Showing posts from category youth.
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GMHC 2010: Empowering the Next Generation
›“We do not need new legislation… we need affordable, effective, and scalable solutions,” said Shn Gulamnabi Azad, Minister of Health, India, at the opening ceremony of the first-ever Global Maternal Health Conference in New Delhi. Co-hosted by the Maternal Health Task Force and the Public Health Institute of India, this three-day technical meeting builds upon the momentum of Women Deliver and the G8 summit by bringing together 700 researchers, program managers, advocates, media, and young people to exchange ideas, share data, develop strategies, and identify solutions for reducing maternal mortality.
In order to reduce India’s maternal mortality rates, Azad called for the repositioning of family planning programs to include maternal and child health and not limit the scope of services to population control as historically executed. Improving family planning and maternal health services must also address the reproductive health needs of adolescent girls, and India is currently developing a new ministry that will target gender inequality, poverty, early child marriages, as well as other critical health issues important to young girls such as the dissemination of sanitary napkins.
“Although the legal age of marriage is 18, there are districts in India where 35 percent of the population is married between the ages of 15-18,” said Azad. During the side event “Adolescent Girls: Change Agents for Healthy Mother and Child,” technical experts such as Anil Paranjap of the Indian Institute of Health Management presented evidence that girls who marry between 15-18 are five times more likely to die during childbirth than women in their early 20’s.
“We still have deep-rooted subordination that makes it very difficult for young women to realize their sexual and reproductive health rights,” said Sanam Anwar with the Oman Medical College. Interventions such as the UDAAN project – a private-public partnership between the Center for Development and Population Activities (CEDPA) and the Government of India – demonstrate promising solutions for empowering young people through the use of existing infrastructure. In collaboration with teachers, parents, principals, and students, this project successfully increased leadership skills and improved youth knowledge on menstruation, health, friendship, peer pressure, early marriage, and reproductive health, said Sudipta Mukhopadhyay of CEDPA.
Empowering “young people” to improve maternal health also requires that the community support committed new thinkers and future leaders. The Young Champions of Maternal Health Program is a unique and refreshing group of young professionals from 13 countries dedicated to improving maternal health, and I look forward to learning how this new energy will further the maternal health agenda.
Originally posted at Maternal Health Task Force, by Calyn Ostrowski of the Woodrow Wilson International Center for Scholars, Coordinator of the Maternal Health Dialogue Series in partnership with the Maternal Health Task Force and UNFPA.
Photo Credit: “Indian Girl” courtesy of flickr user Jarek Jarosz. -
The Future of Sub-Saharan Africa’s Tentative Fertility Decline
›August 25, 2010 // By Richard Cincotta
In her recent post on The New Security Beat, Jennifer Sciubba argues that the medium-fertility variant projection published in the UN Population Division’s biennial projections — the source of most future data published in the Population Reference Bureau’s 2010 World Population Data Sheet — forecasts an unrealistically low total fertility rate (TFR) for sub-Saharan Africa in 2050, at a rate of 2.5 lifetime childbirths per woman.
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Misguided Projections for Africa’s Fertility
›By assuming that sub-Saharan Africa’s total fertility rate will decrease to 2.5 children per woman by 2050, the most recent population projections issued by the Population Reference Bureau likely continue to underestimate fertility for Africa. Though northern Africa has significantly lowered fertility, sub-Saharan Africa’s TFR is still 5 children per woman. Achieving the levels projected by PRB or the United Nations will largely depend on whether the conditions that led to past fertility declines for other states can be established in sub-Saharan Africa.
Demographers have identified numerous factors associated with fertility decline, including increased education for females, shifting from a rural agricultural economy to an industrial one, and introduction of contraceptive technology. Sub-Saharan Africa is only making slow progress in each of these areas.
Surveying Obstacles to Development
Primary school enrollment is up, but the pace of improvement is declining. Meanwhile, gender gaps persist: Enrollment for boys remains significantly higher than for girls. Girls’ education is associated with lower fertility, partly because education helps women take charge of their fertility and also because education influences employment opportunities. Increased female labor force participation has been shown to increase the cost of having children, and is therefore associated with initial fertility declines.
Disease is one wildcard for Africa that limits the utility of past models of demographic transition in the African context. HIV/AIDS is decimating sub-Saharan Africa’s adult workforce and creating shortages of teachers that will impede future efforts to boost primary school enrollment. According to the United Nations, the number of teachers in sub-Saharan Africa needs to double in the next five years to reach Millennium Development goals.
