The Population and Sustainability Network/Margaret Pyke Trust are pleased to announce the appointment of David Johnson as their Chief Executive.
A warm welcome
David has returned to the UK from South Africa to take up this post. His work for South African NGOs focused on designing and managing integrated sexual and reproductive health and rights (SRHR), women’s rights and conservation projects, fundraising and media activities highlighting the impacts of population dynamics.
Prior to David’s appointment, PSN, guided by Karen Newman, focused on advocacy and the nuanced debate surrounding population dynamics. PSN masterfully increased awareness of population dynamics, including population growth, being appropriately addressed within a human rights context. One of David’s key roles will be to establish integrated projects aligned to the Sustainable Development Goals and into which Karen will have input. She commented, “I’m excited that David is joining PSN. His energy and drive will ensure PSN grows as an organisation and the team is now even better placed to build on its reputation as a compelling voice on population and sustainability issues as we move forward into the post 2015 international development era”.
Three years ago David launched his South African focussed awareness campaign highlighting the impacts of population dynamics in South Africa, a project which PSN promoted at the time. David’s aim was, however, greater than awareness raising. The real purpose of the media campaign was to build up a network of South African NGOs operating in SRHR, women’s rights and conservation which understood the benefits of integrating their work. David has been undertaking consulting work for these NGOs, including the Endangered Wildlife Trust, which via his introduction, became a PSN network member last year.
David is a passionate advocate on issues related to population dynamics and conservation (he is also a qualified Field Guide, colloquially known as a game ranger). David said, “As a white English male, with substantial experience working in poor rural areas of post-Apartheid South Africa, I am particularly aware of the need for sensitive dialogue on population and sustainability issues. PSN is known for its rights based, sensitive approach to discussing SRHR and because of this, I am excited to have the opportunity to work with PSN and its Network to broaden PSN’s mission and begin implementing projects in the global south.”
Sir Richard Ottaway, PSN Chairman, said, “Earlier in the year the trustees made a conscious decision that it was time for PSN to evolve. PSN already has a strong reputation in advocacy, communications and training (and we will continue to develop our activities in this regard) but we also want to use PSN’s Network and contacts to begin implementing projects on the ground. This is where David’s skills will be vital”.
David commenced work on 6 July 2015.
SOURCE: New security beat
A new synthesis report from the Population Council’s Evidence Project and Population Reference Bureau demonstrates that the Population, Health and Environment approach to development can be effective in diverse settings around the world.
Making the links
The PHE approach to development involves projects, often community-based, that integrate population, health, and environmental programming in a single intervention. Practitioners suggest that such integrated programming is more effective and efficient than running simultaneous siloed projects, each focusing on a narrower objective. But does the evidence support this conclusion? How effective is the PHE approach?
Monitoring and evaluation has traditionally been difficult for PHE projects. The integrated nature of programming means that results can emerge on different time frames and some benefits, like the added value from integration (efficiency, cross-pollination between target audiences, etc.), are difficult to capture.
The report demonstrates that the approach can be effective in diverse settings around the world, with data from 35 projects in Africa, Asia, and Latin America.
In addition to summarising the knowledge base, the report looks at what is being measured, gaps in understanding, and successes and challenges. Results were gathered from peer-reviewed articles, the 2013 International Population, Health, and Environment Conference, project reports, report summaries, and other publicly available documents.
Data on family planning – expanding access and use is one of the primary goals of most PHE projects – is among the most consistently reported results. Monitoring family planning outcomes is, after all, relatively standardised. The synthesis report found, however, that projects gathered different kinds of information on family planning. Some measured contraceptive prevalence rate, some measured couple years of protection, and some tracked knowledge and acceptance of modern methods of family planning, making it difficult to compare results from different projects.
Health programming can be a good entry point into communities
Many of the health interventions implemented by PHE projects have clear links to either population or the environment. Maternal and child health programs commonly feature a reproductive health component, for example, and interventions focusing on clean cookstoves and water, sanitation, and hygiene improve both human health and protect the surrounding environment.
Projects found that health programming can be a good entry point into communities. By implementing health programs which quickly produce results, like child immunisation campaigns, projects are better positioned to introduce programs which take longer to produce positive results, like reforestation or other environmental activities.
Data on environmental interventions was scarcer. Results from environmental interventions can be harder to measure, especially in the limited timeframe of most projects. Instead of measuring the actual impact on the environment, many projects instead focused on measuring the attitudes and behaviours of community members toward natural resource management practices like reforestation or sustainable fishing.
Projects have measured positive changes ranging from reductions in destructive fishing techniques and increases in fish yields to reforestation and increased uptake of clean cookstoves, which burn less firewood.
Many projects include other program activities as well. Some have provided training on alternative livelihoods, for example, which allow community members to provide for their families without destroying the local environment.
Similarly, projects which promote good nutrition also improve the health of community members, especially women and children. Most, however, tend to not collect the information needed to document their impact on livelihoods, nutrition, food security, or resilience.
This is also true for activities related to increasing community resilience to climate change. While some projects are beginning to incorporate adaptation to climate change in their programming, climate change activities are not yet standard components of PHE interventions. Tools are becoming available for measuring and applying climate change data at the local level, creating opportunities for future projects to demonstrate the links between PHE, climate change, and resilience, but they are just beginning to be adopted.
Some PHE projects also use the integrated approach to address gender dynamics. Many work to increase men’s support of and involvement in family planning. Conversely, some use non-traditional entry points like clinics and literacy classes to encourage or enable women to be involved in conservation efforts. Others have found that the integrated message especially resonates with young people, encouraging them to participate in both natural resource management and activities promoting positive messages about sexual and reproductive health.
The Measurement Imperative
This synthesis of results makes clear PHE projects are improving the health, wellbeing, and environment of households and communities across diverse settings and landscapes. But, as has been recommended in the past, the authors call for more efforts to document the impact of integration.
Projects should focus on data collection as they begin and reach out to organizations with more experience in monitoring and evaluation if necessary. As challengers to the status quo of more siloed approaches to development, PHE projects need to measure what makes them different, specifically the added benefits of integrated programming as well as the project’s impacts on livelihoods and other aspects of community development beyond health and the environment.
By improving the monitoring and evaluation of PHE projects to document evidence of the benefits across each sector, current programs can provide a firm foundation for expanding the approach.
This article, published by New Security Beat, has been reproduced by PSN and does not necessarily reflect our views. Minor changes and cuts may have been made for the purpose of brevity and relevance.
SOURCE: UN News
On this year’s World Environment Day, the UN addresses the world’s unsustainable consumption of resources, and calls on everyone to take responsibility and care for the Earth by becoming ‘agents of change’.
Our planet, our responsibility
With many of the earth’s ecosystems nearing “critical tipping points,” the United Nations invited each of the seven billion people on the planet to mark this year’s World Environment Day by making one change towards a more responsible consumption of resources – “be it refusing to buy single-use plastic bags or riding a bike to work.”
“Humanity continues to consume far more natural resources than the planet can sustainably provide,” Secretary-General Ban Ki-moon said in this year’s message for the Day, observed annually on 5th June. “It is time for us to change.”
“The goal of sustainable development is to increase the quality of life for all people without increasing environmental degradation and without compromising the resource needs of future generations,” he noted. “We can do this by shifting our consumption patterns towards goods that use less energy, water and other resources and by wasting less food.”
The theme of this year’s Day – “Seven Billion Dreams. One Planet. Consume with Care,” – emphasises the personal responsibility each person bears for enabling inclusive and sustainable economic development while stabilising and reducing the rate of resource use.
Achim Steiner, Executive Director of the UN Environment Programme (UNEP), invited “everyone to imagine what the world would be like if each of the seven billion people made one change towards a more responsible consumption of resources.”
Individuals can make a difference
“I would like you to hold on to that vision and strive to make it reality – be it refusing to buy single-use plastic bags or riding a bike to work,” Mr. Steiner said in his message.
Noting “it is easy to underestimate the power of individual action,” Mr. Steiner said “our daily decisions as consumers, multiplied by billions, have a colossal impact on the environment – some of them contribute to the further depletion of natural resources, others help to protect fragile ecosystems.”
“We must ask ourselves what the consequences of this pace of consumption and trajectory of population growth – forecasted to reach nine billion by 2050 – will be,” he said.
“Under current trends, global extraction of resources is set to reach 140 billion tonnes by 2050, compared to around 7 billion tonnes in 1900,” said Mr. Steiner. “This will probably exceed the availability and accessibility of resources, as well as the carrying capacity of the planet to absorb the impacts of their extraction and use.”
World Environment Day “is the opportunity for everyone to realise the responsibility to care for the Earth and to become agents of change,” Mr. Steiner said.
