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Nepal

Pour un accès plus équitable à la planification familiale en Asie du Sud

Julie McLaughlin's picture

Le 11 juillet, lors de la Journée mondiale de la population, des acteurs mondiaux de premier plan dans le domaine de la santé se réunissent à Londres pour tenter de mettre la priorité sur l’enjeu de la planification familiale. Cet enjeu est au cœur des travaux du personnel de la Banque mondiale chargé des questions de santé en Asie du Sud, qui s’emploie à trouver les moyens qui lui permettront d’aider plus efficacement les femmes et les familles à espacer les naissances et à éviter les grossesses non désirées.

 

Même si les pays d’Asie du Sud ont progressé dans l’élargissement de l’accès à la contraception moderne et dans le recul global de la natalité, la région accuse la deuxième plus forte mortalité maternelle du monde. Dans ces pays, les ménages pauvres, marginalisés et non instruits n’ont pas accès aux services de santé génésique dont ils ont besoin, et notamment à la planification familiale.

 

En Inde, au Népal et au Pakistan en particulier, les taux de fécondité et d’utilisation de contraceptifs diffèrent considérablement d’une catégorie socioéconomique à l’autre : en Inde, alors que le taux de fécondité n’est que de 1,8 chez les femmes les plus aisées, il se maintient à 3,9 parmi les plus démunies. Au Népal, les femmes instruites ont, en moyenne, 1,9 enfant, contre 3,7 pour les femmes non instruites. Au Pakistan, la prévalence de la contraception atteint aujourd’hui 32 % chez les couples riches et seulement 12 % chez les couples pauvres. En Inde, dans l’État du Meghalaya, 36 % des couples désireux de recourir à la planification familiale n’ont pas accès à une contraception efficace.

Planificación familiar en Asia meridional: Mejorar la igualdad de acceso

Julie McLaughlin's picture

 

El 11 de julio, Día Mundial de la Población, mientras los líderes mundiales de la salud se reúnen en Londres para debatir sobre el otorgamiento de una mayor prioridad a la planificación familiar, el personal del Banco Mundial que trabaja en el sector de salud en Asia meridional estará pensando en cómo respaldar más eficazmente a las mujeres y las familias de esta región para espaciar los nacimientos y evitar los embarazos no deseados.

 

Aunque los países de Asia meridional lograron aumentar el acceso a la planificación familiar moderna y reducir los índices totales de fecundidad, la región sigue teniendo la segunda tasa más elevada de mortalidad materna. Los hogares pobres, marginados y sin educación no cuentan con los servicios de salud reproductiva que necesitan, incluida la planificación familiar.

 

En India, Nepal y Pakistán, en particular, las diferencias en la fertilidad y el uso de anticonceptivos entre los grupos socioeconómicos son sorprendentes: en India, la tasa de fecundidad en la parte más rica de la población es de 1,8, mientras que sigue siendo de 3,9 entre los más pobres; en Nepal, las mujeres con educación tienen en promedio 1,9 hijos, mientras que las menos educadas tienen un promedio de 3,7; en Pakistán, la prevalencia de anticonceptivos es del 32% en las parejas más ricas y de apenas el 12% entre las parejas pobres, y en el estado indio de Meghalaya, el 36% de las parejas que quiere practicar la planificación familiar carece de acceso a métodos anticonceptivos eficaces.

Family planning in South Asia: Improving equity of access

Julie McLaughlin's picture

On July 11, World Population Day, while global health leaders  meet in London to discuss giving greater priority to family planning, World Bank health staff in South Asia will be thinking about how to more effectively support women and families in this region to space births and avoid unwanted pregnancies. 

 

While the countries of South Asia have made progress in increasing access to modern family planning, and reducing total fertility rates, the region still accounts for the second highest burden of maternal deaths. Poor, marginalized and uneducated households do not have access to the reproductive health services they need, including family planning.

 

In India, Nepal and Pakistan in particular, the differences in fertility and use of contraception across socioeconomic groups are striking: In India, the fertility rate among the wealthiest part of the population is only 1.8, while it remains 3.9 among the poorest. In Nepal, educated women have on average 1.9 children while the least educated have an average of 3.7.In Pakistan, contraceptive prevalence is 32% among wealthier couples and yet only 12% among poor couples. In the Indian state of Meghalaya, 36% of couples who want to practice family planning lack access to effective contraception.

