On Monday, September 17, the Woodrow Wilson Center in Washington, DC, hosted “Maintaining the Momentum: Highlights from the 2012 London Summit on Family Planning (FP).” This panel discussion was a virtual who’s who in family planning – with the main room full as well as two additional rooms literally overflowing – as folks gathered to hear current luminaries talk about highlights and next steps to the 2012 London FP Summit, what is now called FP2020. Panel moderator Karen Hardee, of the Futures Group, reminded us that the Summit confirmed family planning as a critical and global issue and that it set impressive goals and raised $2.6 billion dollars in pledged funding over the next eight years with the goal of expanding access to voluntary rights-based family planning for 120 million new users in poorer countries. The gathering represented a melting pot of perspectives with a mix of representation from government, civil society, and the private sector. There were lots of champagne toasts, speeches, and celebration in London, like at any wedding. Now, two months into the marriage, the hard work begins: how do we implement the summit’s lofty goals?
During the month of July 2012, two landmark gatherings advanced global progress in sexual and reproductive health. The Family Planning Summit was held in London on July 11. Co-hosted by the UK Government and the Bill & Melinda Gates Foundation, the Summit’s goal was to offer millions of vulnerable women around the world renewed hope that they will soon have the means to determine the timing and spacing of their pregnancies through access to modern family planning methods. Less than two weeks later, the AIDS 2012 Conference was held in Washington, D.C. Organized by the International AIDS Society, AIDS 2012 was a multitrack, week-long convention of 24,000 attendees, including heads of state, celebrities, philanthropists, researchers, activists and people living with HIV. Their optimistic vision is to attain an AIDS-free generation.
Many of us who spend our time in the youth sexual and reproductive health (YSRH) world don’t often cross paths with those in the business of economic empowerment and livelihoods programs for young people. Although both worlds are aware of the converging paths, funding streams generally keep us operating on parallel roads. Therefore, I was pleased to facilitate a panel session this morning at the conference: “Exploring the Intersection of Adolescent Girls’ Reproductive Health and Economic Empowerment.” During a lively session, panelists shared their experiences with both issues for girls. Some of the themes were:
- Even though we are aware of the problem, the data on SRH and economic empowerment for girls, taken together for developing countries, is shocking. The rates of HIV, maternal mortality and morbidity, poverty and isolation paint a dismal picture for girls.
- Programs that target girls and adults in the community, with messages on both SRH and economic empowerment, are showing some successes. There’s more to learn, but results are encouraging.
- Models that incorporate peer education and work with girls on SRH and economic empowerment show positive results: the Tesfa program led by the International Center for Research on Women, the Siyakha Nentsha program in South Africa led by Population Council, and a program by Restless Development in Northern Uganda all included a peer education component.
- Reducing social isolation seems key for increasing both SRH and economic outcomes for girls. Girls need access to other girls for many reasons, but importantly, to give them an outlet to talk about themselves: their ideas, dreams and goals.
- It’s important to work with the adults, not just the girls. Teachers, parents and faith leaders all play roles in girls’ lives, and we need to get them on board with difficult topics. Sex and money are not easy to discuss with young people, and the adults need to build their skills to do it.
Today’s session initiated some vital discussion about next steps. It’s my hope that the two worlds of SRH and economic empowerment for young people will start to cross more often and begin to operate more closely together. This year’s conference is an encouraging step toward that. Look for more information on this topic, including a research brief and e-forum, by visiting the Interagency Youth Working Group website.
Imagine a line of dominos stretched out as far as the eye can see, with additional lines branching off into the distance. This web of dominos represents the multiple connections between family planning and every dimension of sustainable development. What many still don’t comprehend is how large and far reaching this web truly is.
We’ll begin with a simple and intuitive causal relationship: voluntary use of contraception prevents unintended pregnancies. Unintended pregnancies result in thousands of deaths globally and many more disabilities each year. Many unplanned pregnancies end in abortion. Almost half of the 40 million abortions performed each year are unsafe, placing nearly 20 million women at risk for infection, hemorrhage, disability, and death. Thus, contraception prevents unintended pregnancies and saves women’s lives.
