The organizers expected about 800 people to show up for the Ottawa Women’s March on Saturday, January 21st. Instead, between 6,000 and 8,000 people converged on the Human Rights Monument –women, men, and children, many wearing versions of the now iconic pink pussy hat and carrying clever signs playing on Trump’s vulgar comments about how to treat women. In cities and towns across Canada, people came for many different reasons, but there was a clear sense of pushing back against Trump’s values in the United States and their seepage into Canada. The mood was friendly, upbeat and hopeful – a wonderful antidote to the sense of doom that has plagued many since the November 9^th election. In the United States some 500,000 people showed up on the Washington Mall and across the U.S. at least 3.2 million people participated in marches, making this the largest protest in U.S. history. Globally, an estimated 5 million people took part in the marches. Women’s voices are not always heard in official channels, but that Saturday women and their allies demonstrated that they will not be silent.

The following Monday, Trump fired back by signing a presidential memorandum that stunned people working on women’s health and reproductive rights around the world. The memorandum reintroduces and extends the Mexico City Policy (also referred to as the Global Gag Rule), an intermittent United States government policy that in the past meant that foreign NGOs must disavow any involvement with abortion in order to receive U.S. family planning funding. Trump’s version of the global gag rule expands the policy to all global health funding. The new rule means that rather than threatening $600 million in U.S. foreign aid, it will affect $9.5 billion in global health funding, which includes programming for maternal health, family planning, HIV/AIDS prevention and treatment, and more. According to Nicholas Kristof in the New York Times, one NGO providing family planning services, Marie Stopes, estimated that if it cannot find replacement funding, the new policy will result in 6.5 million unintentional pregnancies, 2.2 million abortions and 21,700 women dying in pregnancy or childbirth.

Some countries responded immediately. The Dutch Minister of Foreign Trade and Development Assistance announced that she intends to establish an international fund that will finance projects relating to access for birth control, abortion and woman’s education throughout the developing world. She said that her government has been in touch with 15 to 20 other donor countries.

The Belgian Deputy Prime Minister and Minister of Development Assistance followed quickly with a statement of support for the Dutch proposal. It notes, “This American decision of the White House has a direct impact on the lives of millions of girls and women in developing countries. Information on family planning and the possibility of abortion are of great importance for the development of girls and women.” He goes on to say that cutting funding to women’s health organizations reduces access to contraception and increases the number of abortions and number of deaths from unsafe abortions.

Canada’s International Development Minister Marie-Claude Bibeau said the Dutch initiative will be considered alongside the government’s other options in this area. According to her statement, Canada’s intention is to advance a strong women’s empowerment agenda. This will include an increase in investments to support advocacy work for women’s reproductive rights and for the provision of comprehensive sexual and reproductive health services, including safe abortion, where abortion is legal, and post-abortion care.

The 2030 Agenda for Sustainable Development, unanimously adopted by 193 countries at the UN General Assembly, specifically targets universal access to sexual and reproductive health as critical to the reduction of poverty and the fulfillment of human rights.

The Marches indicated that there is a global network committed to pushing forward on women’s rights. Canada seems to be one of the few lights of liberal democracy in the western world and others may look to us to be a convincing global advocate for women’s rights and the importance of truth and evidence in developing policy. Canada and its allies, both governments and civil society organizations, must do their part to safeguard and advance women’s sexual and reproductive health and rights. They can do this by:

• Increasing funding to support a comprehensive package of sexual and reproductive health services, including access to safe abortion;
• Advocating at the UN and in international fora for greater attention to the links between poverty reduction and family planning and the impact of pregnancies on women’s and children’s lifelong health;
• Educating Canadians on the importance of a comprehensive package of sexual and reproductive health services as a foundation for advancing women’s rights.

It is true that one march or even a series of marches is not a strategy. But that is not the point. What the global Women’s March demonstrated is that women and their allies across genders will not be gagged on these issues. Governments and civil society organizations around the world need to step up and channel the energy and power so evident in the marches into support for effective strategies for the promotion of women’s rights and sexual and reproductive health worldwide.

The post BEYOND THE MARCH: SUPPORTING WOMEN’S REPRODUCTIVE RIGHTS GLOBALLY first appeared on The McLeod Group.

The lack of public consultation and evidence-based policy-making that characterized the Conservative government resulted in a dilution of Canada’s historically strong reputation as a global human rights champion, especially when it came to the promotion of gender equality and women’s rights on the international stage. The recent independent evaluation of Canada’s Maternal, Newborn, and Child Health (MNCH) Initiative that Prime Minister Stephen Harper launched at the 2010 G8 summit in Muskoka noted that while Canada’s international MNCH investments were effective in responding to developing country priorities, they left out any significant support for women’s and girls’ sexual and reproductive health and rights (SRHR). There is extensive evidence to show that SRHR interventions, such as family planning and the provision of safe abortion services, are critical to the achievement of gender equality and the fulfillment of women’s full human rights.

In a welcome shift from what characterized public policy-making over the last ten years, the new Liberal government has launched public consultations as part of its International Assistance Review. The discussion paper accompanying the consultation process commits to filling the previous gap with a new focus on SRHR, especially with respect to adolescent girls. This is welcome news, and a strong basis upon which to build Canada’s new feminist approach to foreign policy, but we must be careful not to abandon the achievements of the last five years under the MNCH Initiative as the Liberal government tries to shake off remnants of the Conservative approach to Canadian foreign policy. In particular, women’s health must not continue to languish behind advances made in reducing infant and child mortality.

