The EngenderHealth News Blog
EngenderHealth on YouTube EngenderHealth on Twitter EngenderHealth on FaceBook The latest news from and about EngenderHealth, a leading international nonprofit working in sexual and reproductive health. For more information, visit our web site or join us on YouTube, Facebook, and Twitter.
Showing posts with label family planning. Show all posts
Showing posts with label family planning. Show all posts

Friday, May 18, 2012

On Alice Radio: A Conversation with Pam Barnes

Our goal is to be sure that women can have the number of children they want, and not the number of children that their circumstances dictate.”
~ President Pamela W. Barnes


Last week, Alice Radio (97.3) in San Francisco featured Pam Barnes on its Sunday Magazine program to discuss the top reproductive health challenges facing women today and what EngenderHealth is doing to address them.

Listen to the  interview here. Or, skip to the topics that interest you:

01:30 …on advocating for national policies that promote women’s health
03:06 …on global progress in women’s health
05:25 …on the benefits of investing in women
07:17 …on engaging men to support women’s health
09:45 …on EngenderHealth’s work to address women’s health through comprehensive & integrated services
11:30 …on meeting the needs of women living with HIV, including family planning and preventing mother-to-child transmission (PMTCT) of HIV
13:12 …on Gender Matters, our teenage pregnancy prevention program that addresses gender norms among adolescents in Austin, Texas
15:45 …on why issues across the globe should matter to Americans
18:25 …on what YOU can do to support EngenderHealth’s work to improve women’s reproductive health

Thursday, May 17, 2012

Maternal Health: On the Mind and In the Media


Mother’s Day may be over, but our work to improve mothers’ health isn’t!

Check out what we’ve been reading here at EngenderHealth—a selection of our favorite articles on and around Mother’s Day.
  1. In the Huffington Post, the head of the UN Population Fund (UNFPA) reminds us that even strong mothers need continued support in reproductive health care.
  2. New estimates from the United Nations reveal a near 50% decline in annual maternal deaths between 1990 and 2010.
  3. Ms. Magazine explains why celebrating birth control on Mother’s Day isn’t as counterintuitive as it sounds.
  4. New York Times columnist Nicholas Kristof highlights the plight of women living with fistula. EngenderHealth has also provided nearly 20,000 fistula repairs around the world to date.
  5. In Newsweek magazine, philanthropist Melinda Gates unveils her new crusade and why she’s making family planning her “signature issue.”
  6. Women Deliver celebrated the lifesaving work of midwives on May 5, the International Day of the Midwife.
  7. USA Today discusses the U.S. ranking in the annual report on the State of the World’s Mothers.

Friday, January 13, 2012

EngenderHealth on the Move

International conferences are always on our agenda. But this winter has been particularly busy so far, with staff attending the International Conference on Family Planning in Dakar, Senegal, and the International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA) in Addis Ababa, Ethiopia. Since our field staff cannot pack you in their suitcases and take you with them—they’re just not that strong!—we asked them to tell you a little about their experiences now that they are back home. 

 





2011 International Conference on Family Planning, Dakar: JAWEER BROWN (Technical Advisor, Family Planning)

What were some of your favorite moments from the conference, and why?

One of my personal highlights from the conference was a presentation by a young activist living with HIV. He really moved me and set the stage for my experience in Dakar. Against the backdrop of a large tent and competing with the rumblings of an enthusiastic audience, the activist reminded us of the human face behind the words family planning, HIV, systems strengthening, development, and all the jargon we use in our work. He represented the lives of so many we refer to as “client,” ”population,” or ”user.” With a palpable candor and passion, he pressed us to adhere to our commitments to make real change and embodied the purpose of our work: to meet the urgent sexual and reproductive health needs of young people like him.

Were there any takeaways from discussions surrounding the issue of HIV risk and hormonal injections?

Going into the conference, we knew the facts surrounding this important issue. An important takeaway that emerged on this topic, however, is the fact that we may never have conclusive evidence about a link between hormonal contraceptives and HIV risk. Strong leadership, therefore, is vital for proceeding within this uncertainty. This will involve investing more resources and attention to expand the contraceptive choices available to women and increase access to a wide method mix, including long-acting and permanent methods of family planning.

