-UNDP adaptation initiative undertaken in Uganda as a framework for potential adaptation interventions in the Horn. They conclude that the initiative’s approach – pairing locally-focused sustainable farming techniques with a national-level emphasis on adaptation programs, and upscaling lessons learned from one level to the other – “will increase local buffering capacity against droughts, make communities more independent from direct aid, etc., build resilience and improve livelihoods overall.” -
Healthy People, Healthy Ecosystems: Results From a Public-Private Partnership
›“A lot of people probably don’t think that an organization with a name like ‘World Wildlife Fund’ would have a program on population, health, and the environment,” said WWF’s Tom Dillon at the Wilson Center, but actually it is very natural. “Most of the people we work with are in rural areas, and they depend on their natural resources for their own livelihoods and for their own well-being. Of course, if you are in that situation, in order to be a steward of the environment, you’ve got to have the basics. You have got to have your own health.”
Dillon was joined by staff from WWF, as well as Scott Radloff, director of USAID’s Office of Population and Reproductive Health, and Conrad Person, director of corporate contributions at Johnson & Johnson, to talk about the results of a three-year partnership between USAID, WWF, and Johnson & Johnson. The joint effort, a formal Global Development Alliance, provided health and family planning services, clean water, and sanitation to communities in three of WWF’s priority conservation landscapes: The Salonga National Park in the Democratic Republic of Congo (DRC), the Lamu Archipelago in Kenya, and the Terai Arch Landscape in Nepal.
By creating an innovative public-private partnership that linked health objectives, particularly related to family planning and maternal and child health, to environmental and conservation activities, “this alliance was ahead of its time,” said Radloff.
Human Health Linked to Environmental Health
The project had four objectives, said Terri Lukas, WWF’s population, health, and environment (PHE) program manager: improve family health; reduce barriers to family planning and reproductive health services; improve community management of natural resources and habitat conservation; and document and promote successful approaches.
“Human health cannot be separated from environmental health anywhere,” Lukas said, “but most especially when we are working with very poor people who live very close to nature.”
Projects Provide Integrated Services
The Salonga National Park in the DRC is home to many endangered species, including the bonobo, one of the four great apes. Local communities are very isolated, and lack access to safe drinking water and sustainable livelihoods, as well as basic health and family planning services, according to Lukas. The PHE project was able to train 135 voluntary community health workers in family planning and maternal and child health care, including 55 women. One year after the training, health workers were distributing contraception to more than 300 new users per month, Lukas said.
The alliance has also integrated health and family planning services into conservation programs in Kenya’s Kiunga Marine National Reserve, in part, “to demonstrate to the people that we care about them as well as the environment, and also to show them the synergies that exist between the health issue and the environment issue,” said WWF Program Coordinator Bahati Mburah. The region has been suffering through a year-and-a-half-long drought, and has one of the highest population growth rates in east Africa, placing considerable pressure on natural resources.
“We talk to [the fisher folk] about health and family planning, and how they are related to the management of fisheries,” said Mburah. With improved transportation and mobile outreach services provided by the project, 97 percent of women are now able to access family planning services within two hours of their home, she said.
The third site is in the Terai region along the southern border of Nepal. In this lowland region, the alliance is attempting to safeguard and restore forest areas in order to allow wildlife to move and breed more freely, while at the same time improving the health and economic prospects of the people. By linking these goals, support for conservation efforts increased from 59 percent to 94 percent of households, with 85 percent attributing positive attitude changes to increased access to health services and safe drinking water, according to Bhaskar Bhattarai, project coordinator for WWF-Nepal.
Documenting and Promoting Successful Approaches
Cara Honzak, WWF’s senior technical advisor on population, health, and environment, said the global objective of the alliance was to document and promote successful PHE approaches. Comprehensive baseline and endline surveys provided critical evidence that integrated PHE programming increases family planning use in remote areas, improves conservation buy-in within communities, and leads to increased participation of women in community leadership and decision-making.
“We have played a key role in producing some of the evidence that has been used throughout Washington [D.C.], especially to provide information to government bodies that are making decisions about bringing more money into family planning, health, and particularly in the environmental sector,” said Honzak.
“After two decades in the field, and working in this area, I wasn’t expecting many surprises. I couldn’t have been more wrong,” Lukas said. “These three years have changed almost everything about the way I now view health development…I have long called myself a conservationist, but now I say to my international health colleagues: we are all conservationists, and if we aren’t, we should be.”
