Thursday, July 25, 2013

Family Planning and Africa's Next Generation of Women

Today's numbers indicate that we are 7.2 billion human beings inhabiting the Earth. And projections forecast we will multiply to nearly double digits (9.6 bn) by 2050! These numbers raise clear concerns related to sustainability, such as resource scarcity and climate change.

So what lies at the heart of the population issue and why can't we control it?

Much of the developed world has managed to stint it's population growth with future expected increases due largely to migration. But the least developed countries of the world (most of which are in Africa) maintain high fertility rates and continue to grow somewhat uncontrollably. Researchers have confirmed statistically the perceivable correlations between large family sizes in poor countries to lower child survival rates.

But what is not as obvious, is that by focusing on improving child survival rate, you can as an outcome, reduce average family sizes in the developing world.

I realize this solution sounds paradoxical, so let me explain.

The equation for improving child survival rate includes family planning. A major function of family planning services is that they promote birth spacing methods that advise against having a baby within two years of a previous baby. Considering that there are regions in Africa where women can have between 4 to 6 babies before entering their late twenties, the potential implications for child survival and population sustainability become clear.

In addition, there are several other upsides to family planning interventions that I should mention.

They prevent unintended pregnancies that far too often lead to malnutrition, as extra mouths to feed trouble families already struggling for resources. Family planning also has positive implications for maternal health, because birth spacing methods can prevent 20-35% of all maternal deaths.

So what are the challenges for family planning and health-care advocates?

While it may be relatively easy for middle and higher income sexually-active couples to plan for child birth, their poorer counterparts living in rural villages, largely do not have adequate and consistent access to contraceptive supplies and reproductive health services (including staff) necessary to aid them in planning. These supplies and services are also complimentary and essential to maternal health as 20% of maternal deaths in Africa are due to HIV (pregnant women also die from malaria).

But even where condoms are plentiful, they presuppose a male's willingness to wear them. This reduces the women's agency in planning a pregnancy.

Furthermore, there is a huge cultural aspect that presents challenges for family planning advocates.

During my time living in a rural village in Tanzania, one of my personal highlights came from the time I was invited to accompany my host dad, who was the proud father of five daughters and two sons, on a small journey to negotiate and collect bride price for his youngest daughter who had been married several years before. For my host family and the tribe they belonged, bride price, which is an amount of money or property paid by the groom or his family to the bride's family, was compulsory in order to validate the marriage. The entire process was very formal from start to finish and included witnesses, a pastor, signed agreements, cash and cattle payment, and a ceremonial feast. Today, I can still vividly remember the pride and joy that exuded from my host dad on that day; and while he and his family were more "well-off" than most others in the village, the six cattle and huge stack of cash he received as bride price for his fifth daughter was nonetheless graciously accepted.

That example highlights a tradition practiced by many tribes and cultures in rural Africa. Many families rely on daughters being married in order to guarantee cattle and other wealth, and sons are likely the only form of life insurance a couple can hope to secure. These customs and circumstances make it extremely difficult to advance a trend towards smaller families in Africa.

Knowing these challenges, what can/should be done?


  • African governments need to ensure health programs are adequately funded. While on aggregate, health spending has increased from 8.8% to 10.6% since 2001, when member-states of the African Union pledged in the Abuja Declaration to allocate at least 15% of their annual budgets to healthcare by 2015. But to date, only 6 governments have met their targets while about a quarter of AU member-states have regressed and are spending less.

  • Appropriate health funding will help provide all regions and districts with access to consistent and adequate reproductive health and family planning services and supplies. Funding should also be used to supply and train health staff who can facilitate these services as well as help research new interventions for contraception that will grant agency to Africa's women.

  • Lastly, trained local staff represent local voices using local languages that can support and reiterate family planning knowledge and it's importance to families in rural regions. 


But before I leave, I wanted to remind readers that it's easy to put all of the blame on the developing world for issues related to global sustainability. But let's not forget our responsibility in the developed world to practice sustainable living and examine our own policies and procedures that interrelate with global sustainability.


Tuesday, February 1, 2011

Water Wars

In the midst of the current protests in Egypt, few outsiders to the region are aware of another major issue that's been boiling: control of the river Nile.

Here are the facts.

The Nile, the longest river in the world at over 4,000 miles, nourishes life in 9 countries, flowing through Ethiopia, Sudan, Uganda, Kenya, Tanzania, The Democratic Republic of Congo, Burundi, Rwanda, and Egypt. With the Nile crossing so many borders, one is astonished to learn that 66% of it's waters are controlled by Egypt. In fact, the Nile Water Agreement, guarantees Egypt 55.5 billion cubic meters of water, out of a total 84 billion cubic meters.

Herein lays the problem.

The Nile Agreement was signed in 1929 by Britain on behalf of it's then East African colonies (Uganda, Kenya, & Tanzania). It's evident looking back that Britain needed to strategically benefit Egypt because of shipping routes (see Suez Canal), at the expense of the millions of people along the Nile basin merely looking to harvest its waters for their livelihoods. Those upstream countries, plagued by drought, first need the consent of downstream Egypt before proceeding with any irrigation (or hydropower) projects. But Egypt (and Northern Sudan) have been unwilling to change the agreement, which the other countries understandably argue did not & does not represent their best interest, as they (with exception of Ethiopia) were under colonial rule at the time of it's signing.

Egypt's refusal to equitably share the Nile's water seems pretty audacious considering that 85% of it's flow comes from the Blue Nile, which originates in Ethiopia, with the remaining 15% of flow coming from the White Nile, which originates from Lake Victoria, whose shorelines grace Kenya, Uganda, & Tanzania. The best argument I've heard thus far in Egypt's defense, is that they do not benefit the same from seasonal rains as their sub-Saharan counterparts, making the Nile it's lifeblood.

As it stands now, the 7 upstream countries (Uganda, Kenya, Tanzania, Rwanda, Burundi, & DRC) recently met to sign a new agreement, giving Sudan and Egypt one year to answer to a more equitable sharing of the river Nile's resources.

With Southern Sudan soon gaining their independence from the North, the balance of power is expected to tilt in favor of the Nile Basin countries, who command less diplomatic clout than Egypt. Consider international donor countries who are reluctant to advance funds to Nile Basin countries for major water projects for fear of damaging relations with Egypt, all as a result of the power granted them via this Colonial-era agreement.

Lets hope the negotiations will remain peaceful and another war in Africa isn't ignited due to external puppeteering.


Thursday, October 8, 2009

Playing For Change

"As a human race we come together for birth, we come together for death. What brings us together in between is up to us. Stop and listen to the universal language of music and bring that positive energy with you everywhere you go."
- Mark Johnson

What I know is, music crosses all borders and brings healing to the soul...no matter where we're from, even those of us experiencing the most extreme poverty, share this connection.
"Playing for change" represents a movement connecting the world through music. Watching the DVD gave me chills...and hope...a must have for the collection.

To learn more, go to: