What Does “Investing in Women” Really Mean?

Last week the World Bank announced the creation of a new $4 billion fund to spur investment in improving maternal and newborn health globally. It’s called the Global Financing Facility (GFF); a joint initiative which includes the US, Norway, and Canada all contributing millions of dollars. According to the World Bank’s announcement, “The GFF will support countries in their efforts to mobilize additional domestic and international resources required to scale up and sustain essential health services for women, children and adolescents.” The countries referred to are the developing countries which account for 99% of all of the deaths of women and babies in this world. The rest of the funding will come from “low-interest loans and grants” to these countries, from the International Development Association.

It’s a lot of money — and a lot of promises. But is money enough to cement real, significant, lasting change when it comes to improving the health and lives of women and newborns in the lowest resource regions of the world? It isn’t if we don’t, simultaneously, work to dismantle the structures which support the inequities that cause these health disparities for women and girls in poor countries.

In 2012 Melinda Gates announced her focus for the next thirty-odd years of her life: expanding access to contraceptives for women and girls in the lowest resource regions of the world. To enable this work, the Bill & Melinda Gates Foundation (in partnership with the UK) pulled off an impressive feat: the London Summit on Family Planning.

The Summit called for “unprecedented global political commitments and resources that will enable 120 million more women and girls to use contraceptives by 2020.” And it delivered on it’s funding promises. It secured almost $3 billion in commitments for extra funding to reach those 120 million more women and girls with the contraceptives they need and want by 2020. An impressive, diverse group of NGOs, foundations, developing country governments, donor countries, and private sector players came together to assert that expanded access to family planning for the women and girls in the lowest-resource regions of the world was critical not just to the health and lives of women and girls themselves but that it was, in fact, the “right of women and girls to decide, freely and for themselves, whether, when and how many children they have.”

In other words, the Summit enabled a mechanism to collect promises for funding and commitments to engage in the work necessary to expand contraceptive access. But the underpinning of the call was (and is) to support women’s and girls’ rights.

Family Planning 2020 (FP2020) is the organization formed to support the ongoing logistical work necessary to track the commitments made at the Summit and ensure the pledges come to fruition, and monitor the progress within countries and globally.

FP 2020 does, in fact, have a “Rights & Empowerment Working Group.” Their work plan and updates on progress can be found here. The members of the working group are dedicated to family planning advocacy to be sure (Population Action International, USAID, UNFPA, Marie Stopes International, International Center for Research on Women are members, among others). Their goal is noble but they cannot do it alone. These groups cannot ensure “the rights of women and girls to decide freely, and for themselves, whether, when and how many children they have” in the developing countries where contraceptive access is most needed, without the watchful eyes and dedication of rights-based advocates and activists holding them to their plans.

Ensuring women and girls have these rights will require a shift in the ways in which women and girls are treated: under the law, and in all of the countries, societies, cities, villages and homes where women and girls reside. This will require the voices and time and energy and money of individuals who care deeply about this issue; both within the countries where change must occur and in rich countries that have the most to contribute.

As major actors step up, including country governments, donor countries, and multilateral organizations, to make large funding commitments to improve the health and lives of women and newborns, we must keep a rights-based framework front and center. There is no question that more money is needed to strengthen health-systems, increase the number of skilled, trained health workers in facilities, purchase more medical supplies and improve technology, as well as improve the quality of care overall within facilities.

Money will not change the laws of a land without a side-by-side investment in raising the status of women and girls. Funding from donor countries, if used well, will help create needed programs and spur initiatives to expand access to contraceptives but will not teach the male leaders of a town or a village that women and girls have the right to access contraception without their permission. Government funding, without the heavy lifting of addressing the second class status of women and girls, will not shift the perception that girls and women should not have equal access to the education and information that improves ones’ opportunities and chances for a healthier life. What will persuade a woman who does not believe she has the right to a safe childbirth in a clean facility that, in fact, it is her basic human right to do so? There is no doubt that more funding to ensure the existence of high-quality facilities that provide low-cost services will be critical to improving her health. But the work of shifting deeply entrenched cultural beliefs that women and girls are not worthy of safe, respectful health care requires knowledgeable, devoted advocates who understand how to make these changes from the ground-up; not from the top down.

Money certainly can and will provide the mechanism for the creation of strong, evidence-based programs that help to address these inequities. Let’s ensure, however, that we build an equally strong scaffolding for the human rights and dignity that women and girls deserve, as we invest the much-needed funds to improve their health and lives.