Development that would shift the region’s economies from agriculture to industry is also lagging. While several West African countries are seeing some gains, the African continent on the whole faces major structural impediments to development. In The Bottom Billion, Paul Collier points out that many of these countries may have “missed the boat” to attract investment and industry that would pull the region out of poverty, partly because the least developed countries are still not cost-competitive enough when compared with current centers of manufacturing, like China.
Finally, there remains a high unmet need for family planning. One in four women aged 15 to 49 who are married or in union –- and who have expressed an interest in using contraceptives — still do not have access to family planning tools. In general, maternal mortality remains high and adolescents in the poorest households are three times more likely to become pregnant and give birth than those in the richest households, according to the most recent UN Millennium Development Goals report.
Sub-Saharan Africa: Off the Radar?
Sub-Saharan Africa suffers from a lack of attention by the international community and lack of political capacity at home. Many countries in the region are plagued by civil strife and poor governance, and developed countries continue to fall short of development assistance pledges. There is not the same sense of urgency today among developed countries about the global population explosion as there once was. Cold War politics and the environmental and feminist movements motivated much of the study of fertility and funding of population programs during the second half of the 20th century. Attention by governments and NGOs sped the fertility transition among many countries.
Today, the world’s wealthiest countries are not concerned primarily with Africa’s problems, but rather are more concerned with their own population decline and with the national security implications of population trends in areas associated with religious extremism. The recession has further hindered the flow of development funds.
Fertility is the most difficult population component to predict, and demographers must draw on the experiences of other regions to inform assessments of Africa’s population patterns. Demographers seem to be overconfident that Africa’s fertility will follow the pattern of recent declines, particularly in Latin America, which were more rapid than Western Europe’s decline due to the diffusion of technology and knowledge.
Once states begin the demographic transition towards lower fertility and mortality, they have tended to continue, with few exceptions. Therefore, most projections for Africa assume the same linear pattern of decline will hold. Yet, the low priority of Africa’s population issues among the world’s wealthiest states, combined with shortfalls in education, development, and contraception, may mean that the demographic transition in Africa will be slower than predicted.
Projections are useful to give us a picture of what the world could look like if meaningful policy changes are made. In the case of sub-Saharan Africa, prospects for these projections are dim.
Jennifer Dabbs Sciubba is the Mellon Environmental Fellow in the Department of International Studies at Rhodes College in Memphis, Tenn. She is also the author of a forthcoming book, The Future Faces of War: Population and National Security.
Photo Credit: “Waiting,” ECWA Evangel Hospital, Jos, Nigeria, courtesy of flickr user Mike Blyth. -
Land, Education, and Fertility in Rural Kenya
›August 10, 2010 // By Wilson Center StaffExcerpted from a summary on the Population Reference Bureau‘s website, by Karina Shreffler and F. Nii-Amoo Dodoo. The original version of this article appeared in Population and Environment 30, no. 3 (2009): 75-92.
Little is known about the role of land inheritance in the link between land availability and fertility. The recent transition from high to lower levels of fertility in some African countries presents an opportunity to clarify the underlying causes of this decline, since the individuals involved in the transitions are still alive.
Using data from focus group discussions with people whose childbearing occurred before and during the rapid and unexpected fertility decline in Nyeri District in rural Kenya, we examined the impact of diminishing land availability, farm size, and inheritance patterns on fertility decisionmaking and behavior. The results shed new light on the role of education, long considered the key determinant of fertility transition.
Our research suggests that rather than inheritance being an external factor affecting fertility behavior, parents in Nyeri District chose to educate their children after realizing they would not be able to bequeath a sufficient amount of land. Our work provides evidence of the importance of considering the influence of environmental factors on demographic processes, particularly in regions of resource dependence.
Continue reading on PRB.
For more on Kenya’s youth, see New Security Beat‘s interview with Wilson Center Scholar Margaret Wamuyu Muthee.
Photo Credit: “Olaimutiai Primary School (Maasai Land, Kenya),” courtesy of flickr user teachandlearn. -
Population Reference Bureau Releases New Projections
Seven Billion and Counting
›August 6, 2010 // By Russell SticklorThe Population Reference Bureau recently released its annual World Population Data Sheet, and lo and behold, the world is getting more crowded. By next year, the global total is expected to top seven billion, as we march toward upwards of nine billion by mid-century.
