Experts Call on Obama to Recommit U.S. Funds to Family Planning and Reproductive Health Programmes

From 1978 through 2006, Joseph Speidel, Steven Sinding, Duff Gillespie, Elizabeth Macquire and Margaret Neuse successively directed the U.S. Agency for International Development's (USAID) Population and Reproductive Health program. These five development experts recently issued a report entitled Making the Case for U.S. International Family Planning Assistance, urging President Obama to double U.S. Investments in USAID programmes.

USAID was established in 1961 by President John F. Kennedy, and since then has implemented reproductive health programmes in 50 countries. The programme’s funding peaked in 1995, and has continuously declined thereafter. The five said that this may have resulted from the (mistaken) belief that rapid global population growth has halted; from diversion of resources to other needs. . . and from lack of understanding that family planning is not only essential for women's health, but also a critical part of any successful development strategy." In actuality, donor funds for family planning programmes are more crucial now than ever before as countries around the world work to achieve major progress in the arena of sexual and reproductive health in order to meet approaching international deadlines.

The five development experts suggested that President Obama should move quickly to meet the growing demand for planning services worldwide if the goals of the ICPD and Millennium Development Goals are to be reached. U.S. investment in contraceptive supply and reproductive health programmes run by USAID should be doubled, and the United States should recommit itself as a world leader in family planning. With a new administration and Congress in session, the experts urged a reversal in former funding policies that did not meet the demand for women's reproductive health services, and suggested an increase to $1.2 billion for USAID's population budget by 2010. A future increase to $1.5 billion in 2014 was also predicted, taking into account their imminent plans to expand their work into 17 additional countries with unmet family planning needs. The continuous decline in family planning and reproductive health funding has forced many successful programs to remain stagnant or close. The global fertility decline has slowed and the number of women dying from pregnancy-related complications is unacceptable. The U.S. should take the lead in re-establishing appropriate funding to programmes such as USAID, setting the example for countries worldwide to realize the importance of family planning, and commit themselves to effective programmes.

The report discusses the global unmet need for family planning, family planning as a global success story, family planning as a declining priority, USAID as an effective and capable agency, and the request for more funds. Examples of countries excelling in the fields of family planning and reproductive health are also examined throughout the report, and should be looked to as a resource for South-South cooperation.

The entire report can be found online at http://www.prb.org/pdf09/makingthecase.pdf

An audio clip of the press conference for USAID can be heard at http://www.ccmcfiles.org/population/making_the_case/making_the_case_audio_call_4_21_09.mp3

To read more about what President Obama has accomplished in his first 100 days, regarding women's health, check out http://www.planetwire.org/details/7969

Waiting Houses in Mozambique Aim to Decrease Maternal Mortality

Waiting houses, or Casas de Espera, as they are referred to in Mozambique, allow at-risk pregnant women to reside in a home near the local hospital in order to provide immediate care when labor begins. As many of Mozambique's citizens live in rural areas, far from a reliable hospital, these waiting houses are crucial to prevent pregnancy related complications and maternal death from occurring. The Mozambique government has recently decided to revamp its waiting house programme in order to combat maternal mortality and progress toward achieving MDG5.

At the African First Ladies Health Summit last week Maria de Luz Guebuza, the First Lady of Mozambique, explained how 75% of Mozambique's 128 districts now have waiting houses for mothers-to-be. By providing such accommodations, pregnant women are able to travel before their labor begins and remain in the vicinity of well trained professional health care workers, should a complication arise. Women in the community at risk for complicated deliveries, such as pre-eclampsia, history of cesarean section or severe bleeding, malpresentation, or cases of multiple births, are often advised to travel to a casas de espera anywhere from 2 to 4 weeks before their pregnancy. Once there, the women are often able to learn from midwifes on pregnancy-related topics such as development of the fetus, labour and delivery, breast-feeding, immunization and family planning. In some cases the women use their spare time to make crafts and dresses, in order to sell their products to the local community and generate funds for maintenance. Since most of these houses are free of charge, any extra revenue is especially helpful in maintaining the facilities.

Mozambique is not alone in providing such waiting houses. Many other countries throughout Africa and Asia have instituted similar programmes and are moving toward achieving MDG5. In 1987, a study was conducted in Zimbabwe that found that women who stayed in these antenatal accommodations experienced better pregnancy outcomes than those women who entered the hospital directly from the community. Since then, improvements have been made and the effectiveness of such a program is remarkable. In addition to maternal mortality decreasing, infant survival rates are also being positively affected.

It is crucial that governments provide funding for such initiatives and that South-South cooperation continues to be emphasized at international conferences, such as the African First Ladies Health Summit. By sharing the effectiveness of such a program with other regional leaders and policy makers, it is PPD's hope that maternal mortality can be significantly reduced in the next few years.

You can read about other country case studies at http://who.int/reproductive-health/publications/MSM_96_21/MSM_96_21.chap4.en.html

African First Ladies Health Summit Meets in Los Angeles

"You as First Ladies are powerful champions for the causes you support. Powerful role models, motivators and catalysts for action. Your work is formidable. If we can also harness the efforts of civil society and clinicians to support you, you will be unstoppable."