What other research highlights received special attention from conference participants?

I am a tech geek in disguise, and I really enjoyed a presentation on new contraceptive technologies. Two innovations in particular caught my eye: the microbicide/hormonal contraceptive ring, and the development of a topical gel contraceptive. 

What were some major contributions EngenderHealth made at the conference?

EngenderHealth contributed a great deal to the Implementing Best Practices (IBP) sessions, which were another major highlight of my experience in Dakar. The format of these sessions was unique.  Rather than Powerpoint presentations followed by a question-and-answer period, the sessions were broken up into roundtables, allowing for open dialogue in small groups of 8–10 people. It was a rare opportunity to sit down with colleagues and experts from around the world and take a bird’s eye view at what we do and how we do it.


2011 International Conference on AIDS and STIs in Africa, Addis Ababa: MARK BARONE (Senior Medical Associate)

What were some of your favorite moments from the conference, and why?

A favorite moment from the conference was a presentation that my colleague Dr. Quentin Awori delivered on our randomized controlled trial of the Shang Ring versus conventional male circumcision in Kenya and Zambia. Dr. Awori works in Homa Bay, Kenya, and is a co-investigator on the study. He is an up-and-coming young researcher, which made it even more gratifying to see our work presented by him. The presentation generated a lot of discussion and offered great hope that a device will simplify male circumcision and allow for more rapid scale-up.

I also particularly enjoyed the opportunity that the conference presented to connect with many of the people that I know who are working in the field of HIV and to meet new people. Conferences like this provide a venue to learn not only from the actual conference sessions, but also to talk with others and get a better sense of what is going on more broadly in the field  and to create opportunities for future collaborations.

What other research highlights received special attention from conference participants?

Voluntary medical male circumcision received a great deal of attention during ICASA, including a number of special sessions and many oral and poster presentations. I hope that emphasis on this proven HIV prevention intervention will spur along some of the programs in Sub-Saharan Africa that have been lagging a bit.

What work did EngenderHealth present, and how did it fit into the overall conference narrative and themes?

EngenderHealth was well represented at the conference, with oral and poster presentations that highlighted our work in voluntary medical male circumcision for HIV prevention, gender, and our work with most-at-risk populations (MARPs). We also had a booth in the exhibition area highlighting our HIV-related work, with a special focus on our work with MARPs in Ethiopia.

Wednesday, December 21, 2011

Repro Health in Review: 11 Highlights of 2011

We saw a number of significant moments in global reproductive health during 2011 -- from historic court rulings to scientific breakthroughs to the launch of a new UN agency dedicated to women's equality and empowerment. Check out our digital timeline of 2011 highlights! Or scroll down for a complete list.




  • October 31: The world’s 7 billionth baby joins the global community.
  • October 4: A study published in Lancet Infectious Diseases (October issue) suggests a possible link between hormonal contraceptives and HIV.
  • August 10: The UN CEDAW issues an historic ruling that governments have a human rights obligation to guarantee access to maternal health services.
  • August 1:  The Obama Administration issues new standards requiring health insurance plans to cover women's contraceptives without co-payments.
  • July 6: In a 2-1 decision, a New York appeals court ruled that the “anti-prostitution pledge” violates the First Amendment by forcing funding recipients to take on the government’s viewpoint as if it were their own.
  • May 17: The World Health Organization expands its list of essential medicines to include misoprostol, a lifesaving drug that prevents postpartum hemorrhage, a leading cause of maternal death.
  • May 12: A study by National Institute of Allergy and Infectious Diseases reveals that early treatment for HIV patients can significantly reduce chances of transmission.
  • April 15: The U.S. Congress passes the FY2011 Continuing Resolution, ending a budgetary impasse that sparked a nationwide debate about women’s reproductive health and rights.
  • March 3: Two Ugandan families take maternal health rights into their own hands by bringing a lawsuit against their government for the needless deaths of two mothers in a North Uganda clinic.
  • February 1: A 2010 Demographic Health Survey in Bangladesh reveals a significant 40% decline in maternal mortality in less than a decade. Learn about EngenderHealth’s role in improving maternal health in Bangladesh.
  • February 24: Secretary General launches UN Women, signifying a historic step to marshal resources and mandates for greater impact in gender equality and women’s empowerment.
  • January 6: 600 UK women reported unwanted pregnancies while using the Implanon contraceptive implant, creating a pregnancy scare among clients. Read our commentary on the role of training for implants.
  • Wednesday, November 30, 2011

