Showing posts from category gender.
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Addressing Gender-Based Violence Across Humanitarian Development in Haiti
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Women and girls living in displacement camps in post-earthquake Haiti are “the most vulnerable of a very vulnerable population,” according to Amanda Klasing, women’s rights researcher at Human Rights Watch. Klasing was joined by Leora Ward, technical advisor for women’s protection and empowerment at International Rescue Committee (IRC), and Emily Jacobi, executive director of Digital Democracy, for a November 15 panel discussion at the Wilson Center on gender-based violence in Haiti. “Unless we address the violence – the actual experience of violence that women and girls continue to experience at very high rates in Haiti – we [aren’t] going to be able to create a general environment for women and girls to participate in the rebuilding of their country,” Ward said.
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New Population, Health, and Environment Program for Lake Victoria
›With some of Africa’s highest population densities, ethnic diversity, and biodiversity, the Great Lakes region is one of the most volatile intersections of human development and the environment. A new population, health, and environment (PHE) initiative from Pathfinder International, announced Monday at the International Conference on Family Planning in Senegal, aims to help address these issues by supporting sustainable resource management and women’s right to choose when and how often they have children.
Jointly funded by the David and Lucile Packard Foundation and the John D. and Catherine T. MacArthur Foundation, with additional support from USAID’s Office of Population and Reproductive Health, the project will focus on Ugandan and Kenyan sections of the Lake Victoria basin.
Lake Victoria is the second largest freshwater source in the world, a biodiversity hotspot, and an important regional waterway, but regional population growth among the highest in Africa and economic development have led to declining water quality, reduced fish stocks, and industrial pollution. The basin as a whole supports upwards of 35 million people.
“This new project is a welcome development for many reasons,” said ECSP Director Geoff Dabelko. “It brings the integrated PHE approach to one of the world’s greatest lakes, it enables respected health NGO Pathfinder to pursue PHE efforts, and marks the return of a leading private donor, the MacArthur Foundation, to a group of foundations willing to support this innovative approach.”
Sono Aibe, senior advisor for strategic initiatives at Pathfinder emphasized the integrated challenges facing the region. “In these remote, resource dependent areas of the world, the interconnectedness between the health of people and the health of the environment is undeniable,” she said in a press release. “When women are empowered to participate in the sustainable management of natural resources alongside men and youth, as well as have access to sexual and reproductive health care services, their lives will improve and so will the condition of the ecosystems that they depend on.”
The project’s objective, according to Pathfinder, is to reduce threats to biodiversity, conservation, and ecosystem degradation by increasing access to family planning and sexual/reproductive health services. The project plans to develop scalable approaches that can be adopted by communities, local governments, and national governments. Technical support is to be provided by the BALANCED Project, ExpandNet, and the Population Reference Bureau.
“Lessons learned from this new project will help us better develop and design projects for vulnerable communities in fragile ecosystems, while simultaneously advocating for increased government support for integrated programs throughout the Lake Victoria Basin,” said Lucy Shillingi, Pathfinder’s country representative for Uganda.
The Lake Victoria effort will build upon the experiences of other integrated PHE efforts in the region, such as Rwanda’s SPREAD Project, Uganda’s Conservation Through Public Health, and Tanzania’s TACARE and Coastal Management Partnership.
Sources: Lake Victoria Basin Commission, Pathfinder International, UNEP. -
Jeanne Nyirakamana, PHE Champion
Reaching Rural Rwandans With Integrated Health and Livelihood Messages
›This PHE Champion profile was produced by the BALANCED Project.
Rwanda is one of the most densely populated countries on the planet, with more than 11 million people in one of Africa’s smallest countries, most of whom depend on the land as subsistence farmers. The country has diverse mountain, lake, and savannah landscapes, and the Virunga Mountain chain in the northwest part of the country is home to one-third of the world’s threatened mountain gorilla population. At the same time, the population throughout the country suffers from high rates of unmet need for contraception, and three percent of the adult population lives with HIV/AIDS. In a land under such intense pressure on natural resources, rural livelihood initiatives are critical to ensuring people have options for meeting their daily health and well-being needs.