Italy is the host of this year's celebrations of the Day which are taking place at Expo Milano 2015, which runs from 1 May to 31 October and is expected to include over 140 countries plus a significant number of international organisations.
This article, published by UN News, has been reproduced by PSN and does not necessarily reflect our views. Minor changes and cuts may have been made for the purpose of brevity and relevance.
The World Health Organization on Monday added a series of long-acting, hormonal contraceptives to the list of globally recommended family planning methods, which will significantly reduce mothers’ risk of dying during childbirth, experts say.
A welcome decision
The WHO’s guidelines relax restrictions on the use of hormonal methods for breastfeeding women who are less than six weeks postpartum, according to researchers at the John Hopkins Bloomberg School of Public Health.
The guidelines are welcome in many poor countries, where the researchers hope policymakers and health industries will adopt the updated recommendations to battle high maternal death rates.
More than half of women in low- and middle-income countries (defined as nations with a gross national income less than $12,615 per capita) become pregnant within two years of a first birth, despite their desire to postpone pregnancy or not have another baby, according to a study in Contraception, a reproductive health journal. Pregnancies that occur within that interval are at higher risk of resulting in maternal, newborn or child death, according to the researchers.
Experts writing on Global Health Now, a blog affiliated with John Hopkins Bloomberg School of Public Health, called the move “bold” and “overdue” — one that increases women's chances on accessing safe reproductive healthcare worldwide.
Addressing unmet need
Every year, 87 million women become pregnant unintentionally due to the underuse of modern methods of contraception, according to a 2014 study in 35 low- and middle-income countries published in Human Reproduction, an Oxford University journal. An estimated 222 million girls and women who want to avoid another pregnancy are not using any method of contraception, according to the WHO.
While more than 92 percent of mothers do not wish to give birth again soon after a pregnancy, 61 percent of postpartum women in low- and middle-income countries do not use family planning methods, according to the Contraception study.
At least half of these women give birth again within an interval that’s deemed unsafe to the mother’s health, according to the same study. Even when a mother is using contraceptives, the study found, she is relying on short-acting methods rather than long-acting ones such as implants.
Previously, medical practitioners were discouraged from prescribing hormonal family planning such as patches and implants to women who are less than six weeks postpartum. Many women rely on barrier methods, such as condoms, or believe that practicing breastfeeding prevents pregnancy, fueling many unwanted births that put mothers’ health at risk, according to the John Hopkins Bloomberg School of Public Health's researchers.
"The support for postpartum family planning contained in the revised MEC [WHO recommendations] should usher in a wave of policy changes that make the FP2020 commitment an attainable goal rather than a lofty target," the researchers added, referring to the Bill and Melinda Gates Foundation's public health target of reaching 120 million more women and girls with voluntary family planning options.
This article, published by Aljazeera, has been reproduced by PSN and does not necessarily reflect our views. Minor changes and cuts may have been made for the purpose of brevity and relevance.
A new article published in the journal 'Population Studies', describes how population growth and changes in demographic structure are a key factor influencing future climate change, as well as people’s ability to adapt.
Population, education and climate change links
The research relies on new IIASA population projections, which include not just the numbers of people, but also the composition of populations by age, sex, and educational attainment for a number of different scenarios designed for climate research, the Shared Socio-economic Pathways (SSPs).
“These new population scenarios that are embedded in the context of the SSPs provide a much broader account of the relevant social changes that matter for climate change mitigation and adaptation. They allow researchers from different fields to study the complex dynamics between population and climate change in a more comprehensive and policy relevant way,” says Lutz.
Population growth leads to greater emissions of greenhouse gases that contribute to climate change. But a growing body of research shows that people’s education level, age, and other socio-demographic factors play a large role in their lifestyle. These factors influence not only emissions, but also people’s ability to adapt to climate change.
“Population growth is undoubtedly one of the main drivers of greenhouse gas emissions and thus climate change. What’s far less acknowledged is the importance of differential climate impact depending on demographic characteristics,” says Striessnig.
For example, in a recent study the researchers showed that education makes people less vulnerable to the types of natural disasters—floods, landslides, and storms—that are expected to intensify with climate change.
Until now, climate models have included only very rough estimates of future population changes. With the new SSPs, developed with a large contribution from IIASA research programs, the scenarios can now take into account multiple population characteristics.
The links between population characteristics and climate change are not simple one-to-one relationships, the research shows. For example, while increasing education is linked to increased affluence, and therefore greater consumption and emissions, research also shows that at a given level of income better educated people make more environmentally friendly consumption choices. IIASA researchers are also exploring these links.
