Population Matters

Mulling the Motherhood Mandate

October 29th, 2014

Of all the important decisions we make in our lives, questions about whether to have a child or not, or even when to have a child, have to be near the top of the list, and while that is true for men, it is certainly the case with women. Given the enormous personal stakes in childbearing, it is surprising that more women have not written a book about the pros and cons that go into making childbearing decisions.

The latest contribution to this field comes from Melanie Holmes, a mother with two grown sons and a 12-year-old daughter at home. Her book, The Female Assumption, seeks to free women “from the view that motherhood is a mandate.” The author makes it clear from the outset that she does not regret having three children, but she tells her readers that “females should be raised hearing that motherhood is only one option out of many paths that they might choose in order to live a full, happy life.”

For the vast majority of human history the ‘default’ choice for women has been to have a child, if not several children. And that’s been good on several levels, not the least of which is the survival of the human species. Looking back, if women on average had fewer than two children each, we would not be here today. Indeed, child mortality rates were so high for millennia that women, on average, had to have several children or population would have rapidly declined. Large family size, for much of human history, has been a biological imperative.

Today, however, with 7.2 billion of us on the planet and demographic projections indicating that world population will increase by another 2.4 billion by mid-century, humankind is in no danger of shuffling off its mortal coil and women with access to modern contraception can now space or limit their pregnancies, and can opt, if they so choose, to go childless. But despite their reproductive freedom many women in the world are still under a lot of pressure to have children.

In many developing countries a woman may have little voice in determining the size of her family, particularly if she was a child bride. But even in the United States women can be pressured into having children. Holmes writes that “girls are coached, almost from birth, to embrace motherhood,” and that “married women without children are often bombarded with questions.” In the course of writing her book, Holmes interviewed more than a hundred women with daughters, and she reports that 88 percent of them said that they “assumed” that their daughters would have children, though only 42 percent said they would actively encourage their daughters to have children.

In Chapter 4 of her book, Holmes lists seven “dirty little secrets” that mothers refrain from telling their daughters about raising children. In a subsequent chapter, she also writes about the many “joys” of motherhood, but she concludes that, once you opt for motherhood, life as you have known it “ceases to exist,” and that “you must forego many other choices that could be equally rewarding.” In reaching that conclusion, Holmes talked to dozens of women who chose not to have children, many of whom, including my wife, reported no regrets about their decision.

Holmes is not the first woman in recent years to publicly attack the “assumption” that women cannot lead fulfilling lives if they do not have children. A few years ago, Lisa Hymas, a senior editor at Grist, generated some debate within the environmental community when she criticized the pressure that family and friends often put upon young women to have children. In a strong defense of her decision not to have children, she coined the phrase, “green inclination, no kids” or GINK, for short.

What sets Holmes apart from some of the other “child-free” advocates is that she is a mother of three and still willing to defend women who opt not to have children. For obvious reasons, it is a bit of a tightrope act; Holmes does not regret the “three beautiful souls” who came into her life, but neither does she shrink from describing the downsides of motherhood. The result is a fresh and balanced perspective on the relative merits of having children versus not having children.

Holmes treats childbearing as a highly personal decision, which it most certainly is, but for some people, like me, decisions on childbearing can also include larger, non-personal considerations, such as the impact that ever growing human numbers are having on the planet. As a man who decided early on that he would prefer to not have any children, I do not question those who elect to have children, but by the same token I do not think parenthood should be entered into lightly. For all the reasons outlined in The Female Assumption and more, I believe that women — and men — should think carefully about one of the most momentous decisions they will ever make. If you are woman and you have not decided yet whether to have children, I urge you to read The Female Assumption.

This blog by Population Institute President Robert Walker originally ran on October 24, 2014 on The Huffington Post

Child Marriage Undermines Progress on the MDGs

October 10th, 2014

Every year 15 million girls are married before their 18th birthday. Today there are 700 million women alive who were married before their 18th birthday, and 1 in 3 of these women, about 250 million, were married before they turned 15. If we do not take urgent action to address child marriage now, by 2050 there will be 1.2 billion women in the world who will have been married before they turned 18. Tomorrow is the International Day of the Girl and it is imperative that we recommit ourselves to putting girls at the center of the development agenda. Eliminating child marriage will help us to succeed on 6 of the 8 Millennium Development Goals (MDGs).

