Population and Reproductive Health

In its Population and Reproductive Health grantmaking, the Foundation remains committed to a world that allows for the full richness of human experience, both personal and global. Family planning is a central component of the Foundation's grantmaking in this area. In 2008 and 2009, the Population and Reproductive Health program awarded grants that aimed to increase funding and other resources for family planning services and improve systems of care that deliver family planning services.

Increase Funding and Other Resources for Family Planning Services

The Foundation supports efforts to increase resources available for family planning services. It places special priority on projects that develop new constituencies and/or link support for family planning to other movements and issues.

Federal funding of international family planning is largely supported by governmental actors that focus on international development. It is not, broadly speaking, part of the nation's human rights agenda. Taking advantage of Secretary of State Hillary Clinton's considerable support for women's rights and issues, the Center for Reproductive Rights (CRR) aims to mainstream reproductive rights into the nation's human rights policy. With Foundation support, CRR is advocating for inclusion of reproductive rights in the State Department's Country Reports on Human Rights. These reports help shape foreign policy, based on human rights, in Congress and other branches of government. CRR will also investigate strategies for using these reports to advocate for stronger reproductive rights policies internationally.

The Foundation has long taken a leadership role in linking population and reproductive health to the environment, including projects to strengthen support for reproductive rights among environmental constituencies. The Global Population and Environment Program of the Sierra Club, the nation's largest grass roots environmental organization, has recently launched a new campaign, the Population Justice Environmental Challenge. With Foundation support, the Sierra Club is conducting a book tour to the organization's chapters and groups, featuring a reproductive justice framework presented in A Pivotal Moment: Human Population, the Environmental Crisis and the Justice Solution, edited by Laurie Mazur (developed with Foundation support and described in previous highlights). By working with multiple partners and linking to the many constituencies represented in the book, the Sierra Club aims to broaden support among its members for international family planning.

The Worldwatch Institute is recognized internationally for disseminating research on pressing environmental issues, through many media. In 2009, Worldwatch's Robert Engelman was invited to author the annual publication of the United Nations Population Fund (UNFPA), the "State of World Population 2009." The 2009 edition, subtitled "Facing a Changing World," has as its theme population, women's lives and climate change. With Foundation support, Worldwatch is leveraging Mr. Engelman's work for UNFPA, raising the profile of the population-climate link among its global dissemination network. Specifically, the project is offering a compelling argument through multiple media that expanded funding for family planning can serve as a "wedge" in efforts to reduce emissions that contribute to climate change.

In addition to linking to other issues, such as the environment and human rights, the Foundation supports other projects that aim to increase funding for family planning and other reproductive health services. Outside the U.S., many donor countries and multi-lateral donors are delegating decisions about the allocation of international aid to recipient governments. Family planning advocates in the Global South need both the skills and the capacity to ensure that their governments allocate sufficient funds for reproductive health services. The International Health Programs (IHP) division of the Public Health Institute has developed an innovative model of leadership training that combines increasing the skill set of individual advocates with seed grants, sustained technical assistance, and a regional network. With Foundation Support, IHP is now launching a new training program that focuses on increasing the capacity of leaders in Central America to advocate for adolescent reproductive health services.

Some countries are further delegating responsibilities for funding and stocking of contraceptives to state and local governments, which may or may not prioritize reproductive health services for women. The Mexican government is delegating greater responsibilities to Mexican states, including the purchase and maintenance of contraceptive supplies and management of multiple funding streams that support family planning services. With Foundation support, Equidad de Genero will monitor the funding and availability of family planning methods in two Mexican states. Findings from this research will shape their advocacy efforts with state and local partners.

The Foundation also supports a small number of projects that explore its population and reproductive health goals through the arts. The Moxie Institute combines film and educational tools using emerging internet technology to engage Americans in a dialogue about social issues. With Foundation support, the Institute is creating Connected: A Declaration of Interdependence, a film and educational materials that examine the links between environment, poverty, globalization, population, and reproduction. The project has the ear of major public figures. After a meeting with Secretary of State Hillary Clinton, the Institute was invited by the State Department to screen Connected when it is complete. In partnership with the Aspen Institute, the Moxie Institute also plans to launch an International Interdependence Day, using Connected as the centerpiece.

Improve Systems of Care that Deliver Family Planning Services

In its grantmaking to improve systems of care, the Foundation recognizes that increasing access to high quality family planning services often requires differing service delivery models, especially for underserved populations of women and men.

Since the early 1990s, the Foundation had taken a leadership role in grantmaking in addressing the reproductive health needs of women in conflict settings, linking two of its priority areas, Population & Reproductive Health and Peace & Security. With support from the Foundation, the International Rescue Committee (IRC) is forging new ground in southern Sudan by integrating family planning into its primary health care system.

The Foundation recognizes that achieving reproductive health and well being also includes assuring equitable access to safe and affordable abortion. In the U.S., the "Hyde Amendment" does allow public funding of abortion in limited circumstances, (e.g., rape). However, many women who present cases that meet the "Hyde criteria" are nonetheless unable to access public funding. With Foundation support, Ibis Reproductive Health is conducting research to examine the system barriers faced by these women; Ibis will use the findings to advocate for policy and system change, in partnership with advocacy organizations.

High quality systems must address barriers posed by the unique aspects of family planning services. For example, some women may experience unwanted side effects and "compliance" with a method may involve uncomfortable conversations with a sexual partner. Service delivery models commonly do not address these "post visit" barriers to care. With Foundation support, NARAL Pro-choice Colorado Foundation is piloting a new model of service delivery to reach low-income women who are most likely to experience unintended pregnancy. Based on its research on barriers to family planning services experienced by women in Colorado, the organization partnered with a community clinic to develop this model, which includes community- and clinic-based health education.

Adolescents face special barriers to care, given their minor status. Despite laws that allow confidential health services for teens, there remain many barriers, including misunderstandings on the part of clinicians, parents and teens themselves. With Compton support, the California Adolescent Health Collaborative is updating the Minor Consent and Confidentiality Toolkit in partnership the Adolescent Health Working Group, creator of the original toolkit. The updated toolkit will address these barriers, reflecting the adolescent health field's growing recognition of the important role of parents in nurturing their teen child's increasing independence.