For the past three years, Jeanne Nyirakamana has served as head of the health program for the Sustaining Partnerships to Enhance Rural Enterprise and Agribusiness Development (SPREAD) Project. Supported by the U.S. Agency for International Development through Texas A&M; University, the SPREAD Project is integrating a dynamic coffee production and quality improvement program in Rwanda with health outreach to improve community well-being. The health component works to improve the lives of coffee farmers and cooperative members by providing them with health information and services related to family planning, maternal and child health, prevention of sexually-transmitted infections (including HIV), and water and sanitation.
Training Peer Educators
Working closely with the coffee program, Nyirakamana’s team has trained more than 540 men, women, and youth peer educators who have reached more than 95,000 coffee farmers with education and services. Key communication messages highlight the links between sound decision-making and health-seeking behaviors, productive farms and agribusinesses, and strong and healthy families.
The program also leverages and supports local health resources through referrals to existing public health services, organization of mobile clinics, and community-based distribution of a socially marketed water purification solution (Sur Eau) and condoms (Prudence). According to Nyirakamana, one of the project’s greatest successes is the increased acceptance of family planning by farmers and their families and the more than 7,500 farmers who have been tested for HIV. In order to draw in as many coffee farmers as possible, many of the health and livelihood activities take place at the stations where the coffee beans are washed, at other buildings used by the coffee farmer cooperative, or during combined community meetings or home visits. At the washing stations, Nyirakamana’s team supports local health center staff to provide voluntary counseling and testing (VCT) and de-worming services while at the same time SPREAD-trained peer educators and coffee/health extension agents disseminate family planning information.
The cooperatives’ buildings have clean water, hand-washing stations, and small kiosks where condoms and Sur Eau are sold. These community health agents work with SPREAD to ensure that the greater community, not just the coffee farmers, has access to health knowledge and services. They learn how to teach the community about a range of health issues and each month they submit reports showing how many people they reached and with what kinds of messages. They are also becoming increasingly engaged in coffee and agribusiness activities. Through the success of their health activities, these agents are seen as vital community resources.
Integrated Results
By implementing this integrated population, health and environment (PHE) approach, the SPREAD Project staff is ensuring the health of the people and environment and success of the agribusiness. “You cannot care for the environment without first caring for the people who live and use that environment, so when you transmit dual messages [agriculture and health] you are able to hit two birds with one stone,” said Nyirakamana.
According to a 2010 evaluation of the project, farmers and their families reported improvements in personal and household hygiene; an increase in understanding and acceptance of family planning; uptake of HIV and VCT services; and use of condoms and other local health services. As well, they noted shifts in gender norms affecting household revenue use, alcohol, and reproductive health. The agribusiness stakeholders value the integrated approach as a means to more holistically meet farmers’ goals of increased incomes and improved lives and livelihoods.
This PHE Champion profile was produced by the BALANCED Project. A PDF version can be downloaded from the PHE Toolkit. PHE Champion profiles highlight people working on the ground to improve health and conservation in areas where biodiversity is critically endangered.
Photo Credit: BALANCED Project. -
UNiTE To End Violence Against Women
›November 25, 2011 // By Schuyler NullToday is the International Day to End Violence Against Women, an awareness and advocacy campaign organized by a host of UN agencies and offices “to galvanize action across the UN system to prevent and punish violence against women.”
Gender equity and inequity play a role in a myriad of international development, health, security, and even environmental issues, from rape as a weapon of war; demography’s effects on political stability; maternal health and its impact on child development; women’s rights as a social stability issue; and the disproportionate effect of climate change on rural women.
The numbers around gender-based violence are staggering. According to the UN:
Here are some of New Security Beat’s posts on gender-based violence and inequity and their intersection with development, the environment, and security:- 70 percent of women experience physical or sexual violence from men in their lifetime.
- Approximately 250,000 to 500,000 women and girls were raped in the 1994 Rwandan genocide, and in the eastern Democratic Republic of Congo (DRC), at least 200,000 cases of sexual violence, mostly involving women and girls, have been documented since 1996, though the actual numbers are considered to be much higher.
- In the United States, one-third of women murdered each year are killed by intimate partners; in South Africa, a woman is killed every six hours by an intimate partner; in India, 22 women were killed each day in dowry-related murders in 2007; and in Guatemala, two women are murdered, on average, each day.
