Showing posts from category family planning.
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Dispatches From the World Conservation Congress: Jason Bremner on Healthy Environments, Healthy People
›October 8, 2008 // By Jason Bremner
I’ve been busy the last several days attending the “Healthy Environments—Healthy People” stream of the World Conservation Congress. While there has been much talk about the connections between environmental services and people’s livelihoods and allusions to how this links with human health, I’ve been surprised by the scarcity of actual documented linkages between conservation strategies and human health.
This conundrum got me thinking about why there aren’t more people trying to actually evaluate impacts on human health. Do environmentalists simply lack the tools and expertise to evaluate human-health impacts? Are human-health benefits too hard to measure? Or does conservation not really have any human-health benefits? No, no, and no again are my answers to these questions.
I think the real problem is that “healthier people” is really just a good selling-point for conservation rather than a true objective of most conservation institutions. In other words, arguing that environmental health promotes human health is a good way for conservation organizations to expand their constituency.
Am I a jaded conference participant who has simply attended one too many sessions? I don’t think so, based on a meeting I attended last week of the EuroNGOs, a network of European organizations advocating for sexual and reproductive health. The topic of this year’s EuroNGOs meeting? The interface between population, environment, and poverty alleviation. Was this really a group of population and health organizations interested in adding an environmental dimension to their work or interested in the environmental benefits of their work? No—the real purpose was to increase funding for sexual and reproductive health by discussing the links and benefits related to environmental conservation and poverty alleviation. So these are different communities coming together for a common goal: to increase the funding for their particular missions.
Does this mean, however, that it is wrong to advocate for conservation interventions based on health benefits or wrong to advocate for health interventions based on environmental benefits? I don’t think so. I just think we need to do a better job of building bridges across communities. It would have been wonderful to have a few environmental organizations at the EuroNGOs meeting and a few more health organizations at the World Conservation Congress. Perhaps then we would do a better job evaluating the cross-sectoral benefits of our health and environment work.
Jason Bremner is program director for population, health, and environment at the Population Reference Bureau.
Photo courtesy of Geoff Dabelko. -
“New Demography” Drives World Bank Population Policy in Africa
›August 26, 2008 // By Sonia Schmanski“African elites have long had the perception that rapid population growth was not an issue because of the vastness of Africa, abundance of resources, relatively low population densities and, more recently, the threat of HIV/AIDS,” but as rapid population growth becomes a more urgent problem across the continent, that view is increasingly falling out of favor, said World Bank lead demographer John May in a recent interview with the African Press Organization. As governments work to improve their population programs, the World Bank is adopting “new demography” principles that examine age structures, dependency ratios, human capital investments, and the demographic dividend to craft cross-sectoral approaches to population policy.
Current demographic trends, the result of reduced infant and child mortality and slowly falling fertility rates, will double the population of Africa by 2036 if left unaddressed, said May. The security implications of this population growth are readily apparent. Rapid population growth has been identified as a factor in increasing resource scarcity and can help lead to conflict. In Sudan, for example, the pressures of overgrazing, desertification, ongoing drought, and escalating competition between pastoralist and agriculturalist communities have contributed to violence. Kenya presents a similar scenario: Rapid and uneven population growth led to land scarcity in the late 1980s, exacerbating latent political and ethnic tensions. The violent conflict that erupted between 1991 and 1993 was fueled in part by natural resource scarcity. More recently, insecure land tenure, shaky property rights, and competition over natural resources have triggered violence across East Africa. Population pressures also play a part, and some argue that demographically-induced land scarcity was at the heart of violence in Kenya earlier this year.
May lamented that far less attention has been paid to population than to humanitarian crises, good governance, and climate change—despite compelling evidence that population growth is likely to negatively impact the chances for peace. Sexual and reproductive health, for example, form 20 percent of the global disease burden, and there is compelling evidence that good reproductive health leads to poverty reduction. He reminds us that demographic issues are inextricably tied to larger development issues, and must be addressed together.
Some countries have successfully reduced fertility rates, May noted. In the 1960s, the Tunisian government introduced a program to reduce fertility rates through increased education for girls, government provision of family planning services, and legal reforms to increase the economic status of rural women and girls. Today, the country boasts a replacement-level fertility rate. Efforts to improve gender equity are highly effective in reducing unsustainable population growth: “It could be argued that the population issue in sub-Saharan Africa is in essence a gender issue,” said May, who argued that “[e]conomic and social development is of course the best contraceptive.”
“The task ahead is huge and difficult, however some concrete results have already been obtained,” said May. He offered a simple suggestion to governments wondering how to craft population policies: “let people, especially women, decide for themselves and…provide them with the means to exert their choices.”
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Senate Bill Links Population Growth to Conflict, Environmental Degradation
›August 1, 2008 // By Meaghan ParkerThe Senate’s FY 2009 foreign assistance bill cites the stresses “caused by high rates of population growth, which contribute to competition for limited resources, environmental degradation, malnutrition, poverty and conflict” in its recommendation for funding family planning. The $520 million in funding is $15 million above the FY08 level and $219 million above President Bush’s request. This noteworthy new language cements the re-emergence of population issues in Congress, following the record $600 million in reproductive health funding recently approved by the House (also nearly double Bush’s request).