Much of that growth, of course, will be unfolding across Asia — China and India already account for more than 35 percent of the world’s population, and the two countries will continue to drive global demographic change. But the PRB report emphasized that Africa will also contribute significantly to world’s shifting demographics in the coming decades. By 2050, the continent’s population is slated to double, reaching the neighborhood of two billion. In that time span, the Democratic Republic of Congo and Ethiopia are expected to knock Russia and Japan off the list of the world’s top 10 most populous nations.
The Young Continent
Africa’s population growth through 2050 could actually be even greater than PRB predicts, since current projections assume that total fertility rate in sub-Saharan Africa will drop from 5.2 to 2.5 in that time span. The assumption is that as the region’s countries travel farther down the path to economic modernization, access to family planning services will become more widespread, resulting in smaller average family sizes—a trend well-documented in other parts of the developing world.
A slower than expected decrease in total fertility rate (TFR) across sub-Saharan Africa over the next 40 years could render current predictions inaccurate, however. While TFR has dropped significantly over the past 50 years in countries like Ghana (where it is now 4.0), just 17 percent of married women in sub-Saharan African utilize a modern type of family planning. That is one of the reasons Africa as a whole maintains a high average TFR of 4.7 children per woman, and why countries like Niger and Uganda sport some of the highest TFRs in the world (at 7.4 and 6.5, respectively).
According to the 2010 PRB Data Sheet, Africa is also notable for its demographic youth bulge. Of the world’s 10 countries with the highest percentage of their populations aged 15 or younger, nine of them—Niger, Uganda, Burkina Faso, the DRC, Zambia, Malawi, Chad, Somalia, and Tanzania—are on the continent. The question facing these countries is whether their young populations will yield a “demographic dividend” during the coming decades, whereby the large youth bulges translate into a sizeable and productive workforce. Harnessing the economic potential of the younger generation could help accelerate the development process in many of the region’s nations, but it will require significant investment in health and education infrastructure—funding that may prove hard to come by for many cash-strapped governments.
Persistent Divides
Other findings featured in the report involved sanitation and wastewater treatment, where some headway is being made at the global level. The PRB Data Sheet reveals that 43 percent of urban populations in sub-Saharan Africa (and 24 percent of the region’s rural populations) now have access to improved sanitation, while 86 percent of urban populations (and 55 percent of rural populations) have better sanitation services in Latin America and the Caribbean. The figures highlight progress, but reveal the significant divide that persists between urban and rural areas in terms of access to quality sanitation. According to the PRB, some 2.7 billion people—40 percent of the world’s total—still do not enjoy adequate sanitation facilities, and most live in rural areas of the developing world.
Finally, an interesting trend that will impact developed and developing nations alike involves elderly support ratios, or the number of active workforce members between the ages of 15 and 64 available to support a nation’s non-working, 65-and-older population. While rapidly growing countries in the developing world will continue to enjoy high elderly support ratios, a number of countries across the developed world will face a potential financial crisis, as comparatively low support ratios combine with rapidly aging populations to strain available financial resources earmarked for covering pension payments and healthcare infrastructure costs. To make up for the shortfall over the coming decades, the PRB report predicts that some developed nations may be inclined to further throw open the doors to immigration to bolster workforce ranks—a step recommended by Jack Goldstone in ECSP Report 13.
Sources: New York Times, Population Reference Bureau, Population Council, PR Newswire, United Nations Population Division, WHO/UNICEF Jointing Monitoring Programme for Water Supply and Sanitation
Photo Credit: “Famine in Niger, Africa,” courtesy of flickr user liquidslave. -
Boosting the U.S. Role in the Global Health Arena
›A new video from the Commission on Smart Global Health Policy, which was established by the Center for Strategic & International Studies, reviews the commission’s progress towards its goal of encouraging the U.S. government to embrace global health as a pillar of U.S. foreign policy.
The video reviews the recommendations from the commission’s March 2010 report, A Healthier, Safer and More Prosperous World: 1) Maintain robust U.S. support for the fight against HIV/AIDS, malaria, and tuberculosis; 2) Prioritize maternal and child health, especially in sub-Saharan Africa and South Asia; 3) Help other nations improve their capacity to prevent and respond to outbreaks of contagious disease; 4) Expand U.S. capacity to fund future global health initiatives by securing long-term investments for such efforts; and 5) Step up U.S. funding for multilaterals engaged in the global health field, including the World Health Organization, Global Fund, UNICEF, the World Bank, and the GAVI Alliance.
