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Gates Foundation Spearheads London Summit on Family Planning
›July 12, 2012 // By Carolyn Lamere“Given the option, [women in developing countries] will have fewer children,” said Melinda Gates in a TEDxChange talk in April. “The question is: are we going to commit to helping them get what they want now? Or are we going to condemn them to some century-long struggle, as if this were still revolutionary France and the best method was still coitus interruptus?”
Wednesday, The Bill and Melinda Gates Foundation followed through on Gates’ pledge, helping to raise more than $2.6 billion at the London Summit on Family Planning as part of an ambitious goal of helping 120 million additional women in developing countries gain access to contraception by 2020. The summit was co-hosted by the UK Department for International Development and garnered support from other foundations and governments, including the United States, France, Germany, the Netherlands, South Korea, Norway, Sweden, and Australia.
To quote the Population Institute’s Robert Walker on Dot Earth, this is a big deal:Many of the challenges that we face (hunger, severe poverty, energy, food, carbon emissions) are seemingly intractable. Population growth, which is a challenge multiplier, is not intractable. Far from it. There are proven highly cost-effective means of lowering fertility rates: providing access to contraceptives, keeping girls in school, ending child marriage practices, and changing social norms (including attitudes toward women and desired family size) through entertainment media.
The focus on family planning for the Gates Foundation – one of the largest philanthropic organizations in the world – is relatively new (though their commitment to global health and development is not). Melinda Gates announced a commitment to maternal health in 2010, and the foundation first issued a family planning strategy in April of this year.
The move has been unwelcome by some, particularly some Catholic institutions who object to family planning. But Gates has been adamant that contraceptives “should be a completely non-controversial topic.” She argues that 90 percent of Americans find contraceptives “morally acceptable,” including herself and many other Catholics, so there is no reason for the taboo around international aid for family planning to continue.
“We’re not going to agree about everything, but that’s OK,” said Gates in a recent interview with CNN.
In the TEDxChange talk, which helped launch this year’s push, she credits her upbringing for instilling a strong sense of social justice. During her travels with the Gates Foundation, one woman from a slum in Nairobi told her, “I want to bring every good thing to this child before I have another.” That statement resonated with Gates: “We all want to bring every good thing to our children,” she said. “But what’s not universal is our ability to provide every good thing for our children.” Gates pointed to contraception as a way for families to plan for their future and manage their resources. She recognized the controversial history of family planning as population control, but argued that this new initiative is about providing choices to individuals, not imposing values.
Gates remains confident that as long as the foundation makes its mission clear, people will rally behind the cause.
“We’re not talking about abortion. We’re not talking about population control. What I’m talking about is giving women the power to save their own lives, to save their children’s lives, and to give their families the best possible future.”
Sources: BBC, The Bill and Melinda Gates Foundation, CNN, Catholic Family and Humans Rights Institute, Catholics For Choice, Dot Earth.
Video Credit: TEDxChange. -
UNHCR Report on East African Environmental Migrants: Long on Anecdotes, Short on Data
›July 6, 2012 // By Graham NorwoodAs part of the recently-concluded Rio+20 Conference on Sustainable Development, the UN High Commissioner for Refugees (UNHCR) presented a new report last week, titled Climate Change, Vulnerability, and Human Mobility: Perspectives of Refugees From the East and Horn of Africa. The report was created in order to “understand the extent to which refugees and IDPs (internally displaced persons) in the East and Horn of Africa have perceived, experienced, and responded to climatic events and trends in recent years.”
In order to achieve this goal, UNHCR and its collaborators (including the United Nations University Institute for Environment and Human Security, the London School of Economics, and the University of Bonn) interviewed approximately 150 refugees and IDPs in parts of Ethiopia and Uganda.
While the narrative is more anecdotal than data-driven, it nevertheless identifies several apparent trends in climate-related migration:Overwhelmingly, stories of mobility associated with moving away from worsening impacts associated with climate variability followed a specific pattern. That is, where movement related to climatic stressors did occur, such movement was taken as a last resort (only after all efforts to remain and adopt other methods of adaptation had been exhausted), particularly where the land being left was self-owned and only after all efforts to remain and try a number of alternative forms of adaptation had failed. Where movement occurred, in most cases it was likely to be internal, circular, and temporary rather than cross-border and permanent.
