Alisha Graves contributed a blog post to the Wilson Center’s New Security Beat. Read the article here.

Governments worldwide must invest in girls’ education, family planning, agriculture and security in this vulnerable region.

By Alisha Graves, Lorenzo Rosa, Abdoul Moumouni Nouhou, Fadji Maina & Djimé Adoum

Let’s begin not with dreams but by going to the zoo. Penguins are monogamous. Females lay a large egg and then return to the sea to feed. The male incubates the egg for many weeks. When he is nearly dead from hunger and cold, the egg hatches and his mate returns. She regurgitates food to feed the fledgling while he goes to sea to feed. Many bird species are monogamous because the two sexes can share in bringing up the next generation.

Sixty years ago, one of the most consequential events of the past century occurred: the first sale of a drug called Enovid. At the time, it was illegal to use any form of contraception in Massachusetts, where Enovid was developed. But soon everyone just called Enovid the Pill.

What is women’s empowerment, and how and why does it matter for women’s health? These are questions that the University of California Global Health Institute’s (UCGHI) Center of Expertise (COE) on Women’s Health, Gender, and Empowerment aimed to answer with this book. Since 2009 the COE has brought together a multidisciplinary network of experts from across the University of California (UC) campuses and departments, along with their global partners, to advance research and education on what has become a capstone theme in the global health and development agenda: women’s and girls’ empowerment and health. Women’s Empowerment and Global Health demonstrates the outcomes of COE's commitment to advance pedagogy and present the work of thought leaders in this domain.

Warrantage and FMNR are two farmer-led practices to help mitigate impacts of climate change on agriculture in the Sahel. In late 2016, the OASIS Initiative released two reports on these practices. The two comprehensive literature reviews were commissioned by USAID’s Sahel Resilience Learning Project. We are now disseminating the findings to local partners and organizations to assist them in making evidence-informed decisions based on the experiences of communities and experts in the region.

We are excited that the next phase of this effort will build on our “Sister School” partnership with the University Abdou Moumouni (UAM) in Niamey, Niger. Several graduate students from UAM will be focusing on these topics for their masters theses, providing them with valuable experience conducting community-level research as well as gathering and building the evidence base on perspectives of communities who are practicing Warrantage and FMNR in the region.

After a generation of partial neglect, renewed attention is being paid to population and voluntary family planning. Realistic access to family planning is a prerequisite for women's autonomy. For the individual, family, society, and our fragile planet, family planning has great power.

A consensus emerged in the late 1990s among leaders in global maternal health that traditional birth attendants (TBAs) should no longer be trained in delivery skills and should instead be trained as promoters of facility-based care. Many TBAs continue to be trained in places where home deliveries are the norm and the potential impacts of this training are important to understand. The primary objective of this study was to gain a more nuanced understanding of the full impact of training TBAs to use misoprostol and a blood measurement tool (mat) for the prevention of postpartum haemorrhage (PPH) at home deliveries through the perspective of those involved in the project. This qualitative study, conducted between July 2009 and July 2010 in Bangladesh, was nested within larger operations research, testing the feasibility and acceptability of scaling up community-based provision of misoprostol and a blood measurement tool for prevention of PPH. A total of 87 in-depth interviews (IDIs) were conducted with TBAs, community health workers (CHWs), managers, and government-employed family welfare visitors (FWVs) at three time points during the study. Computer-assisted thematic data analysis was conducted using ATLAS.ti (version 5.2). Four primary themes emerged during the data analysis, which all highlight changes that occurred following the training. The first theme describes the perceived direct changes linked to the two new interventions. The following three themes describe the indirect changes that interviewees perceived: strengthened linkages between TBAs and the formal healthcare system; strengthened linkages between TBAs and the communities they serve; and improved quality of services/service utilization. The data indicate that training TBAs and CHW supervisors resulted in perceived broader and more nuanced changes than simply improvements in TBAs’ knowledge, attitudes, and practices. Acknowledgeing TBAs’ important role in the community and in home deliveries and integrating them into the formal healthcare system has the potential to result in changes similar to those seen in this study.

By Clara Ejembi, Oladapo Shittu, Molly Moran, Faraouk Adiri, Olugbenga Oguntunde, Babalafia Saadatu, Idris Hadiza, Larai Aku-Akai, Mohammed A. Abdul, Victor Ajayi, Natalie Williams and Ndola Prata

Meeting the world’s need for family planning is a human right and a climate imperative. Wherever women have been given information and access to family planning, birth rates have fallen – even in poor, low-literate societies like Bangladesh or conservative religious countries such as Iran.

Parts of Africa have the most rapid population growth in the world. Recent studies by climatologists suggest that, in coming decades, ecologically vulnerable areas of Africa, including the Sahel will be exposed to the harshest adverse effects of global warming. The threat hanging over parts of sub-Saharan Africa is extreme. Fortunately, there are evidence-based achievable policies which can greatly ameliorate what would otherwise be a slowly unfolding catastrophe of stunning magnitude. But to succeed such measures must be taken immediately and on a large scale.

The wide gap in maternal mortality ratios worldwide indicates major inequities in the levels of risk women face during pregnancy. Two priority strategies have emerged among safe motherhood advocates: increasing the quality of emergency obstetric care facilities and deploying skilled birth attendants. The training of traditional birth attendants, a strategy employed in the 1970s and 1980s, is no longer considered a best practice. However, inadequate access to emergency obstetric care and skilled birth attendants means women living in remote areas continue to die in large numbers from preventable maternal causes. This paper outlines an intervention to address the leading direct cause of maternal mortality, postpartum haemorrhage. The potential for saving maternal lives might increase if community-based birth attendants, women themselves, or other community members could be trained to use misoprostol to prevent postpartum haemorrhage. The growing body of evidence regarding the safety and efficacy of misoprostol for this indication raises the question: if achievement of the fifth Millennium Development Goal is truly a priority, why can policy makers and women’s health advocates not see that misoprostol distribution at the community level might have life-saving benefits that outweigh risks?