This article is part of the Sacred-Public Partnerships series, published in collaboration with Shared Justice, an initiative of the Center for Public Justice. The series explores the ways in which faith-based organizations – the sacred sector – and government partner for good. Sacred-Public Partnerships focuses specifically on the intersection of the sacred sector, religious freedom, and government-administered social safety net programs and explores why partnership between government and the sacred sector is essential to the success of social services in the United States.
By Julia Metcalf
Many organizations have taken notice of the number of women and children that are at-risk due to a lack of healthcare and health education surrounding pregnancy and childbirth. The number of deaths and illnesses during pregnancy and childbirth for women and children is staggeringly high in the U.S., even with our immense access to medical technology and professionals. However, the number, as one might imagine, is higher still in developing countries. Hope Through Healing Hands, a nonprofit organization with a mission “to promote improved quality of life for citizens and communities around the world using health as a currency for peace,” reported that worldwide “more than 303,000 women die annually from complications during childbirth and pregnancy,” and in sub-Saharan Africa, for instance, “a woman’s maternal mortality risk is 1 in 38 compared to 1 in 3,700 in developed regions.”
Addressing this crisis requires a shared response. In many cases, sacred-public partnerships are essential in providing education, resources, and services both domestically and internationally. The health and safety of mothers and children throughout the world is a shared goal among many sectors of society – not just government or nonprofits and faith-based organizations, for example. The Center for Public Justice espouses a public justice framework which places a high priority on the relationship between government and civil society institutions, as well as the proper roles and responsibilities of those institutions.
Hope Through Healing Hands and the Bill & Melinda Gates Foundation are two examples of civil society institutions that make distinct contributions to maternal health and also interact with government in a variety of ways. Both advocate for Healthy Timing and Spacing of Pregnancies (HTSP), which is commonly known as Family Planning (FP) within North American culture. HTSP is a planning tool that helps women evaluate and make a conscious decision about the number and timing of their pregnancies. According to Hope Through Healing Hands, the strategic use of HTSP can “dramatically improve the health and chances of survival of both women and children.” Similar guidance is given by the United States Agency for International Development (USAID), which has found that if women leave three years in-between a birth and a new pregnancy, approximately 1.6 million deaths of children under five years of age could be prevented annually.
USAID is an independent agency of the federal government which provides civilian foreign aid and developmental assistance and partners with faith-based organizations, nonprofits, and other civil society institutions. HTSP is a part of USAID’s RISE initiative, which began early 2014. Although the initiative began as an internal effort of USAID, it soon evolved into a meaningful partnership between USAID and other organizations that now work collaboratively toward the same goal.
“The health and safety of mothers and children throughout the world is a shared goal among many sectors of society …”
Hope Through Healing Hands and the Bill & Melinda Gates Foundation are not alone in their efforts to increase survival rates of mothers and their children. Many other organizations have adopted the HTSP strategy. These organizations include but are not limited to, nonprofit organization like World Vision and FHI 360, intergovernmental organizations (IGOs) such as the World Health Organization, and government agencies like USAID. By adopting the same HTSP strategy, these other organizations provide assistance and guidance to the “220 million women around the world who want to avoid pregnancy [and who] do not have access to effective contraceptives, counseling or services.” This HTSP strategy of preventing unwanted pregnancies has also proven crucial in the fight against HIV-transmission.
The World Health Organization, a specialized agency of the United Nations, has taken a particular interest in unwanted pregnancies and the danger and effects of unsafe abortions. Some factors that perpetuate unsafe abortions include restrictive laws, lack of resources, lack of accessibility, and stigma. Again, although this is also a problem in the U.S., it effects women in developing countries more dramatically because those populations have minimal access to effective contraception and safe abortions. The World Health Organization reported that “mortality from unsafe abortions disproportionately affects women in Africa. While the continent accounts for 29% of all unsafe abortions worldwide, it accounts for 62% of unsafe abortion-related deaths.” In those cases where death was avoided during the unsafe abortion, the complications that often follow, such as hemorrhage, infection, or injury to internal organs, are just as deadly. These complications are largely the result of inadequate medical care.
The lack of HTSP education and accessibility is not only present in the pregnant mothers but is also generally lacking amongst healthcare providers in these undeveloped nations. FHI 360 is a human development initiative of the government-funded USAID Community Care Project. This nonprofit human development organization partners with organizations such as Africare, World Relief and Project Hope in order to improve education and training for medical providers.
After recognizing the substantial benefits achieved through effective planning and education, FHI 360 recently renewed its commitment to Family Planning 2020. The Family Planning 2020 initiative is “a global partnership whose goal is to enable 120 million more women and girls to use contraceptives by 2020.” The initiative is based, in part, on a study finding that “in Rwanda, fewer than half of the providers of HIV services had been trained in FP, and only about one quarter had been trained in FP services specifically for HIV-positive women.” Providers in the three African countries in which the study was conducted—Kenya, Rwanda and South Africa—“evidenced widespread misconceptions about the safety of contraception for women living with HIV.” USAID partnered with FHI 360 in Envision FP: Transforming Contraception to Expand Access and Choice, an initiative that began in 2015 and is now the “flagship project on contraceptive technology research” for USAID.
In 2012 the Bill & Melinda Gates Foundation cohosted the London Summit on Family Planning – which brought together several governments, international organizations, nonprofit and faith-based organizations, foundations, and the private sector – to dialogue about the most effective ways to promote maternal and child health. During the summit a global partnership was created called Family Planning 2020 (FP2020), which has “created global momentum on the issue of access to contraceptives and has spurred-on collaboration, innovation, and greater accountability in family planning efforts.”
Cross-sector collaboration and partnership is essential to addressing maternal health across the globe. Each sector possesses unique insights and resources. The collaboration and partnership that has occurred around the Healthy Timing and Spacing of Pregnancies framework demonstrates what is possible in efforts to ensure the health and well-being of mothers and their children.
Julia Metcalf is a senior Master of Divinity Student at Princeton Theological Seminary and a former Center for Public Justice intern.
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