Stories of international migration were rare, and generally occurred either because migrants already lived near a border and were familiar with the area, or because they had encountered violent conflict (often of a political nature) during an earlier intra-state relocation.
The report also mentions that a majority of those interviewed claimed to have noticed significant changes in weather patterns over a 10- to 15-year period. In fact, many interviewees frequently claimed to be able to distinguish “normal” climate variability from more “permanent” changes.
Significantly, Climate Change, Vulnerability, and Human Mobility highlights several ongoing sources of debate and controversy regarding the issue of climate-induced migration as well.
The links between climate change, migration, and violent conflict are not well understood. And the question of whether climate change precipitates conflict or merely exacerbates it is still unresolved, though research on the subject is ongoing.
The terminology used to describe climate migrants remains a hotly-contested issue as well. While terms like “environmental refugee” and the especially popular “climate refugee” can make for good headlines, the UNHCR report strongly disapproves of such terms, given that the word “refugee” has a very specific legal definition.
Indeed, there is still much debate over how to classify climate migrants. It has been pointed out, for instance, that it is virtually impossible to separate out the various factors that induce migration, and questions as to whether migration is forced or voluntary also persist. For the most part, the UNHCR report shies away from such contentious questions, aiming instead to present a general and “human” narrative designed to call attention to the plight of climate migrants.
Definitional debates aside, the issue of climate-induced migration has been in headlines recently. The Asian Development Bank reported in March that 42 million people were displaced in the region during the last two years due to storms, floods, and other extreme weather events. And Israel signaled a tougher stance on immigration by deporting South Sudanese refugees in the wake of a major Israeli Ministry of Environmental Protection report warning of future climate-induced migration.
The particular vulnerability of women too is drawing increased interest. An article in Environmental Research Letters points out that “women tend to be poorer, less educated, have a lower health status, and have limited direct access to or ownership of natural resources,” and will therefore be disproportionately affected by climate change. Gender disparities must be accounted for in policymaking then, to ensure that future climate migration policies are equitable and inclusive, the author, Namrata Chindarkar, argues.
The challenges of defining and measuring the phenomenon remain – the UN Environment Program’s 2006 prediction of 50 million climate migrants by 2010 has not come true, and has even been a source of some embarrassment for the organization – but the recent UNHCR report is a timely reminder that climate-induced migration remains a major issue with tremendous long-term implications.
Sources: Asian Development Bank, Environmental Research Letters, Human Rights Education Association (HREA), The Jerusalem Post, The New Republic, National Geographic, OECD, Scientific American, Der Spiegel, UNHCR, The Washington Post.
Photo Credit: Displaced Somalis, courtesy of UNHCR. -
Book Review: ‘World Population Policies’ Offers Sweeping Overview of a Complex Field
›July 2, 2012 // By Elizabeth Leahy MadsenWith much attention in the international family planning community directed to the impending anniversary of the 1994 International Conference on Population and Development and the closing date of the Millennium Development Goals, the fact that 2012 is the 60th anniversary of two other milestones in population programming may have escaped notice. In 1952, the International Planned Parenthood Federation was created, and India became the first country to formulate a national policy to reduce population growth.
These and many other landmarks are highlighted in World Population Policies: Their Origin, Evolution and Impact, a new book by demographer John May that reviews several decades of policies, advocacy, and program interventions addressing the full range of diverse demographic trends seen globally.
May, who spent more than two decades working on population issues at the World Bank and other international institutions before recently assuming a fellowship at the Center for Global Development, is well-positioned to provide such an ambitious overview. Although the breadth of material included in the book means that some topics receive less coverage than a specialist might wish, it serves as a sound introduction to this diverse field, and offers some particularly interesting case studies.
The book’s main chapters begin with a summary of current population trends, including a comprehensive array of figures and statistics about population size, distribution, and projections. Some important concepts, such as the demographic transition and dividend, are perhaps covered too quickly, and in such cases the book would have benefited from more than a handful of figures, charts, and graphs. May classifies regions and countries as demographic “hotspots,” where the number of people outstrips available resources, and “coldspots,” which have too few residents. He makes an ambitious suggestion that high-density countries facing resource challenges, such as Bangladesh, should consider promoting rapid fertility decline below replacement level to stop population growth, then reverse course and increase to a rate that promotes a stable population – but such a reversal from low fertility is a feat that has stymied several countries in Europe and East Asia.
Evolution of the “Population Movement”
In addition to summarizing the ways that demographic issues have been framed in the past several decades, May briefly describes the long-running debate between demographers and economists about the ways in which population is theorized to affect economic development.
Three points in this chapter were particularly striking: First, the concept of family planning as a human right dates from well before the 1994 International Conference on Population and Development. In 1968, the Tehran International Conference on Human Rights defined the ability to choose family size and spacing as a fundamental right; still, some programs, such as India’s under the Emergency-era government of the late 1970s, adopted coercive practices. Second, population policies are not limited to official initiatives targeting fertility, mortality, and migration, but also encompass implicit or “passive” policy measures that arise without advance planning or that have an unintended effect on demographic trends. Related to this, May suggests that “contextual variables” such as education, health, gender, culture, and religion can have a greater impact on population policies’ effectiveness and demographic outcomes than government structures or funding.
Although population policies are most often designed at the national level, May’s discussion of the “population movement” highlights the influence of international networks and donors on such policies. By the late 1960s, the U.S. Agency for International Development had begun funding family planning programs overseas, and the United Nations Population Fund (UNFPA) was active. Although the United States has become less dominant over time, population programming remains a Northern-driven movement.
Beginning with a meeting in Belgrade in 1965, a series of international population conferences successfully raised the prominence of population issues on the global development agenda and built consensus around international goals, while also becoming increasingly political.
May’s cautions about such conferences are timely given this month’s London Family Planning Summit: “Consensus-building through international conferences and their preparatory meetings is often inefficient as a process, whereas such events could be used to promote learning among policymakers and experts…The gap between the conferences’ resolutions and the actual policies implemented at country level is important to remember” (110).
Growth and Aging Distinguish the Demographic Divide
In his chapter focusing on the developing world, May notes that population policies have become broader in the nearly 20 years since the Cairo conference, incorporating a reproductive rights framework while also addressing new issues such as the environment, HIV/AIDS, and poverty. But under this more holistic approach, national policies are susceptible to becoming overly diffuse, with an ambitious agenda not matched by concrete action plans.
The challenges expand to policy implementation as well. Kenya is profiled as emblematic of the difficulties facing population programs in fast-growing sub-Saharan Africa, particularly political disinterest, mismanagement, opposition from some religious groups, and commodity shortages. But when implemented well, such policies can be very successful. The book offers a thorough summary of research findings on the common features of effective family planning programs (such as leadership, monitoring performance data, and opening access to contraceptive methods at lower levels of the health system), as well as their demographic impact. Several country examples are cited to show that family planning programs reduce lifetime fertility rates by 0.5 to 1.5 children per woman, while also benefiting individual and social health, income, and well-being.
While population policies have been often effective at shaping demographic trends in high-fertility settings, even in changing cultural norms about family size, May notes that their impact has been notably weaker in reversing the trajectory of declining fertility in developed countries. While countries such as France have maintained a fertility rate close to, albeit still below, replacement level thanks to generous paid parental leave, housing initiatives and public child care facilities, policies that try to boost low fertility through financial compensation have been particularly ineffective.
Developed countries are less likely to have formal population policies and tend to address demographic issues through incentives and disincentives implemented by multiple agencies. Aging and immigration are receiving greater attention in such countries, along with low fertility rates. Population aging raises policy concerns that are both economic and social, and May focuses largely on the benefit of reducing incentives for early retirement. He notes that thanks to improvements in health and life expectancy, “today’s 65-year-old persons are young compared to their counterparts” of previous generations (180). Despite their economic soundness, government efforts to raise retirement ages are widely unpopular, and France’s newly elected president has promised to cut the retirement age from 62 to 60 for some workers.
What Comes Next
Some observations are intriguing and could have been further detailed. For example, May notes a recent “fragmentation” of organizations working on population issues, and suggests that “too many institutions and NGOs appear to support their own limited mandates as they also struggle for resources that are less abundant” (5). Decentralization and integration within health systems is a growing trend that could have been discussed in more detail, along with the legacy of pronatalist laws and attitudes by colonial powers in Africa, the effect of recent European efforts to tighten immigration policies, and the achievements of forums designed for collaboration on population policy issues (for example, the United Nations Commission on Population and Development or the Reproductive Health Supplies Coalition).
