Denied! Witholding of UNFPA Funds Matters

Anika Rahman

At the dawn of a new year, women around the world still rely on crucial funds from UNFPA for health care and family planning. But our current administration continues to withhold the money.

Many, many times in this forum I've lamented that while the U.S. Congress allocates a contribution to UNFPA, the current Administration withholds the funds, making us the only country in the world that has ever declined to support UNFPA for reasons that are political rather than financial. Ever wonder where the money goes?

Much as I wish it did, the money doesn't just sit in a bank account, waiting for a change of heart or a more supportive President. Most of it reverts to the United States Agency for International Development (USAID) for global health and child survival programs.

The omnibus appropriations bill that passed Congress last month earmarks $40 million for UNFPA. This is a $6 million increase over last year's allocation, which is progress, except for that whole withholding problem.

USAID provides international assistance – which among other things includes contraception, safe motherhood initiatives, HIV prevention – in about 100 countries that are strategically important to the United States. For example, since the 1970s, Israel and Egypt have long been the largest recipients of U.S. aid. Not surprisingly, recently, Iraq has received a huge amount of foreign assistance from our government. Our government also invests in global health issues, particularly HIV/AIDS. (I will discuss at some other points the restrictions we place on these funds, particularly the requirement that one-third of our HIV/AIDS funds be focused on abstinence.) The theory being that the healthier a nation is and the better living standards it has, the better it is for its citizens and for us all. And the more educated the people, the better their chances of a government that recognizes human rights.

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This is all very necessary and important. But here's why it's important for the United States to contribute to UNFPA in addition to all the work it does through USAID.

UNFPA works in about 150 countries based on the needs on the grounds, not the political priorities of powerful nations. So the women of Niger get international assistance because their government requests it. Why? Unselfish motivation: all people are entitled to human rights and a basic standard of living. Selfish motivation: when women are healthy, more economically stable and more able to participate in society, the society evolves to the benefit of all of us.

UNFPA's funding is very much based on this idea of global community. In 2006, Niger – the country ranked last on the economic development index – contributed $5,000, which goes into the pot with the contributions from all over the world, including countries like the Netherlands which contributed almost $70 million.

From this pot of money, UNFPA supports change from the bottom up and the top down. For example, part of the money goes to support programs created and implemented by local women to address challenges within their own community. So, in Niger, UNFPA funds Dimol, a non-profit created by Salamatou Traoré (whom I've mentioned before) to support fistula patients and prevent fistula at the community level.

That pot of money also funds UNFPA's Campaign to End Fistula which, among other things, sponsors trainings where the small number of doctors who can do fistula repair, train their peers from all over Africa and Asia.

And because UNFPA has the legitimacy of the United Nations, it can also work with governments to promote women's access to health care and to implement laws and policies that support girl's education or prevent violence against women. UNFPA is the watchdog for the world's women, ensuring that their particular needs are considered when international aid is established in the wake of a natural disaster.

As a multilateral organization, UNFPA's work is not subject to the policies of one particular country. So, for example, condom distribution is based on what the government of a country believes its people need, not what the government of the United States believes another country's citizens need.

Perhaps the best way to explain the importance of a U.S. contribution to UNFPA, even while our government contributes a much larger amount for similar programs through USAID, is UNFPA's family planning program in Iran. It is unlikely that Iran would accept a similar program funded by USAID. Most of us would agree that while we may dislike the policies of the Iranian government, we support the rights of Iranian women.

So, as we close one year with hopes and aspirations for the next, let's bring peace and prosperity by continuing to believe in women and investing in their wellbeing-universally and without bias.

Analysis Maternity and Birthing

Data Show Maternal Deaths Continue to Decline Worldwide

Jessica Mack

Last week the UN released its latest estimates on global maternal deaths, just  two years after the last figure. From 1990 to 2010, they found, the number of women dying from pregnancy- and childbirth-related causes worldwide dropped from 543,000 to 287,000, a near-fifty percent reduction in fatalities.