 
MDG 1 Eradicate Extreme Poverty and Hunger
Poverty is both a cause and an effect of child marriage. Girls from poor households are nearly two times more likely to marry before they are 18 years of age than other girls. Once these girls are married they are often trapped in poverty because they are pulled out of school. Unable to complete their education, these girls will have limited economic opportunities and are more likely to remain poor.

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MDG 2 Achieve Universal Primary Education
When girls get married they are often removed from school, which will limit their ability to lift their families out of poverty. Education is also one of the best tools to help girls avoid child marriage. Girls who have secondary schooling are up to 6 times less likely to be child brides than girls who have little or no education.

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MDG 3 Promote Gender Equality and Empower Women
Child marriage disempowers girls. It not only prevents them from completing their education; it generally means that they will have little choice or control over whom they will marry. Child brides are effectively denied gender equality, and are more likely to experience physical, sexual and psychological violence. Child marriage, in fact, may be the single biggest obstacle to achieving MDG 3.

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MDG 4 & 5 Reduce Child Mortality and Improve Maternal Health
Child brides are often encouraged, or even forced, to have a child before they are physically or emotionally ready to become mothers. This has a devastating effect on the health of child brides. Girls under 15 are 5 times more likely to die in childbirth than women in their twenties. Child marriage, in fact, is one of the biggest impediments to reducing maternal mortality and achieving MDG 5. When a mother is under 20, her child is 50 percent more likely to die within its first weeks of life than a baby born to a mother in her 20s, undermining progress on MDG 4 (reducing child mortality).

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MDG 6 Combat HIV/AIDS, Malaria, and other Diseases
When girls marry young they do not have the power or knowledge to negotiate safe sexual behavior, and are therefore more vulnerable to contracting HIV/AIDS and other STIs.

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These are just a few of the reasons why ending child marriage must be part of the post-2015 development agenda. If we do not end child marriage, it will undermine progress on many of the other development goals. So this International Day of the Girl let us raise our voices and speak out to prevent another 15 million girls from becoming child brides next year.

 
Posted by Jennie Wetter, Director of Public Policy

Contraception: Saving Lives… and the Planet

September 29th, 2014

On Friday, September 26, the world is celebrating World Contraception Day. Okay, ‘celebrating’ may be too strong a word. ‘Observing’ may be more like it. And the number of people actually observing the day in some form is probably small. Okay, very small. To borrow a phrase from Lincoln’s Gettysburg Address, the world “will little note, nor long remember” World Contraception Day 2014. That’s too bad. For in truth, there’s a whole lot to celebrate, and a whole lot more left to do if men and women everywhere are going to have access to the contraceptive method of their choice.

The obvious reason for celebrating modern contraceptives is that they allow us to have children by choice, rather than by chance. They minimize, in other words, the chances of an unintended or unwanted pregnancy. That mere fact itself is worth a celebratory cheer, but there is a lot more to get excited about.

Contraception is a life-saver.

Contraception saves lives
, particularly in developing nations where access to contraception can mean the difference between life and death for girls and women who do not have access to adequate medical care. This is particularly true for child brides who are not physically mature enough to give birth, but pregnancy is a significant health risk for women of any age who are unable to space their pregnancies more than 18 months apart.

In the United States, very few women die from pregnancy-related causes, but in some rural parts of Africa, women have a 1 in 30 lifetime chance of dying as a result of a pregnancy. Of the 800 women in the world who die every day from pregnancy-related causes, the vast majority are in the developing world.

There are an estimated 222 million women in the developing world who want to avoid getting pregnant, but who are not currently using a modern method of contraception. The Guttmacher Institute estimates that meeting this ‘unmet need’ for family planning, would save the lives of 79,000 women each year by allowing these women to delay motherhood, space births, and avoid unwanted pregnancies.

Increasing contraceptive use in the developing world would also reduce the number of infant deaths. Closely spaced pregnancies are associated with an increased risk of low birth weight, preterm birth, and other health risks for infants. Birth spacing also gives mothers more time to breastfeed, improving infant health and nutrition. Guttmacher estimates that expanding contraceptive use could prevent 1.1 million infant deaths every year.

One contraceptive method in particular, the condom, plays a crucial role worldwide in reducing the transmission of HIV and other sexually transmitted diseases. The World Health Organization emphasizes that the “Consistent and correct use of condoms, male or female, is critical for prevention of HIV transmission to non-infected sexual partners.”

