Showing posts from category gender.
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Women, Water and Conflict as Development Priorities Plus Some Geoengineering Context
›September 24, 2010 // By Geoffrey D. DabelkoHere are some useful links to environment, population, and security work that recently crossed my desk.
• NYU’s Richard Gowan dissects UK development minister Andrew Mitchell’s encouraging speech identifying conflict-affected states as special DFID priorities. Gowan pulls out highlights from the speech and parses NGO reaction to it on Global Dashboard.
• Council on Foreign Relations’ Isobel Coleman provides five practical suggestions for tapping into women as the “new global growth engine,” on Forbes.
• The Aspen Institute announced its Global Leaders Council for Reproductive Health this week. Their goal: meeting unmet demand for family planning services by 2015 on the MDG schedule. That is over 200,000,000 women who want services but do not have access.
• I’m heartened to see the U.S. Senate pass the Senator Paul Simon Water for the World Act. Hoping the House will follow suit. Last time Congress passed legislation on water, sanitation, and health priorities, the 2005 Senator Paul Simon Water for the Poor Act enjoyed overwhelming bipartisan support.
• Colby historian Jim Fleming, writing in Slate, puts the increasing fascination with geoengineering as a climate response “option” in some sobering historical context. “Weather as a Weapon: The Troubling History of Geoengineering” is the short read. Tune in to hear Jim present the book length version, Fixing the Sky, at the Wilson Center, October 6th at 10:30 am EST.
Follow Geoff Dabelko (@geoffdabelko) and The New Security Beat (@NewSecurityBeat) on Twitter for more population, health, environment, and security updates. -
UN Millennium Development Goals Summit: PHE On the Side
›September 21, 2010 // By Wilson Center StaffFrom 20-22 September 2010, world leaders will meet in New York City to discuss the United Nations’ “We Can End Poverty 2015” Millennium Development Goals, which include food security, maternal and child health, and environmental sustainability as key objectives, but controversially, make no mention of population. Officially, there is only one small “side session,” organized by Vicky Markham of the Center for Environment and Population, devoted to talking about the MDGs in the integrated context of population, health, and environment (PHE).
Since 2005, annual Millennium Development Goals reports have published data from a large number of international organizations and UN agencies to track progress. According to the 2010 Millennium Development Goals Report, the 2008 economic downturn has stalled momentum to achieve the eight goals. The report also stated that “though progress had been made, it is uneven. And without a major push forward, many of the MDG targets are likely to be missed in most regions.”
While PHE remains somewhat taboo at the UN, The New Security Beat continues to highlight the important linkages between these issues. Check out some of our recent coverage including Calyn Ostrowski’s blogging from the 2010 Global Maternal Health Conference, perspectives on Pakistan’s ongoing environmental and development disaster, the World Bank’s latest report on international land grabs and their effect on food security, and our coverage of all things population, health, and environment.
Sources: AFP, United Nations.
Photo Credit: Adapted from “United Nations,” courtesy of flickr user Ashitakka. -
Improving Monitoring, Transparency, and Accountability for Maternal, Newborn, and Child Health
›“There is a knowledge gap between global targets and locally owned goals,” said Sallie Craig Huber, global lead for results management at Management Sciences for Health (MSH). The seventh meeting of the “Advancing Policy Dialogue on Maternal Health” series – cosponsored by the Global Health Council, MSH, and PATH – comes at a critical time as world leaders meet next week at the high-level, plenary UN Summit to review progress toward the Millennium Development Goals (MDGs).
Panelists Marge Koblinsky, senior technical advisor, John Snow Inc., Ellen Starbird, deputy director, U.S. Agency for International Development, and Monique Widyono, program officer of PATH, discussed strategies for improving maternal health evaluation methods while balancing the interests of donors and beneficiaries.
