family planning

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What’s to be done about the stalled decline of fertility in Africa? | 

The fertility rate across Africa has not declined as quickly as the rest of the world. The Economist recently raised the alarm about the problem, but some experts have said that it is not all bad news.

Given the strong correlation between lowering birth rates and improving life outcomes, the news is a bit disappointing.  The population of Africa will reach 2.7 billion if current trends hold, a near tripling in a matter of only 40 years.

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“This extra half-billion people will damage Africa’s prospects. The continent will find it hard to educate the next generation—and education is the most important step in realizing the demographic dividend,” warned The Economist in an article from earlier this month.

There are thirteen countries on the continent that are doing well and moving in the right direction. The rest, accounting for roughly 78% of the population in Africa, are not doing so hot. They include places like Kenya and Madagascar, where fertility rates are below 5 births per women, but have stagnated. Places where rates exceed 5 births per women, reaching a global high of 7.5 in Niger, are showing weak signs of progress.

The British publication pins much of the problem on the lack of access to modern contraception. It suggests that the wide population distribution as compared to the densely packed Asian countries makes things more difficult, but the rate is far too low. It argues that the evidence is clear that contraception can reduce fertility, citing the difference between neighboring Tanzania and Uganda.

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The 10 stories you missed while following the Philippines | 

The disaster following Typhoon Haiyan in the Philippines rightly has dominated the global twenty-four hour news cycle. Humanosphere has devoted more of our reporting time to the issue than anything else this week. With nearly one million people displaced and close to twelve million affected, the scope of the problem is vast and the relief effort has a long way to go.

While we were paying attention to the Philippines, there were other notable news stories that garnered less attention. Here are ten notable events and happenings (presented in no particular order) that you might have missed this week. It is by no means a comprehensive list. Do add anything else of note in the comments section.

1) Polio is worse this year in Pakistan, so the region is taking on the challenge by working together.

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Gates Foundation

The number of polio cases in Pakistan have already exceeded the total from 2012. Health officials announced Wednesday that there are sixty-two cases of polio in 2013. The total for 2012 was fifty-eight. Pakistan is one of only polio-endemic countries, alongside Afghanistan and Nigeria.

Attacks on polio workers over the past year have hampered the effort to vaccinate children. An estimated 240,000 children living in the northwest were not vaccinated in August due to a ban by the Taliban.

The problem is affecting neighboring countries. An outbreak of polio in Syria was recently linked to Pakistan. To deal with the issue, the WHO is working with twenty-one Middle Eastern countries to stop polio in its tracks. However, much of what happens in Pakistan is out of the control of the UN and its neighbors.
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When access is not enough for family planning | 

A community health worker visits with Dorcas Owino.
A community health worker visits with Dorcas Owino and her family.

Sauri, Kenya – Efforts are increasing to bring family planning access to some two hundred million women around the world.

Melinda Gates launched a new effort at the London Summit on Family Planning in July 2012. Shortages and a lack of options present significant challenges to many women. However, access is not the only issue in family planning.

There is also the matter of convincing men and communities to support the decisions of their partners. In some cases, availability of family planning methods does not determine whether or not a woman uses them.

Dorcas Owino, 30, opted for an intrauterine device (IUD) after giving birth to her fifth child. She and her husband, Joseph, were educated on the importance of birth spacing. With a total of seven children to care for, Dorcas decided to put things on hold. Continue reading

Does TV ownership in India correspond to better family planning? | 

Soap operas promote family planning. That’s what this article in Conservation magazine posits, written by Fred Pearce. A geographer arrived at the conclusion that TV ownership may explain India’s success at reducing its birth rates in some communities. How? Here’s what Pearce reports:

(Researchers) noted that the new diet of game shows, soap operas, and reality shows instantly became the villagers’ main source of information about the outside world—especially about India’s emerging urban ways of life… an eye-opener for millions of rural Indian women. They saw their urban sisters working outside the home, running businesses, controlling money, and—crucially—achieving these things by having fewer children. Here was TV showing women a world of possibilities beyond bearing and raising children—a world in which small families are the key to a better life.

Since the research was done by a geographer, we have to include at least a few maps.

