Midwives play a critical but unheralded role in maternal health. Their skills are sometimes marginalized in otherwise well-meaning discussions about professionalizing care, or even worse, they are subject to abuse, as was discussed at the Wilson Center earlier this month. So when I found the room overflowing at a Women Deliver panel yesterday on the disempowerment of midwives and how much it undermines global efforts to increase access to care, I took that as a good sign that midwives will not be overlooked much longer.
It’s funny when you bump into your neighbors on the other side of the world. Today I spoke about the Global Health Initiative’s recent collaboration with the Population Foundation of India at a regional briefing on health in South and Southeast Asia before the 2013 Women Deliver conference in Kuala Lumpur, Malaysia. The special roundtable was part of a week-long study tour for a group of U.S. Congressional staffers that work on foreign affairs.
On day three of the 2013 Global Maternal Health Conference here in Arusha, Tanzania, I was joined by the Global Health Initiative’s partners to present the results of the Wilson Center’s four-year-old Advancing Dialogue on Maternal Health Series. This series is unique in its convening power, helping to bring together experts and policymakers from around the world to collaborate on a shared goal: healthier mothers and children.
Delivering Solutions to Improve Maternal Health and Increase Access to Family Planning (Policy Brief)›
The Wilson Center Policy Briefs are a series of short analyses of critical global issues facing the next administration that will run until inauguration day.
According to the World Health Organization (WHO), approximately 800 women die daily from preventable causes related to pregnancy and childbirth. Almost all of these deaths occur in developing countries, with higher rates for women living in rural areas and among poorer communities.
›July 13, 2012 // By Sandeep BathalaA month ago this weekend I boarded a plane to Rio de Janeiro for the UN Conference on Sustainable Development. Over the past few weeks, I have had some time to reflect on the amazing (and exhausting) experience afforded to me. Unfortunately, the final Rio+20 outcome document (considered by some to be misnamed as “The Future We Want”) failed to recognize the connections between reproductive rights and sustainability. However, since I returned I’ve also found myself in conversations with colleagues eager to celebrate the successes of the conference.
Jason Bremner, program director at Population Reference Bureau, reminds me that the initial “zero draft document” that was circulated prior to Rio had absolutely no mention of reproductive health, family planning, or population. “Though the ultimate conference document wasn’t a success by many measures, I commend the efforts of the many advocacy organizations that resulted in the inclusion of reproductive health and family planning as a key aspect of sustainable development,” he said.
Other wins were recognized at Rio as well. On a panel organized by the International Planned Parenthood Federation, Brazilian Minister of Policies for Women Eleonora Menicucci de Oliveira pointed out that the presence of women this year was much stronger than at the 1992 conference. And she stressed that the overall importance placed on the reduction of poverty will have a big impact for women.
Though the official language was weakened in the final outcome document, there was much more support expressed at side events and off the record conversations. Speaking at the same event as Oliveira, Christian Friis Bach, Minister for Development Cooperation in Denmark, said that “one leader after another has stood up for reproductive rights, and we’ve started a campaign which will go on until ICPD+20.”
In fact, as the Wilson Center’s Brazil Institute Director Paulo Sotero points out, there was a great deal of progress made by non-government representatives alongside the main conference:
I left Rio more hopeful about the future than the official part of Rio+20 would allow. As governments clearly fumbled in the face of the complex challenges of imagining and building a more equitable and sustainable economic growth model in the decades ahead, I saw senior business executives and leaders of civil society engaged in intelligent and productive dialogue about difficult issues at hundreds of thematic panels held at the Corporate Sustainability Forum and other sessions held in Rio.I felt the same energy. And many groups there seemed to already be planning for next steps.
On the first day of side events I attended, members of the Population and Climate Change Alliance discussed strategies to ensure that in the post-2015 (i.e. post-Millennium Development Goals) international development agenda sexual and reproductive health and rights are explicitly recognized as core to sustainable development. The panel included Mialy Andriamahefazafy of Blue Ventures Madagascar, Joan Castro of PATH Foundation Philippines, Inc., and Negash Teklu of PHE Ethiopia Consortium, who all shared examples of efforts in their countries to integrate reproductive health with other sustainable development programs.
Joan Castro on PATH Foundation’s work in the Philippines
The Rio+20 conference was, at the very least, a re-affirmation of the tenets set down by the ‘92 Earth Summit – that is, that there is middle ground between full-tilt economic development and uncompromising environmentalism, called “sustainable development,” and we ought to be moving towards it. It was also a fantastic gathering place for disparate groups of people to come together on to similar issues and to build momentum and networks on their issues.
For those hoping to see a stronger link recognized between reproductive rights, population, and the environment, the good news is that elsewhere, awareness and momentum seems to be growing. Just this week, The Bill and Melinda Gates Foundation joined the United Kingdom, United States, France, Germany, the Netherlands, South Korea, Norway, Sweden, and Australia to pledge more than $2.6 billion towards meeting global unmet for contraceptives. And the connection to development was explicit: “Contraceptives are one of the best investments a country can make in its future,” reads the summit website.