This article, published by IIASA, has been reproduced by PSN and does not necessarily reflect our views. Minor changes and cuts may have been made for the purpose of brevity and relevance.
SOURCE: IPS News
Dr. Babatunde Osotimehin, United Nations Under-Secretary-General and Executive Director of the United Nations Population Fund, looks back at 70 years of the UN and its many achievements including advances in rights-based approaches to sexual and reproductive health, including voluntary family planning, which have benefitted millions across the globe.
70 years of commitment to human rights
Seventy years ago, with the founding of the United Nations, all nations reaffirmed their faith in fundamental human rights, in the dignity and worth of the human person, and in the equal rights of men and women and of nations large and small.
The commitment to fundamental human rights that was enshrined in the United Nations Charter and later in the Universal Declaration of Human Rights lives on today in many other treaties and agreements, including the Programme of Action of the 1994 International Conference on Population and Development.
And it was remarkable in its recognition that reproductive health and rights, as well as women’s empowerment and gender equality, are the foundation for economic and social development.
The PoA is also rooted in principles of human rights and respect for national sovereignty and various religious and cultural backgrounds. It is also based on the human right of individuals and couples to freely determine the number of their children and to have the information and means to do so.
Promoting reproductive rights
Since it began operations 46 years ago, and guided by the PoA since 1994, the United Nations Population Fund has promoted dignity and individual rights, including reproductive rights.
Reproductive rights encompass freedoms and entitlements involving civil, political, economic, social and cultural rights.
The right to decide the number and spacing of children is integral to reproductive rights and to other basic human rights, including the right to health, particularly sexual and reproductive health, the right to privacy, the right to equality and non-discrimination and the right to liberty and the security of person.
Reproductive rights rest not only on the recognition of the right of couples and individuals to plan their families, but also on the right to attain the highest standard of sexual and reproductive health.
The impact of the PoA has been nothing short of revolutionary for the hundreds of millions of women who have over the past 21 years gained the power and the means to avoid or delay a pregnancy.
The results of the rights-based approach to sexual and reproductive health, including voluntary family planning, have been extraordinary. Millions more women have become empowered to have fewer children and to start their families later in life, giving them the opportunity to complete their schooling, earn a better living and rise out of poverty.
Realising the demographic dividend
And now there is a wealth of indisputable evidence that when sexual and reproductive health is integrated into broader economic and social development initiatives, it can have a positive multiplier effect on sustainable development and the well-being of entire nations.
Recent research shows that investments in the human capital of young people, partly by ensuring their right to health, including sexual and reproductive health, can help nations with large youth populations realize a demographic dividend.
The dividend can help lift millions of people out of poverty and bolster economic growth and national development. If sub-Saharan Africa realized a demographic dividend on a scale realized by East Asia in the 1980s and 1990s, the region could experience an economic miracle of its own.
The principles of equality, inalienable rights, and dignity embodied in the United Nations Charter, the Universal Declaration of Human Rights and the Programme of Action are relevant today, as the international community prepares to launch a 15-year global sustainable development initiative that builds on and advances the objectives of the Millennium Development Goals, which come to a close later this year.
Looking to the future
The new Post-2015 Global Sustainable Development Agenda is founded on principles of equality, rights and dignity.
Upholding these principles and achieving each of the proposed 17 new Sustainable Development Goals require upholding reproductive rights and the right to health, including sexual and reproductive health.
Achieving the proposed goal to ensure healthy lives and promoting well-being for all at all ages, for example, depends in part on whether individuals have the power and the means to prevent unintended pregnancy or a sexually transmitted infection, including HIV.
Human rights have guided the United Nations along the path to sustainability since the Organisation’s inception in 1945. Rights, including reproductive rights, have guided UNFPA along that same path for decades.
As we observe the 70th anniversary of the United Nations and look forward to the post-2015 development agenda, we must prioritise the promotion and protection of human rights and dignity for every person, for current and future generations, to create the future we want.
This article, published by IPS News, has been reproduced by PSN and does not necessarily reflect our views. Minor changes and cuts may have been made for the purpose of brevity and relevance.
Commission on Population and Development unable to agree upon proposed resolution, reproductive rights among points of contentionApril 22, 2015
SOURCE: UN News
The 48th session of the Commission on Population and Development concluded on Friday with a failure to adopt a draft resolution which emphasised that reproductive rights, population and development were interlinked with sustainable development and essential to the realisation of social justice.