India TV fertility
Conservation, Geocurrents

Gates Foundation wants to make safe sex more fun | 

Happy Condoms
Flickr, bnilsen

The Bill & Melinda Gates Foundation thinks safe sex isn’t as much fun as it should be.

At least, that seems to be the gist of one request for a grant application from the world’s largest philanthropy as part of its Grand Challenges Explorations program. One of the goals for this round is to develop a better condom – and by better they basically mean a condom that doesn’t suck.

“It is a bit unusual,” said Stephen Ward, the program officer with the Gates Foundation administering the project.

In its request for proposals, the foundation opens with a detailed description of the global production of condoms (15 billion units per year), usage (750 million) and a ‘steadily growing market.’ When used properly, the Gates Foundation notes, condoms can protect females from pregnancy and both partners from sexually transmitted infections like HIV. They are cheap, ubiquitous and a great example of a ‘multi-purpose prevention technology.’

“The one major drawback to more universal use of male condoms is the lack of perceived incentive for consistent use.”

Yeah, they suck. They’re no fun. Continue reading

Will Melinda Gates’ family planning boost improve women’s health overall? | 

Analysis

Chris Kleponis, AFP/Getty Images

Melinda Gates

Today, in London, Melinda Gates and a few big guns in the British government did a much-needed and celebrated thing — getting billions of dollars from the international community to fund family planning services for some 120 million women and girls.

The Guardian Rich countries pledge $2.6 billion for family planning in global south

TIME Melinda Gates Launches Global Crusade for Contraception

Yes, this is another one of those promises of foreign aid that rich countries seem to make all the time and then break later when you’re not paying attention. But it’s important to recognize they do keep some of these promises (see funding for AIDS, malaria and child vaccines over the past 10 years) and this one does appear to have momentum.

Improved access to contraception has been estimated to reduce maternal mortality by a third. Providing women with greater control over reproduction is widely regarded as fundamental to empowering women, and as a basic human rights issue. Finally, the public does seem a bit more worried about global population growth these days.

So this campaign — largely led by Melinda Gates, against her church — may indeed represent a significant turning point for family planning and for maternal health worldwide.

But the question some raise, usually those way in the back of the room without access to the microphone or TV cameras, is if this is actually good for women’s health overall. Continue reading

Melinda Gates says family planning should not be controversial | 

By Keith Seinfeld, KPLU

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Chris Kleponis, AFP/Getty Images

Melinda Gates

Melinda Gates is promoting access to contraceptives around the world, and urging everyone to believe it’s not a controversial step.

She’s co-hosting a global summit on Wednesday in London, along with the British government.

The Bill & Melinda Gates Foundation hopes to overcome religious and cultural resistance by saying birth control is simply one option that women want.

The foundation says simply: “There is no controversy.” And, it has created a website called No-Controversy.com, where women can share stories of how birth control changed their lives.

Enter the Catholic Church

However, when the Catholic Church and some Muslim groups are actively campaigning against it, and when some U.S. states are blocking all funding for Planned Parenthood, saying birth control is not controversial might seem implausible.

Here’s how Melinda Gates explained her position, as a Catholic, on CNN last week:

“To me the contraceptive piece is not controversial. My roots, part of why I do what I do in the foundation, comes from that incredible social justice upbringing I had, this belief that all lives, all lives have equal value.”

Gates made a similar point on the Colbert Report, telling Stephen Colbert, “We’ve made it controversial in the United States, and it doesn’t need to be. In fact 90 percent of Americans say they find contraceptives morally acceptable. But, because we’ve made it controversial, it’s come off the global health agenda.” Continue reading

Contraception could cut global maternal death toll by one-third | 

The New York Times reports:

A new study by researchers at Johns Hopkins University shows that fulfilling unmet contraception demand by women in developing countries could reduce global maternal mortality by nearly a third, a potentially great improvement for one of the world’s most vulnerable populations.

The study, published on Tuesday in The Lancet, a British science journal, comes ahead of a major family planning conference in London organized by the British government and the Bill and Melinda Gates Foundation that is an attempt to refocus attention on the issue. It has faded from the international agenda in recent years, overshadowed by efforts to combat AIDS and other infectious diseases, as well as by ideological battles.