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In Building Resilience for a Changing World, Reproductive Health Is Key
›April 20, 2012 // By Laurie Mazur
Change is a constant in human (and natural) history. But today, we have entered an era in which the pace, scale, and impact of change may surpass anything our species has previously confronted.
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Yemen: Revisiting Demography After the Arab Spring
›April 17, 2012 // By Elizabeth Leahy Madsen
Along with other countries where the Arab Spring caught hold, Yemen has been gripped by major upheaval over the past year. Although President Ali Abdullah Saleh finally ceded power in February after his administration’s violent reprisals failed to deter protesters, the country remains at a crossroads. As its political future continues to evolve, the new government must also address a range of deep-seated economic and social challenges. In addition to claiming more than 2,000 lives, the crisis has undermined Yemenis’ livelihoods and even their access to food. A recent World Food Program survey found that more than one-fifth of Yemen’s population is living in conditions of “severe food insecurity” – double the rate measured three years ago – and another fifth is facing moderate difficulty in feeding themselves and their families.
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John Williams: Helping People and Preserving Biodiversity Hotspots
›March 16, 2012 // By Schuyler Null“Both humans and the number of species in the world are not evenly distributed across the globe,” said John Williams of the University of California, Davis, who recently spoke at the Wilson Center about his contribution to Biodiversity Hotspots: Distribution and Protection of Conservation Priority Areas. “In particular we find that species diversity is concentrated in what’s called the biodiversity ‘hotspots.’”
Largely in the tropics, Mediterranean climates, and along mountain chains, biodiversity hotspots are “where there’s a real concentration in number of species and also unique species – plants and animals that exist nowhere else on Earth,” he said.
“It’s a very complex relationship between biodiversity and human population, because it’s not necessarily [true] that places of high human population are a threat to biodiversity,” said Williams. Many different factors play a role, “like education, like consumption, like economic development, different cultures – how people interface with the natural world – all these things create nuances as far as what that relationship is between biodiversity and where people live.”
“There are some basic things we can do that are going to be good for human welfare, as well as biodiversity,” he continued. A few are addressing lack of education, especially among girls, in areas of high biodiversity; providing basic health services, including family planning, where rural growth rates are highest; and improving physical access to rural areas to promote economic development.
“We see there’s a direct correlation between each additional year of schooling a girl has and their fertility during their lifetime,” Williams said. “As people climb out of poverty, they also choose to have smaller, healthier families.” -
Kavita Ramdas: Why Educating Girls Is Not Enough
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“I’m a big proponent of girl’s education. I believe that it’s a very important and a very valuable human rights obligation that all countries should be meeting,” said Kavita Ramdas, executive director for programs on social entrepreneurship at Stanford University, at the Wilson Center. However, “in the past seven to eight years we have found ourselves in a situation where there’s kind of an enchantment with girl’s education, as though it were the new microenterprise magic bullet to solve everything from poverty, to malnourishment, to inequality.”
“The outcomes that we ascribe to girl’s education…are not anything that I would argue with,” she said, yet, this enchantment “has happened simultaneously with a significant drop in both funding and support for strategies that give girls and women access to reproductive health and choices, particularly family planning.”
This is a problem, said Ramdas, because we cannot rely on education alone to do all the heavy lifting required to empower women.
“I think it’s important for us to recognize that there are societies where girls and women have achieved significantly high levels of education in which gender inequality remains,” she said, “for example, places like Japan and Saudi Arabia, where you have high per capita income, high levels of education, and yet…where women and girls are still marginalized and on the edges in terms of decision making.”