Closing its forty-eighth session, the Commission on Population and Development failed to adopt a draft resolution that had been prepared by its Chair after several days and nights of intense negotiations.
By the draft text, the Commission would have emphasized that population and development issues were interlinked with sustainable development at the subnational, national and international levels, requiring a multi-stakeholder and multi-level approach.
It would have stressed, among other things, that gender equality, the full realization of the human rights and fundamental freedoms of all women and girls, including their reproductive rights, were critical to sustainable development and essential to the realization of social justice.
The draft was not adopted after an exchange between the representatives of Groups of States.
Following the presentation of the text prepared by Commission Chair Bénédicte Frankinet (Belgium), which she called an “honest attempt” to reflect the many disparate views of Member States, the representative of Nigeria, speaking on behalf of the African Group, expressed his hope that the text was still open for discussion, as its current iteration contained language that would impose “impossible and unacceptable commitments” upon Member States.
In response, the Chair said that the document before the Commission was her best attempt to reconcile the differing opinions of various States. In that regard, she declined to alter the text, and instead, withdrew the draft.
“This is a kind of hard medicine the Chair had given us,” said John Wilmoth, Director of the Population Division, in closing remarks. The deliberations of the Commission had nevertheless reaffirmed the integration of population concerns in global processes related to development including the elaboration of the post-2015 development agenda, he said.
Also taking the floor in closing remarks, Babatunde Osotimehin, Executive Director of the United Nations Population Fund (UNFPA), said that the Chair’s text had contained “all the things we wished to see” in order to jump-start a transformation to a sustainable world. It was important for the international community to be tolerant, and to reflect the true reality of countries. Some of the comments and positions taken had not spoken to that reality, and it was unfortunate that the Commission had been unable to adopt the Chair’s text. “I wish to put on record that I truly regret that,” he stressed.
Some States then took the floor to add their support for the draft text, as well as their regret that it had not been adopted. In that vein, Switzerland’s delegate said that his country had been ready to join consensus on the text, which struck a fine balance on negotiations between different Groups and States.
SRHR: central to population issues
The representative of the Netherlands, speaking on behalf of a number of likeminded States, said that sexual and reproductive health and rights (SRHR) were central to population issues going forward. “We heard strong appeals to have sexual and reproductive health and rights embedded in the outcome document,” he said, adding that all people had the right to decide freely about their health and bodies, free of coercion. The Commission was the place to discuss those issues at the multilateral level, and he regretted that the text could not be adopted.
Other speakers, however, disagreed with the draft text or with the course of the negotiations in general. In that regard, the representative of Nauru expressed concern at attempts by UNFPA to “harass” and “discredit” his country’s position on such issues as sexual and reproductive health.
Taking up the themes for its forty-ninth and fiftieth sessions, the Commission adopted the draft decision, entitled, “Special themes for the Commission on Population and Development in 2016 and 2017”.
It also adopted a draft decision entitled, “Future organization and methods of work of the Commission on Population and Development”, and the “Provisional agenda for the forty-ninth session of the Commission”.
Vice-Chair and Rapporteur Mesbah Ansari Dogaheh introduced the draft report of the Commission on its forty-eighth session, contained in document E/CN.9/2015/L.3, which was then adopted.
This article, published by UN News, has been reproduced by PSN and does not necessarily reflect our views. Minor changes and cuts may have been made for the purpose of brevity and relevance.
PSN member, Blue Ventures, has received a distinguished accolade for social enterprise. The $1.25 million Skoll Award for Social Entrepreneurship will help Blue Ventures to expand its horizons and move closer to its goal of reaching three million people in tropical coastal communities by 2020.
A groundbreaking approach
In Velondriake, a remote fishing community in southwestern Madagascar, a quiet revolution is under way that takes marine conservation beyond saving the environment to improving economic opportunities and offering health services.
The driving force behind this is Blue Ventures, a UK-based marine conservation charity, which works with Madagascar's semi-nomadic Vezo communities to create sustainable fisheries by giving local people responsibility for managing them.
Blue Ventures co-founder Alasdair Harris said that when he saw the rapid decline of the area's marine environment through over-fishing and climate change it became clear that his efforts had to focus on people as much as on saving endangered species.