In countries with rapidly growing population, increased contraceptive usage helps to relieve the pressure on overloaded health care delivery systems, freeing up resources for the treatment of malaria, tuberculosis, and other deadly diseases. In countries already struggling with hunger and malnutrition, increased contraceptive use can improve food security by lowering population growth rates. Current population projections indicate that Niger, which ranks very high on the Global Hunger Index, could nearly quadruple its population in the next 40 years. Without a reduction in fertility rates, it is hard to imagine how Niger could ever hope to adequately feed its population.

While contraception is saving lives, it is also saving the planet.

Contraception is helping to save the planet from the harm that humanity is doing to the climate, the oceans, and the survival of endangered species. Thanks to expanded use of contraception, fertility rates continue to fall, but world population, currently 7.2 billion, is still expected to reach 9.6 by mid-century and 11 billion by the end of the century. Scientists are warning that our consumption of material resources, driven by rising population and higher standards of living, is threating to breach “planetary boundaries,” causing irreparable harm to the environment and threatening the well-being of future generations.

Humanity is already over-consuming water and other vital resources. The Global Footprint Network warns that by 2030 we will need two Earths to meet our demand for renewable resources. Lakes and rivers in many areas are shrinking and wells are going dry. Arable land is in short supply, topsoil is eroding, and deserts are expanding.

Our over-consumption of fossil fuels is altering the climate and the chemistry of the oceans. As emissions increase, temperatures and seas are gradually rising, while drought and flooding are intensifying. Dead zones are forming in the oceans, coral reefs are being destroyed, and the ocean ‘harvest’ is gradually declining from its historical peak.

And it’s not just humans that are endangered. Scientists are warning that human activity is triggering a “sixth mass extinction. Many of the world’s most beloved animal species– including elephants, lions, tigers, rhinos, and polar bears–could face virtual extinction in the wild, long before this century ends.

There’s more to be done.

Contraception is helping to save both lives and the planet, but there is so much more that needs to be done: About 40 percent of pregnancies worldwide are unintended, including about 50 percent of pregnancies here in the United States. We desperately need to improve contraceptive options for people around the world, particularly for adolescents and young adults. We need to expand the availability of IUDs and ‘injectable’ contraceptives that more effectively prevent unplanned pregnancies. We also need to eliminate the cultural and informational barriers that effectively prevent girls and women in developing countries from using contraceptives. Child marriage practices, in particular, should be abandoned, and we need to invest more resources in educating girls and providing women with better economic opportunities.

World Contraception Day is more than a celebration: It’s a call to action.

Posted by Robert Walker, President

This was originally posted on the Huffington Post on September 25, 2014

World Population Day: How Are We Doing?

July 11th, 2014

Twenty-five years ago, the United Nations Development Programme declared July 11 to be World Population Day. Much has changed in the past quarter century. Significant progress has been made, but many challenges remain. More women than ever are able to decide freely how many children to have and when, but many women in the world still lack access to modern methods of contraceptives, and gender inequality in the developing world prevents many girls and women from exercising their reproductive freedom. As a result, global fertility rates have fallen, but not as fast as once expected. Without access to reproductive services, maternal and infant mortality remain unacceptably high, and the challenges posed by a growing world population continue to mount.

Every woman in the world should be able to decide, free from any coercion, when to have children and how many children to have. As part of the Millennium Development Goals (MDGs), the UN set 2015 as the target year for achieving universal access to family planning and reproductive health services, but that target will not be met. Twenty-five years after the first World Population Day, the international community needs to recommit itself to empowering women and girls and ensuring that they have access to reproductive health services. Here’s why:

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Population is still growing. Twenty-five years ago, world population stood at 5.2 billion. Today, it’s 7.2 billion, and if global fertility rates were to remain unchanged, world population would soar to an unsustainable 27 billion by the end of the century. In 1989, women on average had 3.3 children in their lives; today they have 2.5 children. Fortunately, demographers are generally agreed that fertility rates will continue to fall, and if they fall as fast as currently projected world population will reach 9.6 billion by 2050 and nearly 11 billion by the end of the century. Even that projected growth path, however, has its perils.

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The Global Footprint Network estimates that we are already overusing planetary resources. In terms of renewable resources and the Earth’s capacity to absorb carbon, toxic chemicals and other forms of pollution, we will need two Earth’s by 2030 to sustain us for the long haul. Our current growth path is unsustainable. The warning signs are all around us, as rivers and lakes shrink, water tables fall, carbon emissions rise, deserts expand, forests shrink, and fisheries collapse.