“I don’t think we have to wait for one to be able to do the other,” she said. “As we support programs for girls’ education, we also need to demand that those programs be buttressed by strong programs in adolescent health, strong programs in sex education, strong programs that actually provide girls and women with access to family planning and contraception.” -
Women’s Health: Key to Climate Adaptation Strategies
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The discussion about family planning and reproductive rights “needs to be in a place where we can talk thoughtfully about the fact that yes, more people on this planet – and we’ve just crossed seven billion – does actually put pressure on the planet. And no, it is not just black women or brown women or Chinese women who create that problem,” said Kavita Ramdas, executive director for programs on social entrepreneurship at Stanford University. [Video Below]
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Programming to Address the Health and Livelihood Needs of Adolescent Girls
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“There are 750 million adolescent girls in the world today, and this is by far one of the world’s most marginalized and vulnerable demographics,” said Denise Dunning, the Public Health Institute’s program director for emergency contraception in Latin America during a February 2 panel at the Wilson Center. Dunning, who also leads the Adolescent Girls’ Advocacy and Leadership Initiative (AGALI), was joined by Margaret Greene, director of Greeneworks, and Jennifer Pope, the deputy director of sexual and reproductive health at Population Services International, to discuss how to better reach underserved adolescent girls in developing countries with health and livelihood programs.
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Afghanistan and Pakistan: Demographic Siblings? [Part Two]
›February 15, 2012 // By Elizabeth Leahy MadsenLate last year, Afghanistan’s first-ever nationally representative survey of demographic and health issues was published, providing estimates of indicators that had previously been modeled or inferred from smaller samples. My first post on the survey focused on the methodology and results, which found that Afghanistan is not as much of a demographic outlier as many observers had assumed. But perhaps the most surprising finding is how the results compare to those of Afghanistan’s neighbor, Pakistan.
The political future of each country depends largely on the other and, with Afghanistan making progress on reproductive health issues that remain stalled in Pakistan, their demographic trajectories are heading toward closer synchronization as well. In one key measure – use of contraception among married women – Afghanistan is almost identical to Pakistan. The modern contraceptive prevalence rate is 19.9 percent, slightly lower than the rate of 21.7 percent in Pakistan.
While Pakistan faces its own serious political instability, it is widely regarded as more developed than its neighbor. Afghanistan is included in the UN’s grouping of least developed countries, and Pakistan is not. Pakistan’s GDP per capita is almost twice as high. On the surface, this should suggest lower fertility. There is a general negative relationship between economic development and fertility, though demographers are quick to point out its complexities, and David Shapiro and colleagues have found that countries with larger increases in GDP actually experience slower fertility declines.
Pakistan’s fertility rate of 4.1 children per woman is in fact 20 percent lower than Afghanistan’s, but the similarities in contraceptive use, which is one of the direct determinants of fertility, suggest that this gap could be shrinking. If Afghanistan’s median age at marriage (18 compared to 20 in Pakistan) was higher and more women were educated (76 percent of women have never been to school compared to 65 percent in Pakistan), the two fertility rates might be closer.
Pakistan’s Entrenched Challenge
Why are these indicators closer than might be expected? Relative to the other countries in South Asia, Pakistan has had considerably less success in promoting family planning use. Bangladesh has a per capita income about half that of India and one-quarter that of Sri Lanka, yet the three countries’ fertility rates are identical. Nepal has the lowest income in the region – even slightly below Afghanistan – yet more than 40 percent of married women use modern contraception and fertility is three children per woman. And then there is Pakistan. Despite a per capita income 90 percent that of India, only 22 percent of married women use modern contraception and fertility remains persistently high at over four children per woman.
The weaknesses of Pakistan’s family planning program have been well-documented. Government commitment has been lacking and cultural expectations and gender inequities are a powerful force to promote large family size. The country’s most recent DHS report cited disengagement with the program among local agencies, low levels of outreach into communities, and weak health sector support as likely causes for the stagnation of contraceptive use. In summer 2011, the Pakistani government abolished the federal Ministry of Health and empowered provincial governments with all responsibilities for health services. This transfer of authority could pay dividends by increasing local ownership of health care, but some in and outside Pakistan have raised concerns about the loss of regulatory oversight and information sharing entailed in total decentralization.