- Over 60 million girls worldwide are child brides, married before the age of 18, primarily in South Asia (31.1 million) and sub-Saharan Africa (14.1 million).
Gender-Based Violence in the DRC: Research Findings and Programmatic Implications:
Dr. Lynn Lawry, senior health stability and humanitarian assistance specialist at the U.S. Department of Defense, presented findings from the first cross-sectional, randomized cluster study on gender-based violence in the DRC at the Wilson Center this year. The first of its kind in the region, the population-based, quantitative study covered three districts in the DRC and a total of 5.2 million adults, comprehensively assessing gender-based violence, including its prevalence, circumstances, perpetrators, and physical and mental health impacts.
Pop Audio: Judith Bruce on Empowering Adolescent Girls in Post-Earthquake Haiti: “The most striking thing about post-conflict and post-disaster environments is that what lurks there is also this extraordinary opportunity,” said Judith Bruce, a senior associate and policy analyst with the Population Council. Bruce spent time last year working with the Haiti Adolescent Girls Network, a coalition of humanitarian groups conducting workshops focused on the educational, health, and security needs of the country’s vulnerable female youth population.
The Walk to Water in Conflict-Affected Areas: Constituting a majority of the world’s poor and at the same time bearing responsibility for half the world’s food production and most family health and nutrition needs, women and girls regularly bear the burden of procuring water for multiple household and agricultural uses. When water is not readily accessible, they become a highly vulnerable group. Where access to water is limited, the walk to water is too often accompanied by the threat of attack and violence.
Weathering Change: New Film Links Climate Adaptation and Family Planning: “Our planet is changing. Our population is growing. Each one of us is impacting the environment…but not equally. Each one of us will be affected…but not equally,” asserts the new documentary, Weathering Change, launched at the Wilson Center in September. The film, produced by Population Action International, explores the devastating impacts of climate change on the lives of women in developing countries through personal stories from Ethiopia, Nepal, and Peru.
Sajeda Amin on Population Growth, Urbanization, and Gender Rights in Bangladesh:
The Population Council’s Sajeda Amin describes the Growing Up Safe and Healthy (SAFE) project, launched in Dhaka and other Bangladeshi cities last. The initiative aims, to increase access to reproductive healthcare services for adolescent girls and young women, bolstering social services to protect those populations from (and offer treatment for) gender-based violence, and strengthen laws designed to reduce the prevalence of child marriage – a long-standing Bangladeshi institution that keeps population growth rates high while denying many young women the opportunity to pursue economic and educational advancement.
No Peace Without Women: On October 31, 2000, the UN Security Council adopted Resolution 1325, which called for women’s equal participation in all efforts to maintain and promote peace and security; however, little progress has been made over these last 10 years and women remain on the periphery when it comes to post-conflict reconstruction and development. A report from the humanitarian organization CARE concedes that “much of the action remains declarative rather than operational.”
Addressing Gender-Based Violence to Curb HIV: At last year’s International AIDS Conference in Vienna an astonishing development in the campaign to stem the spread of HIV/AIDS was unveiled – a microbicide with the ability to reduce the risk of transmission of HIV. This welcome development coincides with an intensified focus on women’s health and security needs among donors, especially the United States.
The Future of Women in the MENA Region: A Tunisian and Egyptian Perspective: Lilia Labidi, minister of women’s affairs for the Republic of Tunisia and former Wilson Center fellow, joined Moushira Khattab, former minister of family and population for Egypt, this summer at the Wilson Center to discuss the role and expectations of women in the Egyptian and Tunisian revolutions, as well as issues to consider as these two countries move forward.
Sources: UN Secretary-General’s Office. -
7 Billion: Reporting on Population and the Environment
›“It’s an issue – population – that is immensely diverse in its effects and repercussions, and it’s a great opportunity for reporting,” said Jon Sawyer, executive director of the Pulitzer Center on Crisis Reporting at a November 1 roundtable discussion at the Wilson Center. The session, reporting on population and the environment connections, also featured Dennis Dimick, executive environment editor at National Geographic; Kate Sheppard, environment reporter for Mother Jones; and Heather D’Agnes, foreign service environment officer at USAID.