Going forward, the health of women and girls must be seen from a perspective that moves beyond their narrowly defined role of mothers, or mothers-to-be, and embraces a rights-based, life-course approach to women’s health, so that Canada’s investments aim for the highest attainable standards of health and well-being for women and girls at every age.

Only with this more comprehensive view of women’s health can Canada ensure that it does not overlook the rights and needs of the most vulnerable, nor exacerbate the inequalities that can arise when the donor community seizes upon its latest priority. Such an approach would build on Canada’s strength as a gender-equality champion and place the focus on providing support that empowers women and girls to claim their rights, while encouraging policy makers to meet their obligations to create more responsive health systems.

Women’s health encompasses so much more than just pregnancy and motherhood—even when sexual and reproductive health and rights are added to the list. Breast and cervical cancer, sexually transmitted infections besides HIV, gender-based violence, mental health, and obesity-related diseases such as diabetes and cardiovascular disease, are significant health challenges for many women and girls, depending on where they are in the world and in their lives. Cervical cancer claims the lives of 200,000 women every year, 80% of whom are in developing countries. Gestational diabetes, which increases a child’s chance of developing Type 2 diabetes by four to eight times, is also on the rise. Canada can empower women and girls to identify their own health priorities, and then respond—not set the priorities for them.

As a first step towards a return to evidence-based policy-making and the implementation of a feminist foreign policy agenda, Global Affairs Canada (GAC), the federal department responsible for Canada’s official development assistance, will need to rebuild its cadre of technical specialists in the areas of health and gender equality to inform policy and program development. Cuts to the public service by the Harper government took a heavy toll on subject matter experts, as GAC shifted priority to employing generalists who rotate positions every few years. The result is no one and everyone is an ‘expert.’

The few technical specialists who are left have minimal interaction with country programs—where the large part of Canada’s investments are planned and implemented—and have little time or management support to remain abreast of the latest developments in their fields. It is hard to imagine how Canada can develop evidence-based policies and programs without in-house experts with extensive knowledge of the latest research and trends. If the Canadian government is truly serious about being a global leader in women’s and girls’ health, then it must have the dedicated technical expertise to back it up.

Alison Y. Riddle is a former health and gender equality specialist with CIDA and a Ph.D. candidate in the School of Epidemiology, Public Health and Preventive Medicine at the University of Ottawa. The views expressed in this article are those of the author.

The post WOMEN’S HEALTH: KNOWLEDGE, EVIDENCE AND COMMITMENT PLEASE first appeared on The McLeod Group.

After several years of pointedly snubbing important UN General Assembly gatherings, Prime Minister Harper deigned to appear this year. His speech was full of his familiar platitudes about maternal and child health care, but without any reference – as always – to the reproductive health issues that kill so many young women and mothers. This deadly oversight notwithstanding, Mr. Harper has developed a proprietorial attitude towards maternal and child health, as though it is a Canadian invention – a kind of Dyson vacuum cleaner that – with enough advertising – everyone will buy. The issue has been with us for generations, however. It is integral to the Millennium Development Goals that were established in 2000. Many other countries spend much more money on maternal and child health than Canada does. On this subject we are essentially telling grandmothers how to suck eggs.

But Mr. Harper is no Johnny One Note. He also had things to say about the menace of Islamic State fundamentalism. There Canada is playing an important role sending dozens (count them, dozens) of military advisers. We are deeply concerned about Ukraine as well, sending that country vital military assistance, possibly taken from museum-class Hercules aircraft.

Where global threats are concerned, the Prime Minister has said repeatedly that Canada will not stand idly by. A good example is the threat of global warming. Canada is certainly not standing idly by. It isn’t even there. One hundred and twenty heads of state attended the landmark summit on global warming in New York this week. But (except for the dinner afterwards) not Mr. Harper. Because if he had attended, he would have been standing idly by, as Canada has on this issue since his election. Mr. Harper has famously said in relation to global warming that “no country” – e.g. Canada – “is going to take actions that are going to deliberately destroy jobs and growth in their country.” It’s not clear who proposed that jobs and growth should be deliberately destroyed, but it’s clear enough that they will be if major polluting countries like Canada stand idly by.

And what about Ebola? President Obama has called the Ebola epidemic a human tragedy and a “potential threat to global security.” Canada chairs the UN Peacebuilding Commission’s “country specific configuration” for Sierra Leone. But apart from platitudes and tiny tokens of support, Canada waited until the Prime Minister was at the United Nations to make an announcement of any significance on the matter.

It’s sad, really, that we want so badly to play with the big kids on issues where we won’t make the slightest difference, and yet on issues where we could, we are miserly, slow or absent. This must have been obvious to those who bothered to listen to what Mr. Harper said at the United Nations. It’s very obvious to those who once knew they could count on Canada for real support in places where it mattered. Today, they cannot. Our leaders are like vacuum cleaner salesmen with attitude, an embarrassment to all but themselves.

The post Canada at the UN: Vacuum Cleaner Salesmen with Attitude first appeared on The McLeod Group.

The Canadian government’s recent Maternal, Newborn and Child Health (MNCH) Summit in Toronto has not lacked for cheerleaders, especially NGOs receiving funding under the MNCH initiative. Prior to the summit, only a few critical voices were cited in the media (mainly from the McLeod Group) and most journalists, such as Paul Wells, initially set aside their cynicism and were won over by the cause. However, the government alienated many by excluding the media from most of the discussions, allegedly ‘to ensure frank discussions’, but more likely to prevent the reporting of criticism of Canadian government policy. In other words, to avoid frank discussions. Increasingly, the event looked like a vanity summit, seeking to show a kinder, gentler face of Conservatism and rally Canadians around its championing of a literal motherhood issue – while ensuring that the voices of those who had evidence-based criticisms of the Canadian approach would not be heard.

