Showing posts from category family planning.
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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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The Missing Links in the Demographic Dividend
›March 9, 2012 // By Elizabeth Leahy Madsen
The “demographic dividend,” a concept that marries population dynamics and development economics, is on the rise in policy circles – Rajiv Shah, Melinda Gates, and African government ministers have all discussed it recently in high-level forums. Most notably for demographers, World Bank Chief Economist Justin Yifu Lin wrote a blog post that focuses on the demographic dividend’s potential to give developing countries a powerful economic boost through declining dependency ratios and a proportionately large working-age population.
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Reaching Out to Environmentalists About Population Growth and Family Planning
›“Promoting women’s empowerment is an effective strategy for looking at climate and the environment but also is important in its own right,” said the Sierra Club’s Kim Lovell at the Wilson Center on February 22. “Increasing access to family planning for women around the world is a climate adaptation and climate mitigation solution.” [Video Below]
Drawing on research by Brian O’Neill (National Center for Atmospheric Research) and others Lovell explained that meeting the unmet need for family planning around the world could provide up to 16 to 29 percent of the emissions reductions required by 2050 in order to avoid more than two degrees of warming (the target set by nations to prevent the most damaging effects of climate change).
For environmentalists and those concerned with climate change, “sometimes the idea has been that population is toxic, that we can’t talk about population growth,” said Nancy Belden of Belden Russonello and Stewart Consulting, but the results of a recent survey and several focus groups conducted in association with Americans for UNFPA demonstrate that there is great potential for engaging the environmental community in such a discussion.
Belden and Lovell were joined by Kate Sheppard from Mother Jones to discuss how the population and environment communities can come together in the lead-up to the Rio+20 UN sustainable development conference.
Besides providing a basic health commodity, empowering women through access to family planning also improves adaptation outcomes, said Lovell. “Climate change is already happening and women and families around the world are suffering from the effects of water scarcity [and] of erratic weather patterns,” she said. But “when women have the ability to plan their family size and have more choices about their families and about their reproductive health and rights, that makes it easier to adapt to those climate change effects that are already taking place.”
Resonating With Environmental Priorities
“The people who really care about the environment are generally the same people who care about access to contraception and birth control and family planning…they’re a ready audience to hear about these connections and they’re a ready audience to take action about them,” said Kate Sheppard. Reproductive rights issues are something that people can really connect with, she said; “most women, most men too…understand why it’s an important issue and they’ve understood it in their own life and they have [a] very strong response to it.”
When we approach the linkages between environment and population, said Sheppard, it is important to recognize the role of empowering language – language about access to services, education, and resources for women.
The aim of the Americans for UNFPA survey was to find out whether environmentalists can be engaged in discussions of population issues such as family planning and international voluntary contraception, and if so, how?
The results show that “environmentalists are ready to talk about population, they’re ready to listen – it’s not toxic,” said Belden. She outlined three key findings:
First, environmentalists prioritize the environment but they also give a high priority to empowering women, said Belden. “Population pressures are seen as an environmental problem…they don’t dismiss it,” yet the “strongest framework that we could come up with…for engaging people on the issues around voluntary family planning and contraception focuses on women.”
Second, the environmental community is relatively optimistic about the potential outcomes of family planning programs and of foreign aid in general. When queried, half of the environmentalists strongly supported the idea of U.S. contributions to UN programs that provide voluntary access to contraception in developing countries, said Belden.
When asked to mark their top priority among a list of possible outcomes of providing voluntary access to contraception, 47 percent of the environmentalists selected either “improving living conditions for women and their families” or “ensuring women have options and can make reproductive decisions” as their top priority. While a significant number are also concerned about stalling population growth, this integrative focus on improving the lives of women and their families is heartening, said Belden.
In the Run-Up to Rio+20, More Than Pop
One point that all three speakers stressed is the need to integrate consumption into the integrated population message. In her survey work, Belden found that “if you don’t talk about consumption in the same breath, [environmentalists] start wanting to put it in there because otherwise…this is someone blaming others.”
