Memo to the President-Elect: Improve Reproductive Health to Strengthen Foreign Aid

Susan Farnsworth

To truly strengthen international development, President-elect Obama and the new Congress need to de-politicize foreign aid and focus on improving impact on the ground.

The U.S. Congress has put
reforming the 40-year-old Foreign Assistance Act high on their agenda for next
year.  If done correctly, it can help ensure that our aid to other nations
is responsive to local needs, is effective and has long-lasting impact. This
will be one of the most important global challenges for the next Congress, and
for President-elect Barack Obama.

Though we don’t know
his specific stance on foreign aid reform, Senator Obama has indicated that he
supports strengthening U.S.
foreign assistance in his campaign platform. It states that his administration
will "embrace the Millennium Development Goal of cutting extreme poverty
around the world in half by 2015" and "help the world’s
weakest states to build healthy and educated communities, reduce poverty,
develop markets and generate wealth."

To truly strengthen
international development, President-elect Obama and the new Congress will need
to focus reform efforts on improving impact on the ground and
putting the needs and lives of people at the center. Because of the
politicalization of so many areas of aid, one of their most difficult tasks
will be to agree on program priorities in a revised Foreign Assistance

With over thirty years of
experience working hand-in-hand with local organizations to improve
communities, the Centre for Development and Population Activities (CEDPA) has a
number of specific recommendations that would go a long way to make aid more
effective.  Chief among these is the need to recognize the linkages
between sustainable development, women’s empowerment and gender equality,
and health, including reproductive health.

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Decades of research from the
United Nations, the World Bank and others show that greater investments in
women’s empowerment and gender equality reduces poverty and improves
governance. A reformed U.S. foreign
aid system must reflect this consensus, and do a better job of using gender
analysis at all levels of planning and implementation, and provide dedicated

It is difficult to talk
about women’s empowerment without addressing their reproductive health
needs. Pregnancy-related complications are among the greatest killers of women
of reproductive age in developing countries. Despite the fact that more than a
half a million women die each year in pregnancy and childbirth, and that
maternal mortality could drop by 25-35% if family planning methods were
available for the estimated 137 million women in the developing world without
access to these services (according to the Guttmacher Institute), too often
U.S. domestic politics trump the realities faced by millions of women living in
developing countries.

Most of the rest of the
world supports investments in reproductive health through decades of global
agreements–including most recently the Millennium Development Goals.
President-elect Obama and Congress should join this global consensus and
integrate the reproductive health needs of women and girls into their foreign
aid reform plans.

CEDPA’s experience on
the ground gives us firsthand knowledge that reproductive health programs are
cost-effective and have broad and sustainable development impact.  In Nigeria,
for example, CEDPA has worked since 1985 to empower women and their families to
improve reproductive health and reduce maternal mortality. Nigerian women have
a 1 in 18 lifetime risk of dying in childbirth, among the highest in the world.

of our recent efforts, the "Kyautatawa Iyali" (Family Welfare)
project, educates families about reproductive health and provides
community-based family planning services in the largely Muslim northern
Nigerian states of Bauchi, Kano
and Plateau. CEDPA’s program works closely with religious and community
leaders, who we find recognize the benefits of family planning for improved
health and the necessity to address the reproductive health needs of young

hallmark of the Family Welfare program is the door-to-door delivery of 
information and services to families. Teams of community health extension
workers go from house to house, talking to men and women, old and young, about
the importance of family planning and reproductive health care for the
well-being of women and families. Often, male and female workers go out
together so they can talk with both husbands and wives about their health

date, CEDPA and its partners have reached more than 500,000 people directly
with family planning services, and many millions of men and women with
educational information through interpersonal talks, home visits, mass media,
and public events and rallies. The program will continue through 2010, with
special attention to building the capacity of CEDPA’s local partners so
that each can carry on the important work of improving family health-and
saving the lives of mothers and their children long after the project formally

Family Welfare program in Nigeria
is an example of a development program that strengthens and empowers
communities to take responsibility for the well-being of their families. We
must recognize that to be truly effective, communities must be supported by a
policy environment and a governance structure that allows them to exercise
their responsibilities and their rights to improved health.

reformed U.S. foreign aid program that takes into account local needs and
builds local capacity and support-and prioritizes proven, lifesaving
interventions such as family planning-will go a long way to reducing
poverty and improving health. The incoming administration and the 111th
Congress need to put politics aside and promote and support such efforts.

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