The billions of dollars promised at the summit are very welcome and will do great good. However, Canada could do much better. The importance of human rights and access to safe and legal abortion have already been discussed in blogs by the McLeod Group and Amnesty International, as well as a Globe and Mail editorial, among others. Here, we want to raise three other issues that have not received enough attention in public discussions of MNCH: contraception, sustainability and root causes.

First, contraception. The single best way to ‘save’ the lives of mothers and children is to increase the accessibility and availability of modern contraceptives. A trial in a rural area of Ghana found that when contraceptives were made available through local health clinics, deaths of children under five declined by almost 60%. In other words, the easiest way to save the lives of young children is to make modern contraceptives widely available at affordable prices and to help make their use socially acceptable. This approach has proven successful in countries as varied as Iran, Bangladesh and Rwanda.

And that is only one of the benefits. A widely accepted study determined that modern contraceptives avert 187 million unintended pregnancies per year (and an additional 16-20% if current demand were met). These averted pregnancies, in turn, prevent:

• 60 million unplanned births
• 105 million induced abortions
• 22 million spontaneous abortions
• 215,000 pregnancy-related deaths (79,000 from unsafe abortions)
• 2.7 million infant deaths
• 685,000 maternal deaths

This information leads one to question why the availability of family planning is not front and centre on Canada’s MNCH agenda, as it is in the US and the UK.

Second, sustainability. While international and local NGOs can provide maternal and child health services, what happens when the external funding runs out? The emphasis needs to be on delivering health care through national systems and strengthening those systems, not setting up special, time-bound initiatives that will fail when salaries can no longer be paid or supplies run out. It’s not only today’s babies and mothers that need ‘saving’ – it’s tomorrow’s too. This essential element of ‘local ownership’ is key to effective, sustainable development assistance (see also previous McLeod blog).

Third, root causes. The government’s approach to MNCH lacks an understanding of cause and effect, of symptom and cause. It’s like the story of well-intentioned people pulling babies out of the river and feeling they are doing a good thing, without finding out why the babies are falling into the river in the first place. That’s not to say that cause-and-effect relationships are simple. But the best evidence we have in this area comes from two recent World Bank reports: the World Development Report 2012 and Voice and Agency: Empowering Women and Girls for Shared Prosperity.These reports tell us that a key determining factor affecting health outcomes, including MNCH ones, is the degree to which women have a say in their lives and their communities. A CARE study in Bangladesh, for example, shows that programs that empower women were more than twice as effective at reducing stunting rates in children as comparable ones that didn’t. (See also previous blog.)

Instead of organizing narcissistic, self-serving summits, Canada would do better to follow more closely what the evidence tells us on MNCH. That would ensure the billions of dollars we are spending are put to the best use possible. In the end, that is far more important that feel-good messages and photo ops.

The post Mr. Harper’s Maternal and Child Health Summit, Part 5: What’s still missing? first appeared on The McLeod Group.

More maternal and child health funding is welcome, but the lack of focus on the human rights of women and girls is not.

In taking stock of last week’s maternal, newborn and child health summit, Prime Minister Stephen Harper gets kudos for pledging more money to achieve UN Millennium Development Goal 4, to reduce child mortality, and Goal 5, to improve maternal health. But the second target of Goal 5, ‘achieve universal access to reproductive health,’ was very much neglected.

When speaking to the press, Mr. Harper gave muted recognition to the need to integrate family planning services and contraceptives into the MNCH initiative, and Melinda Gates spoke even more strongly. But both argued against support for abortion services as an integral part of a MNCH initiative. Mr. Harper even called the issue ‘divisive’.

Two points should be made crystal clear: first, increased development funding for the health of mothers and children is important and welcome; but the lack of focus on the human rights of women and girls is not.

The prime minister, in reaction to a question on vaccination, said on the CBC, ‘I frankly don’t understand people who are walking away in our society from something that’s proven to work… [who do] not listen to the scientific evidence.’
But we know, from evidence, that the greatest risk for maternal mortality (and lasting health damage such as fistula) occurs when girls have children too soon for their young bodies and when women have children too often for theirs.
We also know, from evidence, that more than 200 million women and girls want to delay or avoid pregnancy but don’t have access to a modern, effective method of family planning. And we also know, from evidence, that where women and couples are able to use effective methods of family planning, the rate of abortion declines (although never to zero).

And we know, from evidence, that unsafe abortion accounts for 13 per cent of all maternal deaths, more than 47,000 deaths a year in developing countries.

The table below illustrates why Canada’s medical-only approach to maternal health is inadequate. In the 10 countries of focus for Canada’s MNCH programming, the rates of child marriage (before the age of 18) are very high. And a girl, taken out of school to marry an older man, is in no position to negotiate sex or delay pregnancy. Even if a girl or a woman knows enough to ask for family planning information, there is a large gap in access to services and availability of supplies. Thus, you can read the World Health Organization estimate of the unmet need for family planning by country of focus.

Girls and women are also at risk because they are treated as second-class citizens whose rights as individuals and as citizens are disregarded. And all of Canada’s ‘countries of focus’ rank 111 or lower on the United Nations’ Gender Inequality Index (Canada, by the way, ranks 18th).

We have learned over the years, from evidence, that death from unsafe abortion is rare in countries where abortion is permitted and quality, affordable services are available.