Maternal Health Indicators: Contact vs. Context
“Skilled birth attendants [have] become the strategy [for improving maternal mortality rates], but one size does not fit all,” said Koblinsky. The proportion of births attended by skilled birth attendants is a key maternal health indicator; however, it is not sufficient and says little about what the attendants actually did during the birth.
Koblinsky demonstrated how other indicators such as near-miss morbidity, rates of cesarean section, and contraceptive prevalence rates (CPR) are better aligned with maternal mortality outcomes. “CPR is much more closely linked with the outcome we desire as [contraception] reduces pregnancies for those at higher risk and reduces unwanted births and unsafe abortions,” said Koblinsky.
“Are the present benchmarks enough?” asked Koblinsky. “The answer is no….Indicators based on contact with skilled birth attendants focuses attention on contact, not on the quality of care or event context.”
Qualitative Data Is Necessary
“When we talk about monitoring and evaluation, transparency and accountability, it’s really critical to engage [in a discussion] on how we gauge progress,” said Widyono. In the field, “collection of data varies widely and depends on the capacity of those collecting, aggregating, and analyzing the information,” said Widyono. Such inconsistencies demand increased investment in local research capacity and qualitative analysis.
Such engagement also provides an opportunity for feedback. This “qualitative data helps to reinforce, illuminate, and deepen the understanding of what this quantitative data is showing on the ground,” said Widyono. Moving forward, policymakers, donors, and program managers will need to find a balance between these two sets of data and work together to galvanize action.
“There is a lack of attention paid to developing local, sustainable research capacity,” said Widyono. “We have an obligation to build local research capacity and disseminate findings in collaboration with the people who are going to be affected by this data,” she said.
Innovation and Research
“We really need to think about monitoring and evaluation and research and innovation as a continuum,” said Starbird. “They reinforce each other and play different roles in helping us understand what makes programs work or why they are not working.”
“We have a myriad of indicators that we expect people to monitor, collect data for, and report back to headquarters in a way that has not given countries and programs the freedom to be country-specific,” said Starbird. Therefore, “one of the goals is to minimize the reporting burden and better coordinate around indicator definition with other donors,” she said.
In order to strengthen “M&E;” for maternal health, Starbird called for new indicators as well as new ways of thinking about data analysis. “Having a results framework is really important to do good monitoring and evaluation,” she said. Evaluating the relationship between inputs, outputs, outcomes, and impacts requires a wide range of data resources so we can “get under the numbers” and determine what needs to be improved, she said.
“It’s really important to have realistic goals, otherwise it’s difficult to put programs into place and get where we want to go,” said Starbird. She said that MDG 5.B, which calls for universal access to reproductive health, “is great, but there’s never going to be universal access to reproductive health. If we really want to make progress we need to define something that is achievable and is something we can come together around.”
In conclusion, it is necessary to provide “countries with the room to do what needs to be done locally, so we can better understand these concepts rather than imposing indicators on everybody,” said Starbird. -
Climate Science, Military and Gender Roles, and the Tibetan Plateau
›September 14, 2010 // By Geoffrey D. DabelkoHere are some useful links to environment, population, and security work that recently crossed my desk.
• Need a break from the raging debate set off by Halvard Buhaug’s Proceedings of the National Academy of Sciences quantitative-based critique of climate and African civil war linkages (or lack thereof)? Check out some of the correlations Cullen Hendrix and Idean Salehyan of University of North Texas find in their piece “After the Rain: Rainfall Variability, Hydro-Meteorological Disasters, and Social Conflict in Africa.”
• A German military think tank report worries about the economic and political implications of peak oil over a relatively short time frame.
• Militaries’ humanitarian responses to extreme weather events rather than actual shooting wars are the focus of “The Coming Conflicts of Climate Change,” by U.S. Navy Foreign Area Officer Michael Baker. Baker is writing for the Council on Foreign Relations as one of their International Affairs Fellows.
• Oxfam America and IUCN staff experts call for greater consideration of different gender roles in addressing climate change. UN climate institutions are targeted in the IPS story.