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Current trends would suggest that we are on our way to becoming a “single-specie” planet. We have already using about half of the world’s land surface to grow our crops, raise livestock, construct our roads, and build our towns and cities. To grow our crops, we are using a land area about the size of South America, and to raise cattle and farm animals we have cleared an area greater than the continent of Africa. There is still land available, but what’s left, for the most part, consists of mountains, tundra, deserts, and lands of marginal utility. If we need more arable land, and it appears we do, we must chop down more forests, including tropical forests.

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Our claims upon the planet are having a devastating toll on all the other species that call this planet home. Scientists are warning that we are triggering the “Sixth Mass Extinction,” the great extinction, perhaps, since the dinosaurs were extinguished 65 million years ago. Rates of species extinction are currently about 1000 times higher than the natural rate.

Preventing unplanned pregnancies is in everybody’s best interests. In the developed world, where you and I are consuming a highly disproportionate share of the world’s resources, preventing unplanned pregnancies will help to reduce carbon emissions and slow the headlong depletion of the world’s limited resources. In the developing world, where fertility rates are still very high, family planning services are desperately needed to reduce maternal and infant mortality, fight poverty, end hunger, reduce gender inequality, and, in many areas, mitigate water scarcity and deforestation.

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The United Nations estimates that there are 222 million women in the developing world who want to avoid a pregnancy, but who are not using a modern method of birth control. Meeting that contraceptive need would cost only $3.5 billion a year. By any global standard that’s a tiny investment of money, but it’s one that would pay enormous dividends in terms of improving the health and well-being of families. But in addition to expanding access to contraceptive options, we also need to empower girls and women.

Child marriage, in particular, needs to end. It’s a violation of human rights that imperils the health and wellbeing of girls, and one that serves to perpetuate the cycle of poverty and hunger in desperately poor countries.

Today, as in 1989, we need to recommit ourselves to a healthier and more sustainable world, and that begins by promoting gender equality and providing universal access to family planning and reproductive health services. It’s not just a moral imperative, it’s a global imperative, and that’s why the Population Institute has launched a population education campaign that features a brand new series of graphics and factoids that can be shared with your family and friends. Click here for more information.

Posted by Robert Walker, President

This was originally posted on the Huffington Post on July 10, 2014

The Supreme Court thinks it is 1964, not 2014

July 1st, 2014

In 1965 the Supreme Court ruled in Griswold v. Connecticut that married women could legally use birth control. Yesterday, 49 years later, the Supreme Court ruled that your boss’ religious views could trump your own beliefs and prevent you from accessing affordable contraception. It is nearly impossible for me to wrap my head around the idea that in 2014 women are still fighting for the right to access affordable contraception.

Contraception is basic health care for women. Not only does birth control allow women to plan when and if they get pregnant, thus preventing unintended pregnancies and reducing the need for abortion, it is treatment for a number of medical conditions. According to the Guttmacher Institute 62% of all women of reproductive age are currently using a method of contraception and 99% of women of reproductive age who have ever had sex have used a method of contraception.

When the Institute of Medicine was making its recommendations for what should be classified as preventative services, and thus available without a co-pay, it recognized that cost can be a barrier. This is particularly true with the IUD, which is the one of the most effective types of birth control, but not widely used in the United States for a number of reasons, cost among them. However, research has shown that when cost and lack of information are not a consideration women are much more likely to use a more effective method like an IUD or implant.

By allowing bosses to impose their religious beliefs on their employees fewer women will consistently use birth control and fewer will choose the most effective method, a concern that was raised in Justice Ginsburg’s dissent.

“It bears note…that the cost of an IUD is nearly equivalent to a month’s full time pay for workers earning the minimum wage…Working for Hobby Lobby…should not deprive employees of the preventative care available to workers at the shop next door.”—Justice Ginsburg

Unfortunately for any woman affected by yesterday’s decision, there will now be one more person in the doctor’s room with her when she chooses a contraceptive method… her boss.

Posted by Jennie Wetter, Director of Public Policy

Hobby Lobby: The Day After

July 1st, 2014

In the 24 hours since the Supreme Court handed down its decision in the Hobby Lobby case, volumes have been written about the outcome of the case, but one of the best analyses that I have seen was written by Richard Cizik before the decision came down. Cizik, an evangelical leader of long standing, argued in a blog written for the Huffington Post that a victory for Hobby Lobby would be, in reality, a loss for all those “pro-life” Christians who are opposed to abortion. As Cizik duly notes, contraceptive coverage without a co-pay prevents abortion by preventing the unwanted pregnancies that lead women to terminate pregnancies. Cizik, citing medical opinion, rejects the argument made by Hobby Lobby that some of the contraceptive methods being funded by the Affordable Care Act are abortifacients.

