“One of the reasons why population grows very rapidly in Bangladesh is women get married very early and have children very early,” the Population Council’s Sajeda Amin told ECSP in a recent interview. “So even though they are only having two children, they are having them at an average age of around 20. As demographers would say, women ‘replace’ themselves very rapidly.”

Largely through the promotion of contraceptive use, family planning programs implemented over the past 35 years by the Bangladeshi government and a variety of NGOs have helped lower the country’s total fertility rate to 2.7 from 6.5 in the mid-1970s. To build on this progress, the Population Council has joined a consortium of other organizations – including the Bangladesh Legal Aid and Services Trust, Marie Stopes International, and We Can End All Violence Against Women – to launch the Growing Up Safe and Healthy (SAFE) project in Amin’s native Dhaka and other Bangladeshi cities.

“The issues of population, health, and environment are pretty foreign to a lot of people,” said Alecia Fields, a recent University of Kentucky graduate who participated in a Sierra Club Global Population and Environment Study Tour of Ethiopia last summer as a student fellow.

“I learned about the program, how to be an effective advocate, and I took those tools back to my university on campus and shared it with young people,” said Fields in this interview with ECSP.

The original version of this article, by Emily Puckart, appeared on the Maternal Health Task Force blog.

I attended the two day Nairobi meeting on “Maternal Health Challenges in Kenya: What New Research Evidence Shows” organized by the Woodrow Wilson International Center and the African Population and Health Research Center (APHRC). [Video Below]

The original version of this article, by Farahnaz Zahidi Moazzam, appeared on the Population Reference Bureau’s Behind the Numbers blog.

My name is Farahnaz Zahidi Moazzam, and I’m a freelance journalist, writer, and editor from Pakistan. My passion is writing about human rights with a special focus on gender issues and reproductive health. Blogging is a personal joy to me, as I put my heart into my writing and blogging allows for a more personalized style. Digital journalism is a sign of evolution – one I happily accept. My pet peeve is marginalization on any grounds. I am a mother of a teenage daughter and live in Karachi.

“The reasons for state weakness and failure are complex, but not unpredictable,” said J.J. Messner, one of the founders of the Fund for Peace’s Failed States Index, at the launch of the 2011 version of report in Washington last month. The Index is an analytical tool that could aid policymakers and governments seeking to prevent and mitigate state collapse by identifying patterns of underlying drivers of state instability.

“By reducing population growth, we are going to have a better chance of sustaining the gains of an environmental conservation project,” said Leona D’Agnes in this interview with ECSP. D’Agnes, a technical advisor to PATH Foundation Philippines, served as lead author on a research article published late last year in Environmental Conservation titled, “Integrated Management of Coastal Resources and Human Health Yields Added Value: A Comparative Study in Palawan (Philippines).” The study provided concrete statistical evidence that integrated development programming incorporating population, health, and the environment (PHE) can be more effective in lowering population growth rates and preserving critical coastal ecosystems than single-sector development interventions.

High population growth and population density have placed serious stress on natural resources in the Philippines. No one lives far from the coast in the 7,150-island archipelago, making the population extremely dependent on marine resources and vulnerable to sea-level rise, flooding, and other effects of climate change. The coastal megacity of Manila – one of the most densely populated in the world – is beset by poor urban planning, lack of infrastructure, and a large population living in lowland slums, making it particularly vulnerable to increased flooding and natural disasters. [Video Below]

The Philippines is now home to 93 million people and by 2050 is expected to reach 155 million, according to the UN’s medium fertility variant projections. Development programs in the country have made great strides towards increasing access to family planning and reproductive health services as well as improving management of marine resources, but the underlying trends remain troubling.

The Battle Over Reproductive Health

Since 1970, the government’s Commission on Population has been addressing population growth, reproductive health, and family planning. “The impact of the high rate of population growth is intricately linked to the welfare and sustainable development for a country like the Philippines, where poverty drives millions of people to overexploit their resource base,” wrote the commission. As a result of these efforts and others, total fertility rate has dropped from 6.0 children per woman in 1970, to the present 3.2.

The Philippines has also made great gains towards achieving Millennium Development Goal targets, “particularly in the alleviation of extreme poverty; child mortality; incidences of HIV/AIDS, tuberculosis, and malaria; gender equality in education; household dietary intake; and access to safe drinking water,” according to the United Nations Development Program (UNDP). Yet, “glaring disparities across regions persist,” UNDP states.

One of the poorest regions in the country, the Autonomous Region of Muslim Mindanao, is also home to a violent separatist movement. With limited access to health services, fertility and population growth rates are the highest in the country. Women in Mindanao average 4.2 children per woman; one in four married women has an unmet need for contraception; and 45 percent of households live in poverty (compared to 24 percent nationally).

Nationally, “serious challenges and threats remain with regard to targets on maternal health, access to reproductive health services, nutrition, primary education, and environmental sustainability,” according to UNDP–in particular, indicators on maternal health are “disturbing” and of all the MDGs, are labeled “least likely to be achieved.”