In the months ahead, commission members will be participating in public forums throughout the United States to discuss and promote the recommendations included in the report, before gathering in January to review the Obama administration’s progress on global health as the administration begins its third year. To date, the centerpiece of the administration’s health outreach efforts has been the six-year, $63 billion Global Health Initiative, designed to promote an enhanced U.S. role in addressing public health issues overseas.
The CSIS Global Health Policy Center will also be launching a year-long debate series called “Fault Lines in Global Health,” focusing on controversial topics in the global health field. The series’ kick-off event will center on U.S. AIDS funding, and is scheduled for Friday, August 6, 2010, from 9:30-11:00 a.m. -
Interview With Wilson Center Scholar Margaret Wamuyu Muthee: Envisioning a New Future for Kenya’s Next Generation
›July 29, 2010 // By Wilson Center StaffYouth in sub-Saharan Africa constitute a large and growing portion of the region’s population, yet remain underserved by family planning and reproductive health programs. New Security Beat recently interviewed Margaret Wamuyu Muthee, an Africa Program Scholar at the Woodrow Wilson Center, about this problem. Muthee is currently working on a project documenting both the opportunities and challenges for young people growing up in Kenya.
New Security Beat: How do you define youth?Margaret Wamuyu Muthee: The African Union has defined youth as every person between the ages of 15 to 35 years, while the United Nations defines youth as persons between the ages of 15 and 24. I will be concentrating on the age group defined by the African Union.
NSB: What are some opportunities and challenges facing youth in Kenya?
However, I will not only be relying on age. There are other aspects that I must take into consideration. Many children assume the roles of an adult or a care-taker when they are at an early age. Children in African nations face different challenges [compared to children in Western countries], as there are fewer opportunities for transition in Africa.MWM: This is a very important stage for exposing youth to the available support and teaching them about the social economy. Some of the difficulties lie in the lack of resources and corruption, such as misuse of funds that are provided to the government by outside sources.
NSB: Which programs are taking actions to empower youth in Kenya?
On a more positive outlook, youth are very resilient. They have a wide range of potential and capacity that can be utilized right away. African nations, just like China, have an enormous population that can be a human resource. All we have to do is positively tap into their potential to make good changes.MWM: The Youth Enterprise Development Fund (YEDF) works to increase economic opportunities for Kenyan youth in nation-building through enterprise development. YEDF also works to lower the unemployment rate and teach certain skills for future employment. One downside of this fund is that even though it provides money, it does not provide mentorship for the youth who execute the programs.
NSB: Are these programs enough to address youth challenges?
Another program is Yes Youth Can! This $45 million initiative was created by the U.S. ambassador to Kenya and USAID. The program is designed to create local and national networks of youth leaders to advocate peaceful economic and governmental reforms. The wonderful thing about this organization is that it is completely youth-driven.MWM: Sometimes these programs are seen as too small and too late. Youth are seen as violent, and these programs are made to keep them busy. Programs need to address all the facts, from start to finish.
NSB: Are there programs specifically targeted at female youth?MWM: We need programs that address pregnancies, HIV/AIDS, and education for young women. These education programs not only need to teach them about pregnancies and HIV/AIDS, but also educate women about their rights: how to say “no” and object to certain actions.
NSB: Are family planning and reproductive health incorporated into youth education?
However, there are complications when it comes to female rights. There are sexual offense laws that females do not even know about. The implementation of these laws can be non-existent. Either the police system is flawed or accessing lawyers is too expensive for females. And even if a lawyer is hired, the rapist can pay off a judge, so the judge will not convict him.MWM: There are already reproductive health campaigns in Kenya. One example is the ABC program: Abstinence, Be faithful, Condom use. Everyone these days, in rural and urban environments, knows about HIV/AIDS. There needs to be more programs regarding family planning and health; there is only a limited amount of knowledge getting passed around about those two issues.
Margaret Wamuyu Muthee is the Programs Manager for Kenya’s University of Nairobi Center for Human Rights and Peace, and a current scholar in the Woodrow Wilson Center’s Africa Program.
There is a new proposed Kenyan constitution that bans abortion unless a doctor permits the abortion due to health reasons, or if the mother’s health is in critical danger. Many females die because they cannot legally get an abortion and try to abort their baby on their own, or accept services from a backstreet clinic.
We also have cultural practices that put up barriers to the spread of family planning and health. One such example is the practice of early female marriages. Girls as young as 10 years old will be forced to marry a much older man. These girls have not had proper education on reproductive health or family planning.
