PRB

The advent of crises—whether sudden, such as the COVID-19 pandemic, or protracted, such as climate change—exacerbates existing inequality by disproportionately impacting the most vulnerable populations, such as women and girls. Although men and boys also suffer, through for example disruptions to the workforce or educational opportunities, in the face of crises that span social, economic, and environmental spheres, women and girls are particularly exposed to the cascading impacts of inequality.¹

Holistic, integrated solutions are key to address the interlinkages of the gendered impacts of crises. Increasing access to voluntary family planning and reproductive health programs, through cross-sectoral approaches such as Population, Environment, and Development (PED), has the potential to mitigate many of the inequitable effects and improve resilience for households and communities in the face of shocks. With cross-cutting benefits that affect gender equality, women’s empowerment, and resilience, family planning is a multisectoral high-impact practice that should be prioritized among solutions to current development challenges across sectors.

COVID-19 Exacerbates the Gendered Impacts of Climate Change

In the current context, the pandemic has compounded pressing challenges to women’s well-being caused by climate change. Evidence of the link between climate change-driven resource scarcity, migration, conflict, and other factors related to women’s security is increasing. More frequent weather extremes, droughts, and flooding, as well as rising temperatures and coastal sea levels combine with health crises such as the pandemic to place stress on individuals and communities. Competition for access to resources such as water, land, food, and fuel under crisis conditions can reinforce harmful gender norms, discriminatory practices, and gender-based violence (GBV), and compound the existing impacts of limited access to essential health care. As these crises disrupt livelihood activities, they add to economic instability and food insecurity, with further negative impacts on women and girls.²

Crises’ Effects on Women Create Wide-Reaching Impacts on Society

The stresses of sudden, acute crisis situations such as the COVID-19 pandemic often create an environment of increased violence and a myriad of other harmful effects on women, which build upon the long-term stresses caused by diffuse crises such as climate change. Combined with existing harmful gender norms, these detrimental effects span many aspects of women’s lives and well-being, as shown in the figure below.

FIGURE 1. WOMEN AT THE CENTER: THE COMPOUNDING IMPACTS OF CRISES LIKE COVID-19

Source: UNESCO, “UNESCO COVID-19 Education Response: How Many Students Are at Risk of Not Returning to School?” Advocacy paper July 30, 2020 (Paris: UNESCO, 2020); Taylor Riley et al., “Estimates of the Potential Impact of the COVID-19 Pandemic on Sexual and Reproductive Health in Low- and Middle-Income Countries,” International Perspectives on Sexual and Reproductive Health, no. 46 (2020): 73-6; United Nations (UN), Policy Brief: The Impact of COVID-19 on Women (New York: UN, 2020); Food and Agricultural Organization of the UN (FAO), International Fund for Agricultural Development, UNICEF, World Food Programme (WFP) and World Health Organization, The State of Food Security and Nutrition in the World 2020: Transforming Food Systems for Affordable Healthy Diets (Rome: FAO, 2020); WFP, “COVID-19 Will Double Number of People Facing Food Crises Unless Swift Action Is Taken,” (April 21, 2020) www.wfp.org/news/covid-19-will-double-number-people-facing-food-crises-unless-swift-action-taken; and UN Environment Programme (UNEP), UN Women, UN Development Programme and UN Department of Political and Peacebuilding Affairs/Peacebuilding Support Office, Gender, Climate and Security: Sustaining Inclusive Peace on the Frontlines of Climate Change (Nairobi: UNEP, 2020).

One particularly disturbing effect of the pandemic, which has also been observed during other social and economic shocks, is a dramatic increase in cases of GBV, including domestic and intimate-partner violence.³Some projections estimate a worldwide increase of up to 31 million additional cases of GBV during a six-month lockdown period.⁴

As women face increased risk of violence during times of instability and crisis, they also face setbacks to reproductive health that can have long-lasting effects. The latest evidence, compiled before the spread of the pandemic, indicates that 218 million women ages 15 to 49 in low- and middle-income countries have an unmet need for modern contraception.

In addition, nearly half (49 percent) of pregnancies in low- and middle-income countries (some 111 million total) are unintended.⁵ Early projections of the pandemic’s toll warned that an additional 47 million women and girls from low- and middle-income countries could have unmet need for modern contraception, assuming a confinement period of six months.⁶ Initial phone survey results on the pandemic’s effects indicate that access to care has indeed been a barrier: In the Democratic Republic of Congo, 54 percent of women surveyed reporting difficulties accessing care due to COVID-19.⁷ Women’s ability to access family planning and reproductive health services is also influenced by factors such as decisionmaking power, access to information on sexual and reproductive health, financial resources, and level of education. In societies with discriminatory gender norms, women may have less autonomy and knowledge, as well as agency in their reproductive lives, to meet their sexual and reproductive health needs.⁸ Crises can further exacerbate these harmful gender norms when women face increased restrictions on their movement.