And the benefits of family planning don’t end with women. Families using contraception have fewer, healthier children and reduced economic burden. Children born to mothers who have used modern contraception in planning their families are not only more likely to have a mother, and one who is healthy, they also are more likely to have been breast fed for longer and received more parental attention, support and resources than children born in to families that were not planned. All of these factors increase the chances that they will survive infancy into childhood. Therefore, family planning also saves children’s lives. Moreover, if after childhood girls and women are given control over their fertility, they are more likely to stay in school and to get jobs. Educated, employed women are in turn more likely to use contraception, thus re-initiating the virtuous cycle of benefits that family planning brings to women and their families.
The benefits still don’t end there. Ensuring that we can feed our growing population while protecting the planet has quickly become one of the most pressing challenges in sustainable development. Regions of the world with the highest unmet need for family planning are already forced to bear the burden of climate change effects to which they have contributed the least. These effects include drought and famine. Turning an extra acre of forest into tilled land is not a choice for a woman without access to reproductive health resources. It is a matter of survival. And it is a preventable scenario. Right now more than 200 million women worldwide want to plan and time their pregnancies but are unable to do so for lack of information and access to contraceptive resources. If the percentage of women with unmet family planning needs remains constant, developing country populations are expected hit 9.7 billion by 2050, and 25.8 billion by 2100. By filling this need, we could greatly relieve some of the combined pressures being placed on resources and communities, including a growing demand for food.
The right and ability of women and couples to plan their families is not peripheral to the aims and objectives of Rio+20. Indeed, the call for greater attention to women’s rights and issues at Rio+20 is growing into a crescendo. Women’s Major Group is mobilizing women across the world to share their stories and ensure that women’s rights are front and center on the agenda. Over 100 of the world’s leading scientific academies have called upon world leaders to enact rational, evidence-based responses to sustainable development challenges, including global access to comprehensive reproductive health resources.
Until now, too few people have been aware and too few leaders willing to acknowledge the essential role that family planning plays in achieving sustainable development. Rio+20 is our chance to tip this pivotal domino piece forward, and witness the measurable cascade of progress it evokes.
International media coverage paints a bleak picture of how fair, open and representative many recent presidential elections have been. Thanks to Programme Gouvernance et Paix (PGP), an FHI 360-led program funded by USAID, the 2012 presidential election in Senegal saw increased transparency and also increased participation from women and youth.
Senegal is an island of stability in a tumultuous region. Peace and democracy in Senegal have helped it become a hub for regional and international organizations that work in West Africa. And though the country has a long democratic history, there had been a regression in democratic indicators over the last ten years. FHI 360 teamed with the International Foundation for Electoral Systems (IFES) to support the electoral process in Senegal.
Before the election occurred, PGP launched a civic awareness campaign that increased voter registration by 120% in Grand Yoff, a working-class suburb of 200,000 in Dakar. This initiative worked with women’s groups and youth organizations to boost voter registration in two underrepresented demographics. The project’s daily dialogue radio campaign was so successful that AFIA FM, one of the 17 implementing stations, incorporated it as a permanent fixture.
Beyond simply helping the public monitor the election, PGP took proactive steps to increase transparency in the pre-election period. PGP experts worked with leaders of both opposition and ruling parties to amend the election code. Negotiations reached consensus on more than 85% of issues. As a result of these negotiations, a single ballot was approved and a gender parity article was inserted. The next legislative election will, for the first time, provide gender and religious parity in the country’s General Assembly.
Working closely with print media, PGP trained journalists to monitor elections and provide objective coverage. As a result, those reporters published more than 30 election-related articles in prominent newspapers. Youth and female journalists trained through PGP interviewed presidential candidates about issues important to their respective demographics. Subsequent monitoring by journalists and interested constituencies has confirmed that Macky Sall, the current president, is adhering to the promises he made during these interviews.
PGP also coordinated a “situation room,” which connected election observers to a centralized technical center. This initiative, funded by USAID and implemented by local CSOs, deployed more than 1,500 election observers for each round of elections. Utilizing the mapping technology of partner OneWorldUK, the program facilitated the first real-time monitoring of a Senegalese election.