“It’s an issue – population – that is immensely diverse in its effects and repercussions, and it’s a great opportunity for reporting,” said Jon Sawyer, executive director of the Pulitzer Center on Crisis Reporting at a November 1 roundtable discussion at the Wilson Center. The session, reporting on population and the environment connections, also featured Dennis Dimick, executive environment editor at National Geographic; Kate Sheppard, environment reporter for Mother Jones; and Heather D’Agnes, foreign service environment officer at USAID.The PBS NewsHour segment on “seven billion” featuring collaboration with the Pulitzer Center and National Geographic.
A Cumulative Discussion
“I ended up covering reproductive rights and health issues because I saw a need and a gap in coverage,” said Kate Sheppard. “I had been an environmental reporter for years…and so it sort of became this add-on beat for me.” But, she emphasized, they are actually very related issues.
“It’s a cumulative discussion,” said Dennis Dimick, speaking about National Geographic’s “7 Billion” series this year. “[Population] really hasn’t been addressed that much in media coverage over the past 30 years, in this country at least, and I think that the idea was that it wasn’t really just a discussion about the number seven billion, which is a convenient endline and easy way to get into something, but really to talk about the meaning of it, and the challenges and the opportunities that means for us as a civilization living on this planet.”
The series has had stories on ocean acidification, genetic diversity of food crops, the transition to a more urban world, as well as case studies from Brazil, Africa’s Rift Valley, and Bangladesh. “What we are trying to do in this series is really paint a broad picture to try to unpack all these issues and try to come at this question in sort of broad strokes,” Dimick said. “It’s sort of like we are orchestrating a symphony. Even though it’s a printed magazine, it’s a multimedia project – more than just words and more than just pictures.”
Collaborative Reporting
The Pulitzer Center, a non-profit journalism organization that seeks to fill gaps in coverage of important systemic issues, was able to commission pieces for PBS NewsHour that complemented the National Geographic series. This population collaboration launched the Center’s own initiative on population. “Our hope was that by having that platform, and the visibility of National Geographic and NewsHour, that it would bring attention to the rest of our work,” Sawyer said. The Pulitzer Center has gateways on water, food insecurity, climate change, fragile states, maternal health, women and children, HIV/AIDS in the Caribbean, and Haiti, in addition to population.
Playing off a story that was already making world headlines, the Pulitzer Center supported reporting by freelance journalist Ellen Knickmeyer on the demographic dimensions of the Arab Spring, and particularly the role of young people. The stories explored youth’s frustration at high unemployment and lack of prospects, their roles in the revolutions, and their expectations for the future.
“Of course, we had the advantage that the world was interested in North Africa because of the amazing events that were taking place, but it was an opportunity to get them to look at the other dimension to it,” Sawyer said.
Based on a model developed to cover water and sanitation in West Africa, the Pulitzer Center also created a partnership with four African journalists to produce reporting on reproductive health that will be distributed in both international and African media outlets. “They have important things to say to American audiences, to international audiences,” Sawyer said. “And so we see this project as an opportunity to bring them into the international media discussion.” The journalists will be reporting from the upcoming International Conference on Family Planning in Dakar, Senegal, later this month.
Advocating Discussions
“It’s really a nuanced discussion, and that is why covering these topics, and looking at all the different aspects of it, is really important,” said USAID’s Heather D’Agnes. Furthermore, speaking as a development practitioner, she emphasized the importance of offering solutions, such as family planning, as part of an integrated development approach.
“In our journalism we don’t pretend not to have arguments, or ideas, or thoughts about the issues we are covering,” said Sheppard, speaking of Mother Jones. “I think that the value is that you tell the story well and you do solid reporting – that gives people a more informed perspective.” Especially with complicated issues, like population and the environment, “people find it more accessible if you have a perspective…they can associate better with a story if you walk them through the process you have gone through as a reporter.”
“What we are really trying to do is to advocate a discussion of issues that aren’t getting well-aired in other media,” said Dimick. Sometimes you need to find an interesting or counterintuitive framework, such as the National Geographic story about rural electrification and TV novelas in Brazil. It started as a story about the booming popularity of soap operas, but also created the opportunity to talk about gender equity, family planning, and other complex issues. While the magazine does not advocate a position, like the editorial page of a newspaper might, Dimick said, they do use case studies to guide readers through the range of risks, choices, and opportunities and to help them understand their implications.