- Sarah Brown

On April 20th and 21st, 14 First Ladies from across Africa met in Los Angeles, California to discuss and publicize prominent health issues in Africa. Organized by U.S. Doctors for Africa (USDFA) and African Synergy, the two day summit focused on maternal health, malaria, gender inequalities in education, and HIV/AIDS related issues.

Although the meeting tackled a wide range of topics, the focus was unquestionably on women's health and the likelihood of achieving Millennium Development Goal #5, reducing maternal mortality by 75% by 2015. Sarah Brown, wife of British Prime Minister Gordon Brown, spoke at the event and emphasized the importance of maternal health care, stating that "a health system that works for mothers, works also for early infant care, for vaccinations, for infection control, for blood transfusions, for emergency surgery for every member of the community. Build for mothers and you build for everyone." The 14 First Ladies that met in L.A. emphasized the importance of South-South cooperation and finding answers to complicated African problems through dialogue. By sharing both their own countries policy and programmes, as well as holding one another accountable for achieving Millennium Development Goals, the First Ladies summit looks promising as a catalyst for action.

Los Angeles may seem an unlikely venue for a summit promoting African health, but the high celebrity turnout and the First Ladies fashion choices drew a horde of media attention and helped to spread the importance of addressing African health issues worldwide. Agreeing to strengthen their leadership roles in their respective nations and work with U.S. based health experts, the First Ladies departed with a commitment to launch new efforts in health care. USDFA Chairman, Ted Alemayhu explained how "empowering Africa's First Ladies is an innovative approach to bettering the lives of Millions of Africans." South-South cooperation and the pairing of African First Ladies with U.S. experts and organizations creates ongoing partnerships and the potential to achieve change.

You can read Sarah Brown's entire keynote address online, at http://www.huffingtonpost.com/sarah-brown/build-for-mothers-and-you_b_189527.html

Pictures from the First Ladies Health Summit can be viewed at http://www.huffingtonpost.com/sarah-brown/build-for-mothers-and-you_b_189527.html

http://www.unicef.org/specialsession/about/sgreport-pdf/09_MaternalMortality_D7341Insert_English.pdf provides more information on maternal mortality and progress toward achieving MDG5

Commission on Population and Development to Focus on Contribution of ICPD to MDGs

This week (30 March- 3 April) the forty-second session of the Commission on Population and Development will meet at the United Nation's headquarters in New York. The theme this year is "The contribution of the Programme of Action of the International Conference on Population and Development to the internationally agreed development goals, including the Millennium Development Goals."

Founded by the Economic and Social Council in 1946, the Commission is most recently involved in monitoring and assessing the implementation of the International Conference on Population and Development (ICPD 1994). This year's session will focus on lowering population growth, and effective family planning in the least developed nations of the world, in order to reduce overall poverty and remove the barrier to achieving Millennium Development Goals (MDGs).

Since the 1960's, the least developed nations, many in sub-Saharan Africa, have been unable to reduce their overall fertility rates, leading to rampant population growth. On average, these countries have fertility rates of 4.6 children per woman, which is significantly higher than the estimated goal of 2.17 births per woman to achieve "near-replacement-level fertility." Hindered by their inability to reduce population growth, the Commission will emphasize the necessity for these least developed nations to ensure a quicker decline in fertility, in order to "reduce maternal mortality, improve child survival, promote women's empowerment and contribute to poverty reduction." The Commission on Population and Development's second focus this year is on effective family planning, helping to contribute to poverty reduction. By reducing the number of births within a family, the ability to save money becomes more easily attainable and a greater investment in the health and education of each individual child born into the family can be achieved. Furthermore, improved access to efficient family planning contributes to enhanced maternal health and a greater survival rate of young children.

Although efforts are underway to improve the implementation of both population reduction and family planning, the forty-second session this week will express the need for a stronger political commitment and increased funding, in order to achieve significant progress on the ICPD PoA. In addition, the Commission recommends continued implementation of successful programs, an emphasis on national leadership and ownership, the development of effective health systems, and an investment in pro-poor policies.

The Commission explicitly points to South-South cooperation as vital in order to identify what programs are working, and what policies are most efficient, stating that "South-South cooperation is valuable, especially for the identification of best practices and the exchange of lessons learned." A continuous exchange of information between countries will help to improve the overall trend in reaching the MGDs.

Population growth and family planning are crucial topics that must quickly be addressed, and it is the PPD ARO's hope that the this year's session of the Commission on Population and Development will be able to bring to light this year's crucial issues and further encourage South-South cooperation in population and development. Keynote speakers this year include David Canning (Harvard School of Public Health), Jean-Pierre Guengant (Representative from Institut de Recherche pour le Développement, Burkina Faso), and Zeba Sather (Country Director of the Population Council in Pakistan).

To learn more about the Commission on Population and Development, you can access a summary of the session at http://www.un.org/News/Press/docs//2009/pop970.doc.htm

You can also read the keynote address, official statements, and agenda items in English and French for the Forty-second session at: http://www.un.org/esa/population/cpd/cpd2009/comm2009.htm