Event Resources- Bhaskar Bhattarai presentation
- Cara Honzak presentation
- Terri Lukas presentation
- Bahati Mburah presentation
- Photo gallery
- Video
-
Emily Puckart, MHTF blog
Maternal Health in Kenya: New Research Unnecessary, Time to Address Existing Gaps
›The original version of this article, by Emily Puckart, appeared on the Maternal Health Task Force blog.
During the recent Wilson Center/African Population and Health Research Center meeting in Nairobi on improving health systems through a maternal health framework, participants focused on knowledge gaps in the Kenyan health system that can negatively affect maternal healthcare. This focus on gaps sparked discussion around research needed (or not needed) in the maternal health field, supply gaps, and gaps between addressing technical, medical issues of maternal health (like preeclampsia or postpartum hemorrhage), and larger society-wide gaps like gender equity. The gaps highlighted by participants at the Nairobi dialogue included:- Gaps in knowledge: During the dialogue, members of the Kenyan maternal health community discussed the possibility of strengthening community health workers as an information delivery platform. Participants wondered about the possibility of using community health workers to distribute information both downward to the end user (patients), and then again to gather information from end users and distribute it upwards through the system to reflect the opinions of the direct users of the healthcare system.
- Supply gaps: Participants argued that while there is a large body of information in terms of maternal health supplies at the national level in Kenya, there is not as much data on supplies at the actual health facility level, where it is much needed and would be very helpful to successfully treat patients.
- Gaps in healthcare delivery: There is a strong need to address inequality in the distribution of health services as there are unequal services in rural and urban areas. Within those broad areas there may be further inequalities, as even in urban areas, slum areas or neighborhoods on the edges of cities may have less access to quality healthcare than populations that live in wealthier areas of the city or closer to the city center. Further there are broader questions of gender and access to care. Where women are not able to control household finances, they may be unable to access and pay for lifesaving care. Participants framed the question in a rights framework, “Do we value the lives of women less than men?”
- Health workforce gaps: There is a mismatch between the supply of health workers and the absorption of those trained health workers in Kenya. Many of them are not incentivized professionally or financially to stay in the system where they are trained. These health workers may leave for other countries or prefer to stay in urban areas depriving rural areas of a surplus of trained health workers.
- Gaps between words and actions: Several of the small working groups pointed to accountability as a serious issue, as there are gaps between the words of politicians on health issues and actual actions. The gap between the government promised funding for health and the actual lower amount of spending was consistently highlighted during the Nairobi dialogue as a serious gap in holding governments accountable for their promises.
The lively conversation provoked by a broad discussion of gaps in the Kenyan health system provided fertile ground to develop action points on maternal healthcare that participants then presented on the second day of the meeting to several Kenyan members of parliament. Ideally, this will be the first discussion of many as maternal health advocates, field workers, and researchers coalesce around ways to address the gaps in maternal healthcare in Nairobi and elsewhere.
Emily Puckart is a senior program assistant at the Maternal Health Task Force (MHTF).
Photo Credit: Jonathan Odhong, African Population and Health Research Center. -
Twin Challenges: Population and Climate Change in 2050
›With global population reaching 7 billion, a lot of attention has been paid to the question of how to sustainably support so many people, much less the 9 billion expected by 2050, or the 10 billion possible by 2100. Add in the environmental variability projected from climate change and the outlook for supporting bigger and bigger populations gets even more problematic. Two new maps – one by the Population Reference Bureau (PRB), the other by McGill University PhD candidate Jason Samson – show how the world might change over the next 40 years in the face of these twin challenges.
Nine Billion in 2050
PRB’s map, built using their DataFinder tool, shows the world in 2050 in terms individual country growth rates between now and then. Japan, Russia, and countries in Eastern Europe are set to grow more slowly than anywhere else, and some of that group will actually shrink by 10 to 20 percent of their current size. Western, Central, and Eastern Africa will be home to the highest increases. Niger’s 2050 population is expected to be 340 percent its 2011 size – the largest growth of any country.
