Population Matters

Time to Make Child Marriage History

May 30th, 2013

Child marriage, a marriage where one or both of the parties are under the age of eighteen, is a violation of human rights, yet it happens every day around the world, across religions and cultures. The numbers are sobering, one in three girls in the developing world will be married before she turns eighteen and one in seven before she turns fifteen.  Everyday 13,000 girls under the age of fifteen are married, some as young as eight or nine. This translates into nearly five million girls under the age of fifteen being married every year. Experts predict that if the current trend continues by 2020 fifty million girls will be married before they turn fifteen. That means fifty million girls will be married against their will and have their childhoods cut short.

According to a new report by the Council on Foreign Relations, not only is child marriage a violation of human rights it also has major implications for U.S. foreign aid and policy. The report argues that “this tradition traps girls and their children in a cycle of poor health, illiteracy, poverty, and violence that has consequences for development, prosperity, and stability. As such, child marriage undermines U.S. aid investments and foreign policy objectives around the world.” The report argues that child marriage undermines U.S. interests and investments in four main areas: health, education, economic development, and stability.

The Obama administration has made global health, including maternal and child health and family planning a priority. Unfortunately investments in these areas are being undermined by the practice of child marriage. When girls marry young they are unable to negotiate safe sexual behaviors and are at an increased risk for HIV and other STIs, and are often unable to access contraception resulting in early childbearing. Bearing children at such an early age puts their lives in danger. Girls between the ages of fifteen to nineteen are twice as likely to die from a pregnancy-related cause as girls in their twenties, and girls under fifteen are five times more likely to die in childbirth. This leads to the shocking fact that complications from pregnancy and childbirth is the leading cause of death for girls between age fifteen and nineteen in the developing world. Not only is the mother’s health in danger; so is the child’s.  Stillbirths and infant mortality are fifty percent more likely when the mother is less than twenty years old.

Child marriage also undermines education and economic development. Girls’ education is one of the most important drivers of economic development. When girls stay in school they tend to marry later and have smaller, healthier families. However when girls are forced to marry early they are often pulled out of school limiting the girl’s economic potential. It perpetuates the cycle of poverty by keeping the girl illiterate and preventing her from competing in the job market later in life.

Finally, the report highlights how child marriage is undermining U.S. investments in health and stability. Girls who are married as child brides are more likely to experience domestic and sexual violence, and research suggests that violence against women and girls is correlated with civil strife and conflict.  Not surprisingly perhaps, child marriage is often prevalent in fragile states.

Looking at the way child marriage undercuts U.S. investments in health, education, economic development, and stability the Council on Foreign Relations report concludes that:

“In this time of austerity, policymakers should recognize that addressing child marriage is not only a moral imperative—it is also a cost-effective and strategic imperative to achieve the United States’ diplomatic and development goals. The reach and success of U.S. efforts to improve global health, bolster education, foster economic growth, and promote stability and the rule of law will grow stronger if this persistent practice comes to an end.”

It is time to speak out in defense of the five million girls under fifteen who will otherwise be married this year.  They should be allowed to be girls, not brides. It’s time to make child marriage history.

Posted by Jennie Wetter, Director of Public Policy

Women Deliver. How About Men?

May 24th, 2013

Next week in Kuala Lumpur thousands of people from around the world will gather for the third global Women Deliver conference (May 28-30).  The participants will include government leaders, policymakers, healthcare professionals, reporters, and nonprofit leaders.  Their goal, which is as urgent as it is worthy, is to promote the health, rights, and empowerment of girls and women.

Most of the participants will be women.  That’s not surprising:  Who else knows more about the crucial importance of empowering girls and women than women?  But it is disappointing.  And it is also a reflection of how far we still have to go in achieving full gender equality.

Around the world women are delivering…in every conceivable way.  In addition to delivering children, girls and women are doing more than their fair share to make the world a better place.  And they ‘deliver’ in many cases despite physical abuse and impossible odds.

What many, if not most, girls and women in the world do not have is a fair chance to succeed, and until they are better protected from sexual violence and coercion, they will never have that fair chance.

This week in Malaysia, where the conference is being held, a 40-year old man, who was recently charged with raping a 13-year old girl, told the court this week that he is now married to the girl. The Malaysian Attorney General and Malaysian Ministry of Women, Family and Community Development are urging that the man still be convicted of statutory rape.  It is unclear though whether the prosecutors will proceed with the case.

As shocking as this incident sounds to many of us, marriage by rape or abduction is still a prevalent practice in many developing countries, particularly in rural areas of South Asia and sub-Saharan Africa.  The defendant in the Malaysian case argued in his own defense that, “There are many cases of men marrying underage girls. I do not see why my case should be any different.”

That comment reflects the deeper problem. In some parts of Malaysia and in many parts of the developing world the idea that women should be subservient to men is still deeply engrained in culture and tradition.

The high-profile raping of girls in India has generated virulent protests in recent months and may force prosecutors in India to take rape cases more seriously, but it does not change the fact that child marriage is still prevalent in many parts of India and that girls in many areas do not receive the same schooling as boys.  Yes, the Indian parliament in March passed a more stringent law to guard women against sexual violence, but until India does more to elevate the status of girls, females will continue to suffer from inequitable treatment and high levels of sexual violence.

In the past decade the developing world has made significant progress in enrolling more girls in primary schools, but their enrollment in higher education continues to lag, in part because child marriage is still prevalent in many areas.  In male-dominated societies, where child marriage has been practiced for centuries, leaders often see little need to enforce laws against under-age marriage.  That must change, for whenever girls are deprived of schooling and women are denied their reproductive rights, everyone suffers…women and men.  Gender equality is a moral imperative, but it is also an economic and social imperative.  No country, no society, however industrious or blessed with resources it may be, will ever reach its full potential so long as women are denied theirs.

