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Behind the Numbers: The PRB blog on population, health, and the environment

The PRB blog on population, health, and the environment

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Health

Political Will Needed for Real Change

April 1st, 2013 | Posted in Gender, Health

This is the sixth in a series of blogs posts on the Sixth Joint Annual Meetings of the ECA Conference of African Ministers of Finance, Planning and Economic Development; and AU Conference of Ministers of Economy and Finance.

by Jay Gribble, vice president, International Programs

It’s worth noting that African nations have signed a number of regional proclamations and agreements that support the health and well-being of their people. A speaker on youth reminded the audience that the African Union has put forward a number of agreements that support youth labor programs; the Abuja agreement calls for countries putting 15 percent of their budgets into health; another speaker pointed out that Africa has numerous agreements that support maternal and child health. But what difference do these agreements really make?

As I reflect on the number of policies, agreements, and declarations that have been signed into existence, I can’t help but wonder why progress on social and economic development is so slow. Why sign so many declarations if there isn’t the political will to carry them out?  One thing we have learned from work in policy and advocacy efforts is that there is no substitute for political commitment. Historically, we saw it in Thailand and South Korea; today we see it in Rwanda and Malawi. Leaders must step up and speak out in favor of the issues that they are supporting through these declarations.

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Total Fertility Rate Increases in Chad; Child Nutrition Improves Slightly

January 30th, 2013 | Posted in Health, Reproductive Health

by Carl Haub, senior demographer

The 2010 Chad Multiple Indicator Cluster Survey-4,the third survey since 1996, showed a total fertility rate (TFR, the average number of children per woman) of 6.9. The 2010 TFR was higher than in two previous surveys, going back to the mid-1990s (see figure). The rate of childbearing among young women ages 15 to 19 was especially high at 203 births annually per 1,000 women.Chad TFR

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16 Day Challenge: Keeping International Workers Safe: Preventing and Responding to Gender-Based Violence

December 14th, 2012 | Posted in Gender, Health

by Sarah Martin, Consultant and Specialist on Prevention and Response to Gender-Based Violence

This post was originally published by IMPACTblog, by the U.S. Agency for International Development (USAID).

This post coincides with the 16 Days of Activism Against Gender-Based Violence event, “Who Takes Care of the Caregivers?  Providing Care and Safety for Staff in Gender-Based Violence Settings,” that took place on Thursday, Nov. 29, 2012 in Washington, D.C., hosted by the Inter-Agency Gender Working Group, funded by USAID.

Gender-Based Violence (GBV) is an issue that impacts aid workers—not just beneficiaries and not just staff that works in GBV settings. This post examines agencies’ duty to care for their workers by preventing and responding to GBV.

The sexual assault of the journalists Lara Logan, Mona Eltahawy, and two unnamed British and French journalists in Egypt, shocked the world and brought the issue of gender-based violence (GBV) against Westerners working in the developing world to the forefront. Global statistics show that 1 out of 3 women has experienced some form of sexual harassment or assault and it’s not only “the locals” being affected*. Not only are journalists at risk but also aid staffers working in conflict settings or GBV program areas.

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One-Year Anniversary of the UN High-Level Meeting on NCDs: Who Will Bear the Burden?

September 20th, 2012 | Posted in Health, Youth

by Wendy Baldwin, president and CEO

Last year the United Nations focused the world’s attention on the growing impact of noncommunicable diseases (NCDs) on low- and middle-income countries. In regions where infectious diseases are still common, diseases like diabetes, cardiovascular disease, chronic respiratory diseases, and cancer are rising at an alarming rate. These diseases will swamp health care systems; and increasing urbanization and development will only accelerate the strain. What can be done?

NCDs share four risk factors: tobacco use, excessive alcohol, poor diet (and obesity), and sedentary lifestyle.

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Preparing to Be Agents of Change in the Developing World

September 19th, 2012 | Posted in Health

by Adriana Biney, PRB 2012-2013 Policy Communication Fellow

 Adriana is a second-year doctoral student at the Regional Institute for Population Studies at the University of Ghana.

“Long-term goals: To become a philanthropist and start an NGO that caters to the needs of orphans in Ghana and developing nations all over the world.”