Last week the UN released its latest estimates on global maternal deaths, just two years after the last assessment. From 1990 to 2010, the UN found, the number of women dying from pregnancy- and childbirth-related causes worldwide dropped from 543,000 to 287,000, a near-fifty percent reduction in fatalities. The UN also finds that:

  • Sub-Saharan Africa continues to have the highest maternal mortality ratio in the world, with a woman in the region facing a 1 in 39 lifetime risk of dying due to pregnancy or childbirth-related complications.
  • Ten countries shoulder 60 percent of the global maternal mortality burden, some of them notably “middle income” and emerging global giants: India, Nigeria, Democratic Republic of Congo, Pakistan, Sudan, Indonesia, Ethiopia, Tanzania, Bangladesh, and Afghanistan.
  • Ten countries have already reached the MDG 5 target of a 75 percent reduction in maternal death: Belarus, Bhutan, Equatorial Guinea, Estonia, Iran, Lithuania, Maldives, Nepal, Romania and Viet Nam.

The is great news, as it was two years ago, when both the UN and the Institute for Health Metrics and Evaluation (IHME) released data suggesting a considerable drop in maternal deaths in the recent decades. IHME updated their own figures last year, suggesting that in 2011, just 273,500 maternal deaths occurred.

This latest data falls in line with what much of the global community has suspected – progress is occurring, though still not at the pace at which it must. These latest numbers makes the picture clearer, though still not clear. Generally spotty data registry systems, for births, illnesses, or deaths, coupled with the large proportion of deaths that take place in rural and remote areas mean that these numbers are vague estimates at best. When a woman dies in pregnancy or childbirth, it may not be captured as a maternal death, and perhaps not captured at all. While it is not the case with all maternal deaths, in societies where women’s health and rights are devalued, their deaths are often not counted.

Another bugaboo in global maternal mortality data is the role of unsafe abortion.

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Unsafe abortion remains a persistent epidemic in developing countries, where 99 percent of maternal deaths occur. Restrictive abortion laws and/or lack of knowledge or access to safe services put women at grave danger. The stigma of abortion means that an abortion-related death will often not be catalogued as such, though the WHO considers it a leading cause of maternal mortality. 

Earlier this year, the Guttmacher Institute released a report showing that while global abortion numbers seem to be down, the number of unsafe abortions happening worldwide are on the rise. Surely this should be reflected in maternal deaths – though may not be immediately for several reasons. The unmet need for contraception around the globe – more than 215 million women – almost certainly contributes to the rate of unsafe abortion, and maternal deaths more broadly.

The two leading causes of maternal mortality – excessive bleeding after childbirth and hypertension that can lead to fatal seizures – can both be treated fairly easily with cheap drugs already available in developing country markets. This is the “close but no cigar” burden under which maternal health advocates are operating: it’s not that we don’t know how to save women, or even that we do not have the means. It’s making the final link, between intention and action, or between availability and access, that remains unfortunately elusive.

The deadline for the Millennium Development Goals (MDGs) is 2015, and MDG 5, calls for improvements in maternal health. Progress has been impressive in some countries, especially where access to contraception has been prioritized, and front-line health workers – or the roll out of basic trained health providers such as midwives – have been supported.

There are clear models of what is working and what isn’t, and as the numbers roll in, it’s up to the maternal health – and broader development community – to assess this and move swiftly before more lives are lost. Maternal deaths are significant losses not just for a family, but for an entire community and nation, with economic, social, and health implications that reach out much farther than we often realize. 

News Law and Policy

India’s Newest Landowners Signal a Sprouting Revolution

Jessica Mack

One year ago, India’s first-ever Women’s Land Rights Facilitation Center opened in Odisha State. This month, 150 local women were approved to receive the titles to their land. There has been increased global momentum around women, land, and farming but for all the talk, will there be the walk? 

One year ago, India’s first-ever Women’s Land Rights Facilitation Center opened in Odisha State. Focusing on women in the coastal Ganjam District – where one in three are agricultural laborers – the Center worked to increase women’s knowledge of land rights and support them in flexing their legal muscles to get it. Twelve months of community outreach, collaboration with local government officials, and guiding women through the bureaucratic land title application process have yielded quite a harvest.