    What It Will Take to Achieve an AIDS-Free Generation

    In a November 8 address, Secretary of State Hillary Rodham Clinton set forth a bold vision that the end of HIV and AIDS is finally in sight, marking the first time in history that the U.S. government has made it a policy priority to end HIV and AIDS.

    Major scientific advances in the last few years offer an historic opportunity for achieving an AIDS-free generation, Secretary Clinton said. This goal is attainable through a combination of three proven interventions—prevention of mother-to-child transmission (PMTCT), voluntary medical male circumcision, and antiretroviral (ARV) treatment to prevention transmission—in addition to condoms and other prevention tools. The Obama Administration is characterizing this approach as “combination prevention.”


    Here, EngenderHealth experts on HIV and AIDS offer their perspectives on the U.S. government’s new policy as well as the new 2011 Worlds AIDS Day report released by the Joint United Nations Programme on HIV and AIDS (UNAIDS).


    Pamela W. Barnes, President and CEO


    Bringing family planning back into the conversation…


    I fully applaud the ambitious goal set forth by the Obama Administration, yet its response doesn’t measure up to the realities facing the majority of individuals living with HIV—women and girls—in Africa. Achieving an AIDS-free generation will require a broad, integrated approach that extends beyond PMTCT to include reproductive choice, which is a fundamental human right for women and girls and an indispensable component of a comprehensive solution to ending HIV and AIDS. (Photo: Pamela Barnes on the right)

    Family planning is part of a four-pronged approach to achieving strong sexual and reproductive health for women living with HIV. We can all cheer when a mother gives birth to an HIV-free baby—no doubt, PMTCT is a critical tool for HIV-positive women who wish to expand their families. But the reality is that we cannot have comprehensive PMTCT without family planning.

    To be effective, PMTCT services must encompass comprehensive care for pregnant women, mothers, and newborns, including family planning, primary prevention, and care and treatment for HIV-positive women and infants. Moreover, women with HIV who have just delivered a healthy baby through PMTCT must also have the means to avoid or delay future pregnancies, if that is what they wish to do.
    The bigger picture of reproductive health...
    In the broader context of sexual and reproductive health, we must also ask ourselves: How do we keep that same mother healthy throughout her life? She may access HIV treatment, but in these very same places, getting pregnant is one of the riskiest things she can do. For example, in places like Niger, a woman has a one in 16 chance of dying due to pregnancy in her lifetime, so meeting a woman’s broader reproductive health needs, including family planning, is imperative if we are to make measurable progress.
    Paul Perchal, Director, HIV and STI
    Universal access to HIV programs is the lynchpin to achieving an AIDS-free generation…

    We are in a truly new era of the AIDS response, with unprecedented opportunities for realizing an AIDS-free generation, but we have a long way to go. Universal access to HIV programs is the lynchpin to achieving an AIDS-free generation. By the end of 2010, only about 47% of eligible people living with HIV were on ARV treatment, and about 48% of pregnant women living with HIV received PMTCT treatment. Moreover, after male circumcision was shown to offer protection against HIV, the United Nations set a goal for 20 million African men to be circumcised by 2015, yet to date only about 600,000 have undergone the procedure. For these numbers to change, strong referral networks are key – they help with client follow-up, and will be critical in scaling up comprehensive prevention, care, and treatment programs.
    On “combination prevention” (PMTCT, MC, and care and treatment)…

    Combining proven approaches must also include behavioral interventions (such as encouraging people to use condoms to reduce risks of transmission) and structural interventions (such as using microfinance loans to reduce women’s dependence on transactional sex for income). Even if HIV services are available, people may not access them or adhere to care and treatment unless they develop positive health-seeking behaviors and can do so without facing stigma and discrimination.
    A shared responsibility…