The map is based on country-level data pulled from a number of sources: the UN Population Division’s latest “World Population Prospects,” the UN Statistics Division’s “Demographic Yearbook 2008,” the U.S. Census Bureau’s International Database, and PRB’s own estimates. It’s unclear what numbers come from which sources, though it is clear that PRB’s 2050 estimates span the UN’s range of medium, high, and constant-fertility variants. In spite of these variations, none of PRB’s estimates come anywhere near the UN Population Division’s low variant estimates.
PRB’s map, echoing its 2011 World Population Data Sheet, shows a world where sub-Saharan Africa will bear the brunt of population growth. The average country in Africa in 2050 is projected to be slightly more than twice its 2011 size; the average European country is expected to barely break even. Africa is home to more countries whose populations are estimated to least double (34) or triple (4) than any other continent. Europe, meanwhile, is home to more countries whose populations will stagnate (8), or even shrink (19), than anywhere else. Interestingly, the Caribbean is a close second in terms of countries whose populations are projected to stay the same (seven to Europe’s eight), and Asia is second to Europe in terms of countries whose populations are projected to shrink (Georgia, Japan, Armenia, South Korea, and Taiwan).
More People, More Climate Change, More Vulnerability
Samson’s map takes on the same time period but projects where people will be most vulnerable to the effects of climate change. Since his map takes into account population growth (measuring where people are most vulnerable, remember), unsurprisingly, Africa, the Middle East, Southeast Asia, and central South America are covered in bright red dots, indicating high vulnerability. Conversely, North America, Europe, and much of Central Asia are in shades of blue.Samson built his index using four environmental predictors – annual mean temperature, mean temperature diurnal range, total annual precipitation, and precipitation seasonality – taken from WorldClim’s 2050 forecasts, and 2005 sub-national population data from Columbia’s Center for International Earth Science Information Network. In spite of the sub-national population data, Samson makes a point to justify his use of supranational climate data in order to best reflect “the scale at which climate conditions vary.” He writes that localized issues like urbanization and coastal flooding “are probably best investigated with targeted regional models rather than by attempting to modify global models to include all factors of potential regional importance.”
Samson’s research shows that, generally, people living in places that are already hot will be more vulnerable to climate change over time, while people in more temperate climates will feel a negligible impact. Though he projects the largest real temperature changes will happen in temperate climates like North America and Europe, the comparatively smaller changes in Africa, the Middle East, Southeast Asia, and central South America are expected to have a greater impact because those regions are already very hot, their natural resources are stressed, and they are expected to bear the brunt of population growth over the next few decades.
These findings reflect a disparity between those responsible for climate change and those bearing the brunt of it, which, although not surprising, “has important implications for climate adaptation and mitigation policies,” said Sampson, discussing the map in a McGill press release.
Sub-National Data “Present a Very Different Picture”
Though they offer a useful approximate glimpse at what the world might look at in 2050, both of these maps fall prey to over-aggregation. By looking at national rather than sub-national data, we miss how nuanced population growth rates can be within a country. Stimson Center Demographer-in-Residence Richard Cincotta wrote in a recent New Security Beat post that “national level comparisons of total fertility rates tend to communicate the false impression of a world with demographically homogeneous states.” Sub-national data, including differences between urban and rural areas and minority-majority fertility rates, “present a very different picture.”
And that difference matters. When it comes to looking at how population interacts with other issues, like the environment, poverty, and conflict, the importance of a sub-national approach becomes evident. In its 2011 data sheet, PRB writes that “poverty has emerged as a serious global issue, particularly because the most rapid population growth is occurring in the world’s poorest countries and, within many countries, in the poorest states and provinces.”Edward Carr, an assistant geography professor at the University of South Carolina currently serving as a AAAS science fellow with USAID, argues that national-level data obscures our ability to understand food insecurity as well. The factors that drive insecurity “tend to be determined locally,” writes Carr in a post on his blog, and “you cannot aggregate [those factors] at the national level and get a meaningful understanding of food insecurity – and certainly not actionable information.”
The same is true when it comes to climate vulnerability. In a report from The Robert S. Strauss Center’s Climate Change and African Political Stability Program, authors Joshua Busby, Todd Smith, and Kaiba White write that “research announcing that ‘Africa is vulnerable to climate change,’ or even ‘Ethiopia is vulnerable,’ without explaining which parts of Ethiopia are particularly vulnerable and why, is of limited value to the international policy community.”
“It is of even less use to Africans themselves, in helping them prioritize scarce resources,” add Busby et al.