Looking towards the future, May foresees continued integration of demography with related development issues, such as poverty reduction and equitable growth, gender and youth perspectives, environmental issues, and conflict prevention. He notes a few challenges, including sub-Saharan Africa’s lag in fertility decline and the overall ineffectiveness of policies aimed at addressing the pressures of urbanization on infrastructure and resources.
In high-fertility settings, May recommends that instead of framing reproductive health writ large, policies should more specifically target family planning and women’s empowerment, including education and income-generation opportunities as well as legal rights. Bangladesh is presented as a model for other countries, as a setting where cultural change and economic development laid the groundwork for successful family planning outreach efforts. Most of all, May entreats government leaders to maintain a policy focus on population issues, regardless of where they stand in the demographic divide.
Elizabeth Leahy Madsen is a consultant on political demography for the Wilson Center’s Environmental Change and Security Program and senior technical advisor at Futures Group.
Photo Credit: “Crowded Shopping District,” courtesy of flickr user EnvironmentBlog. -
Gwen Hopkins, Aspen Institute Global Health and Development
Aspen Ideas Festival Takes on “The Population Challenge”
›The original version of this article, by Gwen Hopkins, appeared on the Aspen Ideas Festival blog.
The pictures flash quickly: lush sea vegetation replaced by empty grey-blue seabed as carbon bubbles out of undersea vents. Reservoirs depleted too quickly, never to refill. Forests and mountains leveled for coal, deep sea oil rigs ablaze, the arctic ice cap visibly retreating. Dennis Dimick is answering the question posed to him with a litany of evidence collected by National Geographic: Does population matter?
Yes, he says – a lot.
Kicking off the Our Planet: The World at Seven Billion track, on a panel called “The Population Challenge,” Washington Post staff writer Joel Achenbach moderated a conversation between Dimick and Helene Gayle, president and CEO of CARE USA, following Dimick’s presentation about how the earth’s human population has made its presence known.
Dimick explains that this new geologic era has been dubbed Anthropocene, the age of man, as we “transform the planet to perpetuate our lifestyle.” That’s a lifestyle powered first and foremost by what he calls “the new sun” – coal, oil, and gas, or in Dimick’s words, “ancient plant goo.” These transformations are deep and widespread – and according to Dimick, growing worrisome in their magnitude. While there is searing inequity – “few have a lot, and a lot have few” – those that lead the consumption have, for example, caught 90 percent of the big fish in the sea already, and burn in one year a quantity of fuel that took a million years to coalesce underground. “If everyone in the world lived like Americans do, we’d need four planets.”
Continue reading on the Aspen Ideas Festival blog.
Photo Credit: Aspen Institute. -
The Economist
Afghanistan’s Demography: A Bit Less Exceptional
›The original version of this article appeared in The Economist, and is based on ECSP Report 14, Issue 1.
This is a story from Afghanistan which is not about fighting, bombs, or the Taliban. It even contains a modicum of good news. It is about demography.
Afghanistan has long been seen as a demographic outlier. In 2005-10, according to the United Nations Population Division, its fertility rate was 6.6 – the second-highest in the world after Niger (the fertility rate is the number of children a woman can expect to have during her lifetime). The contrast with the rest of South Asia is extreme: fertility ranged from four (in Pakistan) to below three (in Bangladesh, India, and Sri Lanka). Afghanistan’s sky-high fertility seems consistent with a view of the country as trapped in an exceptional and dysfunctional mode of development, marked by war, religious extremism, tribal honor codes, and the subjugation of women.
But this fertility rate was always a bit of a guess. The last census was taken in 1979, the year of the Soviet invasion. A whole generation has grown up since then, amid pervasive violence and uncertainty. It has been extremely hard to know how fertility has been changing.
Hence the significance of the Afghanistan Mortality Survey. Based on interviews with 48,000 women and girls aged 12 to 49, it is the nearest thing the country has had to a national census for 30 years (there were smaller surveys in 2003 and 2007-08, but their coverage was not national).
Continue reading on The Economist.
Read more about the Afghanistan Mortality Survey here on the blog with Elizabeth Leahy Madsen’s original posts here and here.