Some 500 million people globally depend on small-scale fisheries for their livelihoods and 90 percent of fish stocks are under severe pressure, so there is an urgent need to build sustainable coastal communities, Harris, a marine ecologist, told the Thomson Reuters Foundation at a conference in Oxford.
"Coastal communities in the tropics are very often living on the front lines of climate change, they are often living in extreme poverty and they are often living with such dependence on fishing for income that they have no alternatives economically for survival," Harris said.
Harris will receive the $1.25 million Skoll Award for Social Entrepreneurship on Thursday, the largest prize of its kind, for his pioneering work in setting up more than 60 locally managed marine areas in Madagascar, run by a committee of local people taking action on anything from over-fishing to fighting poaching and providing family planning services.
Blue Ventures' holistic approach has been endorsed by leading conservationists, such as Britain's David Attenborough who has called it "a model for everyone working to conserve the natural life-support systems of our troubled planet."
Population growth pressures
Harris said Blue Ventures realised that poor local health services and rapid population growth - the population in the southwest of the island is doubling in size every 10 to 15 years - also put pressure on the environment in that region, where most people live on less than $2 per day.
Blue Ventures found that 84 percent of people in Velondriake thought there would not be enough resources for them to survive if they did not practise family planning and that 90 percent of the women would like to be able to plan their pregnancies.
In response to local needs Blue Ventures, which started in 2003 by taking conservation volunteers on diving expeditions to Madagascar, launched its community health service Safidy, which means "freedom to choose" in Malagasy.
The programme allowed local women for the first time to choose how many children they have and how to space their births, a choice they have never had before, said Vik Mohan, Blue Ventures' medical director.
Use of contraception has risen more than fivefold among women in Velondriake to 55 percent since Safidy started in 2007, compared with a national average of around 30 percent, according to Blue Ventures' data.
"What we're seeing now is that women feel more empowered, they're healthier, they have more economic opportunities and can play a more active role in fisheries management," Mohan told the Thomson Reuters Foundation.
The rapid uptake in contraceptive use stems in part from Blue Ventures' good relationships with communities through their marine conservation work, but also from a culturally sensitive, rights-based approach to providing healthcare , Mohan said.
Eugene Andriamasy, partnership co-ordinator at Marie Stopes Madagascar, said collaborating with Blue Ventures had enabled them to reach people in remote areas more easily to provide long-acting contraceptives such as hormonal implants and intra-uterine devices.
"It allows us to do services at a better cost-efficiency ratio than if we did it alone," Andriamasy told the Thomson Reuters Foundation.
Safidy now serves 20,000 people across 50 coastal villages in Madagascar through outreach clinics and by training local women to offer community-based family planning services.
The women receive contraceptives at cost price, which they sell in their village for a small income. They also offer counselling, mosquito nets, water purifying solution, oral rehydration salts and antenatal medication.
This article, published by Reuters, has been reproduced by PSN and does not necessarily reflect our views. Minor changes and cuts may have been made for the purpose of brevity and relevance.
This article looks at the past, present and future of international family planning programmes and calls for the creation of common indicators to measure success that go beyond outcome and output goals, and include process, information, and informed choice.
In recent years, family planning experts have undertaken a number of major policy efforts to shine a spotlight on reproductive health worldwide. With this renewed focus on the power and promise of family planning, now is an opportune time to step back; examine past family planning and reproductive health initiatives; and ensure that lessons we’ve learned inform the work we do moving forward.
Above all, programs and policies should focus on improving the health and lives of people around the world, not numerical demographic targets. An overemphasis on reaching quantitative goals should not take priority over quality of care, voluntary use of contraception, and informed choice. The needs, desires, and well-being of women are paramount.
Prior to the UN’s 1994 International Conference on Population and Development (ICPD), family planning programs in developing countries often focused on the goal of reducing fertility and, in turn, slowing population growth. Indicators such as the percent of women using, or whose partners are using, contraception (the “contraceptive prevalence rate”), or the average number of children each woman would have by the end of her reproductive period (“total fertility rate”), were used by governments and funders to measure program success.
The assumption was that addressing population growth was critical for a country’s economic development, with governments expecting that through trickle-down processes, the result would be improvements in the lives and well-being of its people. But because these indicators only measured specific numerical goals, and not the underlying intent of improving individuals’ well-being, many family planning programs implemented activities that were not fully client-centered, were coercive, and/or did not improve individual well-being or promote the rights of individuals to have the number of children they want, when they want them.