Coincidence to have followed so closely behind a “disappointing” Rio outcome? Perhaps not.
Sources: The Bill and Melinda Gates Foundation, Estado, UN Conference on Sustainable Development.
Photo Credit: “UN Women Leaders Forum at Rio+20,” courtesy of UN Women.
›June 22, 2012 // By Sandeep BathalaAs heads of state get ready to sign on to the outcome document here in Rio, all eyes are on next steps – especially for the reproductive health and integrated development communities, which have seen their hopes of mainstreaming their issues with the sustainable development agenda dashed.
The final outcome document can be found here. USA Today reports that opposition from a group of countries in the 11th hour stripped the text of critical reproductive rights language:
An initial draft of this conference’s outcome document stated, “We are committed to ensure the equal access of women and girls to education, basic services, economic opportunities, and health care services, including addressing women’s sexual and reproductive health and their reproductive rights.”Absent entirely is any explicit connection between reproductive rights, population dynamics, and sustainable development.
In the final draft, the stronger wording “We are committed to ensure the equal access” was switched to the weaker “We are committed to promote equal access.” The reference to reproductive rights was deleted altogether, after opposition from the G-77, a negotiating bloc of developing countries at the United Nations, and the Holy See.
But others, as we have heard repeatedly throughout the conference, insist that gender issues and reproductive rights have a strong and vital connection to sustainable development. Yesterday, USAID, the Aspen Institute, and the Center for Environment and Population held a discussion in the U.S. tent on this very issue, titled “Making Population Matter: The Demographic Dividend and Sustainable Development.”
As Vicky Markham of the Center for Environment and Population reports on RH Reality Check, the side-event aimed to demonstrate the effects of population dynamics, both positive and negative:
We have the largest youth demographic ever in the history of the world, and most developing nations have a “youth bulge.” This can be seen as a challenge, or opportunity, particularly if the focus is on providing development programs for child survival, family planning, reproductive health, and education. The importance of women’s empowerment was also central. But it’s not a given; it’s an opportunity only if we pay attention to these issues to increase the benefits of the “demographic dividend.”The demographic dividend, as described by USAID Deputy Administrator and panelist Donald Steinberg in blog post earlier this week, “is an opportunity that arises when a country transitions from high to low rates of fertility and child and infant mortality.” But it’s not just about ensuring access to family planning and reproductive health; youth-focused economic and education policies are also needed: “Maximizing the dividend requires social and economic policies that reinforce inclusion, equity, and opportunity across the entire population,” he writes. USAID is making a point of creating youth-focused policies for this reason, he said in Rio.
Carmen Barroso, regional director of the International Planned Parenthood Federation’s Western Hemisphere Region, pointed out that Latin American countries could not take advantage of the demographic dividend before recent societal changes occurred, including decreased fertility, increased urbanization (which leads to smaller families), and greater schooling and employment of women.
Seventy percent of world population growth is likely to be generated by Africa this century, said Eliya Msiyaphazi Zulu, executive director of the African Institute for Development Policy – and it is the only continent projected to continue to grow in the next century, he said. He called for redefining growth as more than GDP as that measure does not consider environmental degradation and its costs: “We must have other means to measure development.”
As heads of state and negotiators consider their positions at this conference – which many were hoping would make a much stronger statement – they might do well to ponder today’s comments from Secretary of State Hillary Clinton:
While I am very pleased that this year’s outcome document endorses sexual and reproductive health and universal access to family planning, to reach our goals in sustainable development we also have to ensure women’s reproductive rights. Women must be empowered to make decisions about whether and when to have children. And the United States will continue to work to ensure that those rights are respected in international agreements.Sources: RH Reality Check, UN, U.S. Department of State, USA Today, USAID.
Now none of this is an abstract discussion. There is just too much at stake, too much still to be done. And many of you visited the U.S. Center here in Rio and saw practical solutions related to some of the work I’ve discussed and other goals we hold in common. We believe solutions require action by all of us. Governments, yes; let’s do our part. Let’s do more than our part.
Photo Credit: YouthPolicy.org.
›June 21, 2012 // By Sandeep BathalaWhile I was visiting with youth peer educators yesterday with the Brazilian Society for Family Welfare in the Cachoeirinha favela (see Vicky Markam’s post for details – we were on the same trip), UN member states reached consensus in the Rio+20 negotiations. But, according to reports, although the outcome document includes some mention of reproductive health, gender equality, and women’s empowerment, it fails to explicitly recognize the link between reproductive rights and sustainable development.
Many women’s rights and health observers have, from the start, encouraged this link.