This program exemplifies the FHI 360 tagline, The Science of Improving Lives. We know the context in which we operate — the key actors, stakeholders and issues. We used an evidence-based approach to deliver an integrated solution with measurable impacts.
In the early 1970s, many people began to question why girls did not seem interested in science and math and were not engaged in sports. Research demonstrated that it wasn’t because girls were incapable. Instead, socialization practices, teacher and parental expectations, and media messages told girls that these areas were “not for them.”
So, people went into action. Policymakers put legislation like Title IX in place, and companies changed how girls and women were portrayed in textbooks. It took more than ten years, but eventually the situation improved for girls.
All along, everybody assumed boys were doing just fine. But, current research shows that boys — particularly African-American and Latino boys — are being stigmatized in school. They are falling behind in reading and disengaging from school at a very early age, a trend that has disastrous long-term consequences.
In a chapter titled “Improving Boys’ Achievement in Early Childhood and Primary Education,” published in Lessons in Educational Equality by Oxford University Press, 2012, we synthesize international research about the difficulties boys experience in school and strategies to remedy the situation. The chapter grows out of research and curricula around raising and educating healthy boys that we’ve been doing since 2000. In brief, we argue that the lack of success young boys are experiencing is a gender equity issue, and it calls for some of the strategies that have worked to address gender equity in girls’ education. As a first step, we recommend restoring early education to its roots: making time for play, social-emotional development and exploration.
We found that in countries around the world, but especially the United States, even kindergarteners are spending an increasing amount of time being taught or tested in literacy and math. This mandated curriculum leaves little time for child-initiated learning or unstructured play and contributes to a rise in aggression and anxiety in young children. And, importantly, they don’t have the opportunity to develop critical social-emotional skills.
Diminishing opportunities for play and prosocial learning are especially disastrous for boys. It sets boys up for increased likelihood of violence, lower academic achievement and eventually disproportionately high drop-out rates.
International research is also finding that societal stereotypes about gender — ideas of what boys and girls are supposed to be like — contribute to boys’ lack of success in school.
For instance, a focus group of teachers and parents said boys were expected to be strong and to hide their emotions; those who didn’t would suffer a host of consequences such as being bullied and ostracized. They also said that energetic boys were thought to be troublemakers.
These expectations prevent boys from developing into psychologically healthy young men, and they often leave boys with the sense of being scrutinized, disliked or simply “bad.”
We recommend that teacher education include discussions about gender attitudes and how they affect the way teachers relate to both boys and girls. Change will require intentional focus and concerted effort. But that kind of effort is possible. After all, advocates changed national policies and scaled up programs for girls a generation ago.
To be sure, work on behalf of girls is not done. But we can apply some of that movement’s lessons to improving boys’ well-being and success in school. Ultimately, we believe that it is important to understand and meet all children’s needs in the classroom and that effective gender equity benefits both girls and boys.
Just in time for International Women’s Day, the U.S. Agency for International Development (USAID) released a new gender policy on March 1st. More comprehensive than the former 30-year-old policy, the new policy is a big step forward in the ability of the agency and its partners to tackle the root causes of gender inequality through development work.
USAID Deputy Administrator Don Steinberg emphasized that the agency is integrating gender “into the DNA” of everything they do to more adequately respond to the vast gender-related barriers that persist all over the globe. The new policy will serve as a guide for efforts to change the social norms that, in so many places, continue to lead to gender inequalities and worse. Deep-rooted changes in social mores are needed, as well as a comprehensive approach to the many factors that influence how girls and women fare all over the world.
One such place is Katanga Province in the Democratic Republic of the Congo. Here, when a girl is beaten by a boy in her school, it is not an isolated incident but rather the tip of the iceberg in a country struggling to end conflict-related sexual violence and mend its torn social safety net.
Currently, FHI 360 is leading a project under its C-Change program to influence attitudes and practices in 31 schools in Katanga and surrounding communities. The project engages parents, teachers and students to diminish the instance of school-related gender-based violence. In this preventive program, participants are using innovative avenues of communication for social and behavior change to tackle, at the school and community levels, the underlying factors that make such violence a part of everyday life. For example, teacher mentors use a Congolese-appropriate Safe Schools Guide to work with designated youth clubs to discuss and strategize how to make schools safer.