In response to global advocacy and concern about this approach, in 1994 the ICPD Programme of Action articulated that reproductive rights—including the right to decide the number, timing, and spacing of children—are an integral part of human rights and are essential to the realization of other fundamental rights. This confirmation pushed family planning programs to move toward improving individuals’ reproductive health and well-being, and allowing them to achieve their family planning goals.
Following ICPD, efforts were made by governments and NGOs to align the design and goals of family planning programs by incorporating values like quality of care, voluntary adoption of contraception, and informed choice. While there has been an important shift toward client-oriented care since 1994, and new indicators to measure clients’ health and informed choice have been proposed, implementation and measurement has been spotty.
In 2012, the London Summit on Family Planning brought together the UK government, the Bill & Melinda Gates Foundation, UNFPA, USAID, national governments, donors, civil society, the private sector, and the research and development community to support the rights of women and girls to decide, freely and for themselves, whether and when to have children and how many they wish to have. At the summit, more than 20 governments made commitments to mobilize progress and donors pledged an additional $2.6 billion to enable 120 million more women and girls to use contraceptives by 2020. A global partnership, Family Planning 2020 (FP2020), was formed to achieve these goals.
In the March issue of Studies in Family Planning, a peer-reviewed journal published by the Population Council, past family planning initiatives were analysed and renewed the call for new efforts like FP2020 to be built around one unifying goal: to meet the family planning needs and reproductive goals of their users—not simply to achieve macro level numerical targets like “120 by 20.”
FP2020’s goal was intended as a rallying call for the field, and to ensure that efforts are made at the large scale required to achieve public health benefit. Furthermore, FP2020 has nobly worked to identify core indicators that measure other kinds of progress than this numerical target. That said, this goal has also sparked some concern among those who remember family planning before ICPD, who fear that it may lead countries to unintentionally overemphasize the importance of reaching numerical thresholds, rather than concentrating on the well-being of their citizens.
What Does True Success Look Like?
To measure true success, new indicators are needed. Take “met demand,” meaning the percent of women who are using a modern contraceptive out of the total who would like to avoid or delay having a child.
Currently, met demand is one of the core indicators of success for FP2020 and has also been proposed for inclusion in the post-2015 goals, which seek to ensure universal access to sexual and reproductive health services by 2030. It is a useful indicator, but it misses the full picture. It doesn’t capture whether women made the choice to embrace modern contraceptives voluntarily, or the quality of overall information offered to women about their practices and options.
Instead, we should be measuring indicators like client-provider interaction, content of information provided to clients, voluntary use of contraception, and informed choice. These indicators can only be measured at the service level and in the field. Though it adds some complexity to program evaluation, we believe family planning initiatives must develop confidential, respectful ways of observing consultations between providers and clients, or conducting exit interviews with clients, in order to measure the quality of care provided by a program. What exactly constitutes high quality of care will be made by experts in close consultation with users and advocates.
Additionally, in order to ease the challenges related to monitoring progress, we recommend that family planning indicators and targets be standardized across FP2020, as well as two other major policy initiatives: the UN’s proposed Sustainable Development Goals, which seek to define a range of global development targets for the next 15 years, and ICPD Beyond 2014, the UN review of the ICPD. This will reduce confusion and allow countries to implement—and evaluate—multiple initiatives simultaneously and successfully. In order to monitor progress at the global level, we need comparable data to be available regularly from many countries, which these programs can also provide.
It is an exciting time in the field of family planning. Amid the formulation of new policies and programs, we have an opportunity to shape the reproductive health agenda and influence the services that will be offered to people for many years to come.
Now is the time to develop a set of common indicators for family planning and reproductive health programs that go beyond outcome and output goals, and include process, information, and informed choice. This will ensure that our programs maintain focus on service delivery, meet the reproductive needs of users, and uphold the preferences and rights of the women they serve.
This article, published by RH Reality Check, has been reproduced by PSN and does not necessarily reflect our views. Minor changes and cuts may have been made for the purpose of brevity and relevance.
SOURCE: The Guardian
An article by renowned economist, Jeffrey Sachs, claims that economic policy must be combined with climate and technology if we are to stand any chance of saving ourselves.
Climate in crisis
Recent news brings yet another example of hubris followed by crisis followed by tragedy. The hubris is our ongoing neglect of human-induced climate change, leading to climate disruptions around the world.
One of the many climate crises currently under way is the mega-drought in São Paulo, Brazil. The recent tragedy is an epidemic of dengue fever in the city, as mosquitos breed in the makeshift water tanks that have bought in to maintain supply through the drought.