Karen Newman, speaking to ECSP in April during the Planet Under Pressure conference – a precursor to Rio – said she hoped this week would offer an opportunity to look at “sustainable development in the round” and “re-identify family planning as a core development priority,” given its human rights and health implications and relationship to population growth.
Jenny Shipley (Former Prime Minister of New Zealand) wrote just yesterday on CNN that “we are at a moment in history where we still have time to make a difference. It is essential that the global discussion in Rio not be blind to the potential solutions that access to voluntary family planning could offer to many of the world’s problems.”
“We can no longer afford this outrageous oversight, driven by old-fashioned tradition, discrimination, and pure ignorance,” said Gro Harlem Brundtland (Former Prime Minister of Norway and Former Head of the World Health Organization) at a side event on Monday. “Now is the time to agree to unleash the largest untapped potential for sustainable development and stop all discrimination against women and girls.”
But now that preliminary agreement on the outcome text has been reached, reports have filed in that the connection many were hoping for is absent. Zonibel Woods, blogging on RH Reality Check, wrote:
From the start of the negotiations, gender equality and women’s human rights, including reproductive rights, have continuously been challenged by a few governments, claiming that [these] had “nothing to do with sustainable development.”The lack of consensus among the wider international community may also undercut efforts to highlight reproductive rights in the post-2015 Millennium Development Goals/Sustainable Development Goals framework and as governments ready for the follow-on to the International Conference on Population and Development in 2014. A concrete link to “sustainable development,” whatever form that takes, would help ensure that reproductive health is not side-lined.
This debate continued until the last few hours of the negotiations. In the end, the text includes a re-affirmation of both the Cairo and Beijing agreements, but it falls short by failing to recognize that reproductive rights are also critical to the achievement of sustainable development. If a woman cannot decide if and when to have children and if she is not provided with the reproductive health care that is her human right, it is challenging to contribute to sustainable solutions for the planet.
Immediately following the adoption of the text, women gathered and protested at Rio Centro, the main venue for the conference, and advocacy continues.
Heads of state will in all likelihood sign on to the outcome document by tomorrow (it could technically still be changed, but that appears unlikely). I will keep you posted on the final outcome and will be taking notes at a side-event this afternoon by USAID, the Aspen Institute, and Center for Environment and Population on the demographic dividend and sustainable development, which promises to be spirited given today’s news. You can tune in live to the webcast of that event at 2:30 EST on Ustream.
Sources: AllAfrica, Aspen Institute, CNN, IRIN, RH Reality Check, U.S. Department of State, USAID.
Photo Credit: United Nations Photo.
›June 19, 2012 // By Sandeep BathalaHere we are on my second day of side events at Rio+20 and the Aspen Institute, International Planned Parenthood Federation, and the United Nations Foundation convened a high-level moderated dialogue this morning to raise the profile of human development, gender, and reproductive health at the main conference.
Rio+20 is an unprecedented opportunity to draw attention to sustainable development and the role women’s rights and voices play in it. The Aspen/IPPF/UN Foundation event was timely as some negotiators are questioning the link between women and sustainable development in the 11th hour instead of reaffirming the commitments made 20 years ago at international conferences in Rio, Cairo, and Beijing.
High-level leaders, including Gro Harlem Brundtland (Former Prime Minister of Norway), Musimbi Kanyoro (President and Chief Executive Office of the Global Fund for Women), Tewodros Melesse (Director General of the International Planned Parenthood Federation), Mary Robinson (Former President of Ireland and President of the Mary Robinson Foundation – Climate Justice), and Tim Wirth (President of the United Nations Foundation), spoke to the role of women’s empowerment and family planning in the global discussion of sustainable development.
Some highlights from the meeting:
Brundtland noted that the next increment of economic growth could come fully from women’s empowerment. Family planning is a cross-cutting and cost-effective way to ensure this possibility.
Kanyoro further emphasized that for development organizations, women, more than any other partner, have the potential to enable sustainable growth.
Melesse discussed the role of addressing the special needs of young women. “If they are not met, we will have failed at sustainable development,” he said.
Robinson argued that family planning must be mainstreamed in international conferences, like Rio+20 and the annual UN climate COPs, as a human rights issue. Women’s issues cannot be add-ons in outcome documents – they have to be front and center. “We know what works,” she said, referring to effective reproductive health efforts and their ability to advance human rights and sustainable development
Wirth spoke passionately about the basic rules of diplomacy: do no harm and no backsliding. He remarked that hard earned gains from previous UN documents, although limited, must not be lost. They must be considered as statements from governments around the world and as resounding affirmation of the rights of women, he said.
For more, see Vicky Markham’s thoughts on the meeting at RH Reality Check too.
Stay tuned to see whether official negotiations in Rio – which start tomorrow – will heed these calls.
Photo Credit: “Etiopía,” courtesy of flickr user subcomandanta.
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