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.

What is 3FOR1? Watch our new video, and join us.

Today, EngenderHealth is launching the 3FOR1 campaign urging President Obama and
Congress to commit $1 billion to international family planning programs
in 2010. We're asking you to join us.

Family planning is a basic right. Yet, there are an estimated 201
million women worldwide who want to use it, but can't--they do not have
access. Changing this reality through increased U.S. investment can
bring significant short- and long-term returns: When women and couples
are able to plan their families, they have the chance to have healthier
and better-educated children and more productive lives, which can lead
to more stable and economically strong communities and countries.

President Obama has stated that he wants to change the way the United
States is viewed around the world. One way to demonstrate this is to
commit to improving women's health and welfare through a stepped-up
investment in family planning.

Right now, the U.S. budget for international family planning is not much
higher than it was in 1974, when adjusted for inflation. To keep up with
the large and growing need for family planning, we call on the
President to increase the U.S. contribution to this global effort to
$1 billion. This represents less than one twentieth of 1% of the
proposed 2010 federal budget--less than a penny per day for every American.

Help us ensure international family planning and reproductive health are
top priorities for the U.S. government. Watch EngenderHealth's new video
and write a letter to President Obama calling for $1 billion to be
dedicated to international family planning.

Reproductive Health: Front and Center in Azerbaijan

A recent national conference organized by EngenderHealth demonstrates that reproductive health has become a top priority for the Azerbaijani government. On February 17–18, more than 100 policymakers, health care professionals, and other leaders attended the reproductive health quality improvement conference in Baku. Over the last four years, EngenderHealth has been partnering with the Azerbaijani government (through the ACQUIRE Project) to strengthen its reproductive health systems. The need for better health services is great: Like many former Soviet republics, abortion had been the main method of family planning in Azerbaijan, and contraceptive choice was severely limited.

	“This conference brings reproductive health and family planning issues to a new level among parliamentarians—89% of whom are men and think that reproductive health problems are women’s concerns.” –Malahat Hasanova, member of Parliament

Participants in the meeting included four members of the Azerbaijani Parliament, officials from the government’s Ministry of Health (at the national and regional levels), doctors, health care staff, medical school administrators, and representatives of partner organizations. The discussion centered on barriers to care, and the attendees developed an action plan to address these issues.

A centerpiece of the meeting was the government officials’ presentation of a draft of the country’s first reproductive health law, which ensures the right of all Azerbaijanis to high-quality reproductive health care and family planning.

Throughout the process of developing the law and leading up to this meeting, EngenderHealth has emphasized the importance of improving the quality of reproductive health care and family planning, upholding clients’ rights to safe and effective services, and ensuring informed choice and confidentiality. EngenderHealth staff also successfully advocated for the inclusion of contraceptives on the Essential Drug List and helped the government draft the section detailing the country’s contraceptive supply needs. Additionally, EngenderHealth shared its publications on Islam and family planning, its experience working in other Muslim countries, and its expertise in applying evidence-based quality improvement approaches like COPE®.

CHAMPION Project Launches in Tanzania

What can communities do to help men become part of the solution for healthier families? These and other questions were debated at the launch of the EngenderHealth-led CHAMPION Project in Tanzania on February 17. More than 170 guests gathered at the Mövenpick Hotel in Dar es Salaam for the interactive event. The five-year CHAMPION Project, supported by the U.S. Agency for International Development (USAID), inspires men to become partners and leaders in combating some of the most serious reproductive health challenges in Tanzania, including HIV and AIDS.

“Men have long been acknowledged as providers, central players in the community, and on the world stage. But far less attention has been paid to men’s roles in promoting the health of the family.”
–Robert Cunnane, Director of the USAID Mission in Tanzania

Each invitation for the launch had the message “Be part of the solution” and a puzzle piece, which attendees were asked to bring to the event. At the launch, the puzzle was completed and revealed a photo of a male champion, a man who had taken an active, positive role in promoting health in his family and community. The completed puzzle illustrates that it takes a community to create champions. Other such champions were featured in a photo exhibition spread throughout the venue.

Officiating at the event, the Honorable Samwel Sitta, Speaker of Tanzania’s National Assembly, noted that harmful gender stereotypes had greatly affected the country’s health systems and the health of individual citizens, accelerating the HIV epidemic.

Other attendees included Robert Cunnane, USAID Mission Director in Tanzania; Fatma Hadfidh Mrisho, Executive Chairman of the Tanzania Commission on AIDS; other government officials; and representatives of the donor community and religious organizations.

Making Your List of Top Ten Nonprofits

An article on Fast Company today mentions EngenderHealth in a list of top ten nonprofits, along with advice on choosing a nonprofit to support:

"Choosing your Top Ten nonprofits is very personal. Consider these points as you decide:

1. "What the organization does – the mission and work has to be personally meaningful to you;
2. "The programs – they need to demonstrate their effectiveness in solving the problem
3. "Caliber of the CEO – the CEO must be an expert and a highly effective leader;
4. "Caliber of the board – and especially the board chair/president – for an organization to do its best, the board should be engaged and supportive – and the board should include people from diverse backgrounds and perspectives;
5. "Budget – most nonprofit revenues are stressed right now; the question is whether there is core funding from a solid base, and whether there is active CEO and board involvement in building viable, new revenue opportunities – through philanthropy, or fees for services, or government sources. Even if that’s not the case, perhaps you can help if you are passionate about the mission. Just be aware of how challenging the situation is.
6. "Where you can add value."
   

The full article is online.