The table reveals that abortion is legal, with restrictions, in all but one of the MNCH countries of focus. This means that Mr. Harper is imposing his Conservative agenda for family planning and access to safe abortion. Divisive?

The MNCH initiative demonstrates how Mr. Harper and his government are getting development wrong despite the much-advertised good intentions. Development co-operation is not about charity or ‘aid’. The women it targets are not victims. Women are producers, not just reproducers.

Canada needs to invest in the hard work of creating and implementing legal frameworks and gender-intelligent policies and programs that ensure respect for women’s rights and the recognition of their crucial role in the development of their countries. Without the needed legal and policy framework, money thrown at the symptoms of poverty and exclusion can only achieve temporary success. And frankly, we are not convinced that the MNCH initiative is working with governments to create sustained systemic change in their health delivery systems and overarching institutions like the constitution, the courts, supreme auditors general who ensure legislation is being implemented. Is this mostly one-time life-saving? Are the workers being trained supported by adaptations to institutional support systems? This is the hard work of effective, sustainable development that we don’t see in this initiative. 

If women and girls are not able to live free of violence and rape, inside or outside marriage, why should they be denied access to a clinic that can provide a next-day pill or a safe abortion, a right that all Canadian women have?

The prime minister’s recent statements will only serve to legitimize ‘bad behaviour’ by other governments and service providers that do not provide a full range of reproductive health services to women and girls (and men and boys).
By paying attention to only part of the evidence, the MNCH initiative does not address why women and girls are at risk but just ensures that, once pregnant, there may be a health system to save them.

Is it divisive to care about the 47,000 women in developing countries who each year lose their lives to botched abortions?

CANADA’S FOCUS COUNTRIES

This chart shows how Canada’s 10 focus countries for maternal, newborn and child health stack up against each other on child marriage, gender inequality and family planning.

This article first appeared in Embassy, June 4, 2014.

Diana Rivington is a senior fellow in the Faculty of Social Sciences at the University of Ottawa. Elizabeth J. McAllister worked for the World Bank and for the former Canadian International Development Agency in senior executive positions. She now consults with international organizations on strategy, results and evaluation. Both are Members of the McLeod Group.

Notes

[1] UNICEF Child Info

[2] Unmet need for family planning: From WHO http://www.who.int/reproductivehealth/topics/family_planning/unmet_need_fp/en/

[3] 2012 Gender Inequality Index: https://data.undp.org/dataset/Table-4-Gender-Inequality-Index/pq34-nwq7

[4] Center for Reproductive Rights: worldabortionlaws.com

[5] L= to save the life of the mother

[6] += additional grounds relating to factors like the woman’s age or capacity to care for a child

[7] F= in case of fetal impairment

[8] I= in case of incest

[9] R= in case of rape

[10] NE= no specific exception in the law to save a woman’s life

The post Mr. Harper’s Maternal and Child Health Summit, Part 4: Is it divisive to care about the 47,000 women who die yearly from unsafe abortions? first appeared on The McLeod Group.

Once again Canada’s development cooperation policies are being driven by domestic interests, not the development outcomes and the results the government claims to be seeking. We are going it alone and indeed this time even pretending that everybody else is following our lead. In truth, maternal and child health has been both a global and Canadian priority for decades, with an accelerated focus on reproductive health and rights following the 1994 UN Population conference in Cairo.

We started waving a bigger cheque-book when we chaired the Muskoka G8 meeting. This was welcome news in a largely bleak scene for Canada’s development contribution. But we were just playing catch-up on most other bilateral and key multilateral donors, except now we pretend to be the leader.

All this grandstanding perplexes many other donor agencies and our partners in the G7. It also conceals our cuts on family planning and access to safe abortion. In these days of tight aid money, people are too nervous to push back. However, our aggressive noise actually undermines donor cooperation in this area. We even sent DFATD officials to block multilateral policy statements that reconfirmed old agreements on reproductive health.

For Canada itself, that distorted policy framework means that the several billion dollars we are spending misses key targets. We rationalise that other donors will fill the gap. But our approach undermines the effectiveness of the very health clinics we fund. We harm women, including those who are victims of forced marriages or rape as a weapon of war, by blocking safe abortions or the supply of emergency day-after contraceptives.

Maybe worse still, by our bullying and financial ‘leveraging’, we are blocking others – civil society organizations and international agencies – from providing such help. We distort programming by UN agencies such as UNFPA and WHO, forcing them to alter priorities in the delivery of maternal and child health services.

Why does our government behave so callously? We condemned backstreet abortions as barbaric in our own society many years ago. Family planning services should be available to all. The distortions we impose are essentially ideological. They are not due to the budget cuts or the confused cost-effectiveness that shapes much of Canada’s diminished aid profile.

Many would say the explanation lies in domestic political opportunism. Crudely put, women and girls are dying in developing countries to appease the still strong anti-choice lobby amongst the grassroots ‘core’ of Conservative supporters. We moralize globally about sexual practices via our aid programs. We boast publically of having policies led by principles, but we practice the opposite, making the poor, women and girls, the innocent victims of residual puritanism in small segments of our population.

We have today the perverse reality that the large team of Canadian officials organizing Mr. Harper’s maternal, newborn and child health (MNCH) ‘summit’ have struggled to find people from major international agencies who can be ‘safely’ invited, people or organizations that will not raise the topic of reproductive rights. It seems opposition MPs fall into the same ‘don’t invite’ category. The few NGOs, some perhaps attracted by new funding offers, which have helped mobilize this event, were told that agenda items had to be screened to avoid the gaping Canadian policy flaws around providing safe abortion or basic contraceptive services.