In addition, adults are still too shy to address youth that are having sex, and are embarrassed to talk about their health if they have HIV/AIDS. We need to educate more youth and provide the means for them to live safer lives.
Josephine Kim and Marie Hokenson are cadets at the United States Military Academy at West Point and interns with the Woodrow Wilson Center’s Environmental Change and Security Program.
Photo Credit: “The Mentees and their mentors,” used courtesy of flickr user The Advocacy Project. -
Addressing Gender-Based Violence to Curb HIV
›July 28, 2010 // By Marie HokensonAt the recent International AIDS Conference in Vienna, Austria, 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.
At the conference, the “Gender Programming and Practices: Practical Approaches with HIV and AIDS” session took an integrated approach, examining the links between gender-based violence and HIV/AIDS infection. Women are more vulnerable to gender-based violence and HIV infection than men, particularly in parts of sub-Saharan Africa where “girls and women aged 15 to 19 are three times more likely” to become infected with HIV than men in the same age group, according to the World Bank.
Michelle Moloney-Kitts, with the Office of the U.S. Global AIDS Coordinator, said that gender-based violence “affects not only public health, but [also] the ability of women and girls to contribute to developing their countries.” Since women play integral roles in supporting their families and communities in developing nations, their absence or weakened capacity due to HIV infection, injuries, or unwanted pregnancy can have larger repercussions for economic development and community health.
Deep Roots: Changing Minds About Gender-Based Violence
Elizabeth Mataka, the UN Secretary-General’s special envoy for AIDS in Africa, described the obstacles facing female victims of gender-based violence as “deep-rooted social, economic, legal, and cultural affairs” in their communities. Mataka asserted that “communities must be engaged” through a “change in mindset” in order to allow these women to “claim their basic human rights.” Scrutinizing the paucity of women’s organizations, she cited a “serious shortage of women’s leadership at the grassroots level” as a problem that must be overcome to empower and protect women.
Pamela Barnes, a co-leader of the Partnership to End Sexual Violence Against Girls, highlighted the extent of this “deep-rooted societal issue.” She pointed out that a 2007 Swaziland study found the most “common venue for sexual violence was…within the homes of the victims.”
Rui Bastos, representing Mozambique’s Ministry of Health, added that there is a pressing need to “change relationships between men and women,” and called for a shift in the current relationship dynamic to “give power to the women.” Noting the low number of men receiving HIV treatment, he called on men to “increase demand in treatment” in order to stem the spread of the disease.
Silent Voices: Talking About Sexual Violence Against Minors
Since the Swaziland survey found that “30 percent of the respondents indicated that they had experienced some form of sexual violence prior to the age of 15,” Barnes said greater efforts must be made to educate children about how to protect themselves from sexual violence. She added that efforts to protect children should also address other “risk factors for abuse [which] include lack of education, exposure to emotional abuse, and witnessing sexual assault.”
At a recent Wilson Center event on sexual violence against minors, Jama Gulaid of UNICEF Swaziland said that while talking about sexuality is not easy, “when you bring in violence it is even more difficult.” For that reason, Gulaid said, “you have to do two things—you have to share information and you have to present it in certain ways.” He explained that Swaziland was addressing the issue by relying on school-based interventions, which include trained community-child protection groups, toll-free telephone lines, case investigation services, and personal counseling.
Prevention First: Scaling Up to Stop Rape
While the new microbicide might help female victims of sexual violence avoid HIV infection, it will not stop the problem of gender-based violence. That is why Moloney-Kitts called on donors and NGOs to “scale up gender-based violence programs,” but in a way that goes beyond simply improving “post-rape care” and instead places greater emphasis on prevention efforts.
Not only would better rape prevention help reduce HIV and STD infection rates, but it would also help women avoid psychological damage and unwanted pregnancies—and, as Moloney-Kitts pointed out, improve economic development and enhance public health at the same time.
For more on gender-based violence, see these Wilson Center events:- Gender-Based Violence in Sub-Saharan Africa: A Review of Demographic and Health Survey Findings and Their Use in National Planning
- From Relief to Development: Gender-Based Violence Interventions in Conflict and Post-Conflict Contexts
- Dynamics Of Sexual Violence In The Eastern Democratic Republic Of Congo: Perpetrators, Community Response, and Policy Implications
Photo Credit: “Congo Kivu Violences Panzi,” used courtesy of flickr user andré thiel.
