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How Family Planning Meets Development Goals
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“Knowing is not enough; you must act and let your government know that family planning is a right and saves lives,” said Maurice Middleberg of the Global Health Council at a recent event in Chapel Hill.
The other panelists at “How Can Family Planning Efforts Help Us Achieve the Millennium Development Goals?” (Dr. Martha Carlough of UNC, Dr. Ward Cates of Family Health International, and Pape Gaye of IntraHealth International) all provided compelling statistics demonstrating the effectiveness of family planning as an intervention that addresses the Millennium Development Goals (MDGs).
MDGs 4, 5, and 6 – reducing child mortality; improving maternal health; and combating HIV/AIDS, malaria, and other diseases, respectively – all have obvious connections to health and woman’s reproductive health. An unmet need for family planning, which is measured as the percentage of women of reproductive age who desire to space or limit their births but are not using contraception, can undermine the achievement of these goals.
For example, very early motherhood not only increases the risk of dying in childbirth, it also jeopardizes the well-being of surviving mothers—and their children, too. A child born to an adolescent mother has a greater risk of dying in infancy or childhood.
“Contraception is the best-kept secret in HIV prevention,” said Dr. Cates, who cited research that found that “current contraceptive use in sub-Saharan Africa prevents an estimated 577,200 unplanned births to HIV-infected mothers” and thus prevents the birth of an estimated 173,000 HIV-infected infants each year.
Family planning can help meet the other MDGs, including ending poverty and hunger (Goal 1); providing universal primary education (Goal 2); and promoting gender equity (Goal 3). Young mothers frequently miss out on education and socio-economic opportunities. Being able to make their own decisions about family planning and reproductive health can empower women and improve gender equity. When women are given equal opportunities for education, health, and employment, they are more likely to invest in the education and care of their children. This helps them break the cycle of poverty, hunger, and disease.
Although the MDGS don’t include any formal targets for sexual and reproductive health, the UN Millennium Project has stated that the MDGs cannot be achieved in low-income countries without access to sexual and reproductive health services, including family planning. The panelists agreed that family planning is a cost-effective intervention that provides broader positive benefits for development.
But the real strength of their presentations lay in the personal stories behind the statistics. Middleberg closed the discussion with a story about a woman in Latin America who told him that she loves her husband but was afraid of him every time he touched her. Now, after having undergone sterilization, she no longer worries and can love her husband with no fear of becoming pregnant.
A mother of six interviewed in a 2009 news article about the Philippines’ new family planning bill said, “How can one keep on having children? We don’t earn enough to feed them, much less send them to school.” New York Times columnist Nicholas Kristof interviews a Haitian woman with 10 children in a dramatic video interview, “Saving Lives with Family Planning.”
Underlying all of these facts and stories is the belief that one’s health and well-being, including access to family planning, is a right. But as Middleberg said, believing is not enough.
EngenderHealth, an international reproductive health organization working to improve the quality of health care in the world’s poorest communities, is asking Americans to create a video explaining why we should care about international family planning. Contribute your thoughts on YouTube’s Video Volunteers project.
Lisa Basalla, MPH, is a research associate with the Carolina Population Center. She graduated from Case Western Reserve University with a MPH focusing on reproductive and adolescent health. She has worked with Johns Hopkins University’s Center for Communications Programs on its reproductive health knowledge management project as well as a HIV-prevention behavior change communication project in Malawi.
Photo: A billboard promoting family planning in Phnom Pehn, Cambodia. Courtesy flickr user olerousing. -
Weekly Reading
›The Population Reference Bureau’s 2009 World Population Data Sheet shows that global population numbers will reach 7 billion in 2011. Among its key findings, PRB notes that “population growth is one root cause of increases in global greenhouse gas emissions. But the complexity of the mechanisms through which demographic factors affect emissions is not fully taken into consideration in many analyses that influence governments’ climate change mitigation efforts.”
The Guardian reports that U.S. marines have launched an energy audit of American military operations in Afghanistan, the first such assessment to take place in a war zone. “Some 80% of US military casualties in Afghanistan are due to improvised explosive devices (IEDS),” the article elaborates, “and many of those placed in the path of supply convoys.” DoD’s Alan Shaffer recently told ClimateWire, “nearly three-quarters of what convoys move in Afghanistan’s treacherous terrain is fuel or water.”