The ‘summit’ is in truth a show designed for Canadians. A few world leaders are being rolled out to acclaim Mr. Harper as a leader who cares. But those guests are expected to avoid controversy. The agenda is being managed to leave little scope for criticism. Their dilemma is whether to expose the inconsistencies in Canada’s stance. Or will these guests risk going back to their own domestic audiences and be asked to justify attending a ‘summit’ at which they failed to reiterate the key role of sexual and reproductive rights for vulnerable women and girls?

 All this has created a new absurdity in our relations with the United States. For decades, under the Republicans, the US government routinely blocked reproductive health funding for UNFPA and groups such as Planned Parenthood, despite criticisms by almost all other donors, including Canada. Now the roles are reversed. The organizers hesitated to invite Hillary Clinton, a likely next US President, for fear she would again attack the Prime Minister’s position at his showcase event. Her words last time were: “You cannot have maternal health without reproductive health which includes contraception and family planning and access to legal, safe abortions.” They worry whether star guest Melinda Gates will again publically criticise Mr. Harper’s policy stance. No doubt to his chagrin, Canada has no leverage over her independent and well-funded foundation.

Whatever their decision, Canada will not emerge with much advantage, not even new Conservative votes. It will be either egg on our face or private condemnation by those we wish to have as friends and partners. Nothing we do can retrieve the lost lives and damaged bodies of poor women and abused girls that our policies on reproductive rights have ignored so far.

The post Mr. Harper’s Maternal and Child Health Summit, Part 3: Delusions about International Leadership first appeared on The McLeod Group.

The Harper government’s Muskoka Initiative is based on the fact that “women and children in developing countries are significantly more likely to die from simple, preventable causes, due to lack of proven, affordable and cost effective solutions that most Canadians take for granted,” as  the Canadian government puts it.

The idea was—and is—that by committing major funding, Canada and other donor governments can significantly reduce child mortality and the number of women who die during childbirth. Exaggerations notwithstanding about the volume of new money brought by Canada to the challenge, the premise is good as far as it goes. It is worth doing. But there is a huge hole in the middle of it: human rights.

Foreign Minister John Baird has railed against the forced early marriage of girls, but he goes no farther because he and the government don’t want to open a discussion about choice—the choice a woman has, or should have, about whether to get married, to use contraception or to take an unwanted pregnancy to term. In fact, the Canadian government has refused to discuss or to fund initiatives that deal with these issues and the kind of “solutions that most Canadians take for granted.”

The World Health Organization says that 21.6 million women experience an unsafe abortion worldwide each year, 85% of them in developing countries. Every year, some 47,000 women die of complications from unsafe abortion. This represents close to 13% of all maternal deaths. The Muskoka Initiative has absolutely nothing to say about this and Canada won’t put a dime towards stopping it.

And why are there so many unsafe abortions? Because millions of women don’t know their rights and, worse, in many cases don’t have access to those rights: legal rights, sexual and reproductive rights, human rights. They don’t have access to family planning services, education or the options “that most Canadians take for granted.”

The Boko Haram kidnapping in Nigeria has excited world attention over the plight of 200 girls, when in fact violence is a fact of life for hundreds of thousands of girls  in a more silent, but no less terrible way every year.

Not only does the Muskoka initiative ignore these issues, Canada, once a leader in the promotion of gender awareness and women’s rights internationally, has pushed the subject off the agenda as though it never existed. We have become instead a choirmaster for the promotion of technical approaches to problems that are often deeply embedded in systemic human rights abuse.

None of this is mentioned by the NGOs serving as Mr. Harper’s choir: Plan, World Vision, CARE and others. And it’s likely that none of it will be discussed at Mr. Harper’s “summit” on maternal, newborn and child health at the end of May.

Its theme, ironically, is “Saving Every Woman, Every Child.” Well, maybe not every woman. And maybe not every child bride.

The post Mr. Harper’s Maternal and Child Health Summit, Part 2: The Hole in the Donut first appeared on The McLeod Group.

Maternal health should be about women’s health before, during and after pregnancy, not just mothers. Some women who require maternal healthcare will not become mothers because fetuses and babies may not survive or because the women may not choose to raise these children. Therefore, an effective and comprehensive maternal health strategy is key. It should include services that address women’s maternal health needs, while also addressing the broader societal and gender issues which contribute to high rates of maternal mortality.

The Muskoka Initiative on Maternal, Newborn and Child Health (MNCH), however, focuses almost entirely on mothers. We can witness this in Canada’s official statements on the MNCH initiative. For example, in a September 25, 2013 speech, Prime Minister Stephen Harper referred exclusively to mothers when referring to the MNCH, saying: “one of the world’s great tragedies […] is the shocking mortality of mothers and their young children in developing countries”.

The emphasis on mothers is significant here, however, because it is actually women who die. Some of them never become mothers before their death. Other women may die months following a pregnancy as a result of complications, infections and unsafe abortions.

The World Health Organization estimates that, for every woman who dies in childbirth, around 20 more suffer injury, infection or disease related to their pregnancies, affecting approximately 10 million women each year. Thus, the exclusive focus on mothers reduces women to a specific biological activity: giving birth. The focus on mothers rather than women in the maternal health strategy treats women as “walking wombs” and makes it far more difficult to address the broader health challenges women face in their lives.

Responding to these broader maternal health challenges require a better understanding of gender inequality, including gender-related issues such as lack of access to resources, lack of permission from men in the communities to use household funds for maternal healthcare, and gendered institutional practices that result in women having negative experiences in health clinics. As such, maternal health programs cannot be isolated from broader gendered, societal and community issues that women face in accessing healthcare services.