Photo Credit: “Celebrating International Women’s Day in Afghanistan,” courtesy of the U.K. Department for International Development. -
Pop at Rio+20: Reproductive Rights Missing From Outcome Document – Assessing the Disappointment
›June 22, 2012 // By Sandeep BathalaAs heads of state get ready to sign on to the outcome document here in Rio, all eyes are on next steps – especially for the reproductive health and integrated development communities, which have seen their hopes of mainstreaming their issues with the sustainable development agenda dashed.
The final outcome document can be found here. USA Today reports that opposition from a group of countries in the 11th hour stripped the text of critical reproductive rights language:An initial draft of this conference’s outcome document stated, “We are committed to ensure the equal access of women and girls to education, basic services, economic opportunities, and health care services, including addressing women’s sexual and reproductive health and their reproductive rights.”
Absent entirely is any explicit connection between reproductive rights, population dynamics, and sustainable development.
In the final draft, the stronger wording “We are committed to ensure the equal access” was switched to the weaker “We are committed to promote the equal access.” The reference to reproductive rights was deleted altogether, after opposition from the G-77, a negotiating bloc of developing countries at the United Nations, and the Holy See.
But others, as we have heard repeatedly throughout the conference, insist that gender issues and reproductive rights have a strong and vital connection to sustainable development. Yesterday, USAID, the Aspen Institute, and the Center for Environment and Population held a discussion in the U.S. tent on this very issue, titled “Making Population Matter: The Demographic Dividend and Sustainable Development.”
As Vicky Markham of the Center for Environment and Population reports on RH Reality Check, the side-event aimed to demonstrate the effects of population dynamics, both positive and negative:We have the largest youth demographic ever in the history of the world, and most developing nations have a “youth bulge.” This can be seen as a challenge, or opportunity, particularly if the focus is on providing development programs for child survival, family planning, reproductive health, and education. The importance of women’s empowerment was also central. But it’s not a given; it’s an opportunity only if we pay attention to these issues to increase the benefits of the “demographic dividend.”
The demographic dividend, as described by USAID Deputy Administrator and panelist Donald Steinberg in blog post earlier this week, “is an opportunity that arises when a country transitions from high to low rates of fertility and child and infant mortality.” But it’s not just about ensuring access to family planning and reproductive health; youth-focused economic and education policies are also needed: “Maximizing the dividend requires social and economic policies that reinforce inclusion, equity, and opportunity across the entire population,” he writes. USAID is making a point of creating youth-focused policies for this reason, he said in Rio.
Carmen Barroso, regional director of the International Planned Parenthood Federation’s Western Hemisphere Region, pointed out that Latin American countries could not take advantage of the demographic dividend before recent societal changes occurred, including decreased fertility, increased urbanization (which leads to smaller families), and greater schooling and employment of women.
Seventy percent of world population growth is likely to be generated by Africa this century, said Eliya Msiyaphazi Zulu, executive director of the African Institute for Development Policy – and it is the only continent projected to continue to grow in the next century, he said. He called for redefining growth as more than GDP as that measure does not consider environmental degradation and its costs: “We must have other means to measure development.”
As heads of state and negotiators consider their positions at this conference – which many were hoping would make a much stronger statement – they might do well to ponder today’s comments from Secretary of State Hillary Clinton:While I am very pleased that this year’s outcome document endorses sexual and reproductive health and universal access to family planning, to reach our goals in sustainable development we also have to ensure women’s reproductive rights. Women must be empowered to make decisions about whether and when to have children. And the United States will continue to work to ensure that those rights are respected in international agreements.
Sources: RH Reality Check, UN, U.S. Department of State, USA Today, USAID.
Now none of this is an abstract discussion. There is just too much at stake, too much still to be done. And many of you visited the U.S. Center here in Rio and saw practical solutions related to some of the work I’ve discussed and other goals we hold in common. We believe solutions require action by all of us. Governments, yes; let’s do our part. Let’s do more than our part.
Photo Credit: YouthPolicy.org. -
Pop at Rio+20: Text Finalized, Population-Sustainable Development Links Left Out?