The Department of State released an inspection of the operations of the Bureau of African Affairs that identifies a rift between U.S. diplomats and the U.S. military’s recently established African Command (AFRICOM). As the Wilson Center’s Steve McDonald told Bloomberg.com, “It got off to a hugely bad start…Part of it was tied up with policies of the Bush era, where our own security concerns far overrode any sensitivities to local considerations.”
T. Paul Shultz of Yale University’s Economic Growth Center evaluates population and health policies, looking specifically at “the causal relationships between economic development, health outcomes, and reproductive behavior.”
Oxfam’s “The Future is Here: Climate Change in the Pacific” includes recommendations for adapting and mitigating climate change in Australia, New Zealand, and the Pacific island nations—a region “where half the population lives within 1.5 kilometers of the sea.” -
Budgeting for Climate
›Update: Read a response by Miriam Pemberton“The Obama administration…has identified the task of substantially reducing greenhouse gas emissions as one of its top priorities,” writes Miriam Pemberton in a new report from the Institute for Policy Studies, “Military vs. Climate Security: Mapping the Shift from the Bush Years to the Obama Era.”
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Demography and Democracy in Iran
›August 12, 2009 // By Brian KleinPresident Mahmoud Ahmadinejad might have blamed sinister “foreign powers” for fomenting post-election civil unrest in Iran, but some analysts have fingered another culprit: demography. According to Farzaneh (Nazy) Roudi, program director for the Middle East and North Africa at the Population Reference Bureau, two phenomena “provide a backdrop for understanding Iran’s current instability.” First is the country’s youthful population age structure, or “youth bulge”; over 30 percent of Iranians are between the ages of 15 and 29, and 60 percent are under the age of 30. Second is Iran’s surprisingly comprehensive family planning program, which has empowered women to make their own reproductive choices and enter higher education en masse. -
Copenhagen’s Chance to Reduce Poverty and Improve Human Security
›The climate community is under increasing pressure to help the developing world, especially those at the “bottom of the pyramid.” The people who did the least to cause climate change will suffer its effects the most.
A critical part of the solution to this problem will be enhancing market-based incentives for climate-friendly behavior. The projects that generate credits for sale in the carbon markets vary widely in scale. However, the most successful have focused on large, localized sites, such as the smoke stack of a single plant. These “centimeter-wide, kilometer-deep” projects are easy to monitor and verify.
In contrast, most projects that benefit the poor are “a kilometer wide, a centimeter deep,” with each family across a large territory producing a small emissions reduction. Monitoring and tracking these community-based projects is usually cost-prohibitive.
DRC: Reducing Emissions and Improving Security
A Mercy Corps project in the refugee camps in the eastern Democratic Republic of the Congo (DRC) seeks to improve the security of women and children while simultaneously reducing carbon emissions.
In the war-ravaged province of North Kivu, the total number of Internally Displaced Persons (IDPs) exceeds 850,000. Demand for resources, particularly fuel wood, vastly exceeds the available supply. To collect wood, women and children have to leave the relative safety of the refugee camps, making them vulnerable to sexual assault and child abduction by rebel groups and the army. Mercy Corps surveys indicate that nine percent of women in camps have been raped or otherwise assaulted.
Mercy Corps installs fuel-efficient stoves that reduce the need for dangerous trips into the forest. A commercial carbon broker develops carbon credits from the reduction in emissions that arises from the use of stoves instead of open fires. The upfront funding from the broker supplements a UNHCR grant supporting the project, and serves to help more than 20,000 families in one of the most dangerous places on Earth.
This extreme example is one of relatively few carbon projects generating revenue that benefits vulnerable people. Yet if this kind of project can be successful in the DRC, larger projects in safer countries may be able to generate massive emissions reductions. The Copenhagen conference needs to set the stage for these types of market incentives for better climate behavior.
Raising a REDD Flag
A relatively new, UN-backed initiative known as Reduced Emissions from Deforestation and Forest Degradation (REDD) seeks to compensate forest-rich countries for protecting or regenerating their forests. However, REDD may have the unintended consequences that further erode the human rights of marginalized people dependent on those forests.