The MNCH initiative’s failure to more explicitly link maternal health needs to women’s disadvantaged position in society relative to men further solidifies Canada’s shift away from a gender-and-development approach to a charity-based model. It fails to address the gendered societal norms that prevent women from accessing health services even when they are available. As a result, the MNCH initiative has limited potential for improving the quality of life for women who still have little or no say over sexual and reproductive rights and child spacing.

A focus on the promotion of gender equality in maternal health programs has the potential to correct for this shortcoming. Such a strategy would include education programs and involving women in the design and implementation of maternal health strategies. However, a gender-sensitive approach to maternal health in Canada’s MNCH initiative is unlikely, as illustrated by the problematic language of “saving” mothers and children.

“Saving” mothers and children through maternal health programs is a common theme throughout many of the official Canadian statements pertaining to the MNCH initiative. The announcement of the May 2014 summit titled Saving Every Woman Every Child: Within Arm’s Reach is further evidence of Canada’s charitable approach to maternal health and a narrative that stresses Canada’s role in saving the “vulnerable other”. In so doing, women are further positioned as objects of development assistance (recipients of charity), as opposed to subjects with agency that are capable of being actively involved in the development process.

For four years, Canada has made MNCH a key priority in foreign aid spending. This initiative, however, has been severely limited by its exclusive focus on “mothers”, the failure to put women and gender equality at the centre of these initiatives, and the ongoing paternalistic references to strategies aimed at “saving” vulnerable groups. If the upcoming summit provides a space to reflect meaningfully on what has been achieved through the MNCH initiative to date, it will most certainly need to begin with some reflection on these and other important weaknesses of Canada’s Muskoka Initiative. A renewed commitment to maternal health is welcomed, but achieving success in maternal health services will require a new direction and purpose: one that begins with an understanding of the causes and consequences of gender inequality.

For additional information see: Krystel Carrier and Rebecca Tiessen, “Women and Children First: Maternal Health and the Silence of Gender in Canadian Foreign Policy” in Canada in the World: Perspectives on Canadian Foreign Policy, edited by Heather A. Smith and Claire Turenne Sjolander, Oxford University Press, 2012, pp. 183-200.

The post Mr. Harper’s Maternal and Child Health Summit, Part 1: ‘Saving’ Women and Children by Targeting ‘Walking Wombs’ first appeared on The McLeod Group.

Christian Paradis, Canada’s Minister for International Development, surprised a great many people—stunned might be a better word–when he said this in an April press release:

“Canada recognizes and supports the vital role that civil society plays in reaching development objectives. Civil society engages citizens in their countries’ decision-making processes that affect them. Empowered by the fundamental rights of freedom of expression, association and assembly, civil society enables citizens to hold their governments to account, providing legitimacy to the governing institutions, which in turn ensures growth and sustainable development and reduces poverty.”

It got better, but that isn’t the point. The question for most who read it was, Where is this coming from? (See McLeod Group blog of April 9, 2014.) The Harper government has systematically attacked Canada’s international development NGOs with a ruthlessness never before seen. Funding was so dramatically reduced to organizations with contrary positions on pet government issues that a deep freeze silenced most of the rest. Others have been completely defunded for spurious reasons and, instead of treating NGOs as development organizations in their own right, the government halted co-financing arrangements and initiated a system requiring NGOs—if they wanted any government funding at all—to bid on tenders put out by DFATD. Even that became a farce when the government proved incapable of actually issuing more than nine tenders, and none since 2011, long before the CIDA-DFAIT merger. The result is that many excellent Canadian NGOs have had to terminate good projects and longstanding relationships with civil society organizations in developing countries. Some are on the brink of bankruptcy.

This was the poisoned legacy Christian Paradis inherited last July from previous development ministers Bev Oda and Julian Fantino, but his April press release and his meetings with NGOs in Canada and at the awkwardly named High-Level Meeting of the Global Partnership for Effective Development in Mexico suggest an about-face.

Paradis made similarly positive statements at a meeting co-sponsored by the Canadian Association of International Development Professionals and the Canadian Council for International Cooperation at the Ottawa Convention Centre on May 14. He also announced the long-overdue renewal of funding for youth internship and volunteer sending programs, a very small step forward for a small number of organizations, and still money for which they must compete.

All of this may sound like a whisper of fresh air to a Canadian international development community that has been reeling from deep cuts, attacks and almost nothing but bad news for years. Cynics, however, may be forgiven for sensing something less than a reversal. A few scraps for a small number of organizations, if indeed it happens—doesn’t address the massive cuts to other organizations and the reduction of NGOs to contractors, bidding on proposals that fit the government’s limited priorities and sluggish timetable.

The government will host what it is calling a maternal, newborn and child health “summit” at the end of May. Maternal and child health was a Harper government cornerstone at the Muskoka G8 meeting and the summit will attract senior development practitioners and government representatives from around the world. It wouldn’t look good to have a few pliant Canadian NGOs filling the front seats while dozens of their raggedy, half-starved compatriots NGOs kvetch on the sidelines about how badly the Canadian government treats its own civil society organizations.

And then there’s the 2015 election. There is speculation that the change has to do with Quebec, Paradis’ other portfolio, and what Quebec NGOs may be telling their supporters about the government. Maybe backroom planners think that some of the hundreds of thousands of other Canadians who make donations to NGOs might look askance at a government that has been so mean spirited. Or maybe in Christian Paradis the Harper government has at last found a minister with a heart, a mind and enough common sense to see real value in the work and the independence of Canadian civil society.