I wrote this goal for the 2005 City College of New York’s  Honors Year Book, after graduating with a BSc in chemistry. A few years later, I transitioned into the world of population studies but still wondered about the feasibility of me improving the lives of disadvantaged populations in Ghana. Then, the PRB Policy Fellows Program came along…

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Less Is More: Policies to Help Make Policy

September 13th, 2012 | Posted in Health

by Shonel Sen, PRB 2012-2013 Policy Communication Fellow

Shonel is a Ph.D. candidate in Applied Economics & Demography in the Departments of Agricultural, Environmental and Regional Economics & Demography, at the Pennsylvania State University.

Two small weeks for a workshop, one giant leap for policymaking—when I applied for the PRB Policy Fellows Program in the middle of spring, my idea of policy implications for my research was perhaps a paragraph tucked into the end of my dissertation; however, after the first leg of the program in the summer, that outlook evolved significantly. I discovered that just asking an interesting question, solving a crucial problem or being convinced of its policy relevance is not enough. One has to pull the research out of its academic cocoon and put it out there in the world in the hope that the findings may get translated into policy, the recommendations may actually get implemented, or at the very least, the work may be heard by someone.

I am training to be an economist and a demographer and am interested in finding noncoercive ways to reduce excessive childbearing and to ease the burden of a rapidly growing population. After years of hearing the graduate school mantra of “the more technical, the better,” when I was told to drop words like “utility” and “above replacement fertility” from my vocabulary and replace my pretty equations and complicated tables with simple graphics, my knee-jerk response was not exactly very appreciative. But once I overcame my rebellious reflexes and battled my linear thought process, the listening, learning, and growing began. Read the rest of this entry »


Sahel Drought: Putting Malnutrition in the News

August 30th, 2012 | Posted in Environment, Health

by Jill Hagey, policy analyst

Over the past few months, the Sahel drought has sparked attention of news media and concerned citizens around the world. Throughout this media blitz, I have been struck by the sharp contrast between this coverage and how the devastating effects of malnutrition are usually portrayed. Malnutrition is often overlooked in favor of more “newsworthy” diseases, and it takes a crisis to focus our attention on this public health issue. Yet an emergency such as this drought—affecting more than 18 million people, including nearly 2 million children—is difficult to ignore.

Landscape of Sahel

Sahel, Africa. Photo: Center for International Forestry Research / Flickr.

As the third in a series of droughts in less than a decade in the Sahel, this crisis has affected parts of Burkina Faso, Cameroon, Chad, Gambia, Mali, Mauritania, Niger, Nigeria, and Senegal. This year, the region experienced low rainfall, locust attacks, and violence in Nigeria and Mali. Grain production decreased by one-fourth, and prices increased to the point where few people can afford the food they need. The violence in Nigeria and Mali has prevented people from moving to areas with better harvests, and thousands of refugees have settled into countries without the resources to feed them.

What many may not know is that every year more than 475,000 children die in the region from nutrition-related causes, even when there is no crisis. In fact, the Sahel region has one of the highest rates of stunting—or chronic malnutrition—worldwide. Read the rest of this entry »


Treading Softly, Yet Purposefully on the Research to Policy Bridge

August 23rd, 2012 | Posted in Health

by Funmilola OlaOlorun, PRB 2012-2013 Policy Communication Fellow

Funmi is a Ph.D. candidate in the Department of Population, Family, and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health.

“Brevity is the soul of wit.”

In my humble opinion, this quote in William Shakespeare’s Hamlet, sums up the messages we received during two-week workshop for PRB’s 2012/2013 Policy Communication Fellows. “Less is more” we were told time and time again. Challenged to move beyond our academic approach to communicating research findings, we were stimulated to write in a simple, conversational way that would keep our audience begging for more. We prepared for our prime moment with a policymaker—whether it was a 60-second elevator speech, a 5-minute chat, or a 12-minute presentation—and determined the main message of our research.  We were encouraged to continually ask ourselves questions such as: What must I say to make my case? What can I leave out? What are my key messages? What do they imply? What recommendations can I make from these?

We were a dozen Fellows, a blend of economics, demography, sociology, geography, and medicine. We represented 12 graduate schools. We had to alter our way of thinking to understand why a policy audience is unique. Starting with a fresh slate, we were led—first with baby steps, and then with leaps and jumps—how to best translate our research into a format that could be easily digested by policy audiences.

