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Building Resilience: Learning From Population, Health and Environment Programs

In an era defined by climate change and other disruptions, resilience – the capacity to survive and thrive in times of crisis and change – is increasingly essential.

Today, there is new interest in this topic: many NGOs, foundations and government agencies have launched efforts to define and bolster resilience. USAID, for example, has made resilience a priority objective for U.S. development assistance.

As USAID and others work to reach their resilience objectives, there is much to learn from development efforts that employ a holistic, highly participatory approach. Evidence suggests that population, health and environment (PHE) programs, which combine voluntary family planning with natural resource management, gender equity, food security and sustainable livelihood efforts, can contribute to resilience at the individual, family and community levels.

“PHE is a viable, tested model,” said Clive Mutunga, a family planning and environment technical advisor at USAID, in an interview. “And it demonstrates how to achieve resilience while meeting broader development goals.”

A Brief History of Integrated Development

While integrated approaches to development have been advanced for a half-century or more, PHE programs gained momentum in the 1990s, inspired by a series of UN conferences which recognized that the great challenges of our time – sustainable development, population dynamics, gender equality – are profoundly interrelated. There were calls for programs that address these issues in a seamless way, reflecting the everyday experience of the people they serve. In the years that followed, a diverse group of NGOs, with support from USAID and private foundations, launched PHE programs in Madagascar, the Philippines, Ethiopia and elsewhere.

Because they reflect the concerns and aspirations of the communities they serve, no two of these programs are alike. But PHE programs do share key values and methods: they work with a broad array of community members to understand the interlinked challenges they face and they cultivate participatory engagement in problem-solving. Family planning, women’s empowerment and natural resource conservation are cornerstones of PHE, but some programs have also successfully tackled sustainable livelihoods, food security, primary health care, sanitation and more.

In many parts of the world, PHE programs are outperforming single-sector approaches to health and development. In the Philippine province of Palawan, for example, the Integrated Population and Coastal Resource Management (IPOPCORM) program combined family planning and conservation, producing better outcomes than standalone efforts.

Lessons From Ecology

While PHE programs were hitting their stride, ecologists, led by C.S. Holling and others, were developing a greater understanding of vulnerability and resilience in natural systems. Ecological “resilience thinking” seeks to preserve the integrity of natural systems and to avoid surpassing important thresholds, or tipping points, beyond which those systems collapse.

Resilience thinkers address ecosystems as a whole, rather than their component parts. This is a departure from conventional natural resource management, which focuses on maximizing the yield of commercially important resources such as fish or timber. Of course, trees and fish do not exist in isolation; they are enmeshed in ecosystems of breathtaking complexity. By focusing myopically on one resource or outcome, managers may create unintended effects that disrupt and weaken the larger system.

For example, forest management historically focused on preventing fires (remember Smokey the Bear?). But occasional fires are part of the forest lifecycle; when they are routinely suppressed, dangerous amounts of fuel accumulate. So, by preventing fires – and by failing to understand the complex forest system – managers actually set the stage for truly devastating conflagrations.

While there are important differences between ecosystems and human communities, there are also parallels. Certainly, there have been cases in development where a single-minded effort to solve one problem created others. In Bangladesh, for example, tube wells, which are drilled into deep underground aquifers, were promoted as a solution to contaminated surface water. They did indeed provide more water, but years later it was also discovered many of the wells also tapped into naturally occurring pockets of arsenic, leading to widespread poisoning.

Whether in a forest or favela, building resilience begins with cultivating a deep understanding of complex, interlinked systems and following the lead of those who know them best. This requires deeper engagement with local stakeholders, in order to map the dynamics between ecosystems and the human communities that depend on them and develop appropriate interventions.

Successful PHE programs embody this approach: they work with communities to understand the connections among resources, livelihoods, health, and demographics, and craft solutions that are appropriate for local circumstances. In this way, PHE programs minimize unintended consequences and develop holistic approaches that enhance long-term community resilience.

Social Resilience and the Importance of Agency

Paralleling the work on resilience that emerged from ecology, the social sciences have produced a growing body of literature on the social dimensions of resilience. For example, research shows that a society’s resilience rests on the capability of its citizens: healthy, empowered people are more able to cope with all manner of crises, from crop failures to hurricanes.

PHE programs make important contributions to social resilience. First, they improve public health. An analysis of USAID-funded PHE programs found that those programs generated significant improvements in contraceptive use, immunization, nutrition, and child health.

And PHE programs can bolster agency, which is crucial to individual and social resilience. Resilient people have a sense of control over their destiny. In resilient societies, power and decision-making are distributed broadly, not hoarded by any one group. Agency is fundamentally about power: personal, economic, and political.

Scaling the Mountain: Protecting Forests for Families in Nepal, an original film by ECSP on a PHE program in Nepal

For women especially, the family planning component of PHE is fundamental to agency and self-determination. “Once you are able to control your own fertility, you are better able to take charge of your life,” said Lynne Gaffikin of Stanford University, who has advised a number of PHE projects. Family planning can improve women’s health and afford them more time so that they can play a greater role in their communities. The Lake Chilwa Basin Climate Change and Adaptation Program, for example, started as a conservation project, but when leaders discovered local women could not participate because of a lack of access to family planning, they integrated reproductive health resources into their program.

Not surprisingly, women who are able to plan their families are more likely to finish school, more likely to participate in economic and civic activities, and both they and their children are less likely to be poor. By improving women’s educational status, earning power, and political engagement, PHE can also enhance women’s ability to cope with crises and change.

PHE programs also foster gender equity, by encouraging men and women to step out of traditional roles. For example, the Health of People and Environment Lake Victoria Basin project, led by Pathfinder International, facilitates men’s participation in family planning and enables women to engage in sustainable livelihoods and natural resource management.

By empowering community members to define and address their intersecting concerns, PHE programs contribute to social cohesion, an important building block of resilience. PHE is “all about community building,” said Gaffikin in an interview.

Broad-Based Development Crucial

Today, against the backdrop of accelerating climate change, governments and NGOs are crafting a global development agenda to succeed the Millennium Development Goals in 2015. As they do so, they should heed the lessons of successful PHE programs.

First, in development – as in natural resource management – it is crucial to see the forest and the trees. The burning issues of the 21st century can no longer be addressed in isolation from one another. Integrated approaches, including PHE, can harness positive synergies and build the resilience of individuals and communities.

Second, family planning is key. While many practitioners are experimenting with integrated development programs, PHE is unique in its intentional inclusion of voluntary family planning services and information. According to researcher New Security Beat contributor Kathleen Mogelgaard, family planning is a “force multiplier.” In addition to its positive impact on health, family planning slows population growth by empowering women to and families to decide when to have children, which can reduce stress on natural and social systems. In this way, “family planning makes everything else easier,” said Mogelgaard in an interview.

Clive Mutunga has observed that “communities ‘get it’ – they see the need to include family planning in conservation and development.” And, while there are still some skeptics within development institutions, “we have made good progress; there is growing consensus among many other sectors that family planning is central to resilience,” he said. A longtime PHE advocate who recently joined USAID, Mutunga sees building that consensus as an important part of his portfolio. “My sleeves are rolled up, and I am ready to engage all the stakeholders,” he said.

Author, Laurie Mazur is a consultant on population and the environment for the Wilson Center’s Environmental Change and Security Program and a writer and consultant to non-profit organizations. She is the editor, most recently, of A Pivotal Moment: Population, Justice, and the Environmental Challenge.