 
Cizik also believes that Monday’s Supreme Court decision will turn out, in the end, to be a loss for religious freedom. Whether or not it turns out to be a loss for freedom of religion, it certainly is a loss for women who need and who will now lose contraceptive coverage as a result of the decision. The Supreme Court has joined social conservatives in chipping away at the reproductive health and freedom of women in this country. Shame on the court.

 
I urge our readers to read Cizik’s blog and join with the thousands who have given it a “like” on Facebook.

 
Posted by Robert Walker, president of the Population Institute

 
If Hobby Lobby Wins, Pro-life Christians Lose
Posted: 06/27/2014 9:25 pm

 
We now know with certainty that the Supreme Court will announce its Hobby Lobby decision on Monday. This weekend, the craft and home décor store, along with numerous evangelical institutions that have filed briefs in its support -including my former employer the National Association of Evangelicals–are hoping and praying God will favor them with a whole new expansion of religious freedom and the protection of human life. I’m praying for the opposite.

 
Along with nearly 50 other for-profit corporations, Hobby Lobby is demanding the same religious freedoms and protections that each of us has. Hobby Lobby was not endowed by its Creator with certain unalienable rights. It does not have a soul. It cannot have faith. Yet its owners (and their lawyers) insist that it should not have to comply with the contraceptive coverage requirement in the Affordable Care Act on religious grounds. The Obama Administration reasonably granted an opt-out to houses of worship and other religious nonprofits. Hobby Lobby wants similar treatment.

 
Evangelical intervention on behalf of the multi-billion dollar corporation, which donates generously to their causes, is wrong for many reasons but here are two major ones: If you are pro-religious liberty and pro-life and family, you can’t support allowing a for-profit corporation to use religion to deny contraceptive coverage.

 
First, supporters of Hobby Lobby think they are helping the Christian faith but are actually harming it. In fact, a ruling in favor of Hobby Lobby weakens religious freedom.

 
When anyone can use religion to claim an exemption on anything, religion loses meaning. Rather than a personal belief embedded in our souls, faith would become a set of arbitrary rules any corporation could choose from to skirt the law.

 
Is this what evangelicalism needs? I spent nearly three decades in governmental relations at the National Association of Evangelicals defending the free-exercise of religion and the right to life, among many other traditional values. Coming to the aid of for-profit corporations who want to ride on the backs of religion is not one of these honored principles.

 
Indeed, it is a kind of corporatism invading the body of Christ — concern not for the “least of these” but the richest of those among us. Is this what Christ would do?

 
When corporations are allowed the same exemptions that have always been reserved just for churches–whether on health benefits, hiring, or land use–those special protections become less clear and more open for interpretation.

 
If a for-profit corporation is eligible for legal exemptions on grounds of religious freedom, it puts government in charge of deciding what is or isn’t religion. You can just imagine the lawyers who will find work forever litigating these claims. I know, from experience, that their concern for what should be “legal” is not the same as what is “spiritual” or truly serves the interests of the Church.

 
What if a corporation owned by Jehovah Witnesses refuses to cover blood transfusions? If Christian corporations are allowed to use faith to refuse contraception coverage to women who work for them, what’s to stop a Christian Scientist business from refusing to cover any health benefits?

 
Second, the supporters of Hobby Lobby think they are being “pro-life.” They are wrong. A massive study conducted in 2012 showed that contraception coverage without a co-pay could dramatically reduce the abortion rate.

 
That study, conducted by the Washington University School of Medicine, of 10,000 women at-risk for unintended pregnancy found that when given their choice of birth control methods, counseled about their effectiveness, risks, and benefits, with all methods provided at no cost, about 75 percent of women in the study chose the most effective methods: IUDs or implants. Most importantly, as a result, annual abortion rates among study participants dropped up to 80 percent below the national abortion rate.

 
Well, you might ask, based upon some of the charges being made, aren’t the contraceptive methods being funded through the Affordable Care Act, abortifacients? Not if you believe medical science.

 
In the words of Jeffrey F. Peipert, M.D., Ph.D., the Robert J. Terry Professor of Obstetrics & Gynecology at Washington University School of Medicine, “these contraceptive methods work by preventing pregnancy (fertilization) from occurring in the first place. For instance, the intrauterine device works primarily by preventing fertilization. Plan B (or the progestin-containing, morning-after pill), along with Ella (ulipristal acetate), delay the release of a woman’s egg from her ovary. The egg does not get fertilized, which means the woman does not become pregnant.”