    An effective global response to HIV and AIDS involves a shared responsibility and ongoing moral and financial commitment from both developed and developing countries, communities, and donors. We also need to help support and strengthen local governments and civil society organizations by building their institutional capacity to increase transparency and accountability and ensuring that donor resources actually reach the people they are meant to support in a timely and cost-efficient way.
    On the new global framework described in the 2011 UNAIDS World AIDS Day Report…

    The comprehensive global framework for HIV and AIDS should deliver significant results if countries, donors, and multiple development sectors can commit to it. The framework underscores the need to promote “social enablers,” such as human rights and the capacity of community-based organizations, as well as “program enablers,” such as community-centered program design and delivery, integration, management and incentives, and research and innovation.

    Achieving universal access to HIV prevention, treatment, care, and support by 2015 through the framework will require scaling up funding, including moving closer to spending 15% of government revenue on health (as per the Abuja Declaration for Africa), as well as using existing resources more cost-efficiently. It will also require leveraging synergies with other sectors such as gender, education, social protection and welfare, and economic development.


    Finally, maximizing critical enablers requires program efforts and new innovations that function together and include a combination of biomedical, behavioral, and structural components.

    Tuesday, November 1, 2011

    Capturing the Count: A Round Up of Global Voices on 7 Billion

    In the weeks leading up to the 7 billion milestone, we’ve seen the global population issue captured in so many ways across the multimedia landscape—through videos, web sites, photo essays, social media, and of course, the good old op-ed. Below is a collection of some of the most interesting “7 billion” projects that reflect the diversity, not only of these views, but of our growing world.

    7 billion … in pictures:

    • In a colorful two-and-half-minute video, NPR tells the story of how we got “so big, so fast.”
    7 billion … in soundbytes:
    • A podcast featuring Dr. Babatunde Osotimehin, Executive Director of UNFPA, on family planning and the 7 billion milestone (published by the UK’s Department for International Development).
    • An NPR segment about the most densely populated place in India.
    7 billion … on the web:
    • The National Geographic magazine is culminating a special year-long series on population, including an article, photo gallery, video, and game.
    • What’s your number? Population Action International and the BBC have launched online campaigns showing you where you fit among the world’s 7 billion, using just your birthday.
    • USAID Global Health’s “World at 7 Billion” project demonstrates how a single person in a world of 7 billion can make a difference in his or her community. (Features a story on our very own Esther Nyokabi of Kenya!)
    • UNFPA’s 7 Billion Actions campaign shares stories and films on how individuals and organizations around the world are bringing about positive change.
    7 billion … in social media:
    • Check out the conversation on #7billion in Twittersphere as well as EngenderHealth’s #CountTo7B project on key population factoids and statistics.
    7 billion … in writing:
    • In an Oct. 21 essay on CNN.com, Jeffrey Sachs says technology and stabilization of the population are the answers to this question: How can we enjoy “sustainable development” on a very crowded planet?
    • Helen Epstein discusses the role of religion in contraceptive use for Ghanaian communities in her Oct. 22 New York Times article, Talking Their Way Out of a Population Crisis.
    • On Oct. 24, the Guardian UK underscores the role of education in increasing opportunities for women and girls and, ultimately, slowing population growth in places like Tanzania.
    • Bloomberg offered its own round up of the voices on 7 billion in an Oct. 31 article.

    Monday, June 6, 2011

    EngenderHealth at Global Health Council Summit (June 13-17)

    EngenderHealth next week will host two events at the Global Health Council's annual international global health conference in Washington, DC:

    A June 13 workshop (1pm, Executive Room) highlighting the Supply-Enabling Environment-Demand (SEED) Programming Model, our comprehensive approach to achieving sexual and reproductive health. The session will introduce the new SEED Assessment Guide for Family Planning Programming, outlining 25 essential elements for robust and comprehensive family planning programs.

    A June 14 evening reception (6:30pm, Governor's Ballroom), "EngenderHealth: Celebrating the SEEDs of Success," to celebrate our SEED programming model, along with another great year for EngenderHealth.

