Showing posts from category development.
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Adenike Esiet: Building Support for Improving Adolescent Sexual and Reproductive Health in Nigeria
›“In Nigeria, young people under the age of 25 are driving the HIV epidemic…and that’s been the opening place for people to begin to say, ‘let’s address the issues of young people’s sexual and reproductive health,’” said Adenike Esiet, executive director of Action Health Incorporated in Lagos, during an interview with ECSP.
On any number of health indicators, girls suffer disproportionately. “For every one boy in the age bracket of 10 to 24 who is HIV positive, there are three girls who are HIV positive,” Esiet said. “Over 60 percent of cases of complications from unsafe abortion reported in Nigerian hospitals are amongst adolescent girls. In fact in literature, 10-15 years ago, this was described as ‘a schoolgirl’s problem’…and it’s still an ongoing problem.” She added: “And for girls too, the issue of sexual violence is huge. It goes largely unreported but it’s occurring at epidemic levels.”
Esiet spoke on an adolescent health panel during the April 25 “Nigeria Beyond the Headlines” event at the Wilson Center. Progress is slow on these issues, in large part because “there’s a whole lot of silence about acknowledging young people’s sexuality,” she said.
Adults “want to believe [adolescents] shouldn’t be sexually active.” But turning a blind eye to adolescent sexuality can mean that efforts “to provide access to education or services is hugely resisted by practitioners who should be doing this.”
Action Health works to fill the gap that emerges. “Our work covers advocacy, community outreach, and service provision for young people,” said Esiet.
“Our primary entry road in to work with young people is creating access to sexuality education and youth friendly services. And in the course of trying to do that, we have to do a whole lot of advocacy with government and also with ministries or education and ministries of health and youth development.”
The group has worked with government officials and agencies to establish a nationwide HIV education curriculum and paired with local healthcare providers to increase access to “youth-friendly” sexual and reproductive health services. Funding shortages and insufficient resources have hampered the curriculum’s success, though, and the pervasive attitude against youth sexuality has limited the reach of services, she said. Ultimately, “there are a whole range of issues that truly need to be addressed” for outreach efforts to be successful.
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John May, Center for Global Development
‘People and the Planet’ Study Re-Introduces Demography to Sustainability Debate
›May 15, 2012 // By Wilson Center StaffThe original version of this article, by John May, appeared on the Center for Global Development’s Global Health Policy blog.
Population issues have been conspicuously absent from the discussions on the environmental sustainability of our globalized economy in the run-up to the Rio+20 Conference on Sustainable Development, which will take place in Brazil, June 20-22, under the auspices of the United Nations.
Fortunately, the new report, People and the Planet by the Royal Society, should help change this woefully shortsighted approach. The report demonstrates clearly and convincingly that demographic trends cannot be separated from consumption patterns, and that there is no chance to achieve a path of equitable and sustainable development without tackling population growth and consumption at the same time. In short, population and the environment cannot and should not be considered as two separate issues.
This strong and long overdue pitch to bring back the “p” word into the environmental debate is most welcome. In recent decades, international attention has shifted from rapid population growth to other urgent issues, such as the HIV/AIDS epidemic, humanitarian crises, climate change, and good governance. But reproductive health and voluntary family planning programs are still very much needed, especially in high fertility countries, and they require political leadership and long-term financial commitment. Broader access to family planning services will be needed to accelerate the decline of high fertility rates, particularly in countries where unmet needs for contraception are high.
Continue reading at the Center for Global Development.
Image Credit: People and the Planet cover, courtesy of the Royal Society. -
Nigeria Beyond the Headlines: Environment and Security [Part Two]
›In the coming years, Nigeria’s cohort of unemployed youth has equal potential to “be converted into either a religious or a regional clash, as certain youths get opportunities and other youths do not,” said Pauline Baker, President Emeritus of the Fund for Peace, during the day-long “Nigeria Behind the Headlines” event at the Wilson Center on the April 25 (read part one here). [Video Below]
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Nigeria Beyond the Headlines: Demography and Health [Part One]
›“Nigeria is a country of marginalized people. Every group you talk to, from the Ijaws to the Hausas, will tell you they are marginalized,” said Peter Lewis, director of the African Studies Program at the Johns Hopkins University School of Advanced International Studies. Lewis spoke at an April 25 conference on Nigeria, co-hosted by ECSP and the Wilson Center’s Africa Program, assessing the country’s opportunities for development given its demographic, governance, natural resource, health, and security challenges. [Video Below]
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Roger-Mark De Souza, Climate and Development Knowledge Network
Population-Climate Dynamics: From Planet Under Pressure to Rio
›May 11, 2012 // By Wilson Center StaffThe original version of this article, by Roger-Mark De Souza, appeared on the Climate and Development Knowledge Network (CDKN).
In late May, I presented research on population and climate dynamics in hotspots at the Planet Under Pressure conference in London, in a session organized by the Climate and Development Knowledge Network. As we prepare for the Rio+20 Earth Summit in June, I reflect on the roles of population dynamics and climate-compatible development for ensuring a future where we can increase the resilience of the most vulnerable to the impacts of climate change.- Improving our well-being and the future we can have is within our reach: We can take action to improve well-being through specific actions that can produce short term results. This is a key message encapsulated in the concept of climate-compatible development, reflected in many presentations and discussions that I heard at Planet Under Pressure. Even though others were not calling it “climate-compatible development,” the essence and the meaning behind the research was the same – small concrete discrete steps are possible, and taking action on population dynamics is one of them.
- Population is on the agenda: Population issues – growth, density, distribution, aging, gender – were a constant at Planet Under Pressure – and in more ways than just looking at population as a driver. It is clear that there is interest, and a need, to address population as a key component of climate-compatible development.
