Conserving endangered cranes whilst improving family planning in Uganda

November 23, 2018


Today in south west Uganda the team from the Margaret Pyke Trust, three conservation NGOs, and the local hospital, finalised the first stage of the design work on a new style of conservation project suited to the era of the Sustainable Development Goals (SDGs). The Trust and its partners’ work is being supported by a Darwin Initiative Scoping Award.

The wetlands around Kabale, in south west Uganda, are a classic example of how increasing pressures on wetland ecosystems impact both the ability of people to maintain sustainable livelihoods, and the integrity of habitats on which threatened and endangered species depend. Local environmental problems include loss of ecosystem goods, such as papyrus, soil fertility decline reducing agricultural productivity, and a reduction in access to clean water as wetlands become less able to undertake their natural functions. Wetland degradation is also impacting threatened biodiversity including Uganda’s national bird, the endangered Grey Crowned Crane.

The African Crane Conservation Programme (a partnership between the Endangered Wildlife Trust and International Crane Foundation) and NatureUganda are already supporting local communities to develop sustainable livelihoods. But Kerryn Morrison, of the African Crane Conservation Programme, knew Kabale families were reporting that barriers to family planning mean they are having larger families than they would ideally choose. This increases pressures on families themselves, and local ecosystems, and so Kerryn contacted the Margaret Pyke Trust. A cross-sectoral partnership begun to evolve, recognising that generating sustainable livelihoods alone might not be enough for either the cranes or the local communities.  

David Johnson, Chief Executive of the Margaret Pyke Trust said, “We know from our experience elsewhere in Africa that integrating sustainable livelihood interventions benefitting ecosystem health, with human reproductive health interventions benefitting human health, is an effective way to help both rural communities and the non-human species relying on the same local ecosystems. We believe that by integrating improvements in family planning provision, with the development of sustainable livelihood opportunities, we will be able to generate greater environmental, health and gender outcomes than if we only focussed on one of those sectors.”

Kerryn Morrison explained, “Successful biodiversity conservation requires taking into account people, our health, and our interactions with the natural world. Integrating ecosystem and human health actions responding to population pressures to enable sustainable utilization of wetland ecosystems really is a win-win.” The project hospital partner is Rugarama Hospital and Dr Gilbert A. Mateeka, their Medical Superintendent, explained, “the need for greater community reproductive health knowledge is acute. Integrated programmes provide one way of reaching more people through outreach, as well as being a way to engage men – who are often one of the barriers to women exercising their right to choice. This is something we will address in this project.”

In addition to the health and conservation actions, the academic partner is the London School of Hygiene & Tropical Medicine. Professor Susannah Mayhew, who is also a Trustee of the Margaret Pyke Trust said, “We want to analyse the project outcomes, to determine whether the project partners’ assumption that projects integrating human and ecosystem health interventions generate greater positive outcomes compared to single sector health or environment projects is correct.” Achilles Byaruhanga the Executive Director of NatureUganda concluded, “We are working together to develop an integrated programme which will respond to the connected local environmental, health and livelihood challenges. Securing long-term sustainability of wetlands contributes not only to Convention on Biological Diversity goals, but also our need to have a twenty first century approach to conservation, acknowledging the cross cutting nature of the SDGs, and the demographic realities of a world with a fast growing population.”

Grey crowned cranes in the wetlands around Kabale, Uganda

Our work at the International Conference on Family Planning 2018, Rwanda

November 16, 2018


The International Conference on Family Planning is the leading global reproductive health conference. This year, members of the Population & Sustainability Network were represented in significant numbers. For the first time, at this biennial conference, there was explicit reference to and focus on Population Health and Environment programmes, with the Network heavily involved in significant events focussed on this approach.

The International Conference on Family Planning (ICFP) was established in 2009, with funding from John’s Hopkins School of Public Health and the Bill & Melinda Gates Foundation. ICFP is the world’s most important conference focussed on reproductive health and population. At the 2018 ICFP there were over 3,700 participants, including the Prime Minister of Rwanda, the Secretary of State at the UK Government’s Department for International Development, Jane Goodall, and many others besides.

Five events at ICFP focussed on Population, Health and Environment (PHE) programmes. PHE programmes integrate reproductive health, conservation, and sustainable livelihood interventions. The Margaret Pyke Trust, the Population & Sustainability Network, and collectively its members were involved with all five. The events demonstrate the growing interest in PHE, and increasing understanding of why the removal of barriers to family planning is a relevant consideration in conservation policy and programme design.

Two new Network affiliates, the African Crane Conservation Programme (which is a partnership of the Endangered Wildlife Trust and the International Crane Foundation) and NatureUganda featured at PHE events. Dr. Harriet Davies-Mostert, of Network member the Endangered Wildlife Trust, was one of the speakers at a PHE evening session. ICFP has never previously hosted an event where a conservation leader opened her presentation by making connections between sexual and reproductive health and rights, and the conservation of Africa’s lion.