South Asia's nutrition marketplace

Julie McLaughlin's picture

Malnutrition in South Asia is the worst in the world (yes, worse than that of sub-Saharan Africa). It undermines the efforts of countries to reduce poverty, increase educational attainment and productivity, expand innovation and entrepreneurship, and reduce maternal and child mortality. It’s also why, for the past two years, 21 organizations from India, Nepal, Afghanistan, Pakistan, Sri Lanka and Bangladesh have implemented community-based innovations for improving infant and young child nutrition, financed by a unique World Bank small grants initiative known as the Development Marketplace.

How Can Aid Agencies Promote Local Governance and Accountability? Lessons from Oxfam’s Work in Five Countries

Duncan Green's picture

Community discussion class participants in Bardiya village talk about their plans for building a community clinic.Oxfam is publishing a fascinating new series of case studies today, describing its programme work on local governance and community action. There are case studies from Nepal (women's rights, see photo), Malawi (access to medicines), Kenya (tracking public spending), Viet Nam (community participation) and Tanzania (the ubiquitous Chukua Hatua project), and a very wise (and mercifully brief) overview paper from power and governance guru Jo Rowlands. Here are some highlights:

“Governance is about the formal or informal rules, systems and structures under which human societies are organised, and how they are (or are not) implemented. It affects all aspects of human society – politics, economics and business, culture, social interaction, religion, and security - at all levels, from the most global to the very local."

When Budget Disclosure is Not Enough

Darshana Patel's picture

Deliberations around public budgets can sometimes bring out the worst in parliamentarians but impassioned responses rarely come from citizens themselves. Perhaps it is because budgets come in the form of tomes, with tables upon tables of data and very little context. Even though those tables reflect social services and entitlements that impact us all, simply disclosing this information does not necessarily mean that these documents will be understood or the resources well spent.

The Budget Transparency Initiative (BTI), led by the World Bank’s Social Development Department and funded by the Governance Partnership Facility, has introduced a methodology to disclose, simplify, and analyze budgets at various levels to not only bring this information closer to citizens but also create enabling spaces for them to provide feedback.

Development and Change for LGBT Indians, Nepalese

Elizabeth Howton's picture

Arif Jafar had no choice about coming out as gay. In 2001, he was arrested in the northern Indian city of Lucknow at the AIDS prevention agency where he worked, charged with running a sex club, jailed for 47 days, and named in the newspapers, in a case that helped spark a legal challenge to India’s sodomy law, known as Section 377. (Needless to say, he denies that the AIDS agency was a sex club.)Arif Jafar of the Maan Foundation

“Before jail, I was open, but not that open,” says Jafar, 42, a mosque-going Shiite Muslim who now runs the Maan Foundation, an AIDS prevention group (“maan” means “respect” or “pride”). “Now everybody in the city knows.” Despite the arrest, Jafar (right) says he loves Lucknow and will never leave. “If I ran away, people would start having the perception that I did something wrong,” he says.

Jafar’s case has dragged on for 11 years without coming to trial, but in the meantime, the law criminalizing homosexuality has been overturned in Delhi High Court. Retired Justice Ajit Shah, who wrote the decision, is an unassuming man, greeting us in sandals in his modest apartment. Yet his landmark opinion broke through several centuries of bias and freed up India’s nascent movement of lesbian, gay, bisexual, and transgender (LGBT) people to come into its own.

It’s Time to Collaborate to Tackle the Jobs & Youth Agenda

Anushka Wijesinha's picture

“While unemployment is around 5% in Sri Lanka, youth unemployment is nearly 3 times that. Youth unemployment is a critical challenge for us right now”, I said, in my remarks on Sri Lankan perspectives at a South Asian youth dialogue on the sidelines of the World Bank–IMF Spring Meetings last month. “Hey, what are you complaining about? Youth unemployment is almost 50% in Greece right now!”, was the immediate response I got from a World Banker in the audience. I was taken slightly aback, but it made it very clear to me - the youth unemployment issue is a gripping issue for many of the world’s economies right now, and even if the numbers may not always be on the same scale and each country has different reasons for why it’s a high-priority policy issue right now.

The last year and a half has seen everyone sit up and take notice of youth unemployment like never before – either because of the Arab Spring or protests by discontent educated youth in European capitals. The attention of economists and governments alike is on it – how did it become such a challenge? How can we address it?


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