• Journalist Steve Solomon highlights the high politics of transboundary water in Asia with a piece in Forbes. China’s control of the Tibetan water tower with massive dam building amps up the pressure in South and Southeast Asia.
• Canadian scholar Eric Kaufmann’s book, Shall the Religious Inherit the Earth? breaks down relative population growth rates between the religious and the secular. One is high, one is below replacement level. So far the book is only published in Europe but you can get it from Amazon UK.
• The highly respected science journal Nature editorializes against the rising tide of loud anti-science demagoguery. Strong words on the U.S. political context.
Follow Geoff Dabelko (@geoffdabelko) and The New Security Beat (@NewSecurityBeat) on Twitter for more population, health, environment, and security updates. -
Yemen: Population, Environment, and Security Collide
›September 14, 2010 // By Schuyler NullThe Middle East is home to some of the fastest growing, most resource-scarce, and conflict-affected countries in the world. New Security Beat’s “Middle East at the Crossroads” series takes a look at the most challenging population, health, environment, and security issues facing the region.
Yemen is one of the most kinetic intersections of human and environmental security in the world. At the tip of the Arabian Peninsula, it is a natural gateway for those fleeing hardship in the conflict-wracked Horn of Africa, but observers are concerned it may soon resemble something much less than a haven.
Increased local resistance to a corrupt regime in Sanaa and an influx of Al Qaeda influence recently caused the CIA to reassess the franchise in Yemen as a more urgent threat to national security than the core Al Qaeda elements in Pakistan and Afghanistan.
In addition to these traditional security challenges, Yemen faces a bevy of population and environment-related problems. With its 22.8 million people, Yemen is growing faster than any other country in the Middle East – by 2050, it will rival Spain in total population. It is home to nearly a million impoverished migrants from East Africa, is almost totally reliant on groundwater that is being drained faster than can naturally be replenished, has an unemployment rate approaching 40 percent, the lowest rating in the world for gender equity, and almost no source of income besides oil exports, which have declined 56 percent since 2001 and are expected to continue sliding, barring any major new discoveries.
Beyond its more covert commitments, the United States has pledged over $210 million to Yemen for military, economic, and development assistance for this year alone. Is it enough to stave off collapse in one of the Middle East’s most troubled states?
For more see The New Security Beat’s full feature, “Demographics, Depleted Resources, and Al Qaeda Inflame Tensions in Yemen,” published earlier this summer.
Sources: Associated Press, Association for the Study of Peak Oil – USA, Central Intelligence Agency, Washington Post.
Photo Credit: Adapted from “Old Town Sanaa – Yemen 53,” courtesy of flickr user Richard Messenger. -
GMHC 2010: Lessons Learned & Recommendations
›Over the last three days, 700 technical experts have provided solutions to decrease maternal mortality. In the last year, governments have committed billions of dollars to implement such solutions. Yet, we’ve been here before, reminded Sigrun Mogedal of the Norwegian Ministry of Foreign Affairs during the final plenary session of the Global Maternal Health Conference. “Just look at ICPD, Beijing, and CEDAW. Obviously, there must be something wrong with accountability,” she said, since 15 years later women continue to die every minute giving birth.
Wrapping up the conference with a discussion of accountability makes sense – we need to learn from the past and close the gap between commitments made and real action on the ground. So what does today’s buzzword, “accountability,” mean, and how do we enforce the realization of commitments made…or lack thereof?
“Accountability is power, and includes transparency, answerability, and enforceability,” said Lynn Freedman of Columbia University. Through international law, budget transparency, and grassroots mobilization it is possible to ensure that policies make a difference to improve women’s lives.
A review of the Ministry of Finance’s allocation for health can tell us a lot about the government’s real commitment to eradicating maternal mortality. As the overarching instrument of policy the “budget is inextricably linked to development and exists for those who have less,” said Helena Hofbauer of the International Budget Project. “If there were greater transparency of government spending, we could have done more to push for change five years ago,” said Hofbauer. This is indeed true; however, it is also true that if governments simply followed through on the international agreements they are signatories to, women would be better protected.