Welcome to ‘the age of sustainable development’. We are learning a hard truth: the world economy has crossed the “planetary boundaries” of environmental safety. We now face a momentous choice.
Will we continue to follow our blind economic model at growing threat to humanity, or will we choose a new direction that finally combines economic progress with social justice and environmental safety?
São Paulo is just one of many such cascading disasters. My colleagues at the Earth Institute of Columbia University recently detailed how Syria’s disastrous war was triggered in part by a devastating drought that itself was a signal of long-term drying in the eastern Mediterranean.
Others have used sophisticated climate models and a deep reading of past climate history to show that California’s extreme drought is a foreshadowing of mega-droughts ahead in the 21st century in the US southwest and mid-plains states, as a result of human-induced climate change.
Preparing for the future
But it happens that 2015 is a key year of decision for sustainable development. Twenty-three years after the Rio Earth Summit, the 193 UN member states have resolved to adopt sustainable development goals (SDGs) this September.
Just before that they will meet in Addis Ababa, Ethiopia, to redirect global financial flows towards sustainable investments in health, education, and renewable energy, and away from dangerous fossil fuels. And in December, they have the final opportunity to conclude a climate change agreement that can keep global warming below the agreed upper limit of 2-degrees Celsius.
These are momentous decisions, yet still badly understood globally. Our mental models, analytical fields of study and ethical decision making is poorly equipped to handle the challenges of sustainable development.
We have been walking blindly into tragedies and more will come unless we learn to open our minds and our ethical reasoning to the current crisis. My new book The Age of Sustainable Development is an attempt to help the public understand both the growing crisis and the ways to overcome it.
A new way of thinking
We need a new way of thinking, one that tightly links the human-made world of economics and politics with the natural world of climate and biodiversity and with the designed world of 21st century technology.
Consider my own home field of study, economics. Sometime in the 19th century, economics largely dropped its traditional attention to land, water and food, as industry replaced agriculture as the leading economic sector. Economists decided, by and large, that they could ignore nature – take it “as given” – and instead focus on market-based finance, saving, and business investment. Mainstream economists derided the claims of “limits to growth.”
Of course this was never correct; economies have always depended on what we now call “natural capital.” Yet the complete separation of economics and nature was the predominant way of economics thinking and teaching until very recently. Libertarian free-marketers in the US and UK hold to this day that climate change must be a hoax because if it were true it would overturn the laissez-faire economic philosophy.
Economics also needs to team up again with the engineering world, to realise that the economy is a designed system, and one in which smart thinking is required to get the right design.
Urban historians know that great cities emerge from a combination of planning and self organisation; and in the same way, safe and prosperous economies in the 21st century will need a combination of targeted technologies (eg zero-carbon energy, smart urban grids, and climate-resilient agriculture); forward-looking infrastructure plans at the local, national, and regional levels; and the usual surprises, breakthroughs and evolution of market-based change.
Sustainable development offers not only a new analytical frame, but also a new way of choosing our common future. It suggests an ethical framework that is consistent with the great moral traditions of both East and West. At the core of sustainable development is the normative idea that we must combine economic prosperity with social justice and protection of the physical world.
At this advanced stage of environmental threats to the planet, and in an era of unprecedented inequality of income and power, it’s no longer good enough to chase GDP. We need to keep our eye on three goals – prosperity, inclusion, and sustainability – not just on the money.
Fortunately, if we can just draw our attention to these broader goals, we will learn that they are easier to achieve than we might think. We are the inheritors and beneficiaries of one of the great technological revolutions of human history – the digital age – which rivals steam and electricity in its fundamental power to advance the global economy, and to do so in harmony with environmental needs.
A zero-carbon global energy system, for example, is within reach thanks to breakthroughs in renewable energy and efficient energy transmission and use.
We have entered a new age of sustainable development whether we like it or not, even whether we recognise it widely or not. As the great biologist E O Wilson has put it, we have stumbled into the 21st century with stone-age emotions, medieval institutions, and near godlike technologies. In short, we are not yet ready for the world we have made.
The sustainable development goals will be a vital opportunity to give ourselves new guideposts and measuring posts for prosperity, justice, and environmental safety in our fast-moving, rapidly changing, and dangerously unstable world.
This article, published by The Guardian, has been reproduced by PSN and does not necessarily reflect our views. Minor changes and cuts may have been made for the purpose of brevity and relevance.