 
In sum, Evangelicals supporting Hobby Lobby at the Supreme Court are not actually being pro-religious freedom or pro-life. If they win at the Supreme Court, these causes will be damaged in the long run.

 
Richard Cizik is President of the New Evangelical Partnership for the Common Good. Previously, he was Vice President for Governmental Affairs of the National Association of Evangelicals, an organization he served for 28 years.

Fragile States/Fragile Families

June 29th, 2014

What do Afghanistan, Iraq, Yemen, Somalia and South Sudan all have in common? Plenty.

In Washington DC, a city consumed by headline stories, Foreign Policy magazine and the Fund for Peace this past week teamed up to give an in-depth look at the stories behind all the conflicts and civil wars. The 2014 Fragile States Index (FSI), previously called the Failed States Index, gives an insider’s look at the factors contributing to political and social breakdown.

Behind every country that erupts into civil war, falls victim to famine or flubs in respond to a natural disaster is a government that has failed to protect its citizens. Such failures rarely arise overnight. They give plenty of warning signs, and the FSI identifies and analyzes them in hopes of strengthening these “fragile” states, preventing humanitarian disasters and building a country’s resilience in the face of conflict, climate change and other threats.

Governments can “fail” in numerous respects. They can fuel ethnic division, perpetuate corruption and economic inequality, abuse human rights, neglect basic services or squander human capital. And when they do, their countries become “fragile,” meaning they become far more susceptible to conflict, civil war, drought and other humanitarian disasters.

It’s important to note that the governments of these fragile states are often struggling against impossible odds to meet the needs of their citizens. While some governments are victims of their own ineptitude or corruption, others face major external threats like climate change or regional conflict.

In this year’s FSI rankings, South Sudan replaced Somalia in the top spot, after the fledgling government failed to calm the ethnic tensions that are undermining progress and national unity. The Central African Republic, which now teeters on the brink of genocidal conflict, was bumped up to third place in the FSI rankings. Somalia, Democratic Republic of Congo (DRC), Sudan, Chad, Afghanistan, Yemen, Haiti and Pakistan rounded out the top ten.

There are many factors that distinguish these “fragile” states from one another, but almost without exception they are all struggling to cope with rapid population growth. Rapid population growth can overwhelm a government’s ability to tackle chronic hunger, severe poverty, environmental degradation, political unrest and the depletion of water, forests and other resources.

Sixteen of the countries that top this year’s Fragile States Index have populations that are projected to double in size over the next 35 years. Chad, which ranked 6th, is on course to trip its population by 2050, while Niger, which tied for 19th on the FSI, could nearly quadruple its population. And these projections assume that fertility rates in these countries will continue to decline.

What makes population growth so challenging for fragile countries is that many of them are already on the front lines of poverty, hunger and malnutrition. The International Food Policy Research Institute (IFPRI) publishes a Global Hunger Index. Of the top 20 countries on that list, 15 will double their population in the next 35 years. Four of the remaining five, are projected to increase their population by 60 percent or more. The UN Development Programme (UNDP) publishes a Multidimensional Poverty Index. Eighteen of the top 20 poorest countries will likely double their population in the next 35 years. The other two will increase their populations by 50 percent or more.

Some of the world’s most fragile states — including Yemen, Pakistan, Afghanistan and Jordan — consume 80 percent of more their renewable water resources every year, and yet their populations are projected to increase by 80 percent of more by 2050. No one knows how these countries will meet the anticipated demand for water resources.

The best way to make “fragile” countries stronger and more resilient is to strengthen the family unit. When girls are better educated, women economically empowered and when girls and women are able to space or limit their pregnancies without male or religious coercion, the family is strengthened. Maternal and infant mortality decline. Nutrition and food security improve. Children are better educated and parents are able to devote more resources to improving the family’s income, whether it is buying a new sewing machine or more fertilizer for the crops. Smaller, better educated families are also better able to meet the challenges posed by conflict or natural disaster.

The FSI is a crucial start, but it’s time for a much larger debate about fragile countries and what can be done to strengthen them. Fragile states rarely receive the assistance they need until they become humanitarian disasters. If made in time, small investments — including investments in family planning and gender equality — can pay big dividends.