In further news from ICFP, FP2020 published its latest Progress Report. The report includes an interview with David Johnson, the Network’s Chief Executive. Some of the interview reflects the contents of his presentation forming part of the Network’s ICFP panel, which also included representatives of the London School of Hygiene & Tropical Medicine, NatureUganda, the Endangered Wildlife Trust, Pathfinder International, and DSW.

Read the full interview with Chief Executive David Johnson in the FP2020 Progress Report.

Thanks to the Environmental Funders Network Rapid Response Mechanism, the support of which was critical for several PHE activities at ICFP.

A Re Itireleng—Let’s Do It Ourselves

October 24, 2018


A little over two years ago Population & Sustainability Network members the Endangered Wildlife Trust, Pathfinder International, and Network coordinator the Margaret Pyke Trust, designed and began working on a new Population, Health and Environment programme. Two years on from the launch of “A Re Itireleng” Pathfinder International has published a brief on the project, which can be downloaded here.


USAID feature the Margaret Pyke Trust’s USHAPE programme: Sexual and reproductive health training in south-west Uganda

October 4, 2018


On 3 October 2018, USAID featured the Margaret Pyke Trust’s USHAPE programme on its ‘Training Resource Package for Family Planning’ blog. You can read the original article on USAID’s website here, or alternatively below.

We are excited to once again feature USHAPE (Uganda Sexual Health and Pastoral Education) on the Family Planning Training Resource Package website as it begins a new chapter under the management of the Margaret Pyke Trust. The Margaret Pyke Trust is based in the United Kingdom and has around 50 years of history providing sexual and reproductive health services along with implementing research and training for health care workers. They have the broadest range of sexual and reproductive health training courses in the UK for health care staff. In the last few years, the Margaret Pyke Trust have started working internationally to address the need to advance sexual and reproductive health services and trainings in low- to middle-income countries. Taking over the management of USHAPE only seemed natural, since USHAPE was originally created by UK based volunteer doctors. It has been an optimistic transition for USHAPE to come under the Margaret Pyke Trust as there has been a continued effort to increase capacity of USHAPE’s training programs.

In the past few years, we have noted USHAPE’s adaptations of the TRP and its use in pilot training programs at Bwindi Community Hospital and Kisiizi Hospital to build knowledge among family planning service providers and expand the ability of providers to deliver services to the community. The Margaret Pyke Trust funds a full time family planning nurse at Bwindi Community Hospital in order to strengthen and ensure a sustainable future for the current implemented USHAPE program. Moving forward, the Margaret Pyke Trust is finalizing the USHAPE pilot training program into an adaptable and expandable model. The hope is to start replicating the model in different settings, with each institution leading on its implementation of USHAPE. Preparing for this capacity building feat includes thorough monitoring and evaluation to measure the significant impact of contraceptive prevalence rates, family planning uptake, etc. Kat Lloyd, the Program and Operations Manager at Margaret Pyke Trust, commented, “It is a time of reflection and consolidation [for us], and we are hoping that this will prepare us for the [USHAPE] expansion in the coming years.”

Meanwhile, UK based doctors continue to act as short term volunteers at the USHAPE-implemented sites. One of these volunteers and the USHAPE Clinical Lead, Dr. Clare Goodhart, provided us insight on the TRP influence on creating and continuing to update the USHAPE training program: “When we first started developing the USHAPE 'Whole Institution Approach to Family Planning', we were keen not to 'reinvent the wheel'. We searched the internet and were excited to come across the Training Resource Package because it aligns to the guidance of the Family Planning Global Handbook, which we knew needed to be central to our training. Importantly, the TRP makes it clear that you can freely adapt its materials. We were able to pick out the PowerPoint presentation, role plays and case discussions, which are needed to teach the available family planning methods.

"It took quite a lot of work to reduce the TRP materials so they fit into the different levels of USHAPE training, as we needed to build in other modules to address real life scenarios, such as adolescent-friendly contraception, HIV, sexual infection, cervical screening, post abortion care etc. We put a lot of emphasis on counselling and outreach to the community and felt we had to move beyond the suggestions of the TRP to achieve this. We also vary USHAPE training by integrating short films, which helps with the quality of teaching and reduces pressure of the trainers. However, the TRP has been a great starting point for creating USHAPE training and we often return to it when creating outreach materials, refresher training or for the training of trainers. We are keen to continue to work with the John Hopkins team to move family planning training forward worldwide.”

The elephant left the room quite some time ago; let’s follow

September 3, 2018


On 3 September 2018, the International Union for Conservation of Nature (IUCN) featured an article written by David Johnson, Chief Executive, Margaret Pyke Trust, coordinator of the Population & Sustainability Network on population growth and the resulting pressure on the environment. You can read the original article on the IUCN’s website here, or alternatively below.

One side effect of running an organisation with population in the name is that every week or so a friend will send me an article or video about population. Almost invariably there is mention of population being a “taboo” topic, or “the elephant in the room”. This is in spite of the fact that I can’t honestly recall ever speaking to a conservationist who disagreed that global population is a critical conservation issue, or was shy to say so. There is no taboo.

Given the United Nations projects that the global population will rise from 7.6 billion today to over 9.7 billion by 2050, this is hardly surprising. But there is something glib about merely stating the challenge. What needs to happen is that we move to consider the actions which form part of the effective response.