Among the world’s rural communities, 90 percent of which are in Africa and Asia, women occupy central roles in subsistence activities, agriculture, and food preparation, thereby contributing to food security and family nutrition, and acting as stewards of natural resources.⁹ Discriminatory gender norms—in the form of poor access to land, low economic decisionmaking power, and less access to information, among other factors—impact women’s livelihoods and well-being and, by extension, the health and stability of their families and communities.¹⁰ While nearly half of all small-scale farmers are women, they also make up 60 percent of the 821 million people who are food insecure, with a 27 percent higher chance of being severely food insecure compared to men globally.¹¹ The World Food Programme estimates that if female farmers had resources equal to those of men, they could feed an additional 150 million people.¹²

These vital but often informal roles increase women’s risk of adverse effects in the event of social or environmental shocks.¹³ For example, during the COVID-19 pandemic, women’s caregiving burdens are increasing while they are simultaneously losing opportunities to take part in economic activities outside the home, attend school, and participate in society.¹⁴

Increasing Access to Family Planning Through Multisectoral Approaches Is a High-Impact, Cost-Effective Strategy to Address Intersecting Challenges

Women’s economic, social, and physical well-being is at significant risk due to unequal systemic factors that disproportionately affect them during times of crisis—and their health and well-being have wide-ranging impacts on society and the environment. While ensuring access to reproductive health and family planning is important to meet women’s individual health needs, it also serves as a crucial way to build healthier communities and a healthier planet. The ability to determine whether, when, and how many children to bear better positions women to overcome the adverse effects of climate change, COVID-19, and other shocks by allowing them greater autonomy, educational opportunities, and financial power. In turn, these forms of empowerment and improved equity for women can erode restrictive gender norms.¹⁵

Voluntary family planning is a proven, high-impact, and cost-effective intervention that not only supports improved gender equality through enhancing women’s reproductive choices but has also been demonstrated to contribute to community resilience and promote other development outcomes. It has been identified as a cross-cutting best practice, in these ways among others:

• Family planning improves reproductive, maternal, and child health. With the option to delay or prevent pregnancy, women have better health outcomes and healthier babies. The healthiest period for births for women is between ages 18 and 34, with births spaced at least 24 months apart and avoiding more than four births. It is estimated that increased access to family planning would avert 70,000 maternal deaths per year, a 23% decline.¹⁶
• Family planning helps girls stay in school. Over 22 million girls ages 15 to 19 became pregnant in 2015.¹⁷ Early pregnancy is both a cause and effect of girls’ dropping out of school. Access to family planning helps girls delay childbearing past their teenage years to complete their education, obtain a job, or start a business. Women who have children later in life have better educational outcomes than girls who give birth during their teenage years.¹⁸
• Family planning contributes to women’s economic empowerment. Decreases in fertility lead to increases in female labor force participation—having one fewer child increases female labor participation by two years on average. Longer birth intervals increase the potential for women to enter the labor market between births.¹⁹Studies have also found that women’s access to family planning and maternal health can support higher family income and educational outcomes for children than in families without access to family planning.²⁰
• Family planning combats gender inequality. By supporting women’s health, economic empowerment, and education, access to family planning is an essential component of improving gender inequality and shifting harmful gender norms.²¹
• Family planning reduces pressure on natural resources. In reducing fertility and allowing women the option to space births, access to voluntary family planning reduces stress on natural resources and promotes a healthy environment.²²
• Family planning is cost-effective. Every dollar spent beyond the current amount in investing in family planning care would save $3 in reproductive, maternal, and newborn health care costs.²³

Family Planning Is an Essential Tool to Build Resilience Through Integrated Approaches Like Population, Environment, and Development

Not only does access to family planning enhance gender equality and other development outcomes, but evidence suggests that it promotes stronger resilience to shocks at the household and community level when integrated with other development strategies. Integrated development approaches that recognize the high-impact results of increasing access to family planning across sectors, such as PED, present a compelling alternative to traditional vertical sectoral development and offer the potential to accelerate gains in community resilience, as the world faces setbacks from compounding crises. PED approaches work simultaneously to address community needs, including unmet need for family planning, while enhancing livelihoods, education, natural resource management, and conservation.²⁴ These interventions also address gender norms and equality through increasing access to family planning among women, and importantly through engaging partners and husbands with information, leading to higher engagement of men in family planning decisionmaking than seen in single-sector interventions.²⁵

Two examples from projects led by conservation organizations demonstrate how family planning boosts resilience and contributes to recovery from shocks:

• In a study assessing outcomes from an integrated population, health, and environment project in western Tanzania led by The Nature Conservancy and Pathfinder International, researchers found that family planning is positively associated with all components of resilience, including women’s highest education level; water, sanitation, and hygiene; and food security, livelihoods, and assets.²⁶
• Evidence from an integrated project in Madagascar, implemented by the conservation organization Blue Ventures, shows that integration of population, health, and environment initiatives, including family planning access, helped local communities rebound after a severe cyclone. This resilience is attributed to increased social cohesion, improved health, and diversified livelihoods.²⁷

To achieve a holistic and equitable recovery from the global crises we are facing, women must be empowered as drivers of change, acknowledging the central role they play not only in the family and community but in the economy and natural resource management. Investments that meet women’s and adolescent girls’ needs for family planning and quality reproductive health care increase their agency, address restrictive gender norms, and improve women’s health and futures, opening the door for broader, sustainable development and a better future for the planet. Integrated approaches to PED that include increased access to reproductive health and family planning provide a high-impact and effective approach to build community resilience and reduce gender inequality, with positive outcomes for women and the environment.

This web article was written by Tess E. McLoud, policy advisor at PRB, with contributions from PRB colleagues Kristen P. Patterson, Stephanie Perlson, Elizabeth Leahy Madsen, Kaitlyn Patierno, Heidi Worley, and Anneka Van Scoyoc. The author gratefully acknowledges suggestions from Clive Mutunga, Afeefa Abdur-Rahman, and other colleagues at USAID.