- But those concerns and issues must be location specific, and must be contextualized for the policy and programmatic environment: Population issues must be framed in the appropriate context – and must move beyond academic exploration. I attended one session where a paper presented an academic supposition of whether we should invest in consumption versus fertility reduction to produce short-term returns for climate, but the analysis was completely devoid of any political, policy, or programmatic truth-testing. We must factor in those considerations when making recommendations, if ultimately we are really looking to make the difference that we can.
Photo Credit: “Urbanization in Asia,” courtesy of United Nations Photo. -
Learning From Success: Ministers of Health Discuss Accelerating Progress in Maternal Survival
›“The gains we have made [in reducing maternal mortality rates] are remarkable; however, gains are fragile and donor resources are declining. Substantial investments must be maintained to safeguard these hard-wins,” said Afghan Minister of Health Suraya Dail at the Wilson Center on April 23. [Video Below]
As part of the Wilson Center’s Global Health Initiative, the Advancing Dialogue to Improve Maternal Health series partnered with the U.S. Agency for International Development to co-host Minister Dail, along with Honorable Dr. Mam Bunheng, Minister of Health, Cambodia; Honorable Dr. Bautista Rojas Gómez, Minister of Health, Dominican Republic; and Dr. Fidele Ngabo, Director of Maternal and Child Health, Ministry of Health, Rwanda.
These ministers spoke about the lessons learned in countries where there has been tremendous progress under challenging circumstances.
In the Dominican Republic, Bautista Rojas Gomez said the first challenge was to address the “Dominican paradox,” where maternal mortality rates were high despite the fact that 97 percent of women received prenatal care and delivered in hospitals. The government created a zero tolerance policy that included a comprehensive surveillance system, mandatory maternal death audits, and community oversight of services, which assured better quality services.
Similar political commitment improved indicators in Cambodia, where maternal mortality rates dropped from 472 to 206 per year from 2005 to 2010. “It takes a village…and the prime minister has inspired the country to act,” said Mam Bunheng. Through increased access to contraception the number of children per woman went from seven to three and commitment to family planning, education, technology, infrastructure, and community have been the key drivers of success.
“In Rwanda, the big challenge we are having is education,” said Fidele Ngabo. “Many of the maternal health indicators depend on education.” When women and girls are educated they are twice as likely to utilize modern contraception. The efforts of Rwanda’s government have been instrumental in facilitating positive change, he said, particularly the efforts of First Lady Jeannette Kagame, who he called a “champion” for women and girl’s health.
As witnessed throughout the Advancing Dialogue to Improve Maternal Health series – and reiterated by the ministers of health – the interventions to improve maternal mortality rates exist, what’s left is to generate the needed political willpower.
Event Resources
Photo Credit: David Hawxhurst/Wilson Center. -
New Surveys Generate Mixed Demographic Signals for East and Southern Africa
›May 8, 2012 // By Elizabeth Leahy MadsenThe pace of fertility decline in sub-Saharan Africa will be the single most important factor in whether the global population reaches the UN’s high projection of nearly 11 billion in 2050, or remains closer to the low projection of 8 billion. In recent years, the high projection has seemed more likely, as sub-Saharan Africa has been marked by stalled fertility declines and stagnant rates of contraceptive use. Survey results released over the past year showing dramatic increases in contraceptive use in Ethiopia, Malawi, and Rwanda therefore set demographers and the family planning community abuzz, signaling that concerted efforts to improve health services had paid off and fertility rates were on the decline. But in recent months, additional surveys from Mozambique, Uganda, and Zimbabwe have shown that those positive trends are not universal.
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Carl Haub, Behind the Numbers
Bangladesh 2011 Demographic and Health Survey Shows Continued Fertility Decline, Improved Health Indicators
›May 7, 2012 // By Wilson Center StaffThe original version of this article, by Carl Haub, appeared on the Population Reference Bureau’s Behind the Numbers blog.
The Bangladesh 2011 Demographic and Health Survey is the ninth demographic survey taken in the country since 1975. Except for a few very small countries and city-states, Bangladesh is the world’s most densely populated country with about 1,100 people per sq. kilometer. The country’s area is about the same as the U.S. state of Arkansas and a bit more than Greece but is home to over 150 million people.
The preliminary 2011 report has just been released and it shows that fertility has continued its decline to a low level. The total fertility rate (TFR) for the three-year period before the survey was 2.3 – 2.0 in urban areas and 2.5 in rural areas. The survey interviewed 17,842 ever-married women ages 12 to 49 and 3,997 ever-married men ages 15 to 54 from July to December 2011. Rural women accounted for two-thirds of those interviewed. From 1975 to 1994, the TFR in Bangladesh was in continuous decline. But the next three surveys showed a tendency for TFR decline to “stall” at a medium level (see graph). Desired family size has greatly decreased. In the survey, 76.2 percent of women with two living children said that they did not wish to have any more children, an additional 5.3 percent had been sterilized, and 1.3 percent said they were incapable of conceiving.
In the survey, 61.2 percent of currently married women said that they were using some form of family planning, a level comparable to developed countries. The use of modern methods was quite high at 52.1 percent. Unlike neighboring India, where female sterilization predominates, the contraceptive pill is the most widely used modern method at 27.2 percent, followed by injectables (11.2 percent), and the male condom (5.5 percent). Contraceptive use has risen steadily in surveys, up from 7.7 percent in 1975. Family planning use has risen despite the fact that fewer women report a visit from a family planning worker, either government or private. Overall, only 15.5 percent reported contact with a home visitor, which has been an important part of the country’s family planning program. The report notes that this may be due to workers deciding to provide services from community clinics for three days a week.
Continue reading on Behind the Numbers.
Sources: MEASURE DHS.
Imaged Credit: Carl Haub/Behind the Numbers.
