Showing posts from category global health.
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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. -
Taming Hunger in Ethiopia: The Role of Population Dynamics
›May 4, 2012 // By Laurie Mazur
Ethiopia has been deemed a population-climate “hotspot” – a place where rapid growth and a changing climate pose grave threats to food security and human well-being.
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Nabeela Ali on How PAIMAN Is Improving Maternal Health in Pakistan
›“Maternal mortality is a very complex thing – it’s not just patient-doctor relationships, it has so much to do with behaviors, with communities, with the household, with family members,” said Nabeela Ali, chief of party for the Pakistan Initiative for Mothers and Newborns (PAIMAN), which received USAID maternal and child health funding from 2004 to 2010.
Pakistan is the world’s sixth most populous country, yet has long held one of the world’s highest maternal mortality rates. Ali spoke at the Wilson Center last fall about strategies to better engage faith-based organizations on maternal and child health issues. In this interview with ECSP, she stressed that despite Pakistan’s very religious society, these interventions are possible with the right messaging.
PAIMAN aims to reach vulnerable and isolated groups, including poor, rural, or conservative women. “The areas where no one can reach [are] where we targeted,” Ali said.
In these areas, ulama – influential religious leaders and scholars – are highly trusted. “It was not a one-size-fits-all strategy,” Ali emphasized. “Religious leaders are not technical people, but they are experts in their own field. You have to approach them with trust and respect.”
“The first step is establishing rapport with them; then they listen to you,” said Ali. This is best done through another alim, not a technical person. Those ulama that were approachable proved to be valuable allies in the promotion of maternal health. PAIMAN has reached over 35 million people in Pakistan over its now eight-year run.
Projects like PAIMAN are necessary in areas of the world where religious leaders are the most respected community authorities. In Pakistan, Ali believes that now that this strategy has been demonstrated to be viable, the government should help bring it to scale. An NGO-funded project ends, but a government-funded program has much more continuity, which in turn helps build trust with local leaders, she said.
Sources: UN Population Division. -
Women’s Rights and Voices Belong at Rio+20
›This summer, world leaders will gather in Rio de Janeiro for the 20th anniversary of the first UN Earth Summit to hammer out a new set of agreements on what sustainable development means and, more importantly, how both rich and developing nations can get there before it’s too late. However, for the scores of women who will be attending (and just importantly for those who aren’t), there are glaring omissions: reproductive health, gender equality, and girls education are nowhere to be found on the Rio+20 agenda.
Women offer many of the most promising levers for the transformation to sustainable development. My experience with the Global Fund for Women tells me that women are full of creative and strategic solutions to the problems facing their communities around the world. Their voices must be included in critical decisions affecting our world. And the fact is, sustainable development isn’t sustainable if it doesn’t include empowering women to plan their families, educate themselves, and their children, and have a voice in government at all levels. Rio+20 must have human rights – and women’s rights – at its core. Earth summit planners haven’t yet done that, but women can make it happen.
Women are 51 percent of the world’s population, yet own only one percent of its assets, are two-thirds of the world’s workers but earn a mere 10 percent of wages. Rio+20 must not become another forum in which women’s issues are not heard. Instead, the summit must demonstrate that women’s voices are integral to all development. Environmental sustainability simply can’t happen without women’s inclusion.
For example, in West Africa, women make up 70 percent of workers in agriculture. In Burkina Faso, deforestation, water scarcity, and soil erosion show us that climate change is already impacting women farmers. Women tend to “sacrifice themselves” in order to care for their families – feeding themselves last. And women are most likely to suffer and die in environmental disasters – particularly in the Asian countries most at risk from climate change.
So how do we support women while supporting the environment that sustains us all?
Simply meeting women’s needs for family planning is one inexpensive and powerful development strategy with a host of environmental benefits. Over 200 million women around the world want the ability to choose the spacing and number of children but don’t have access to, or accurate information about, basic contraceptives like condoms, pills, and IUDs. One-hundred and seventy-nine nations already agree that meeting this need is a top priority, and the Millennium Development Goals (MDGs) reflect a goal of universal access to family planning as well.
Satisfying this demand would dramatically reduce maternal and child mortality and enhance human rights. What’s more, two recent studies show that a reduction of 8 to 15 percent of essential carbon emissions can be obtained by meeting women’s needs for family planning. This reduction would be equivalent to stopping all deforestation or increasing the world’s use of wind power fortyfold.
The Earth Summit presents a major opportunity to ensure that women’s needs and rights are given top priority in plans for sustainable development. In a time of multiple, interlinked human and environmental crises and a very tight funding environment, investing in women is a clear winner.
A greater understanding of the impact of environmental degradation, pollution, and climate change on women, coupled with solid public policy that respects and protects women’s reproductive rights, is essential to the “Sustainable Development Goals” that many believe will emerge from Rio+20 to replace the MDGs, which expire in 2015.
As the summit approaches, it’s time to reflect on why women’s full participation and inclusion is so important and call for world leaders to harness the power of women as we launch the era of sustainable development.
Musimbi Kanyoro is president and CEO of the Global Fund for Women, which advances women’s human rights by investing in women-led organizations worldwide.
Sources: Food and Agriculture Organization, Guttmacher Institute, Moreland et al. (2010), O’Neill et al. (2010), Princeton Environmental Institute, UN, UNEP, World Bank, World Health Organization.
Photo Credit: “Reokadia Nakaweesa Nalongo,” courtesy of Jason Taylor/Friends of Earth International. -
Uganda’s Demographic and Health Challenges Put Into Perspective With Newfound Oil Discoveries [Part One]
›April 26, 2012 // By Kate DiamondUganda’s population is the second youngest in the world, with half of the country younger than 15.7 years old (just older than Niger’s median age of 15.5 years). In the past 10 years, the country – about half the size of France in land area – has added 10 million people, growing from 24 to 34 million. That growth, paired with other factors like poor governance and long-standing insecurity, has made providing basic services a difficult task for a government that is one of Africa’s most aid-dependent.
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John Donnelly, Global Post
Aspen Institute on Women, Population, and Access to Safe Water
›April 24, 2012 // By Wilson Center StaffLoading the player…The original version of this article, by John Donnelly, appeared on the Global Post.
The U.S. Census Bureau’s World Clock says that the population of the world today is estimated at 7.008 billion people, while projections show that the world could reach the 9 billion marker by 2050.
In the last of its series called “7 Billion: Conversations That Matter,” Aspen Institute’s Global Health and Development hosted a panel of experts based in Africa and the United States on the interconnectedness of gender issues, family planning, population, and access to safe water.
The point of the series was to ask questions about why it mattered that the world was passing the seven billion mark, and the questions today in Washington were appropriately big: Will water wars replace oil wars? What are the solutions to expand water and sanitation to the 2.5 billion people who don’t have it? And just how many people can the world support in an equitable fashion?
An answer to the last question: You need a bigger pie, better manners, and fewer forks.
Borrowing from a book by Joel Cohen called How Many People can the Earth Support? (written in 1996 when the world supported a 5.7 billion population), Laurie Mazur, director of the Population Justice Project, said that the answer was “it depends on how we use resources.”
Continue reading on the Global Post.
Sources: U.S. Census Bureau.