Event ResourcesVideo Credit: “World’s Population Teeters on the Edge of 7 Billion — Now What?,” courtesy of PBS NewsHour; “7 Billion, National Geographic Magazine,” courtesy of National Geographic. -
George Washington University’s PISA Helps Share Rural Vietnamese Climate Adaptation Strategies
›“Climate change is not a topic of debate in Vietnam, it’s a real challenge to future prosperity and security,” says George Washington University’s Partnerships for International Strategies in Asia (PISA) program in this video about their climate adaptation and mitigation work in Nam Dinh province. “[Vietnam’s] population density (265 people/square kilometer), its long coastline (3,444 km), its two major rivers (the Red and Mekong) – all help make it one of the 10 countries considered most vulnerable to climate change,” the narrator says.
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Emily Puckart, MHTF blog
Maternal Health in Kenya: New Research Unnecessary, Time to Address Existing Gaps
›The original version of this article, by Emily Puckart, appeared on the Maternal Health Task Force blog.
During the recent Wilson Center/African Population and Health Research Center meeting in Nairobi on improving health systems through a maternal health framework, participants focused on knowledge gaps in the Kenyan health system that can negatively affect maternal healthcare. This focus on gaps sparked discussion around research needed (or not needed) in the maternal health field, supply gaps, and gaps between addressing technical, medical issues of maternal health (like preeclampsia or postpartum hemorrhage), and larger society-wide gaps like gender equity. The gaps highlighted by participants at the Nairobi dialogue included:- Gaps in knowledge: During the dialogue, members of the Kenyan maternal health community discussed the possibility of strengthening community health workers as an information delivery platform. Participants wondered about the possibility of using community health workers to distribute information both downward to the end user (patients), and then again to gather information from end users and distribute it upwards through the system to reflect the opinions of the direct users of the healthcare system.
- Supply gaps: Participants argued that while there is a large body of information in terms of maternal health supplies at the national level in Kenya, there is not as much data on supplies at the actual health facility level, where it is much needed and would be very helpful to successfully treat patients.
- Gaps in healthcare delivery: There is a strong need to address inequality in the distribution of health services as there are unequal services in rural and urban areas. Within those broad areas there may be further inequalities, as even in urban areas, slum areas or neighborhoods on the edges of cities may have less access to quality healthcare than populations that live in wealthier areas of the city or closer to the city center. Further there are broader questions of gender and access to care. Where women are not able to control household finances, they may be unable to access and pay for lifesaving care. Participants framed the question in a rights framework, “Do we value the lives of women less than men?”
- Health workforce gaps: There is a mismatch between the supply of health workers and the absorption of those trained health workers in Kenya. Many of them are not incentivized professionally or financially to stay in the system where they are trained. These health workers may leave for other countries or prefer to stay in urban areas depriving rural areas of a surplus of trained health workers.
- Gaps between words and actions: Several of the small working groups pointed to accountability as a serious issue, as there are gaps between the words of politicians on health issues and actual actions. The gap between the government promised funding for health and the actual lower amount of spending was consistently highlighted during the Nairobi dialogue as a serious gap in holding governments accountable for their promises.
The lively conversation provoked by a broad discussion of gaps in the Kenyan health system provided fertile ground to develop action points on maternal healthcare that participants then presented on the second day of the meeting to several Kenyan members of parliament. Ideally, this will be the first discussion of many as maternal health advocates, field workers, and researchers coalesce around ways to address the gaps in maternal healthcare in Nairobi and elsewhere.
Emily Puckart is a senior program assistant at the Maternal Health Task Force (MHTF).
Photo Credit: Jonathan Odhong, African Population and Health Research Center. -
Improving Maternal Health: A Conversation With Kenyan Field Workers and Policymakers
›“The traditional strategies for improving the health system include the horizontal approach, which prioritizes non-communicable diseases, and the vertical approach which prioritizes communicable diseases such as HIV/AIDS,” said John Townsend, vice president of reproductive health programs at Population Council, during a webcast discussion – the second in a series – between the Woodrow Wilson Center in Washington, DC, and maternal health experts in Nairobi, Kenya. [Video Below]
Recently, a third strategy, called the “diagonal approach,” was developed to more clearly define health system priorities and guide general system-wide improvements. Participants in both locations discussed this new approach and other structural improvements that can be made to better integrate maternal health indicators into developing country health systems on October 17.
