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From the Wilson Center
Healthy People, Healthy Ecosystems: Results From a Public-Private Partnership
MORE“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
Topics: conservation, DRC, environmental health, family planning, forests, From the Wilson Center, global health, Kenya, Nepal, PHE, population, USAID -
Eye On
STATcompiler: Visualizing Population and Health Trends
MOREWorld population is growing – earlier this week, the global community symbolically marked the arrival of the seven billionth person. But the unprecedented growth in global population over the last few decades has not affected everyone equally – in 1950, 68 percent of the world’s population lived in developing regions; today that number is 82 percent. MEASURE’s latest version of their STATcompiler tool helps visually highlight areas simultaneously experiencing the most demographic change and poor health indicators.
The revised STATcompiler – released in September – provides new ways for users to visualize data by generating custom data tables, line graphs, column charts, maps, and scatter plots based on demographic and health indicators for more than 70 countries. Users can select countries or regions of interest, and relevant indicators, including for family planning, fertility, infant mortality, and nutrition. Tables can be further customized to view indicators over time, across countries, and by background characteristics, such as rural or urban residence, household wealth, or education. In some cases, sub-national data is available. User-created tables and images are then exportable so that they may be easily used in papers or presentations.
Since STATcompiler is still in active development, certain functions are still being added. HIV data has not yet been integrated into the program, nor has the express viewer function, with customizable, ready-made tables for quick access. Additionally, updated information is not available for all countries, in all categories – for instance, the most recent data available for Mexico comes from a 1987 survey. If preferred, the legacy version remains available to users in the meantime.
MEASURE DHS – the Monitoring and Evaluation to Assess and Use Results Demographic and Health Surveys project – provides technical assistance for data collection on health and population trends in developing countries. Their demographic and health surveys, funded by USAID, provide data for a wide range of monitoring and impact evaluation indicators at the household level in the areas of population, health, and nutrition. They have become a staple data source for researchers, and the addition of better analysis functions and dissemination tools, via STATcompiler, will hopefully help advance understanding of demographic and health trends.
Image Credit: Map from STATcompiler, arranged by Schuyler Null. -
Reading Radar
Health Development: Providing Free Care and Overcoming Gender-Based Violence
MOREIn The Lancet’s “How Did Sierra Leone Provide Free Health Care?,” author John Donnelly of the Ministerial Leadership Initiative attributes the unanticipated success of a free health care program for women and children in Sierra Leone to good organization, transparency, and a high degree of cooperation between the government, donors, and development partners. One distinctive factor that has contributed to the health system’s turnaround is the unusually high level of political will on the part of President Ernest Bai Koroma, writes Donnelly. Similar to Egypt’s health and population initiatives, Sierra Leone’s marked commitment, accountability, and investment as a host country has contributed highly to the success of its program and triggered further investment from donors.In “Systematic Violence: A Barrier to Achieving the Millennium Development Goals for Women,” from the Journal of Women’s Health, authors Joia S. Mukherjee, Donna J. Barry, Hind Satti, Maxi Raymonville, Sarah Marsh, and Mary Kay Smith-Fawzi assert that the elevation of women is integral to the achievement of the Millennium Development Goals, to which structural violence serves as a significant barrier. Murkherjee et al. recommend community-based programs to combat structural violence and prevent disease, such as the Partners in Health (PIH) program in Haiti. PIH trains community health workers, expands health care as a public good, and bolsters social determinants, which include increasing access to family planning and education, providing compensation for medical workers, and improving health infrastructure. -
Watch: Jennifer Dabbs Sciubba on Population and National Security
April 28, 2011 // By Schuyler Null“Long-term trends really are what shape the environment in the future,” said Jennifer Dabbs Sciubba in this interview with ECSP. “As we’ve seen recently with…revolution in North Africa, it’s the long-term trends that act together for these things to happen – I like to say demography is not usually the spark for a conflict but it’s the fodder.”MORE
Sciubba is the Mellon Environmental Fellow in the Department of International Studies at Rhodes College. In her new book, The Future Faces of War: Population and National Security, she discusses the importance of demographic trends in relation to security and stability, including age structure, migration, youth bulges, population growth, and urbanization.
One of the most important things to emerge from the book, said Sciubba, is that countries that are growing at very high rates that are overwhelming the capacities of the state (like many in sub-Saharan Africa) really will benefit from family planning efforts that target unmet need.
Afghanistan, for example, “has an extremely young age structure,” Sciubba pointed out. “So if you’re trying to move into a post-conflict reconstruction atmosphere…you absolutely have to take into account population and the fact that it will continue to grow.”
“Even if there are major moves now in terms of reducing fertility, they have decades ahead of this challenge of youth entering the job market,” Sciubba said. “Thousands and thousands more jobs will need to be created every year, so if you have a dollar to spend, that’s a really good place to do it.”