    RSVP to these events by writing to rsvp@engenderhealth.org.

    For more on EngenderHealth events this summer, see the "Upcoming Conferences" section in our June issue of Connect.

    Tuesday, September 28, 2010

    Closing the Gap Between Contraceptive Technology and Those Who Are in Need



    Learn about the benefits of family planning beyond better health. Check out our 3for1 video!

    Birth Control Over Baldness, Nick Kristof’s op-ed column on September 26, calls for increased investments in contraceptive development, and touts promising new technologies, including a vaginal ring that offers up to one year of contraceptive protection. The ring is a product of our valued partner and sister organization, the Population Council, which has made significant and important contributions to contraceptive development during the past 50 years (including program support so that new products may be available to all women).

    Below, EngenderHealth experts weigh in on what it will really take to forge the missing link in making contraceptive technologies – old and new alike – available to the 215 million women who don’t have access to a modern method of birth control:



    Innovation is Just Half the Equation

    Family planning indeed has a direct link to alleviating poverty. Moreover, its cost effectiveness is irrefutable: In addition to saving lives, each dollar spent on voluntary family planning can save governments $31 in health care, water, education, housing, and more.

    Developing new contraceptive options is critical. But no matter how many technologies come to market, a major challenge remains: ensuring that those who need contraceptives the most—poor women and couples often living in remote communities—can get them. Strengthening health care systems, including training local providers, must be part of the solution.

    We’ve learned from our own experience on the ground that all the technology in the world won’t work without trained providers to offer counseling, information, and quality care for family planning and reproductive health. Innovation is just half the equation. Access and delivery is the other half. Only when you have both will new contraceptives break through.

    — Pam Barnes, President and CEO



    “Software” v. “Hardware”

    New technologies are important, but so many of the access issues in poorer countries relate to “software”. These include knowing about available methods and where to go to get them; human resources, such as the scarcity of trained providers; a competing disease burden (such as HIV and AIDS); and traditional gender norms and other sociocultural barriers. The “hardware” issues of not having sufficient technology to meet demand are still secondary in many places.

    — Dr. Roy Jacobstein, Medical Director



    Interconnections


    To make vaginal rings – or any contraceptive technology - available to those women who currently don’t have access to modern birth control methods is quite simply going to require more than the technology itself. There is a complex set of interconnections among what women and men need, the technologies that can address those needs, the services that can provide those technologies, and the resources available to sustain supply and services.


    — Karen Beattie, Director, Fistula Care



    Investment, Policy, and Accountability


    New contraceptive technology is only part of the solution. Training health providers at every level – community health workers, nurses, midwives, physician’s assistants, as well as doctors
    and positive changes in health systems are needed. But more than that, donors need to invest more in finding innovative solutions. For instance, supplies like condoms, IUDs, and contraceptive pills, don’t always get to where they are needed when they are needed. Without solving what ought to be simple distribution problems (but are actually quite complicated), the vaginal ring will just be one more supply that is stuck in a warehouse and takes weeks if not months to get to rural clinics.

    There needs to be local policy commitment, and investment of local resources and accountability. If we look at success stories, like Thailand, Mexico, and Colombia, where use of modern contraception has greatly expanded (and contraceptive prevalence rates are 70.9%, 71.5% and 78.2%, respectively), it’s because there was political support and investment in improving health systems and making contraceptives available.

    — Terry Jezowski, Vice President, External Relations



    Technology and Stronger Health Systems – We Need Both


    New contraceptive technologies always hold the promise of better options for women and couples. But options don’t de facto equal access. Addressing the health care worker crisis and improving commodity security (e.g. getting needed supplies to clinics and pharmacies so customers can get them when they want them) would go a long way towards helping women access modern family planning methods.


    The cost-effectiveness of family planning is paramount. I was curious that Kristof reports Sino-Implant costs only $3, when the cost typically cited is $8. Both prices make it a less expensive option than Jadelle®, yet in the countries where women most need better access to modern methods, health ministries still don’t have (or allocate) enough money to procure commodities.