Accountability through the legal system is possible and Nancy Northrup of the Center for Reproductive Rights demonstrated how international law has overhauled programs and sparked governments into action. For example, in India, the high court recently ruled that the government must execute audits and report back on the steps taken to align programs with policies that ensure a woman’s right to skilled birth attendance.
In order to bring about such judicial interventions a social movement must first be in place to build awareness and demand accountability. Building such a movement starts at the grassroots level and Aparajita Gogoi of CEDPA presented strategies for empowering local communities with a global voice. By providing a safe space for dialogue, communities are given the opportunity to share concerns and demand action from local health facilitators and government officials.
Increasing opportunities for dialogue allows for bottom up solutions and ensures that contextual variables are taken into consideration. “We need arenas for brokering diverse groups to compare notes and streamline synergies, ” said Mogedal. I am energized by the lessons learned today and eager to apply these key messages next week in Washington, DC during the seventh meeting of the Advancing Policy Dialogue for Maternal Health at the Woodrow Wilson International Center for Scholars that will further address “Monitoring, Transparency, and Accountability for Maternal Health.”
Originally posted on the Medscape blog Global Mamma, 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: “Mothers and children waiting at the Bolemba healt centre” courtesy of flickr user hdptcar. -
GMHC 2010: Maternal Health Realities: Accountability and Behavior Change
›Four days ago a young woman died giving birth in a bustling marketplace in New Delhi. Just steps away from Parliament, this woman was left to die and no emergency care was sent to her – no midwives, nurses, or doctors; just people walking around her accepting the situation as normal and an uncontrollable way of life. But this is Delhi…not a remote tribal village where the nearest health clinic is hours away (on foot).
This juxtaposition lingers on in me as I sit in the plenary session of day two at the Global Maternal Health Conference and listen to Syeda Hameed, member of the Indian Parliament Planning Commission, discuss her recent visit to a remote village where every house has 10 children living in filth, flies, and emptiness.
Although I have been working on such development issues for the last five years I do not work in the field, nor do I visit the developing world on a regular basis. Hearing these stories, coupled with my firsthand experience of witnessing poverty here in Delhi reminds me of the daily reality of those 342,900 women who die every year. This is their way of life and I think it’s poignant that today’s sessions emphasize community based care, family planning, accountability, behavior change, and culture.
“Context, context, context,” said Wendy Graham of IMMPACT at yesterday’s plenary session. I agree, the context of social and cultural norms is an underlying factor that must be taken into consideration when implementing maternal and child health (MNCH) programs. With a background in psychology, I appreciated when Dr. Zulfiqar Bhutta, of Aga Khan University, recognized the toll of poverty on the imagination and the mentality of fatalism.
That is why it is so essential to “ask the people how they feel and bring their voices into the forums where policy decisions are made,” said Hameed. It is also important to hold key players accountable and include men in MNCH activities.
During the side session Male Involvement in Reproductive and Maternal and Newborn Health six field experts (in which half the panelists and audience members were men!) discussed effective methods for increasing male participation in family planning, vasectomies, gender equality, and hospital care.
The key findings from this discussion include:- Targeted interventions that educate men about danger signs and pregnancy complications correlates with behavior change and increased facility births.
- Many young married men feel pressured to prove their fertility. A sample of men was evaluated and those who had increased education and income were more likely to delay first pregnancy.
- Vasectomy is not something men want to talk about with family planning fieldworkers; however, official recognition of the vasectomy benefits by the government did increase referrals.
- Puppet and theater shows that demonstrate gender equity behaviors provide an opportunity for dialogue. Women in this study reported increased gender equity in family planning decision-making.
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: “Parliament Street” courtesy of flickr user ~FreeBirD®~. -
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.