For more on Jennifer Dabbs Sciubba and The Future Faces of War, see her book launch at the Wilson Center with Deputy Under Secretary Kathleen Hicks of the Department of Defense (video) and some of her previous posts on The New Security Beat.Topics: Afghanistan, Africa, demography, family planning, Middle East, military, population, security, video, youth -
Watch: Elizabeth Leahy Madsen Explains the Demography-Civil Conflict Interface in Less Than Two Minutes
April 12, 2011 // By Schuyler NullMORE“We know that historically, as well as in the present, countries that have very young age structures – those that have youthful and rapidly growing populations – have been the most vulnerable to outbreaks in civil conflict,” said Elizabeth Leahy Madsen, senior research associate at Population Action International, in an interview with ECSP. “It’s not a simple cause and effect relationship, but we think that demographic trends and pressures can exacerbate underlying conditions.”
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Beat on the Ground
Philippines’ Bohol Province: Elin Torell Reports on Integrating Population, Health, and Environment
MOREFor 10 years, I have been working on marine conservation in Tanzania with the University of Rhode Island’s Coastal Resources Center. As part of that effort, I’ve helped forge links between HIV/AIDS prevention in vulnerable fishing communities and marine conservation. However, family planning and reproductive health (FP/RH) were relatively new to me. But a recent study tour of an integrated Population, Health, and Environment (PHE) program in the Philippines helped me understand that combining family planning services and marine conservation can help reduce overfishing and improve food security.
Together with developing country representatives from seven African and Asian countries, I spent two weeks in February visiting three PHE learning sites and a marine protected area in Bohol province in the central Philippines, as part of a South-to-South study tour sponsored by the USAID-funded BALANCED Project, for which I work. The tour focused on the activities of the 10-year-old Integrated Population and Coastal Resource Management Initiative (IPOPCORM) project, which is run by PATH Foundation Philippines, Inc. (PFPI).
IPOPCORM has garnered a wealth of lessons learned and best practices to share with PHE newbies like me. Its integrated programs train people to be community-based distributers (CBDs) of contraceptives and PHE peer educators, as well as work with local and regional government officials to build support for family planning as a means to improve food security.
I was most impressed with the ways in which PFPI identifies and cultivates dynamic and motivated local leaders–men, women, and especially youth–to reach out to the members of their community who are highly dependent on marine resources for their survival. My Tanzanian colleagues and I would like to foster the volunteer spirit and “can do” attitudes we experienced through our work in East Africa. (Similar PHE peer educators are successfully working in Ethiopia’s Bale Mountains, as reported by Cassie Gardener in a previous edition of the “Beat on the Ground.”
My favorite part of the tour was a trip to the Verde Island Passage to see PFPI’s efforts in this fragile hotspot. The insights my Tanzanian colleagues and I gained from talking to the field practitioners in the Verde Islands helped us refine our ideas for translating some of the PHE techniques used in the Philippines to the Tanzanian cultural context, including an action plan for strengthening our existing PHE efforts with CBDs and peer educators.
Thanks to the study tour, I now have a better understanding of how to address population pressures in the context of conservation. Overall, my Tanzanian colleagues and I were inspired by the successes we saw firsthand and hope to emulate them to some degree in our own projects.
Elin Torell is a research associate at the Coastal Resources Center at the University of Rhode Island. She is the manager of CRC’s Tanzania Program and coordinates monitoring, evaluation, and learning within the BALANCED project. -
Making the Connections: An Integration Wish List for Research, Policy, and Practice
January 3, 2010 // By Geoffrey D. DabelkoMORENew York Times columnist Nick Kristof is likely a well-known voice to New Security Beat readers. His ground-level development stories from around the world expose a range of neglected issues that usually struggle for mainstream media coverage: maternal health, microcredit, human trafficking, family planning, sanitation, micronutrients, and poverty, among others.
Kristof brought many of these threads together Half the Sky, a book he coauthored with his wife Sheryl WuDunn. I asked about the challenges of addressing these connected problems when I interviewed the couple and two frontline White Ribbon Alliance maternal health practitioners this fall at the Wilson Center.
Now Kristof is asking readers to suggest topics for him to cover in 2010. My suggestions to him are actually a wish list for the wider development community. In short, how can scholars, policymakers, practitioners, and communities better research and analyze these connected topics and then fashion integrated responses? I posted my comment on Kristof’s blog, On the Ground (and I ask your indulgence for the less than polished writing):I’d love for you [Kristof] to explore the challenge of integration from both problem and response perspectives. People in poverty lead integrated lives (just like we wealthier folks do), face connected challenges, and need integrated or multiple responses. Single-sector programs may deliver quicker, more obvious, and/or more countable impacts (or parallel advantages for single-discipline research endeavors). Yet time and time again we see such approaches only partially meeting needs or not meeting them sustainably. There is also a persist danger of undercutting others’ efforts and/or creating high opportunity costs.