The meeting was part of the 2011 Advancing Dialogue on Maternal Health series, with the Wilson Center’s Global Health Initiative and the African Population and Health Research Center. Participants in Nairobi were assigned to three topical groups and asked to identify challenges and opportunities related to their themes.
The Role of Policymakers and Funders“We must engage [policymakers and donors] in forums like this one to share findings and share lessons learned,” said participant Sylvia Bushuru of Kenya as she reported back from the policymakers and funders working group. The group focused on steps required to hold politicians accountable to commitments made to maternal health, such as the Abuja Declaration, which requires the Ministry of Finance to dedicate 15 percent of the budget to health. Currently, only 5.5 percent of the Kenya budget is dedicated to the health sector.
Identifying strategic partners will help in reaching ambitious goals, the group agreed; however, they noted that it’s important to ensure that these partnerships and policies extend to an operational level. Besides the overall budget pledge, important steps like ensuring 24-hour emergency health facilities in rural areas and implementing a results-based financing plan based on maternal health indicators have yet to be completed.
A Definition of Priorities through a Diagonal Approach
James Wariero, a regional health advisor with the MDG Centre for East and South Africa, served as the representative for the group discussing the “diagonal approach,” which focused on how maternal health indicators can best set priorities to improve the overall health system. They identified antenatal care visits as a priority because they also serve as an entry point to other health services, including HIV/AIDS treatment.Discussing gender, he said that “male involvement in maternal health will have benefits for child health and other issues…it is an area with little headway here in Kenya and other similar countries in Africa.” Additionally, Wariero discussed how the diagonal approach could be used to link maternal health indicators with other sectors such as technology and information systems.
The group said that improving the health system should start at the district level to ensure the most vulnerable populations at the community level have proper access. However, they said that ideally district-level programming should be evaluated and funded through results-based financing and structured on clear maternal health indicators.
Knowledge Gaps and Research Needed
“We initially began our discussion surrounding the [World Health Organization’s] six health system blocks,” reported Dr. Kristine Kisaka, a program officer with Deutsche Stiftung Weltbevoelkerung and representative from the “knowledge gaps and research needed” group. This group identified access to mobile phones for maternal health data collection as a major resource gap. Instead of calling for additional research they said they would prefer better implementation of existing, evidence-based programming.
Utilizing the World Health Organization’s health system framework, the group identified existing knowledge gaps to improve maternal health in Kenya and six recommendations:- Strengthen community strategies through a national synchronization of information
- Harmonize planning and implementation of the provisioning of supplies and commodities at the community level
- Address inequalities in the distribution and delivery of health services, ensuring distribution to urban and rural centers, including slums
- Centralize health financing in order to reach both national and community levels
- Empower households in financing, including both women and men, so they plan and save for maternal health
- Address the imbalance in supply and demand of healthcare workers
Linkages: Key To Improving Maternal Health Systems
“It’s really about linkages,” said John Townsend, giving closing remarks after the presentations from Nairobi. Maternal health indicators can be a catalyst for change, due to their strong cross-cutting links to other development systems, such as transportation, the economy, and education. “I think the call to action that the Kenyan working groups made is quite valuable,” he said, but the question is, “How do we get intelligent decision alternatives in front of our leaders to figure out what are the best investments given the critical resources?”
“The private sector [presents] an opportunity,” said Townsend. “I think we need to be more explicit about how we want to engage with them and what we would like to see from them.” He pointed out that the national maternal health strategy in Kenya is explicit and promising, but there needs to be stronger links between the national strategy and the operational aspects of actually implementing it.
Event Resources:- Photo gallery
- Presentation: “Improving Health Systems Through a Maternal Health Framework,” African Population and Health Research Center
- Video
Photo Credit: #1 and #3, courtesy of Jonathan Odhong, African Population and Health Research Center; #2 courtesy of David Hawxhurst/Wilson Center.