According to an email from Tod Preston of Population Action International, “it is the first time in several years (at least) that population language like this has been included in the foreign assistance bill, and it will almost certainly remain as is.” The impact of rapid population growth on critical issues “referenced in the report (i.e., malnutrition, environmental degradation, poverty and conflict) is getting back on the ‘radar screen’ of policymakers and the media,” which “should help increase support for programs such as voluntary family planning and girls’ education, which we know help reduce population growth rates,” he said.
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WWF Uses Integrated Programs to Protect Environment
›August 1, 2008 // By Daniel Gleick“The health of our planet is inextricably linked to the health of people,” says Judy Oglethorpe, director of World Wildlife Federation’s Community Conservation program in “The Human Face of Conservation” (WWF Focus, July/August, 2008). While the links between population, health, and environmental degradation are fairly well understood, environmental groups have largely neglected to incorporate family planning or health programs in their conservation efforts.
Several WWF initiatives are breaking this trend, spreading awareness of ecological issues by integrating health or livelihood strategies. In Mozambique, illegal industrial fishing was leading to conflict with local fishermen, who were left with smaller catches of smaller fish. The WWF program helped authorities crack down on illegal fishing and set aside “replenishment zones” for fish to spawn and grow. As a result, local fishermen “have seen dramatic increases in the size of individual fish and in their overall catch outside these zones – and in their earnings,” allowing them to feed their families.
WWF is also diversifying its focus by partnering with other organizations to bring family planning services to poor communities, including in the Khata corridor of Nepal. “It’s really difficult for women living in remote regions to have access to modern family planning and basic healthcare,” said Population, Health, and Environment senior program officer Cara Honzak. By providing basic family planning services, women in these communities are able to control the growth of their families. With this opportunity, it is easier for communities to support and manage themselves, and reduced population pressures on the environment help maintain their local forest ecosystems.
Programs such as these are popular and effective, because by considering both human and natural needs, both sides can be winners. Said the manager of an initiative in Namibia, “When communities can earn as much – or more – by conserving wild land as they can by burning and planting it, potential conflicts can be turned into win-win situations for both people and wildlife.”
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Population-Health-Environment Video Featuring Lori Hunter Now on YouTube
›July 18, 2008 // By Sean Peoples“Population, Health, and Environment: Exploring the Connections,” an original ECSP video, offers a lively, brief, and accessible explanation of population-health-environment connections, with examples and photos from successful programs in the Philippines. Presenter Lori Hunter of the University of Colorado, Boulder, spoke at the Wilson Center earlier this year as part of ECSP’s PHE meeting series. View the video on YouTube, then rate it, comment on it, favorite it, or post a video response. -
Population, Health, Environment in Ethiopia: “Now I know my family is too big”
›July 16, 2008 // By Sonia Schmanski
In “Life in Abundance,” an article from the latest issue of Sierra magazine, Paul Rauber gives us an inside look at family planning in Ethiopia, speaking with women in urban and rural environments to understand what government support of family planning has meant in practice. The government’s official embrace of family planning is a sharp and welcome shift from the previous dictatorship’s ban on mentioning it, but this endorsement, welcome as it is, doesn’t guarantee funding. Consequently, family planning programming, robust in urban areas, has yet to reach much of the vast rural expanse of Ethiopia. It is also heavily dependent on outside donors and NGOs for funding.
Thanks to one of the highest fertility rates in the world—5.4 children per woman—Ethiopia’s population has quintupled in the last 70 years. It now stands at 77 million, and is projected to double by 2050. Other indicators are equally discouraging: Rauber reports that average life expectancy is 48 years, that one in eight children dies before reaching five years of age, and that half of all children are undernourished.
One group trying to improve these statistics is Pathfinder International, whose integrated population-health-environment program in Ethiopia aims to “boost family planning, healthcare access, and environmental-restoration efforts through improving the lot of women and girls.” Rauber notes that Ethiopian women with at least some secondary education have one-third as many children as women with no or little education. Ethiopia, he says, is ripe for such integrated interventions; two-thirds of women want but lack access to family planning, and only one in 10 rural women uses any form of contraception. Pathfinder’s program, strongly backed by communities, has been successful in enrolling women in literacy classes, testing for HIV, planting mango and avocado trees, and curbing female genital mutilation.
For a look at another integrated PHE program in Ethiopia, see ECSP Director Geoff Dabelko’s photographs of the Berga Wetland Project, which includes conservation activities oriented around the White-Winged Flufftail bird; a small health facility offering basic maternal, children’s, and reproductive health services; and a community school.