This month, 150 women – divorced, widowed, or single mothers, and all heads of their household – were approved to receive the titles (in their own names) to the land on which they already work and live. This is major. “Across India, as per government data, close to 35 percent of all households are headed by women, and they are vulnerable,” said Sanjoy Patnaik, who oversees the Center and directs the work of Landesa in Odisha. With the rights to their land, these women now have financial and agriculture security that allows them to invest and yield much more. They will benefit, as will their families, but so will their community and eventually their national economy.  

India’s economy is one of the fastest-growing in the world, and soon this country that has been “emerging” for so long will be “emerged.” Yet rapid progress in many sectors hasn’t translated as such for half the population. From sex-selective abortion to child marriages, street harassment and lack of land tenure, India’s gender gap has dug its heels in. This gap is perhaps most obvious – and problematic – in the agricultural sector, where women supply approximately 30 percent of the labor countrywide (though this is much higher in some regions). In almost every facet, women are at a disadvantage starting with the most foundational issue, land security, which compels greater investments and greater yields. That includes access to seeds or fertilizer, training on better farming techniques, and even entry into farming collectives.

It’s not just India, though, it’s a global trend. A new infographic called “The Female Face of Farming,” from the inspired collective Farming First, provides a critical primer on issues that rural and farming women face. The contrast between the inequities of those issues and the amount to which women farmers contribute to the nourishment of their (and our!) countries is stunning:

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  • About half of economically active women worldwide cite agriculture as their primary source of income, yet barely any own the land they farm.
  • When women do own land, it tends to be smaller, worse quality, and more insecure plots.
  • Women farmers produce a smaller crop yield than men solely because they have dramatically less access to training and technologies like seeds and fertilizer.
  • Only 10 percent of global aid for agriculture, forestry, and fishing goes to women.

“I find everywhere, even listening to the women farmers in America, that security is not there. We want both men and women to have the liberty to live the way they would like to,” said Dr. Sarala Gopalan, an Indian farmer, advocate, and educator who is part of Farming First. Gopalan was in New York recently for the 56th Commission on the Status of Women, which this year focused on rural women’s empowerment. She works to train and support women farmers across India (when she’s not checking up on her family’s coconut farm).

“My main mission is to see that [women farmers] get the technologies that have been developed. Women are very quick to learn, irrespective of their education level. They catch on to new ideas and then they come back to you and tell you how to do things better. It’s very exciting.”

Women’s access to training and education is a persistent theme. In most rural and hard-to-reach areas where women are farming, ‘agriculture extension workers’ are the lifeline that provide education about techniques and technologies, or deliver supplies. Yet most are men and they tend to reach out to other men. This isn’t a new problem, though, and suggested solutions (like hire women as agricultural extension workers themselves) have been around for decades.

Yet recently there has been an historic upswing in global attention to the intersections of women, farming, and land – intersections where millions of women reside. Growing food insecurity around the world is already adversely affecting developing and developed countries, and it also seems to be finally dawning on people that, around the world, women very often run the farm. There is no shortage of speeches, articles, or global gatherings on this issue in the past several months. But for all the talk, will there be the walk?

Global momentum is a good thing, as long as it can be grounded in concrete actions.

“Women in developing countries are only interested in concrete actions – whether more and better projects for women are actually implemented and whether more women are supported in their efforts to solve their problems on the road to self determination,” wrote D. Obermaier in Development + Cooperation Magazine more than 20 years ago. 

This couldn’t be any truer today. The 150 women approved for land titles this month in Ganjam District are proof that concrete actions and self determination are very possible. “Even just six months ago, there was local apprehension in Odisha that women might not be interested in gaining land titles and therefore there might not be many cases [for the Center]. But many women proved us wrong by trying to learn about the centre on their own and creating a demand,” said Patnaik.

Ensuring land rights for women is foundational. But improving access to farming supplies, training on better farming, and the ability for women to become those trainers themselves is paramount. This is a continuum of access that does not just depend on the right laws and policies, though this is critical. But rather it demands constant vigilance, advocacy, and always walking the walk to change anything for women farmers.