These questions topped my wish list to Kristof last night while procrastinating on other writing. What would be on your wish list for Kristof, the development community, or even just New Security Beat? We at the Environmental Change and Security Program (ECSP) would love to hear from NSB readers so we can keep covering the questions that interest you.
So which integrated research, policy analysis, or field-based programs explicitly recognize that trends that appear to be on the periphery are hardly peripheral? At the same time, if programs try to be all things to all people, they can become bloated, unrealistic, and/or unsustainable.
For example, are the Millennium Villages examples of the former or the latter? How about the much smaller programs under the population-health-environment grouping? What went wrong with Campfire programs to cause so many to abandon the approach? Have the loosened restrictions on what constitutes an appropriate PEPFAR intervention addressed this integration problem, or will politics (exclusion of family planning in PEPFAR, for example) mean we cannot capture the full benefits of integration?
And the big Kahuna: how is the rhetoric and analytical argument around the 3Ds (defense, development, and diplomacy) made real and practicable in the field (as in the United States we anticipated early this year the results of the Quadrennial Defense Review (QDR), Quadrennial Diplomacy and Development Review (QDDR), and Presidential Study Directive on Global Development Policy (PSD))?
And finally, does our (read donors’) penchant for measuring impact and quantifying results force us to narrow interventions to the point of missing key connections in cause and effect of the problems we are trying to address? Is there a better mix of defining and measuring success that captures the challenges and benefits of integration? -
Missives From Marrakech: Enter the Environment
October 2, 2009 // By Gib ClarkeMORE
“Contraception is the cheapest way to combat climate change,” read the headline of The Telegraph in mid-September, announcing the release of “Fewer Emitters, Lower Emissions, Less Cost,”a study from the Optimum Population Trust (OPT) and the London School of Economics (LSE). Similar stories appeared in newspapers around the world.
Though there has been near-universal agreement that the OPT-LSE paper oversimplifies the link between demography and climate change, the buzz among the family planning and environment communities has continued during the IUSSP conference in Marrakech. Perhaps this is because demographers are not used to appearing in the press except when discussing census results. More likely it is the timing of the report, with the Copenhagen conference on climate change coming in December.The buzz hit a peak on Thursday at the IUSSP, with a plenary presentation examining the links. Wolfgang Lutz jumped right in, noting that it’s not as simple as the OPT-LSE study makes it. Population growth is important, but size is not the only thing that matters; other aspects such as age distribution, household structures, and levels of urbanization come into play as well.
In addition, between population size and climate change lie a number of intermediary factors, such as consumption levels, technology improvements, and greenhouse gas (GHG) emissions. Lutz argued that demography has a unique contribution to make to the climate discussion, for no other discipline understands the composition of different populations in different places both now and in the future. Therefore, demographers should explain how different groups will contribute to climate change, and how they will suffer the consequences, so that adaptive capacities can be strengthened and social programs can fill the gaps.
Leiwen Jiang described research conducted by some of the giants in climate and demography: National Center for Atmospheric Research, International Institute for Applied Systems Analysis, and Population Action International. Their work uses a “PET” model – Population, Environment, and Technology – which looks at how the PET elements impact four critical predictors of GHG emissions: consumption, energy use, labor, and savings. A forthcoming paper by this group will delineate the complete findings, including the potential for GHG “savings” brought by decreases in fertility and thus reduced population growth, as well as the added GHG due to future urbanization.
Susana Adamo took a step back to show the audience the view from 30,000 feet – literally, with maps demonstrating that population density is highest in areas most vulnerable to impacts of climate change, such as sea-level rises, droughts, floods, and other severe weather events.
Unfortunately, one of the stars of this research, Brian O’Neill, was unable to attend, due to health reasons. His research, to be published soon, is highly anticipated, and should add additional quantitative fuel to the fire.
Not Just Climate
Environmental links with population and demographic factors have also factored in other parts of this “demography” conference. A host of sessions, many organized by the Population-Environment Research Network, have explored linkages between population growth, migration, and urbanization on the demographic side; and deforestation, natural resource management, and environmental degradation on the environmental side. Questions concerning these and other environmental factors have surfaced at panels exclusively dedicated to other topics such as family planning. Some sessions examined how population and environment concerns can be jointly addressed.
It is encouraging to see demographers and reproductive health specialists taking climate and environmental factors so seriously. The response from the environmental community has been mixed, with some interest in population issues, but also some opposition from the climate community to including discussions of family planning in an already controversial topic. At a similarly large gathering of environmentalists and conservationists, the 2008 IUCN conference in Barcelona, only two sessions addressed health or population. So we have a long way to go progress to unite these communities of researchers and practitioners, and come together in a truly fruitful engagement.
Photo courtesy World Bank Photo Collection.
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