Posted by Robert Walker, President

This was originally posted on the Huffington Post on June 28, 2014

As the World Bank Turns

June 26th, 2014

Something exciting, almost revolutionary, is happening at one of the most conservative of the world’s international institutions. The World Bank, which for decades has been criticized has overly focused on the construction of dams and other infrastructures as the cure for poverty, is turning its focus to the real engine of economic progress in the developing world: girls and women.

The shift from physical capital to human capital has been in the works for several years, but it has accelerated under the leadership of Jim Yong Kim, who became the Bank’s president on July 1, 2012. Kim, an anthropologist by training, understands that gender inequality is one of the biggest obstacles, if not the biggest, to improving economic conditions in the world’s poorest countries.

Two years ago, prior to Kim’s appointment, the World Bank’s annual “World Development Report” focused on the promotion of gender equality, describing it as “smart economics,” but doubts remained as to whether the Bank was really changing its bricks and mortar orientation. The jury is still out, but the Bank’s new concentration on girls and women is gaining critical momentum. And the World Bank Group’s Gender and Development team, led by Jeni Klugman, appears to the leading the charge.

Last month, the team released a new report titled, “Voice and Agency: Empowering women and girls for shared prosperity.” The report argues, and persuasively so, that investing in gender equality will “yield broad development dividends.” Gender equality requires, at a minimum, that women have “voice.” By voice, the Bank means “having the capacity to speak up and be heard and being present to shape and share in discussions, discourse, and decisions.”

But voice alone is not enough. Women also require “agency,” which the Bank describes as, “the capacity to make decisions about one’s own life and act on them to achieve a desired outcome, free of violence, retribution, or fear.”

While full gender equality requires “agency” at all levels, it’s particularly true with respect to childbearing. But girls and women in many of the world’s least developed countries have very little “agency” with respect to spacing and limiting their pregnancies. In many male-dominated societies, men, not women, effectively make the childbearing decisions, particularly in rural areas where child marriage practices are still prevalent.

While the United Nations recognizes reproductive freedom as a basic human right, child brides have a hard time exercising that right. In Yemen, Afghanistan and other countries where old tribal traditions still prevail, it is not uncommon for a girl to be married off before reaching puberty. And not infrequently, the husband can be 20 or 30 years older than the girl bride. In such cases, girls have little or no “agency” in determining when they will have a child.

If women in developing countries are to exercise “agency,” social norms with respect to child marriage, the education of girls, female ownership of property, and desired family size must change. The Bank takes that challenge seriously. Kim insists that “norms can and do change,” and the Bank’s report outlines a number of strategies for changing social norms, putting particular emphasis on the role that “information and communication technologies can play in amplifying women’s voices.”

That is the correct approach. In many parts of the world today, “social content” soap operas are providing positive role models for girls and women and, just as importantly, helping to change the attitudes and behaviors of boys and men towards girls and women. By showcasing what girls and women are capable of in the workforce, and addressing socially harmful practices, like child marriage and female genital cutting, radio soap operas and other entertainment media can change public perceptions as to what is normal and beneficial, and what is not.

Social norms urgently need to change with respect to gender violence. So long as boys and men believe that it is acceptable to inflict sexual violence on girls and young women, very little — if any — progress will be made with respect to reproductive choice and the economic empowerment of women.

If social norms can be changed, and if the World Bank takes a leading role in helping to make that possible, the goal of eliminating severe poverty and hunger in the world may yet be realized. When girls receive the same education as boys, the productivity of the country’s workforce takes a giant leap forward. When girls and women are able to decide — free from male dictates or coercion — the spacing and number of their children, they generally choose to have smaller families. With family planning, maternal and infant mortality decline, child nutrition improves, educational attainment levels rise, and the stage is set for rapid economic advancement. The “demographic dividend,” as economists and demographers describe it, is a time-tested development strategy that contributed to the economic breakthroughs achieved by the emerging economies of Asia and Latin America.

There will always be a need and a role for economic infrastructure improvements, but unless the World Bank and the broader international donor community realize the “human capital” potential of girls and women, the economic potential of many developing countries will remain untapped.

The realization of “voice and agency” for girls and women is not just a moral imperative, it’s an economic one, and the World Bank, it appears, is taking that imperative seriously.

Posted by Robert Walker, President

Originally posted on the Huffington Post on June 25, 2014

Every Two Minutes

May 9th, 2014

This week the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF), the United Nations Population Fund (UNFPA), the World Bank and the UN released a report with the maternal mortality numbers for 2013. The good news is that maternal deaths are down 45% since 1990, dropping from 523,000 in 1990 to an estimated 289,000 in 2013. Even with the decline, however, a woman dies every two minutes due to complications from pregnancy or childbirth, mostly from preventable causes.