›June 21, 2012 // By Sandeep BathalaWhile I was visiting with youth peer educators yesterday with the Brazilian Society for Family Welfare in the Cachoeirinha favela (see Vicky Markam’s post for details – we were on the same trip), UN member states reached consensus in the Rio+20 negotiations. But, according to reports, although the outcome document includes some mention of reproductive health, gender equality, and women’s empowerment, it fails to explicitly recognize the link between reproductive rights and sustainable development.
Many women’s rights and health observers have, from the start, encouraged this link.
Karen Newman, speaking to ECSP in April during the Planet Under Pressure conference – a precursor to Rio – said she hoped this week would offer an opportunity to look at “sustainable development in the round” and “re-identify family planning as a core development priority,” given its human rights and health implications and relationship to population growth.
Jenny Shipley (Former Prime Minister of New Zealand) wrote just yesterday on CNN that “we are at a moment in history where we still have time to make a difference. It is essential that the global discussion in Rio not be blind to the potential solutions that access to voluntary family planning could offer to many of the world’s problems.”
“We can no longer afford this outrageous oversight, driven by old-fashioned tradition, discrimination, and pure ignorance,” said Gro Harlem Brundtland (Former Prime Minister of Norway and Former Head of the World Health Organization) at a side event on Monday. “Now is the time to agree to unleash the largest untapped potential for sustainable development and stop all discrimination against women and girls.”
But now that preliminary agreement on the outcome text has been reached, reports have filed in that the connection many were hoping for is absent. Zonibel Woods, blogging on RH Reality Check, wrote:From the start of the negotiations, gender equality and women’s human rights, including reproductive rights, have continuously been challenged by a few governments, claiming that [these] had “nothing to do with sustainable development.”
The lack of consensus among the wider international community may also undercut efforts to highlight reproductive rights in the post-2015 Millennium Development Goals/Sustainable Development Goals framework and as governments ready for the follow-on to the International Conference on Population and Development in 2014. A concrete link to “sustainable development,” whatever form that takes, would help ensure that reproductive health is not side-lined.
This debate continued until the last few hours of the negotiations. In the end, the text includes a re-affirmation of both the Cairo and Beijing agreements, but it falls short by failing to recognize that reproductive rights are also critical to the achievement of sustainable development. If a woman cannot decide if and when to have children and if she is not provided with the reproductive health care that is her human right, it is challenging to contribute to sustainable solutions for the planet.
Immediately following the adoption of the text, women gathered and protested at Rio Centro, the main venue for the conference, and advocacy continues.
Heads of state will in all likelihood sign on to the outcome document by tomorrow (it could technically still be changed, but that appears unlikely). I will keep you posted on the final outcome and will be taking notes at a side-event this afternoon by USAID, the Aspen Institute, and Center for Environment and Population on the demographic dividend and sustainable development, which promises to be spirited given today’s news. You can tune in live to the webcast of that event at 2:30 EST on Ustream.
Sources: AllAfrica, Aspen Institute, CNN, IRIN, RH Reality Check, U.S. Department of State, USAID.
Photo Credit: United Nations Photo. -
Laurie Goering, AlertNet
Pop at Rio+20: Brazil a Model for Slowing Population Growth, Say Experts
›June 21, 2012 // By Wilson Center StaffThe original version of this article, by Laurie Goering, appeared on AlertNet.
Rosimere Lopes knows what she does not want in life.
The 23-year-old, who lives in Cachoeirinha, a hillside slum in Rio’s gritty North Zone, was born when her mother was just 16, and grew up taking care of her five younger brothers and sisters while her mother worked.
As a result of missing so much education, she’s still trying to finish high school. But she has accomplished one important thing – she has no children of her own yet, despite having a regular boyfriend.
“My mother got pregnant at 16 so I know the consequences. I don’t want that,” she said. “I want to do better.”
In the last decade, Brazil has undergone a family planning revolution. In 2000, the country’s birthrate was 2.4 children per woman, already dramatically down from decades past. Today it has dropped to 1.9 children, below replacement level and on a par with many developed countries.
That slowdown, built on making available better information and contraceptives, and on growing urbanization, is increasingly looked at as a model by experts around the world trying to find ways to dampen population growth and consumption – both linked to accelerating climate change and resource scarcity.
Continue reading on AlertNet.
Sources: UN Population Division.
Photo Credit: A grandmother, mother, and child in Brasilia, courtesy of flickr user babasteve (Steve Evans).
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