    Nonetheless, there are some interesting additional contraceptive technologies on the horizon that Kristof did not mention:
    • Essure is a form of non-surgical female sterilization that is tremendously quick and less invasive than tubal ligation.
    • Mirena® is an IUD that also delivers a minuscule dose of progesterone, which reduces menstrual bleeding – a side effect that women in the U.S. and Europe have warmly welcomed!
    • Sub-Q Depo has the potential of clients self-injecting at home.
    Still, the fact remains that to make any of these viable options for women and men everywhere, we need strong health systems, staffed with well-trained workers and strong distribution networks.

    — Erin McGinn, Senior Technical Advisor for Family Planning

    Thursday, June 3, 2010

    The 50th Anniversary of the Pill: A Moment to Reflect and Recommit to Expanding Options

    By Lynn Bakamjian, Director, RESPOND Project

    The flurry of media attention around the 50th anniversary of the oral contraceptive (popularly known as “the pill”) has been a great reminder to those of us who came of age during this time of the advances that women in the United States were able to make once they had the means to safe, available, and (mostly) affordable contraception.

    On a personal level, having the pill as an option provided me with the knowledge and comfort that whenever I needed to, I had the means to manage my fertility and pursue my education and career without worrying about a poorly timed or unwanted pregnancy. As I reflect on what the pill has meant to generations of women, including my own, I cannot imagine how different my life might have been without it.

    And while there are many blog posts and news articles about the impact that this female-controlled, easy-to-use contraceptive had on women’s lives here in the United States, I am reminded that this is, unfortunately, not yet the case for many women and couples in developing countries.

    More than 200 million women around the world have a desire to use contraception but are currently not using any effective method. This unmet need is largely due to lack of available and affordable options, to fear and concerns about safety due to misconceptions about contraceptive methods, and sometimes even to opposition by husbands or family members.

    There are many options that can provide women with a choice that meets their particular family planning needs—while the pill is great, it’s not the only method. In many countries in Sub-Saharan Africa, for example, many women exceed their desired family size by one or more children, which points to a greater need for options beyond short-acting methods such as the pill, especially underutilized options like intrauterine devices, implants, and sterilization. In most developing countries, however, contraceptive choice is elusive; rarely do women have the range of methods available to meet their needs.

    As we mark this milestone in American history, let us remember the hundreds of millions of women who are living today, like American women were a half century ago, in fear of unintended pregnancy, and let us honor them with renewed commitment and action to bring them not only the pill, but the whole wide range of family planning methods that all women deserve.

    Tuesday, December 1, 2009

    First Lady of Tanzania Visits EngenderHealth-Supported Clinic

    In November 2009, the First Lady of Tanzania, Mama Salma Kikwete, visited Madaba Health Centre, a facility in the Ruvuma Region in southwestern Tanzania that is supported by EngenderHealth and that serves 50,000 people. The First Lady was there as part of a national campaign to reduce maternal and neonatal mortality, and she spoke about the importance of avoiding early pregnancy, improving maternal health care, and openly discussing HIV and preventing its spread.

    EngenderHealth, through a U.S. Agency for International Development–supported ACQUIRE Project Associate Award, is helping to equip facilities in the Ruvuma Region with obstetric wards and is improving the quality and use of family planning services by training health care staff, strengthening supervisors’ skills, and raising awareness in communities. Over the past year, more than 400 clients received long-acting or permanent methods of contraception at Madaba, and nearly 9,000 clients received these methods in the region overall. EngenderHealth, through funding from the President’s Emergency Plan for AIDS Relief (PEPFAR), also trains health care professionals to provide counseling and testing for HIV and AIDS, other reproductive health services, and life-skills coaching to youth.

    Last year, EngenderHealth assisted 38 facilities throughout Tanzania in improving the quality of their maternal health and family planning services.

    Learn more about EngenderHealth’s work in Tanzania.

    Tuesday, March 31, 2009

    Global Health Funding At Risk: Take Action Now!

    Click here NOW to contact your senators.