There are large disparities in maternal deaths between countries and regions, with 99 percent of maternal deaths taking place in the developing world. Sixty percent of all maternal deaths occur in just 10 countries: India, Nigeria, the Democratic Republic of the Congo, Ethiopia, Indonesia, Pakistan, Tanzania, Kenya, China, and Uganda. The riskiest region in the world to give birth is sub-Saharan Africa. Chad and Somalia have the highest lifetime risk of maternal death due to pregnancy or childbirth-related cause: in Chad a woman has a 1 in 15 lifetime risk and in Somalia a woman has 1 in 18 lifetime risk.

 
Eleven countries that had high maternal mortality in 1990 reached their MDG target of reducing maternal mortality by 75 percent. Those countries are Bhutan, Cambodia, Cabo Verde, Equatorial Guinea, Eritrea, Laos, Maldives, Nepal, Romania, Rwanda, and Timor-Leste. While many countries are not on track to meet their MDG target, since 2003 the maternal mortality rate has increased in only eight countries.

 
Unfortunately the United States is one of those eight countries, along with Afghanistan, Belize, El Salvador, Guinea-Bissau, Greece, Seychelles, and South Sudan. In 2013 18.5 women died per 100,000 births in the United States, whereas in 1990 the number was 12.4.

 
The best news is that we know what needs to be done to save more lives. We need to ensure that girls are allowed to stay in school and be girls, not brides. Right now 15 million girls aged 15-19 give birth every year, and there is a much higher risk of death and injury associated with adolescent pregnancy. Next, we need to ensure that young people are given comprehensive sex education, that more skilled birth attendants are trained, and that they have access to the equipment and medicine needed for a safe delivery. With abortion complications accounting for eight percent of maternal deaths, women also need to be able to access safe abortion care. Finally women and girls need access to family planning services. Right now there are 222 million women in the world who would like to avoid a pregnancy, but are not using modern contraception. If their need for family planning services and information were met it would prevent 79,000 maternal deaths.

 
This Mother’s day I will be joining the world in celebrating our mothers, and I will be thanking my mom, in particular, for always being there for me and teaching me the importance of giving back. But I will also be thinking of the 800 women who will die on Mother’s Day from complications related to pregnancy or childbirth, and how those many of those lives could have been saved.

 
Posted by Jennie Wetter, Director of Public Policy

Teen Pregnancy Rate Reaches Historic Low

May 6th, 2014

Happy Teen Pregnancy Prevention Month! The month kicks off with great news from the Guttmacher Institute: the teen pregnancy rate has continued to drop, reaching a historic low in 2010, the most recent year for which data are available. The Guttmacher Institute’s new report indicates that the teen pregnancy rate has fallen in every state and among all racial and ethnic groups, and at the same time the teen birth and abortion rates have continued to drop as well.

The teen pregnancy numbers for 2010 show that the teen pregnancy rate has dropped 51% from the high in 1990 and by 15% from 2008, with 18-19 year olds making up the majority (69%) of the teen pregnancies. Along with the decline in the teen pregnancy rate, the teen birthrate has also fallen 44% from the peak in 1991 and the teen abortion rate has dropped 66% from the peak in 1988.

 
While the teen pregnancy rate dropped in all 50 states between 2008 and 2010, there still are significant differences between the states. The states with the highest teen pregnancy rates were in order: New Mexico, Mississippi, Texas, Arkansas, Louisiana, and Oklahoma. The rates were the lowest in New Hampshire, Vermont, Minnesota, Massachusetts, and Maine.

 
The study also showed that between 2008 and 2010 a greater proportion of 18-19 year olds reported having sex, but fewer teens were becoming pregnant. The finding suggests that teens are increasing their use of contraceptives and that they are now using more effective methods of contraception.

 
While progress is being made, the U.S. still has a long way to go. According to the Guttmacher Institute “teens in the United States and Europe have similar levels of sexual activity. However, European teens are more likely than U.S. teens to use contraceptives generally and to use the most effective methods; they therefore have substantially lower pregnancy rates.”

 
The report also shows the importance of providing teens with comprehensive sex education and easier access to an effective means of contraception. Unfortunately, as was seen in our 50 State Report Card many states continue to rely on unproven “abstinence-only” education programs.

 
Posted by Jennie Wetter, Director of Public Policy

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