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Uganda 2011 Demographic and Health Survey Shows Fertility Decline, Increase in Family Planning Use, and Continued Decline in Infant and Under-Five Mortality

June 12th, 2012 | Posted in Health, Reproductive Health

by Carl Haub, senior demographer

The Uganda 2011 Demographic and Health Survey (DHS) is the latest demographic survey taken in the country and the preliminary report has just been released. The survey interviewed 8,674 women ages 15-49 and 2,295 men ages 15-54. The results show that the total fertility rate (TFR) for the three-year period before the survey was 6.2, 3.8 in urban areas and 6.7 in rural areas. This represents a decline in the TFR since 2006 when the TFR was reported as 6.7 in a country where some have referred to the TFR as being stubbornly high. Rural women accounted for 80 percent of those interviewed. The desire for large families remains rather high, however. Among women with five living children, 53.3 percent said they did not wish to have additional children. An additional 6.2 percent said they were incapable of conceiving or had been sterilized.

In the survey, 30 percent of currently married women said that they were using some form of family planning and 26 percent were using a modern method. As in much of sub-Saharan Africa, “spacing” methods predominate. The most commonly used modern method of family planning was injectables, with 14.1 percent of women using that method, followed by the pill and female sterilization at 2.9 percent each. There has been a steady increase in family planning use, from 15 percent in 1995 and from 24 percent in 2006.

Click on image for full-sized version.

The decline in infant and child mortality, as reported in earlier surveys, has continued. The infant mortality rate (IMR) in the five years before the 2011 DHS was 54 infant deaths below age 1 per 1,000 live births, down from 81 in the 1995 DHS and 76 in the 2006 DHS. The level of the child death rate, ages 1-4, however, remains somewhat higher than might be expected at 38. It was 72 in 1995, not very different from infant mortality.

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Congo (Brazzaville) 2011 Demographic and Health Survey Shows No Fertility Decline, High Maternal Health

May 21st, 2012 | Posted in Health, Reproductive Health

by Carl Haub, senior demographer

The Congo 2011-2012 Demographic and Health Survey (DHS) is the second DHS taken in the country and the preliminary report has just been released. The survey interviewed 10,819 women ages 15-49 and 5,145 men ages 15-59 from September 2011 to February 2012. A major finding of the survey was that fertility has not declined in the country since the previous DHS in 2005. The total fertility rate (TFR) report in the recent DHS for the three year period before the survey was 5.1 children per woman, 4.5 in urban areas and 6.5 in rural areas. This appears to represent an increase in the TFR since 2005 but the survey report cautions that there is likely to have been some understatement of the actual level of childbearing in the 2005 survey, particularly among women ages 25-29. Rural women accounted for two-thirds of those interviewed in the most recent survey of about 4 million population. The rather high TFR is reflected in the desire for large families. Among women with five living children, only 37.3 percent said they did not wish to have additional children. An additional 9.8 percent of that group said they were incapable of conceiving, however.

In the survey, 44.7 percent of currently married or in-union women said that they were using some form of family planning and 20 percent were using a modern method. The most common type of modern method was the male condom at 12.3 percent, a rather unusual pattern of contraceptive use in Africa. That was followed by the pill at 2.9 percent and injectables at 2.8 percent. This continues the often-observed preference in sub-Saharan Africa for methods to space births, not necessarily to limit them. The use of modern contraception was 24.6 percent in urban areas and 11.7 percent in rural areas. Modern contraception rose since the 2005 DHS when it was reported at 12.7 percent and the condom was also the most frequently used method at that time. The prevalence of HIV was reported in the 2009 AIDS Indicator Survey at 4.1 percent for women ages 15-49 and 2.1 percent of men of the same age group.

Source: MEASURE DHS, Congo (Brazzaville): DHS 2011-12 - Preliminary Report (French).

Indicators of maternal care reported in the survey were very good. Of mothers who had given birth in the five years before the survey, 92.6 percent had received prenatal care from a skilled provider; 93.6 percent had had a skilled attendant at delivery; and 91.5 percent had given birth in a health facility. Protection against neonatal tetanus, at 73.5 percent was good but needs improvement. Maternal health indicators were generally a little lower in rural areas but still quite good.

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