Or maybe not. Maybe there really isn’t any real change afoot. Maybe it’s just some repositioning of a few chairs on the upper decks. After all, the Harper government has proven itself very adept at effusive self-advertisement, even when there is nothing to back it up. The proof of this new approach, and the new policy—if indeed there is one—will be in the pudding, when the government actually starts to put some serious money and long-term programming commitments where its mouth is.

The post Paradis Shocker: NGOs Stunned first appeared on The McLeod Group.

The highlight of our participation was a session, ‘Taking Stock: the Changing Context for Development’. The event was informal, even if the room was packed. It was a set of frank and lively conversations orchestrated by Carolyn McAskie (who later played the same role for Joe Clark’s keynote session), with Ian Smillie, Diana Rivington and John Sinclair as the panel. They spoke about three distinct topics under the unifying theme of ‘new myths, old myths and Canada’s future’. These were respectively: private sector, gender equality and global institutions. There was lively interaction with and within the audience on Canada’s recent performance as a global development actor.

At other sessions, Betty Plewes spoke on Women’s Rights and Stephen Brown facilitated a session on multinationals.

This, for the record, is what the McLeod Group ‘Taking Stock’ panel said:

========================================

Ian Smillie:  Myths about the Private Sector and Development

 Old Myth:  Foreign direct investment is the answer to long-term sustainable growth 

• During the 1960s and later, capital intensive industries did the opposite of what was needed: they minimized job creation, did local enterprises out of business and stunted local potential;
• Many were simply assembly plants rather than productive operations, adding little value to local primary products and building few backward and forward linkages into the economy;
• Through the initial tax breaks used to attract companies, and then transfer pricing, the profits of foreign investors were often kept offshore, minimizing local taxes and reducing the value of the investment. 

New Myth: Foreign direct investment is the answer to long-term sustainable growth 

• In addition to all of the old problems, prevalent since the Pearson Commission, we now cheer the fact that FDI outstrips development assistance by a factor of two or three or seven, as though all of the old lessons had been learned (or were never important in the first place);
• The government of a developing country wants FDI for three reasons: job creation, taxes and spinoffs into the local economy. If it doesn’t do these things (and that is a major problem with the extractive sector) then it accomplishes little: it boosts GDP and creates a false sense of growth, but it may actually stunt a country’s ability to create jobs and reduce poverty; 

Old Myth: Technology is the answer 

• Factories running at 25% capacity, broken infrastructure and rusting tractors were evidence that technology could not and cannot be “transferred” simply by loading it onto planes;
• Developing countries need support industries and a light engineering sector that can service larger industrial enterprises, and more importantly, a country’s own small and medium enterprise sector. In many developing countries that didn’t exist and still does not. 

New Myth: Technology is the answer 

• In some ways we are more than ever beguiled by the siren song of technology. The first item in almost every article about “Africa rising” gushes about cell phone usage as though this is a success story rather than a failure. The spread of cell phones is a success story, but the spread is so wide because governments have been unable to provide the most elementary forms of infrastructure: landlines in the case of telephones, electricity, roads, water, sanitation and other basics;
• Where is that light engineering sector that is so essential to almost every aspect of a productive economy?
• Where is the concern about technologies that create rather than reduce jobs? 

Old Myth: The private sector can take care of almost everything 

• No, it can’t. The private sector needs educated, healthy people in order to work well; education and health are functions of the state;
• It needs infrastructure (roads, electricity, water, communications); these are primarily functions of the state;
• It needs a fair and consistent regulatory environment. This is a function of the state. 

New Myth: The private sector can take care of almost everything 

• In addition to everything we can say about the old myth, we seem to be incapable of distinguishing between FDI and private sector development on the one hand, and between the development of our private sector and their private sector on the other. These are very different things;
• Where is the concern about their private sector: the creation of enabling environments for local rather than foreign investment; the care and feeding of small and medium enterprise) which is totally distinct from microenterprise)? Where is the encouragement for a light engineering sector; and infrastructure that encourages and services local investors? 

Some Ways Forward: 

• Developing country governments have to be discerning in the investment they seek and approve;
• Attracting appropriate investments isn’t easy, but it isn’t all about cash incentives and tax breaks; a fair, clear and consistent regulatory framework is essential;
• There is nothing wrong with Canada or any other country promoting its own companies and products abroad, but this is not and should not be part of the aid program;
• Donors need to stop generalizing about the beauty of FDI and look for ways to promote investments that build local capacities, add local value, create local spinoff industries and create jobs;
• Donors need to promote local private sector development as a matter of policy, and to promote the exports of locally produced goods by opening—rather than closing–their markets to producers in poor countries

Diana Rivington:  What’s so hard about gender equality?

 Old Myth: Just add “women” and stir 

• About 40 years ago, civil society, academics, and aid agency self evaluations started remonstrating that, not only was aid programming not delivering for women, but that it was also causing harm
• So, in our rush to make a change, the first myth of women and development was born: just add women and stir.
• In part, the new focus on women in development framed women as helpless and vulnerable, waiting for our help – and agencies focused on process – were women consulted, did they participate in the project, was sex disaggregated information collected?
• It took for policy wonks to recognize that women were already actors in the mainstream of development; to listen to their voices; and to work with them to see that project and programe outcomes, whatever the sector, should lead to an increased voice for women in decision-making; a stronger defence of women’s human rights including sexual and reproductive health rights; and to reduced gender inequalities in relation to the resources and benefits of development whether in education, health, transport, water, small business, or forestry.
• And over the last forty years, there has been a broad international conversation led by global and local women’s organizations and ministries of women’s affairs from developing countries – through the four world conferences on women, the Cairo Conference on population, New York on children’s rights, Jomtien on education, Vienna on human rights, Rio on the environment –to make progress in all these areas, women said that they had as important a voice as men and that their participation was key to achieving international goals in all these areas. That is why goal 3 of the year 2000 MDGs is progress on gender equality. 