If you look closely at those countries where respect for girls and women is lowest, you will invariably  find high rates of maternal and infant mortality, hunger, poverty, illiteracy and disease.  That’s not coincidence.  When girls are denied schooling and women are denied access to family planning and reproductive health services, their families and their communities invariably suffer.  The world can—and does—spend an awful lot of time and resources treating the consequences of gender inequality, when it would be far more cost effective to tackle the underlying problem.

Empower girls and women and they will deliver.  That’s the message that the world will hear next week from Kuala Lumpur.  Let’s just hope the men of the world will be listening.

Posted by Robert J. Walker, president



Celebrating National Women’s Health Week

May 17th, 2013

This week is National Women’s Health Week and given the expanded coverage that is going into effect as a result of the Affordable Care Act there’s lot to celebrate this year.  Not everyone, however, is in a celebratory mood and many are downright unhappy with the expanded coverage.

The House of Representatives celebrated this week by voting for the 37th time to repeal the law.  Yes, that’s right:  the 37th time.  That raises the question, “What is so bad about Obamacare?”  The ACA, after all, has been a huge victory for women’s health.  Prior to the ACA insurance companies could charge women higher premiums than men just because they were women, and could deny women coverage for preexisting conditions like breast cancer or pregnancy.  But thanks to the ACA, they cannot do that any longer.  Today, because of the ACA, 45 million women and counting have received preventative care with no co-pay.

Under the regulations approved by the Department of Health and Human Services, preventative care includes well woman exams, pap smears, mammograms, and birth control.  So what’s wrong with that?  A lot apparently, particularly the part about access to contraceptives.  In the past two years, there has been a firestorm of protest from social conservatives who insist that birth control should not be classified as preventative care.  Excuse me?  By what screwed up logic is the prevention of pregnancy not a preventative measure?  Birth control is an essential part of women’s health care and having birth control available with no co-pay takes women’s health care decisions out of the hands of politicians and insurance companies, and puts the power where it belongs: with women.

On another controversial front, the U.S. Justice Department is celebrating by appealing a federal judge’s ruling that would make Plan B, the most popular form of emergency contraception, available for anyone without a prescription. After the judge’s ruling, the Department of Health and Human Services lowered the age at which a female could obtain emergency contraception without a prescription from 17 to 15. The judge, however, insists that the age restriction should be eliminated altogether, and the Administration is appealing the decision.

Is that how we should be celebrating National Women’s Health Week?  I don’t think so.  Emergency contraception reduces the risk of pregnancy after contraceptive failure or unprotected sex up to 120 hours after, but is most effective in the first 24 hours.  It is important, therefore, that women obtain access to emergency contraception in a timely manner.  The current restrictions can lead to confusion and human error, effectively denying many women access to emergency contraception, particularly young women and those without any government- issued identification.  By making emergency contraception available over the counter to all women regardless of age it would ensure that women have better access to emergency contraception.

When it comes to women’s health, there’s a lot to celebrate this year…but the battle over women’s health rages on. Too bad.

Posted by Jennie Wetter, Director of Public Policy

Politics, Pakistan and Population

May 1st, 2013

On May 11th, voters in Pakistan will go to the polls for one of the country’s most important elections in decades.  With many experts warning that Pakistan’s economy could be headed for collapse, two issues related to population have emerged.  The first is population growth.  Many observers warn that Pakistan’s population growth rate, which has increased in recent years, is economically unsustainable.  The second issue, and it is related, is the status of women.  A lack of gender equity is hindering female participation in the workforce and it is also contributing to stubbornly high birth rates.

Zubeida Mustafa, a two-time winner of our Global Media Awards, has written extensively on both topics.  She is a freelance journalist who writes a weekly column for Dawn, the paper with which she worked as an assistant editor from 1975 to 2008. Dawn is Pakistan’s most widely circulated and influential English language newspaper that was founded in 1947.

In addressing the issue of population as it relates to the upcoming election, she writes, “It doesn’t take rocket science to realise that a rapidly growing population strains the resources of a country and poses a serious hurdle in the way of development strategies.”

She notes, however, that:

There are parties which do not even see a link between a fast-growing population and the failure of the government to provide health and education facilities to the people. The demographic factor drags down economic growth and resource expansion. They are the Awami National Party (quite surprising given its people-centric approach), the Jamaat-i-Islami, the PML-Q and the Jamiat Ulema-i-Islam-Fazl. The last-mentioned party’s spokesman orally confirmed the party’s lack of commitment to population issues.

Mercifully, four major parties, the PPP, the PML-N, the Pakistan Tehreek-i-Insaf (PTI) and the Muttahida Qaumi Movement (MQM) are more progressive on the population question. The first three spell out categorically why an effective family planning programme is closely linked to the country’s development in the economic and social sectors….

The PPP and PTI are quite comprehensive in spelling out their strategy. The PTI promises to make the population welfare programme an integral part of the health policy and make quality education and modern contraceptive services available to women.

Mustafa, who has been a long-time champion of women’s rights in Pakistan, warns, however, that all the parties, as part of their population platform, need to make a clearer and stronger commitment to women’s rights, and not just for improved access to contraceptive services.  She writes that:

Some speak of educating women because educated women have fewer children on account of their better understanding of contraceptive choices. But that by itself does not change the gender priorities of parents who have a preference for sons. That will change only when women gain social acceptance and recognition.

Issues other than population will no doubt determine the final outcome of the upcoming elections, but the future of Pakistan will be determined in no small part by what future Pakistani governments do to improve contraceptive services and promote gender equity.  Let’s hope that the election results will point in the right direction.

Posted by Robert J. Walker, President