Out of three million pregnancies that occur every year, half were unplanned and one-third of these end in abortions, according to a 2006 report of the Allan Guttmacher Institute conducted in the Philippines. Induced abortion was the fourth leading cause of maternal deaths, and young women accounted for 17 percent of induced abortions. Over half of births occurred at home and one-third of them were assisted by traditional birth attendants. Around 75 percent of the poorest quintile did not have access to skilled birth attendants compared to only 20 percent of the richest quintile.

The politically influential Catholic Church recently blocked passage of a reproductive health bill, despite support by President Benigno Aquino and a majority of Filipinos. The bill seeks to provide universal access to contraception and would make sex education required from fifth grade onwards, a provision that has angered Church officials.

Manila Under Water

The Philippines’ combination of high population growth and limited land area (nearly all of which is near the coast) makes the country extremely vulnerable to the effects of climate change. Sixty-five percent of Filipinos live in coastal areas and 49 percent live in urban areas. Paul Hutchcroft, in Climate Change and Natural Security, writes that “even in the best of times, the frequency of typhoons, floods, earthquakes, and volcanic eruptions makes the Philippines one of the most disaster-prone countries in the world” (p. 45).

Population growth, climate change, and deforestation will only increase the severity of these disasters, he concludes. Hutchcroft points out that by 2080, projected temperature increases of between 1.2 to 3.9 degrees Celsius could raise sea levels by an estimated 0.19 to 1.04 meters – a scary thought for the 15 million living within a one-meter elevation zone (p. 46).

In 2009, metropolitan Manila, currently home to 11 million people (18,650 per square kilometer) and projected to grow to 19 million by 2050, was hit by tropical storms that caused devastating flooding – at their peak, waters reached nearly seven meters, according to a World Bank report. “More than 80 percent of the city was underwater,” write the authors, “causing immense damage to housing and infrastructure and displacing around 280,000-300,000 people.”

“Even if current flood infrastructure plans are implemented, the area flooded in 2050 will increase by 42 percent in the event of a 1-in-100-year flood,” says the World Bank report. Climate change could also increase the cost of flooding as much as $650 million, or 6 percent of GDP. Only by considering climate-related risks in urban planning can the Philippines hope to mitigate the effects of climate change, the report concludes.

Integrated Development: One Piece of the Puzzle?

Population, health, and environment (PHE) programs that integrate family planning and natural resource management are one way to help the majority of Filipinos that live in densely populated and resource-stressed coastal areas.

In ECSP’s FOCUS Issue 15, “Fishing for Families: Reproductive Health and Integrated Coastal Management in the Philippines,” Joan Castro and Leona D’Agnes explain how Path Foundation Philippines, Inc.’s IPOPCORM project – which ran from 2000 to 2006 – helped “improve reproductive health and coastal resource management more than programs that focused exclusively on reproductive health or the environment – and at a lower total cost.” A recent peer-reviewed study, co-authored by Castro and D’Agnes and published in Environmental Conservation, proved the same point with rigorous analysis.

“When we started IPOPCORM, there was really nothing about integrating population, health, and environment,” said Castro in an interview with ECSP. IPOPCORM provided some of the first evidenced-based results showing there is value added to implementing coastal resource management and family planning in tandem rather than separately. In part due to the success of the IPOPCORM, the Philippines have become one of the major PHE development implementers in the world.

Creating sustainably managed marine sanctuaries while improving access to family planning provides a way forward for many coastal communities. However, the Philippines’ urban woes – 44 percent of urban dwellers live in slums, according to the Population Reference Bureau – internal divisions, and natural vulnerability will likely make it difficult to dodge considerable climate-related effects in the near future. Already the archipelago’s vast biodiversity is in crisis, according to studies over two thirds of native plant and animal species are endemic to the islands and nearly half of them are threatened; only seven percent of its original old-growth less than 10 percent of the islands’ original vegetation remains; and 70 percent of nearly 27,000 square kilometers of coral reefs are in poor condition.

Sources: CIA, Conservation International, Field Museum, The Guardian, The Huffington Post, Philippines National Statistics Office, Population Reference Bureau, United Nations, U.S. Census Bureau, World Bank, World Wildlife Fund.

Photo Credit: “Climate Risk and Resilience: Securing the Region’s Future” courtesy of Flickr user Asian Development Bank.

The original version of this article, by Michael Kugelman, appeared on Foreign Policy’s AfPak Channel.

Pakistan’s 2011 census kicked off in April, but less than three months later, it is embroiled in controversy. Several members of the Sindh Census Monitoring Committee have rejected as “seriously flawed” the recently completed household count. They allege that census workers, directed by an unspecified “ethnic group,” have counted Karachi’s “inns, washrooms, and even electric poles” as households in an effort to dilute the city’s native “Sindhi” presence.