But governments change and the new players want the new shiny thing, the signature project with the flag on it – They ignore the finding of evaluations and they forget that it took 40 years to learn about development and partnership and how to make it transformative, a contribution to a qualitative change in the lives of women and men. Instead they move back to the charity mode. 

New Myth:  Just add “women and children” and “girls” and stir 

• So now Canada no longer funds women’s rights organizations or projects designed to address gaps in gender equality. It now has a vocabulary of “equality between men and women” and a much vaunted Muskoka initiative that is saving the lives of mothers and newborns. It is not a bad thing to save lives but this approach is not addressing why women and girls are at risk in childbirth.
• Saving women’s lives is not the same as making progress on women’s equality because it fails to tackle why women and girls become pregnant too soon or too often. Where is the quality information on modern family planning methods? What are the social and economic barriers between women and getting to the birth clinic?
• Alas, the Muskoka focus is on women and girls as “wombs on the walk”, whose main duty is to bear children, but not as citizens with the right to seek our support to choose NOT be pregnant.
• Now Minister Baird’s recent attention on child, early and forced marriage is welcome – child marriage is the most egregious and neglected of human rights abuses. But is it enough for Canada did introduce the first resolution in the UN General Assembly on the topic? How does this rhetoric link to development programming?  Where is the increased funding to UNFPA or to girls’ education and keeping girls in school?
• And because of our inaction and our focus on “women and children”, Canada is no longer a trusted participant in the continuing international conversation on gender inequality and how to transform development.

We need a recommitment to gender equality.

John Sinclair  —  Global institutions, dead-end or way forward?  

We live in a globalized world, but its modest successes are often built upon somebody else’s poverty or unemployment.

Old Myth: Decolonization would end poverty.

The myth was that, freed from exploitation by Britain and France, developing economies would flourish and poverty quickly fade.

There were also high expectations for new multilateral institutions such as the UN and World Bank. As sources of skills and financing, they promised to shape a better future.

But these, and new arrangements like the WTO, were shaped to protect the interests of traditional powers.

The shake-up caused by the first energy crisis in the 70s fizzled out as the West found a way of getting OPEC petrodollars recycled. Meanwhile the already poor, were left distinctly poorer.

Longer-term hopes for the UN were undermined, as parts fell into disrepair. Also, tighter aid money moved to the more politically favoured multilateral banks.

By the late-80s, growth — sometimes too fast, often unequal — turned sour. An accumulation of debt hit poorer nations particularly hard.

The ‘cure’ of ‘structural adjustment’ just compounded the problem.  It left many developing countries feeling that old partnerships were just not there to help them.

Even success was undermined.  The East Asia bubble created a huge debt crisis. Countries like Thailand and Malaysia emerged from the experience convinced that partnership, under IMF rules, was focused on protecting Western interests, not theirs.

Today’s Myth: Globalization is defeating poverty.

The new Millennium and its MDGs were an optimistic interlude, but then came 9/11 and the Iraq war. The human and economic costs were enormous.

The Paris Declaration recognized that aid effectiveness demanded partnership and country ownership. But two evaluations later – both led by Canada’s Bernard Wood – we know donors were not walking the talk.

Country ownership was still a myth.

Globalization was proving one-sided. Control of capital and technology favoured the North; developing countries supplied cheap labour, resources and markets. Fair wages and transparent pricing were just not on the table.

Today’s global financial crisis (2007 – now] took us to the brink of a new Depression. The perpetrators, NY bankers, show no remorse. Ordinary citizens, of both North and South, are recognizing that uncontrolled globalization is their enemy, not the way forward.

Inequality, that ‘top 1%’ issue, is increasingly recognized as a major impediment to effective development.

The South, both the powerful BRICS and even the very vulnerable ‘fragiles’, learnt they could tough out a Western economic implosion. And they now demand a stronger voice, real partnership, in managing the economic institutions controlled by the North.

Of course the real poor, such as women in Bangladesh’s garment plants, suffered doubly – they were exploited during the South’s growth spurt and then neglected as the North went into economic crisis.

So is there a Better Future? Is real partnership possible?

Today’s world is not a happy place, economically or politically. Only the very rich have emerged unscathed. The vulnerable are left further behind.

And I am not talking only of Harperland, but also Greece and Egypt even the US, not just the Haiti’s of our world.

We saw the bizarre reality that it was developing countries, especially emerging economies, that coped best.  Optimistically, the global financial crisis may have made us, the North, more conscious that our own future is bound up with the South’s.

But is there an opening for that sort of partnership? If we look at Canada’s present trade policy, one based upon multiple bilateral deals, it is not clear we are on the right path.

There could be a viable partnership path, but it has to be an inclusive one, chosen by equals, in a spirit of sharing, not opportunism, worse exploitation.

A more unified G20, more representative of the poorest, and not just an expanded list of privileged nations, could be a key instrument.

The UN’s Post-2015 Agenda, with its goal of ELIMINATING extreme poverty by 2030, will be the centrepiece.  It will be hard for anybody to not sign on.  But will they deliver?   That will be a quick test of whether North and South have learnt to work as partners.

The post McLeod Group at the CCIC-CAIDP Conference May 2014 first appeared on The McLeod Group.