Considering health sector data

Evidence-based conservation has become standard practice. This includes the systematic assessment of information when designing conservation projects and determining policy. There is also a growing understanding of the need for cross-sector collaboration. So to move on from the mythical elephant in the room, the first step is to consider relevant health data.

The Convention on Biological Diversity (CBD), the United Nations Environment Programme (UNEP) and the World Health Organization (WHO) did exactly that in their 2015 joint report “Connecting global priorities: biodiversity and human health: a state of knowledge review”. They acknowledge that population growth places increased demands on healthcare systems and can greatly increase pressures on natural resources. Most importantly, they acknowledge that population growth could be moderated by greater investments in family planning programmes.

They also explain that greater investment in the education of girls and women and improved access to and awareness of contraception would “not only improve human health and well-being directly, it would also help slow and reverse trends among countries with the highest projected growth rates and concomitant pressures on ecosystems”.

In reaching their conclusions the CBD, UNEP and WHO relied on fertility and other reproductive health data. In the health sector that is elementary. It needs to become standard in conservation too. At the Trust I lead, we are working with an increasing number of conservation organisations which are considering not only population data, but also the evidence of how small improvements in family planning have significant changes on fertility rates, and consequently long-term population size and environmental pressures.

Accepting that barriers to family planning are conservation issues

At the national policy level, there is often acceptance that population is a key conservation challenge. Nigeria’s National Biodiversity Strategy and Action Plan (NBSAP), for instance, highlights high population growth as the first cause of biodiversity loss. Tanzania’s NBSAP states, “Human activities due to rapidly growing population have been one of the major causes of habitat loss and degradation resulting into biodiversity decline in Tanzania.” Nigeria and Tanzania are not alone in making such statements. Many developing nations, with relatively poor healthcare provision and higher fertility rates as a result, make this connection in their NBSAPs.

Poor rural communities often depend most directly on natural resources for their livelihoods, food, water, shelter and cultural practices. When localised human pressures on ecosystems exceed critical tipping points, both community health and environmental health suffer. Poor rural communities in developing nations also face the greatest barriers to the use of and access to reproductive health services.

This is why these areas are such a focus for health advocates. Barriers to family planning prevent women from choosing freely when and whether to have children, threaten family health, create challenges for girls who want to complete their education, and lead to higher levels of fertility and more rapid rates of population growth. These are issues which also directly impact on conservation, and there is often an overlap in areas with the greatest need for better reproductive health services and for conservation. Supporting policy developments that will improve reproductive health services is therefore something conservation organisations should consider including in their strategic priorities.

Conservation organisations can’t provide clinical services. Similarly, family planning nurses can’t implement conservation activities. But this does not mean family planning should be seen as solely a health issue. Conservationists are familiar with overlapping concerns. For example, we are confident to promote renewable energy as part of the response to the environmental threats of climate change, or to advocate for better public transport to improve air quality. These are not merely “energy” or “transport” issues. Conservation organisations do not need to run windfarms or provide train services to promote them as relevant to the environment.

Barriers to family planning increase pressures on ecosystems as well as families. Therefore, as a sector, we should find it as easy to promote universal access to family planning as we do renewable energy. After all, the Sustainable Development Goals call for both.

Moving ahead

Some conservation and reproductive health organisations have already successfully joined forces. There is a growing movement of community-based Population, Health and Environment programmes which take a holistic approach to interconnected issues of poor health, family planning needs, food insecurity, poverty, and unsustainable use of natural resources. Project data shows this approach leads to greater uptake of family planning, better health and gender relations, and increased support for and participation in conservation activities by local communities. Such a multisector approach can also be more cost-effective, and generate more sustainable results.

The Inter-governmental Panel on Climate Change affirmed in a 2014 report that family planning can play a role in reducing climate change vulnerability and is a potential adaptation strategy. The book Drawdown: the most comprehensive plan ever proposed to reverse global warming, details the top 100 solutions that have the greatest potential to reduce emissions or sequester carbon from the atmosphere. Educating girls ranks sixth and family planning ranks seventh. The integration of family planning into conservation and climate change thinking has begun; we need this to become the norm.

The Margaret Pyke Trust has, from its inception, been at the forefront of developments in contraception. In the 1960s that meant opening and running what soon became the world’s busiest family planning clinic. Today, the Trust is likely the only IUCN Member to have 50 years’ family planning expertise. One of our strategic priorities is working with conservation organisations in developing countries to integrate family planning into conservation programmes. We do this because we believe all girls and women have the right to choose freely whether and when to have children, and how many. We also do this because we question whether many traditional conservation projects can have long term sustainable results if they don’t.

On World Population Day in July 2019 we will be promoting the growing collective of visionary conservation organisations which are integrating family planning into their conservation activities by making appropriate partnerships, or supporting policy changes which will make this easier. The Trust is keen to work with other IUCN Members, as well as other conservation organisations worldwide, who understand that it is time we stopped talking about population growth and started to take action to remove barriers to family planning as an integral part of conservation policy.