For decades, tropical forests have been logged legally and illegally by states and private companies, without any input from or compensation to indigenous forest communities, who, in many cases, were displaced or worse.
REDD thus raises a troubling question: If countries can generate carbon revenues through REDD, to whom do the revenues belong, and how will they be allocated? Many forestry ministries have a long history of corruption and mismanagement. There are already signs of ministries competing over putative REDD funds. And high-level discussions in only a few countries have included the role of communities and civil society in implementing REDD and distributing revenues.
The Copenhagen conference will be a critical milestone in the global fight to address climate change. Yet it raises significant and far-reaching questions concerning economic development and human rights of the world’s most vulnerable citizens that must not be swept under the rug.
Jim Jarvie is director of climate change, environment, and natural resources at Mercy Corps. In a recent video interview, he spoke to ECSP about how humanitarian groups are responding to new climate challenges.
Photo: Stoves that are more fuel-efficient not only help curb rapid deforestation, but help women spend less time gathering wood in dangerous areas. Courtesy Dee Goluba/Mercy Corps. -
Weekly Reading
›The NYT’s Andrew Revkin muses about whether “whether family planning programs should be able to get into the carbon business,” citing a study released by Oregon State University that says that the number of children an American resident has could have the greatest environmental impacts of any decision taken by that individual. Reporting on the study, The Oregonian observes that “having fewer children is best way to reduce your carbon footprint.” An interactive graphic from Breathing Earth maps the relationship between population and carbon emissions.
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Focus on Food Security as Clinton Lands in Africa
›August 7, 2009 // By Brian Klein In what CNN has dubbed her “biggest trip yet,” Secretary of State Hillary Clinton has commenced an 11-day, seven-nation tour of Africa that will take her to many of the continent’s most volatile states, including Kenya, South Africa, Angola, the Democratic Republic of Congo (DRC), Nigeria, Liberia, and Cape Verde.
Global hunger and food security are her top agenda items, as Clinton and African leaders discuss how the United States can help improve the continent’s agricultural sector. Also on the table will be the “Second Scramble for Africa“— the recent spate of developed nations buying up African agricultural land (map) to assure their access to adequate food supplies, which was the subject of a recent Wilson Center conference (video).
More Mouths to Feed
According to the Food and Agriculture Organization (FAO), one billion people are undernourished. If current population projections are correct, that figure is likely to grow. “In the coming 20 years alone, worldwide demand for food is expected to rise by 50 percent,” note Horand Knaup and Juliane von Mittelstaedt in Der Speigel.
Climate change will compound the already-daunting challenge of increasing food production by further “reducing harvests in much of the world, raising the specter of what some scientists are now calling a perpetual food crisis,” Joel K. Bourne, Jr. explains in National Geographic‘s special report, “The End of Plenty.”
Africa: Ground Zero
Sub-Saharan Africa—with birthrates averaging 5.4 children per woman and a farming sector dominated by small producers whose average yield per hectare has remained constant over the last 40 years—is particularly vulnerable to such a crisis. Both Secretary Clinton and President Obama have pushed for increased investment in the continent’s agricultural sector.
“There is no reason why Africa cannot be self-sufficient when it comes to food,” said Obama at the conclusion of this month’s G8 summit in L’Aquila, Italy. “It has sufficient arable land. What’s lacking is the right seeds, the right irrigation, but also the kinds of institutional mechanisms that ensure that a farmer is going to be able to grow crops, get them to market, get a fair price.”
Launching his book on African food security, Enough! Why the World’s Poorest Starve in an Age of Plenty, coauthor Roger Thurow told a Wilson Center audience, “We hope to provide both an instructional and inspirational tale to show that hunger today is largely man-made, that so much is also caused by policies and decisions that span the political spectrum, and to inspire by showing hunger is truly achievable to conquer.”
Pledges of Aid, but Land Grab Continues
Largely thanks to Obama’s prodding, G8 countries agreed to invest $20 billion for farm aid in developing countries over the next three years. However, the leaders were unable to agree on a set of shared principles regarding foreign acquisition of arable land.
