“Most of the actual violence around water today is not occurring with armies marching out on the field of battle…[it] is more diffuse, more at the community level, more small scale, but quite real and quite important for us to try to address,” says Ken Conca, professor of government and politics at the University of Maryland during this conversation with ESCP Director Geoff Dabelko. Though the world remains fixated on future “water wars,” we “should not forget the actually existing violence in the world today,” he says.

Climate Change and Security in Africa: A Study for the Nordic-African Foreign Ministers Meeting, a collaboration between the International Institute for Sustainable Development and the Institute for Security Studies, examines the spectrum of literature devoted to the security implications of climate change in Africa. In particular, the study focuses on the economic sectors and regions most susceptible to climate change’s threat multiplier effects. It concludes that “climate change presents very real development challenges which, under certain circumstances, may contribute to the emergence and longevity of conflict.”

“National security often means cyber security, it means energy security, it means homeland security, and more and more…it means environmental security,” says retired U.S. Army Captain James Morin in the Pew Project on National Security, Energy and Climate’s recently released video short, “Climate Patriots.”

“Much of the conversation about the global environment, frankly, is an elite conversation,” says Ken Conca, professor of government and politics at the University of Maryland. “But at the same time there are community-level voices, there are voices of indigenous people, there are voices of the powerless, as well as the powerful…. I think it’s important to capture them and not just limit [the conversation] to the most easily accessible voices.”

“The poor face a triple whammy,” Daryl Collins, senior associate at Bankable Frontier Associates and co-author with of Portfolios of the Poor: How the World’s Poor Live on $2 a Day, tells ECSP Director Geoff Dabelko. The Woodrow Wilson Center hosted Collins and her co-author, Jonathan Morduch, for presentations at the Center and on Capital Hill last September. “They not only have low incomes, they also have very irregular and unpredictable incomes…. The $2 doesn’t come every day. If you did have $2 every day, you’d be solving half of your problems.”

Whether farmers challenged with seasonal incomes or small entrepreneurs fighting to cope with irregular daily wages, Collins has found that the poor strive to actively manage their financial lives. Households, however, often lack the regulated financial tools necessary to do so, sometimes leading to creative, local solutions.

In Portfolios of the Poor, lessons from the field uncovered a social grant system in South Africa that provides old-age pension holders and people with young children dependable monthly income supplements. Through comparison studies with countries without similar grant systems, Collins and her co-authors found the importance of dependable cash-flows staggering. “There was a whole financial engagement that could take off around that regularity,” she said. “You didn’t see [that] in India and Bangladesh.”

“Training is probably one of the biggest interventions in terms of making human resources available,” says Pape Gaye, President and CEO of IntraHealth International, to ECSP’s Gib Clarke in this interview on improving maternal health services in developing countries. “Unfortunately, there are a lot of problems associated with training.”

Gaye says obstacles to scaling up maternal health services in rural areas include employee gender inequalities, poor coordination of supplemental training, and a tendency to only offer in-service training in urban areas. Properly emphasizing pre-service education, he underscores, could remedy some of the problems associated with service provider training.

Increasing retention of medical practitioners is also critical to improving maternal health services in developing countries, Gaye explains. In his experience, however, attempts to address perceived security and financial compensation inadequacies produced mixed results. Instead, Gaye suggests that positive recognition may be one of the best methods for retaining health care workers. “We’re seeing some very good successes in places where we have just simple ways to recognize the work… because if people feel valued in a community, then they are likely to stick it out.”

Every minute, a woman dies in pregnancy or childbirth. But the overwhelming majority of these more than 500,000 deaths a year are avoidable.

“We know how to save women’s lives, we don’t need a cure…this is a political problem and political will is essential,” said Theresa Shaver, the director of White Ribbon Alliance.

Addressing longstanding issues like political will could jumpstart progress toward Millennium Development Goal 5, which seeks to reduce maternal deaths by 75 percent by 2015. We face daunting challenges, but there are some clear steps we can take to meet this critical goal. We must strengthen health systems in the developing world.

Increasing women’s access to quality health services during pregnancy, and ensuring they are attended by skilled providers during childbirth, can help to reduce preventable causes of death, such as hemorrhage, pre-eclampsia, and obstructed labor—which together account for 80 percent of maternal deaths.

Scaling-up family planning services are a cost-effective way of preventing unwanted pregnancies, delaying the age of first pregnancy, increasing the time between pregnancies, and facilitating important relationships between women and health care providers. However, many societal and cultural factors dissuade women and girls from seeking contraception. Culturally sensitive education programs can help overcome this barrier, especially if they include men and local leaders, in addition to women and girls.

We should recognize that improving the well-being of mothers is inseparable from the health of newborns. Efforts to reach Millennium Development Goal 4, reducing under-5 mortality by two-thirds, are integral to improving maternal health. Skilled birth attendants could decrease both maternal and child mortality.
In the United States and abroad, momentum is growing to make the investment necessary to scale up these interventions. In January, Secretary of State Hillary Clinton renewed a commitment of $63 billion for the Obama Administration’s Global Health Initiative, which will include significant resources for maternal and child health.

According to the U.S. Agency for International Development, maternal and newborn deaths cost the world $15 billion a year in lost productivity. Researchers conclude that maternal health services would cost only a $1 per day per woman. That’s a small price to pay for such a high return—saving not only dollars, but also women’s lives.

For more information about maternal health and the Global Health Initiative’s Advancing Policy Dialogue on Maternal Health Series please see this month’s issue of Centerpoint.

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In our latest video interview about PHE programs in Ethiopia, Zuna–a village elder from the Mettu Woreda region of Ethiopia—describes how an integrated intervention by the Ethio-Wetlands and Natural Resources Association (EWNRA) has benefited her community.