Lovell similarly highlighted that “if we’re working to ensure a sustainable planet for future generations to come, we have to think about consumption and population.” For instance, “the United States makes up five percent of the world’s population but consumes 25 percent of the world’s resources,” she said.
Said Sheppard: “It’s not simply a problem that the numbers of people here on the Earth are going up, it’s a problem of how people, especially here in the U.S., live.”
It is imperative – especially from a sustainable development standpoint – that while working towards integrating environment and population we remain focused on a message that includes “using less but still having a high quality of life” here at home, said Sheppard.
Event ResourcesSources: Proceedings of the National Academy of Sciences.
Photo Credit: “Timorese Traditional Home,” courtesy of United Nations Photo. -
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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Championing Women’s Rights and Population Issues in Kenya With the ‘Reject’
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“We find that politicians play around with [population] numbers when it comes to the common man and the common woman,” says Jane Godia in this short video interview. Godia writes for Reject, an African Woman and Child Feature Service biweekly news publication that won a Global Media Award from the Population Institute for its issue on family planning and politics in Kenya.
Godia says that politicians “use these numbers for their gain, they tell women not to use family planning because they want more children so that…they can have more voters, but nobody thinks about if this woman will be able to feed these children, if this family will be able to have their next meal, or even accommodation, or even land to till.”
The Reject’s name comes from the paper’s early practice of running stories – often about underserved groups, like women, children, and the poor – that had been rejected from mainstream publications. Population and environment issues have been highlighted since the first issue came out in September 2009, when “we were talking about families moving on to Mount Kenya…to look for pasture and water for their animals,” says Godia.
“When there’s no water and when there’s no food, people migrate,” she says. “And when people are migrating they’re moving with their animals, they’re moving with their families, and they end up going to places” that eventually become overcrowded and resource-stressed, sometimes introducing the same problems that led people to migrate in the first place. -
Assigning Value to Biodiversity, and the 2011 Human Development Report
›New research in the journal BioScience reports the aggregate economic benefits of conserving high priority biodiversity areas outweigh the opportunity costs of alternative land uses by a multiple of three (where priority is assigned according to a global index of the mapped distributions of 4,388 threatened terrestrial species). The authors of “Global Biodiversity Conservation and the Alleviation of Poverty,” led by Will Turner, estimate the value of highly diverse habitats to the global poor in terms of direct benefits and potential external payments for ecosystem services. They find these environmental flows in excess of $1 per person, per day, for 331 million of the world’s poorest individuals and conclude by arguing that, “although trade-offs remain…results show win-win synergies…and suggest biodiversity conservation as a fundamental component of sustainable economic development.” (For further discussion of development around biodiversity hotspots, see Population Action International’s work on population growth.)
The 2011 UNDP Human Development Report, Sustainability and Equity: A Better Future for All, builds from the understanding that a “failure to reduce…grave environmental risks and deepening social inequalities threatens to slow decades of sustained progress by the world’s poor majority.” A resilient thread in the report highlights the importance of working to ensure women’s equality and reproductive rights for sustainability, claiming that “meeting unmet need for family planning by 2050 would lower the world’s carbon emissions an estimated 17 percent below what they are today.” The report closes with a wide range of policy suggestions that work towards the goal of equating sustainability and equity, including a supportive discussion of a currency transaction tax as a novel and feasible method of providing climate financing.
These pieces address contradictions between environmentally sustainable behavior and the development imperative. Though both acknowledge that the traditional development model of high intensity economic growth has imperiled the environment upon which the livelihoods of many hundreds of millions depend, they suggest practical ways forward. The Human Development Report in particular adopts some of the strongest language yet, claiming that, “the message is clear: our development model is bumping up against concrete limits.” This honest attempt to work through, rather than around, the tension between development and sustainability is perhaps an indication that we are at last beginning to take seriously the concept of sustainable development. -
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. -
Afghanistan’s First Demographic and Health Survey Reveals Surprises [Part One]
›February 14, 2012 // By Elizabeth Leahy Madsen
Late 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. It shows that Afghan women have an average of five children each, lower than most experts had anticipated, and that their rate of modern contraceptive use is just slightly lower than that of women in neighboring Pakistan.