    As you know, we have been urging President Obama and the U.S. Congress to commit $1 billion to international family planning programs in 2010--which would be part of the Federal International Affairs Budget. The House and Senate budget committees have now approved a 2010 budget with significantly less funding for international affairs than in President Obama's original budget proposal, which called for $53.8 billion. The House committee proposes spending 10% less on international affairs than President Obama's budget, and the Senate committee calls for a 7.4% reduction.

    The International Affairs Budget supports critical global development and health initiatives that save children's lives, prevent the spread of HIV and malaria, and provide women and couples with lifesaving family planning that lets them plan their futures and offers opportunities to escape the cycle of poverty. We need to ensure Congress fully funds these vital international programs. The global financial crisis has only worsened conditions for the world's most vulnerable people, and our support now can significantly impact their lives.

    Senators John Kerry (D-MA) and Richard Lugar (R-IN) have introduced an amendment in the Senate to restore President Obama's original request level for the International Affairs Budget. It is very important that you e-mail a letter to your Senators and urge them to co-sponsor and vote for the Kerry-Lugar Amendment and oppose any other reductions in funding. You can also call the Senate switchboard at (202) 224-3121 and ask to speak your Senator's office.

    The time to act is now. Make sure your voice is heard! Go to www.engenderhealth.org/s2010 and send the message to your senators.

    If I Had a Billion Dollars...

    (This post by Dr. Isaiah Ndong, M.D., M.P.H., is Vice President for Programs at EngenderHealth, recently appeared on Reproductive Health Reality Check.)

    If I had a billion dollars, I know exactly how I would spend it: improving women's access to family planning in the world's poorest communities.

    Some might think this is an unusual choice. But throughout my 29-year career as a doctor and public health professional working in developing countries, I have seen first-hand how contraception can change women's lives-allowing them and their families to survive, thrive, and plan for better futures.

    We need to remember - amidst daily reports about a troubled economy here in the United States - that many of those living on the other side of the world confront daily emergencies of their own: poverty, malnutrition, HIV and AIDS, lack of health care, civil strife, and depleted environmental resources.

    There's no doubt that $1 billion is a lot of money. But for what amounts to just .03% of President Obama's proposed federal budget, a $1 billion investment in family planning can help mitigate all of these challenges at once.

    Family planning as a global health and development priority does not get the attention it deserves, particularly the direct connection between population and poverty. The chances that you can achieve a better life for your family are diminished when you are struggling just to feed and support your children. But with smaller families, parents can afford more for each child-providing better food, shelter, education, and health care-and can save more. This greatly improves their chances of breaking the cycle of poverty.

    With better access to family planning come opportunities to improve social, political, and environmental conditions. When women and couples can decide when to have children, their opportunities outside the home can also expand, and they may contribute more to their communities socially and economically. There is less competition for food, jobs, and housing and more equitable and less harmful use of natural resources. For families in rural areas, this could reduce the need to seek a better life in urban areas, where the daily influx of new migrants strains already limited infrastructure.

    Yet right now, millions of women and couples who wish to limit or space their births have no way to access the contraception that would let them do so. Over the last several years, U.S. support for family planning programs has dwindled while the need for it has increased, and few donors have stepped in to fill this gap. So a good portion of a $1 billion investment is needed just to rebuild these programs to the levels they were at several years ago. And across Africa and Asia, high levels of unmet need for contraception are likely to only grow as the largest youth generation in the world's history comes of reproductive age.

    These are all compelling reasons to support family planning, but the bottom line for me is that it is a right, and not having access to it is a price paid in women's lives. Maternal mortality continues to devastate families - with more than 500,000 women dying during pregnancy or childbirth every year. Up to one-third of these deaths could be prevented if women had access to contraception. And, family planning reduces deaths from AIDS; it is the most effective way of preventing mother-to-child transmission of HIV.

    the coming weeks, President Obama will be making allocations for the fiscal year 2010 federal budget. Please join me in calling on him to raise the United States commitment to international family planning programs to $1 billion in 2010-less than a penny per day per American.

    It's sure to be one of our wisest investments.

    Visit www.3for1.org or www.engenderhealth.org to send President Obama a letter and join our campaign.