A number of relatively wealthy but land- and water-strapped nations, including Saudi Arabia, China, South Korea, and the United Arab Emirates, as well as many corporations and other investors, have purchased millions of hectares of land in other developing countries. Asia and South America have been targeted by some, but the inexpensive, fertile land of impoverished Africa appears to be the primary prize.
While some might praise the transfer of land to those with the capital and technology to make it productive, questions abound when one considers the dual pressures of population growth and a changing climate. “[W]hat happens with famine strikes these countries? Will the wealthy foreigners install electric fences around their fields, and will armed guards escort crop shipments out of the country?” ask Knaup and von Mittelstaedt.
The Ethics of Land-Grabbing
In completing such transactions, governments often ignore customary land tenure, selling tracts that are already inhabited and cultivated by small-scale subsistence farmers whose families have lived on the land for generations, but who have no formal deed of ownership.
To prevent such exploitation, experts have suggested the adoption of international rules to govern foreign acquisition of agricultural land in the developing world. A report from the International Food Policy Research Institute recommends a broad swath of measures to ensure transparency, respect for existing land rights, benefit-sharing, environmental sustainability, and adherence to national trade policies.
The Devil Is in the Details
Adding to the strong statements by the G-8 and Secretary Clinton, the FAO plans to convene an international food security summit in Rome this November, which will call for the eradication of hunger by 2025. While these are welcome developments, the details remain unclear.- Will a repeat of the “Green Revolution” save African farmers?
- Is it responsible to engender dependence on petroleum-based fertilizers, if it increases production in the short-term?
- What are the implications of selling arable land to foreign investors?
- How will large-scale commercialization and mechanization of farming transform developing societies?
- What about genetically-modified seeds?
- Can we eradicate hunger in the next 15 years?
Photo: Men gather corn at a farm in Kenya. Courtesy Curt Carnemark and Flickr user World Bank (pool). -
Glaciers, Cheetahs, and Nukes, Oh My! EP in the FT
›August 7, 2009 // By Geoffrey D. DabelkoFinancial Times South Asia Bureau Chief James Lamont has written a flood of environment-as-political-dialogue stories this week! (Well, only two, but that constitutes a deluge in the world of environmental peacebuilding.)
On Monday he wrote about India and China’s agreement to work together to monitor Himalayan glacial melt. The potential decline in water availability from seasonal snow and glacier melt is finally seeping into the consciousness of policymakers outside the climate world, including the diplomatic and security communities. Lamont frames the step as a rare instance of cooperation in a strategically sensitive area at the center of a 1962 territorial war between the countries.
While it would be easy to make too much of such an agreement, it is a tangible recognition of the importance of the ecological unit rather than the national one. It highlights how environmental interdependence across national boundaries can force cooperation in the face of politically difficult relations.
On Wednesday Lamont used cheetah diplomacy between India and Iran as an entry point for his story on international attempts to address Iran’s nuclear proliferation threat. India is asking Iran to help reintroduce cheetahs on the subcontinent, where they are now extinct. In what Lamont said would be an “unusual” example of “high-profile cooperation” for the two countries, diplomats are arranging for talks ahead of a regional wildlife conference. This baby step in relations could be even more significant since the United States publicly acknowledged that India may be able to play an interlocutor role with Iran on the hot button nuclear program question.
While both of these developments are relatively small in the scheme of the larger strategic relationships, they are fundamentally aimed at (re)building relationships between countries by establishing patterns of cooperation where interdependence is obvious and necessary. Such efforts are just one tool in the often-neglected toolbox of environmental peacebuilding.
Photo: Yawning cheetah cub courtesy Flickr user Tambako.
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“Knowing is not enough; you must act and let your government know that family planning is a right and saves lives,” said Maurice Middleberg of the Global Health Council at a recent 
President Mahmoud Ahmadinejad might have blamed sinister “
The climate community is under increasing pressure to help the developing world, especially those at the 
Financial Times South Asia Bureau Chief James Lamont has written a flood of environment-as-political-dialogue stories this week! (Well, only two, but that constitutes a deluge in the world of environmental peacebuilding.)