Understanding the joint problems of climate change and population growth on a global level helps frame the challenges facing the world as it moves toward 8, 9, and possibly 10 billion. But knowing the ins and outs of how these issues interact on a local level will be a necessary step before policymakers and others can hope to craft meaningful responses that minimize our vulnerability to these challenges over the coming decades.
Sources: Center for International Earth Science Information Network at Columbia University, Climate Change and African Political Stability Program at the Robert S. Strauss Center, McGill University, Population Reference Bureau, UN Population Division, UN Statistics Division, U.S. Census Bureau, University of South Carolina, WorldClim.
Image Credit: “2050 Population As a Multiple of 2011,” courtesy of PRB; CDVI map used with permission, courtesy of McGill University; Sub-national total fertility rates in Southern Africa, courtesy of MEASURE DHS, arranged by Schuyler Null. -
Rwanda: Dramatic Uptake in Contraceptive Use Spurs Unprecedented Fertility Decline
›November 8, 2011 // By Elizabeth Leahy MadsenWith over 400 people per square kilometer, the highest rate on the African mainland, population density is perhaps the most widely-discussed factor of Rwanda’s demography. Some scholars, notably Jared Diamond, have argued that it played a primary role in sparking the 1994 genocide through competition for land (although others present a more complex theory based in policies and governance).
-
Watch: Ann Blanc on Finding Unique Partnerships to Address Maternal Health Needs
›In the last five years, maternal health has begun to take a front seat within the larger global health agenda, but when it comes to a neutral space for broader focusing and prioritizing efforts there is still a void. In 2008 the Gates Foundation created the Maternal Health Task Force (MHTF) in an effort to fill that void. In this interview with ECSP, former MHTF Director Ann Blanc discusses how collaboration with the Wilson Center and the United Nations Population Fund has created an ideal space for addressing the technical, programmatic, and policy sides of neglected maternal health issues.
“Part of our mandate,” Blanc noted, “is to bring in the perspective of what we call ‘allied fields.’” The Wilson Center’s Advancing Policy Dialogue to Improve Maternal Health series focuses on engaging with neglected and emerging topics and experts, finding connections and encouraging partnerships with other fields, such as those working in water, sanitation, or HIV/AIDS services.
For instance, a two-day conference last year with private meetings and public dialogues focused on the neglected issue of transportation for women seeking maternal health services. The conference brought together non-traditional actors, including transportation engineers and mobile technology experts, to identify common barriers mothers commonly face like lack of infrastructure, poor security, or limited access to emergency communications.
“We’re constantly trying to push those barriers and look for interconnections between different development sectors and maternal health,” Blanc concluded. -
Improving Maternal Health: A Conversation With Kenyan Field Workers and Policymakers
›“The traditional strategies for improving the health system include the horizontal approach, which prioritizes non-communicable diseases, and the vertical approach which prioritizes communicable diseases such as HIV/AIDS,” said John Townsend, vice president of reproductive health programs at Population Council, during a webcast discussion – the second in a series – between the Woodrow Wilson Center in Washington, DC, and maternal health experts in Nairobi, Kenya. [Video Below]
Recently, a third strategy, called the “diagonal approach,” was developed to more clearly define health system priorities and guide general system-wide improvements. Participants in both locations discussed this new approach and other structural improvements that can be made to better integrate maternal health indicators into developing country health systems on October 17.
The meeting was part of the 2011 Advancing Dialogue on Maternal Health series, with the Wilson Center’s Global Health Initiative and the African Population and Health Research Center. Participants in Nairobi were assigned to three topical groups and asked to identify challenges and opportunities related to their themes.
The Role of Policymakers and Funders“We must engage [policymakers and donors] in forums like this one to share findings and share lessons learned,” said participant Sylvia Bushuru of Kenya as she reported back from the policymakers and funders working group. The group focused on steps required to hold politicians accountable to commitments made to maternal health, such as the Abuja Declaration, which requires the Ministry of Finance to dedicate 15 percent of the budget to health. Currently, only 5.5 percent of the Kenya budget is dedicated to the health sector.
Identifying strategic partners will help in reaching ambitious goals, the group agreed; however, they noted that it’s important to ensure that these partnerships and policies extend to an operational level. Besides the overall budget pledge, important steps like ensuring 24-hour emergency health facilities in rural areas and implementing a results-based financing plan based on maternal health indicators have yet to be completed.