Attaining gender equality takes long-term vision and time. Programs such as C-Change are tackling the foundation of gender inequality: unequal gender norms. Gains for women are being achieved, while making men champions of gender equality.
If the arc of opportunity is long, to paraphrase Dr. Martin Luther King, Jr., it bends toward equality. And we have to be there to meet it.
This month, Degrees is sharing stories from participants in SMARTgirl, an FHI 360-led program aimed at preventing and mitigating the impact of HIV among entertainment workers living in Cambodia. The program provides peer education and social support, and improves access to HIV and reproductive health services. SMARTgirl treats entertainment workers respectfully and celebrates their positive qualities. SMARTgirl is funded by the United States Agency for International Development (USAID).
Twenty-three-year-old Somany is a transgender entertainment worker who has HIV. Social stigma from the community and ostracism from her family leave Somany with a deep sense of loneliness and isolation. Speaking candidly to a SMARTgirl support group, she related how every day feels like a...Read More
Sopheap was born male but, at age 10, realized she identified as a girl. Because Sopheap’s parents feared other people’s responses, she wore boys’ clothing until age 17 “because I had to go to school and my parents didn’t like me wearing girls’ clothes.” Since then, Sopheap’s parents have...Read More
Sineng, 21, works in a beer hall in Phnom Penh, where her job is to serve and entertain men. Sometimes she sells sex to make extra money. In the last month, she was diagnosed with HIV. Sineng fears how the virus will affect her health, her relationships and her job. Afraid and timid, she stood...Read More
Twenty-six-year-old Nguyen's1 husband is a shoemaker, but his income of approximately 40 U.S. dollars a month is not enough to support them and their two children. To help make ends meet — including paying the monthly rent of 30 dollars on their one-room home — Nguyen supplements the household...Read More
World Bank releases World Development Report 2012
Want to know where women stand worldwide? This week the World Bank released its World Development Report 2012, which focuses on gender equality and development. The report finds that development has closed some gender gaps in educational enrollment, life expectancy, and labor force participation. However, gaps persist in girls’ schooling, access to economic opportunities and household decision-making. Further, “females are also more likely to die, relative to males, in many low-and middle-income countries than their counterparts in rich countries.”
What should be the priorities of policy makers interested in bringing about gender equality? What policy actions will result in the greatest benefit? Explore the report in the link above, or examine the issues by viewing a summary of the report here.
Challenges and opportunities for preventing HIV in women by using ARVs were highlighted at this FHI 360 forum.
PowerPoint: by Lori Heise
A Day of Promise, A Day of Reckoning: Making ARV-based prevention work for women
PowerPoint: by Elizabeth Tolley
Planning for PrEP with Women in Mind: Why targeting the “Most-at-Risk” is likely to miss Most Women at Risk
PowerPoint: by Nduku Kilonzo
Women and ARVs for HIV prevention: What do we need to think about?
PowerPoint: by Dazon Dixon Diallo
Social, Structural, and Historical Dimensions of Integrating ARV-Based HIV Prevention into the Lives of African-American and Other Minority Women in the United States
Watch the Webcast
This webcast was recorded on September 29, 2011 from 9:30am until 12:00pm.
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Executive Director, Structural Driver of HIV Research Consortium
Senior Lecturer, London School of Hygiene and Tropical Medicine Chair
Kathleen M. MacQueen
Senior Scientist, Behavioral & Social Sciences
Senior Advisor, Office of HIV/AIDS, Global Health Bureau
Timothy D. Mastro
Vice President, Health and Development Sciences
Opening and closing remarks
Kathleen M. MacQueen
PhD, Forum Chair
Senior Scientist, Behavioral & Social Sciences
Senior Scientist, Behavioral & Social Sciences
Liverpool VCT, Care and Treatment, Kenya
Dazon Dixon Diallo
Sisterlove, Inc., Atlanta, GA