Ethiopia has hosted several large PHE events in recent months, demonstrating the country’s enthusiasm for the approach. In November 2007, more than 200 members of the PHE community gathered in Addis Ababa for “Population, Health, and Environment: Integrated Development in East Africa,” a conference sponsored by the Population Reference Bureau and LEM Ethiopia. Rauber’s tour of Ethiopia, which also included substantial birdwatching, was jointly organized by the Sierra Club and the Audubon Society, both participants at the November meeting. Also emerging from this conference, which ECSP helped organize, was the East Africa Population-Health-Environment Network, a group working toward “an Eastern African region where men, women, and children are healthy, the environment is conserved, and livelihoods are secure.” In May of this year, Ethiopia launched its national chapter of the network, the Consortium for Integration of Population, Health, and Environment, in Ambo.
Photo: Health workers in Ethiopia’s Berga valley, where families average seven children. Now, thanks to the Ethiopian Wildlife and Natural History Society’s Berga Wetlands Project, hundreds of local women get contraceptives from health worker Gete Dida, allowing them to limit their family size – and giving the area’s wildlife a chance at survival. Reproduced from Sierraclub.org with permission of the Sierra Club. © 2008 Sierra Club. All rights reserved. -
In Egypt, Record Food Prices Lead to Family Planning
›June 12, 2008 // By Geoffrey D. DabelkoAt Egypt’s National Population Conference on Monday, Egyptian President Hosni Mubarak—whose government has struggled to respond to recent civil unrest over skyrocketing food prices and bread shortages—told attendees that high population growth is a “major challenge and fundamental obstacle” to development. The following day, Egyptian Minister of Health and Population Hatem el-Gabali announced an $80 million national family planning program with the slogan “Two children per family—a chance for a better life.” Egypt’s current fertility rate is 2.7 children per woman.
With a population of 81 million, Egypt is the 16th most populous country in the world, and, according to Philippe Fargues of the American University in Cairo (AUC), excluding the desert, Egypt has the highest population density in the world—twice that of Bangladesh.
Is the government’s plan a productive long-term response to the food crisis? How can it be part of a larger package? Or is population a distraction from the real issue of corruption, as identified by interviewees in the Washington Post article where I first read about the programs.
I posed these questions to a demography and security listserv and got some interesting responses. According to Valerie Hudson of Brigham Young University, a political scientist known best for her book Bare Branches on the security implications of imbalanced male-female population ratios: “Mubarak would do more to achieve his goal of 2.0 children per woman by a focused plan to raise the status of women, for example, by:- Outlawing polygamy, or erecting such high legal barriers to it that it becomes impractical
- Fully implementing CEDAW [the Convention on the Elimination of Discrimination Against Women]
- Enforcing the ban on FGM [female genital mutilation]; 97% of Egyptian women are circumcised
- Educating women on a parity with men; the median number of years of schooling for men is 6.3; that for women is 4.4
- Raising average age at first marriage for rural women (current average is 19)
- Creating more parity in family law for women in matters such as divorce, inheritance, etc.—all of which can be found in CEDAW.”
“I don’t think population pressure is a distraction from the real issue of corruption; though the government of Egypt is indeed corrupt by developed-world standards (or maybe by any standard). Corruption, which is symptomatic of state weakness, limits the ability of the Egyptian government to address this problem credibly and effectively. But it doesn’t mean they are wrong about the problem.
I was actually struck by the modesty of official ambition to reduce the fertility rate from 2.7 (which is slightly above the world median, apparently) to 2.0 (which I’m guessing is pretty close to the middle). This assumes that, basically, a steady state population of, say, 100M Egyptians would be sustainable indefinitely. I’m not so sure of that. The impact of anticipated climate change on Egypt may prove quite formidable by the end of this century. I’m not sure a leveling off after some additional increase will do the trick….Too pessimistic? I hope so.” -
‘Fatal Misconception’: Fatally Flawed?
›Matthew Connelly recently published Fatal Misconception: The Struggle to Control World Population, a book that has chafed demographers and those working in the family planning sector. If Connelly had foreseen the attention his recounting of the population movement would garner, he might have taken more care to represent more sides of the story. He also might have talked to more living people, especially women, rather than relying so heavily on written archives.
Controversially, Connelly argues that family planning programs in the 20th century were responsible for only 5 percent of the fertility decline experienced during that time. His proof? That fertility levels were already declining before family planning programs began. On page 338, he writes, “Moreover, it could not be shown that even the 5 percent effect was actually caused by such efforts, or whether instead broader socioeconomic or cultural changes explained both the decline in parents’ preference for large families and government willingness to provide them with contraceptives (what economists call the endogeneity problem).”
But examples abound in which fertility declined drastically following the introduction of accessible contraception. For example, after officials in Iran revised the country’s family planning program in the late 1980s, fertility dropped from 5.62 births per woman to just above 2 today. Fertility had been declining since the early 1960s, but at a much slower rate.
In the early 1960s, the fertility rate in Brazil was 6.2. In the years after Planned Parenthood arrived and pharmacies began selling contraceptives, fertility fell to 3.5 births per woman. Today, Brazil’s fertility rate is around 2.35 births per woman, which is close to replacement level.
When women can choose for themselves when to have children, they often choose to have smaller families. The family planning movement has not been perfect, but it has frequently acted courageously to give women the choices they deserve. Its successes should not be overlooked.
Marian Starkey, communications manager at Population Connection, holds a master of science in population and development from the London School of Economics.