A Definition of Priorities through a Diagonal Approach
James Wariero, a regional health advisor with the MDG Centre for East and South Africa, served as the representative for the group discussing the “diagonal approach,” which focused on how maternal health indicators can best set priorities to improve the overall health system. They identified antenatal care visits as a priority because they also serve as an entry point to other health services, including HIV/AIDS treatment.Discussing gender, he said that “male involvement in maternal health will have benefits for child health and other issues…it is an area with little headway here in Kenya and other similar countries in Africa.” Additionally, Wariero discussed how the diagonal approach could be used to link maternal health indicators with other sectors such as technology and information systems.
The group said that improving the health system should start at the district level to ensure the most vulnerable populations at the community level have proper access. However, they said that ideally district-level programming should be evaluated and funded through results-based financing and structured on clear maternal health indicators.
Knowledge Gaps and Research Needed
“We initially began our discussion surrounding the [World Health Organization’s] six health system blocks,” reported Dr. Kristine Kisaka, a program officer with Deutsche Stiftung Weltbevoelkerung and representative from the “knowledge gaps and research needed” group. This group identified access to mobile phones for maternal health data collection as a major resource gap. Instead of calling for additional research they said they would prefer better implementation of existing, evidence-based programming.
Utilizing the World Health Organization’s health system framework, the group identified existing knowledge gaps to improve maternal health in Kenya and six recommendations:- Strengthen community strategies through a national synchronization of information
- Harmonize planning and implementation of the provisioning of supplies and commodities at the community level
- Address inequalities in the distribution and delivery of health services, ensuring distribution to urban and rural centers, including slums
- Centralize health financing in order to reach both national and community levels
- Empower households in financing, including both women and men, so they plan and save for maternal health
- Address the imbalance in supply and demand of healthcare workers
Linkages: Key To Improving Maternal Health Systems
“It’s really about linkages,” said John Townsend, giving closing remarks after the presentations from Nairobi. Maternal health indicators can be a catalyst for change, due to their strong cross-cutting links to other development systems, such as transportation, the economy, and education. “I think the call to action that the Kenyan working groups made is quite valuable,” he said, but the question is, “How do we get intelligent decision alternatives in front of our leaders to figure out what are the best investments given the critical resources?”
“The private sector [presents] an opportunity,” said Townsend. “I think we need to be more explicit about how we want to engage with them and what we would like to see from them.” He pointed out that the national maternal health strategy in Kenya is explicit and promising, but there needs to be stronger links between the national strategy and the operational aspects of actually implementing it.
Event Resources:- Photo gallery
- Presentation: “Improving Health Systems Through a Maternal Health Framework,” African Population and Health Research Center
- Video
Photo Credit: #1 and #3, courtesy of Jonathan Odhong, African Population and Health Research Center; #2 courtesy of David Hawxhurst/Wilson Center. -
Good Company: ‘New Security Beat’ Honored for Best Population Commentary
›The Population Institute’s 2011 Global Media Awards go to a Pulitzer Prize winning cartoonist, the head of the UN Population Fund, PBS NewsHour – and us! We’re thrilled to announce that the New Security Beat has won its third Global Media Award for Best Online Commentary or Blog.
Our company in this year’s line-up is impressive:- PBS NewsHour, for several segments related to population issues, including one on an Indonesian plant showing promise for male birth control and another on how religion and tradition are clashing with family planning efforts in Guatemala;
- Dr. Babatunde Osotimehin, Executive Director of UNFPA, for his editorial in Science, “Population and Development;”
- EarthSky: A Clear Voice for Science, for their series of weekly interviews with scientists around the world, including a series with population experts.
- Population Action International (PAI), for their short film Weathering Change, which tells stories about the impact of climate change on women from Ethiopia, Nepal, and Peru (and which was launched at the Wilson Center).
New Security Beat also got a nice shout-out from Andy Revkin on Dot Earth this week for our “seven billion” stories and coverage from South by Southwest Eco. For more on “seven billion” be sure to read Elizabeth Leahy Madsen’s breakdown of how we got to this milestone, Geoff Dabelko’s take on seven ways seven billion will affect the planet, the webcast of our recent reporting on population and environment event, and our latest YouTube videos, including PAI’s Roger-Mark De Souza presenting at South by Southwest Eco.
Subscribe:
