In “Life in Abundance,” an article from the latest issue of Sierra magazine, Paul Rauber gives us an inside look at family planning in Ethiopia, speaking with women in urban and rural environments to understand what government support of family planning has meant in practice. The government’s official embrace of family planning is a sharp and welcome shift from the previous dictatorship’s ban on mentioning it, but this endorsement, welcome as it is, doesn’t guarantee funding. Consequently, family planning programming, robust in urban areas, has yet to reach much of the vast rural expanse of Ethiopia. It is also heavily dependent on outside donors and NGOs for funding.
Thanks to one of the highest fertility rates in the world—5.4 children per woman—Ethiopia’s population has quintupled in the last 70 years. It now stands at 77 million, and is projected to double by 2050. Other indicators are equally discouraging: Rauber reports that average life expectancy is 48 years, that one in eight children dies before reaching five years of age, and that half of all children are undernourished.
One group trying to improve these statistics is Pathfinder International, whose integrated population-health-environment program in Ethiopia aims to “boost family planning, healthcare access, and environmental-restoration efforts through improving the lot of women and girls.” Rauber notes that Ethiopian women with at least some secondary education have one-third as many children as women with no or little education. Ethiopia, he says, is ripe for such integrated interventions; two-thirds of women want but lack access to family planning, and only one in 10 rural women uses any form of contraception. Pathfinder’s program, strongly backed by communities, has been successful in enrolling women in literacy classes, testing for HIV, planting mango and avocado trees, and curbing female genital mutilation.
For a look at another integrated PHE program in Ethiopia, see ECSP Director Geoff Dabelko’s photographs of the Berga Wetland Project, which includes conservation activities oriented around the White-Winged Flufftail bird; a small health facility offering basic maternal, children’s, and reproductive health services; and a community school.
Ethiopia has hosted several large PHE events in recent months, demonstrating the country’s enthusiasm for the approach. In November 2007, more than 200 members of the PHE community gathered in Addis Ababa for “Population, Health, and Environment: Integrated Development in East Africa,” a conference sponsored by the Population Reference Bureau and LEM Ethiopia. Rauber’s tour of Ethiopia, which also included substantial birdwatching, was jointly organized by the Sierra Club and the Audubon Society, both participants at the November meeting. Also emerging from this conference, which ECSP helped organize, was the East Africa Population-Health-Environment Network, a group working toward “an Eastern African region where men, women, and children are healthy, the environment is conserved, and livelihoods are secure.” In May of this year, Ethiopia launched its national chapter of the network, the Consortium for Integration of Population, Health, and Environment, in Ambo.