Compared to the Afghanistan survey, the most recent Pakistan Demographic and Health Survey provides more detail on women’s motivations and preferences regarding fertility and family planning. Overall, 55 percent of married women in Pakistan have a “demand” for family planning; that is, they wish to avoid pregnancy or report that their most recent pregnancy or birth was mistimed or unwanted. More than half of these women are using family planning, while the remaining 25 percent of married women have an “unmet need.”
Unintended pregnancies and births play a major role in shaping Pakistan’s demographic trajectory. The DHS survey finds that 24 percent of births occur earlier than women would like or were not wanted at all. If unwanted births were prevented, Pakistan’s fertility rate would be 3.1 children per woman rather than 4.1. Yet 30 percent of married women are using no contraceptive method and do not intend to in the future. The most common reasons for not intending to use family planning are that fertility is “up to God” and that the woman or her husband is opposed to it.
Linked Destinies
Just as Afghanistan and Pakistan’s political circumstances have become more entwined, their demographic paths are more closely in parallel than we might have expected. For Afghanistan, given the myriad challenges in the socioeconomic, political, cultural, and geographic environments, this is good news; for Pakistan, where efforts to meet family planning needs have fallen short of capacity, it is not. While Afghanistan is doing better than expected, Pakistan should be doing better.
Regardless, both countries are at an important juncture. With very young age structures and the attendant pressures on employment and government stability, each government must reduce unmet need for family planning or face mounting difficulties to providing for their populations in the future. In addition to rolling out health services, turning the share of women without education from a majority into zero would be an excellent way to start.
Elizabeth Leahy Madsen is a consultant on political demography for the Wilson Center’s Environmental Change and Security Program and senior technical advisor at Futures Group.
Sources: Afghanistan Ministry of Public Health, Bongaarts (2008, 1978), Cincotta (2009), Embassy of Afghanistan, Haub (2009), International Monetary Fund, MEASURE DHS, Nishtar (2011), Population Action International, Savedoff (2011), Shapiro et al. (2011), UN-OHRLLS, UN Population Division, U.S. Census Bureau, The Washington Post.
Image Credit: Chart arranged by Elizabeth Leahy Madsen, data from MEASURE DHS. -
Kim Lovell, Sierra Club
Pop at COP: Population and Family Planning at the UN Climate Negotiations
›February 8, 2012 // By Wilson Center StaffThe original version of this article, by Kim Lovell, appeared on the Sierra Club’s activist network.
“Population, development, and climate should be a single discussion,” explained Jacques van Zuydam of South Africa’s National Population Unit. Van Zuydam, speaking to a sparsely filled room at the United Nations Framework Convention on Climate Change (UNFCCC) in Durban last month, centers his work around the concept that climate matters because people matter.
Given the focus on the Green Climate Fund, climate change adaptation, and the effects of sea-level rise and changing weather patterns on some of the world’s most vulnerable populations, it would have made sense for discussions about population to play a central role at the 17th Conference of Parties (COP-17). Yet despite these obvious links – and lead negotiator Jonathan Pershing’s admission to the U.S. youth delegation that population plays a central role when discussing climate impacts – the issue gained little traction in the formal negotiations.
Pershing said he considers population “too controversial” to play a role in the international climate talks, and recommended raising the issue elsewhere. But where better to talk about the need for increased access to voluntary family planning services than among a group of world leaders considering solutions to mitigate and adapt to climate change?
As Brian O’Neill and his colleagues at the National Center for Atmospheric Research explained in a 2010 paper, meeting the unmet need for contraceptive services worldwide could reduce emissions in 2050 by 1.4 to 2.5 billion tons of carbon per year, or 16 to 29 percent of the emissions reductions necessary to avoid dangerous changes to our climate. And beyond the potential effects on carbon, increasing access to education and family planning resources will have a huge impact on the ability of women and families to adapt to the effects of climate change that are already altering weather patterns, water availability, and agricultural production around the globe.
Continue reading at Sierra Club.
Sources: Amplify.
Image Credit: UNFCCC/Climate Change Information Center of Armenia.
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