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Why the COP26 climate conference needs to count for women’s and children’s health

A message from the incoming Co-Director of MARCH, Professor Susannah Mayhew: Reduced aid for women and children adds to climate stresses but COP26 provides a critical opportunity to inspire change.
A (pre-Covid-19) health talk at one of the Ugandan health facilities supported by the Margaret Pyke Trust. Credit: The Margaret Pyke Trust.

The climate crisis affects us all, but it is women and children in low-income countries who will be affected most. Currently around 21.5 million people are estimated to be displaced each year by climate-related disasters – of whom 80% are women and children. The vulnerabilities of women and girls are increased because of the climate crisis and their access to sexual and reproductive health services is severely reduced during disasters and displacement.

The UK government recently slashed its aid to health, education and development programmes including the United Nations Population Fund (UNFPA), the largest provider of contraception to many low-income countries. These cuts have severely curtailed opportunities for the world’s most vulnerable. Four million girls around the world are currently at risk of dropping out of education because they cannot access family planning to avoid unwanted pregnancies. Building communities and health systems that are resilient to the climate crisis needs participation from women, which is why enabling girls to stay in education and women to make choices about family size and timing is so important.

The climate crisis is altering rainfall patterns, threatening crop security and subsequently leading to malnutrition and hunger. In many countries women are subsistence farmers and are directly affected. Health infrastructures are further weakened, both directly through climate-related disasters, and indirectly through economic pressure. Rights-based family planning and other reproductive health services is low, particularly in remote rural areas, where women face high-risk pregnancies and children face undernutrition given increasing pressures on agricultural land. Gender-based violence may also be increased as a result of environmental pressures.

Connecting health and environment needs a holistic response

The “Healthy wetlands for the cranes and people of Rukiga, Uganda” project, which I lead the research component of, examines interconnections between environmental and human health. It focuses on the impacts of the climate crisis on women and families in the wetland area of Rukiga, Uganda. The London School of Hygiene & Tropical Medicine (LSHTM) is conducting research to support the development of community-responsive programmes to tackle livelihoods and health issues holistically. The implementing partners are the Margaret Pyke Trust (family planning training and integration of health, conservation and livelihood actions), Rugarama Hospital (delivery of family planning and healthcare services) and the International Crane Foundation (crane conservation, wetland restoration and sustainable livelihoods).

A series of key informant interviews and Focus Group Discussions (FDGs) in eight parishes in Rukiga district have highlighted the multiple ways in which degradation of local environments and destruction of crops through flooding directly affects human health.

Many respondents noted how human practices and pressures, including tree-cutting and burning of wild grasses, have exacerbated the challenges these farming communities face, in particular frequent and widespread flooding which destroys crops. When crops fail or are destroyed families cannot be fed, and men in particular felt that they were no longer able to fulfil their duties to provide for their families. This has led to an increase in alcoholism among men, (fuelled by cheap, strong, illegally brewed spirits) which puts an even greater burden on women:

“Every time, the man is at the bar instead of getting a hoe and going with the wife to dig. […] So, you find the woman working alone to sustain a big family. Their income will reduce.” 

Female, farmer, 26 yrs

One consequence of this that was widely mentioned by both men and women was an increase in domestic violence. Domestic violence often exposes women to greater risks of unintended pregnancies, yet women simultaneously noted the difficulties they had accessing good quality family planning services in the remote villages where they lived. One woman who had been able to access family planning services exclaimed:

“I thank those who brought family planning. I thank them so much because if they didn’t introduce it we would have delivered and got tired. We are already tired […] and you find out that you are carrying another pregnancy to increase on the number. So those who brought family planning I thank you so much.”

Female in FGD of women aged 24-38, all married, all farmers

Both men and women were also very aware of the connections between local population growth and degradation of their local environment and biodiversity: 

“Now the population is growing and the land is still small, this has caused people encroach on the wetlands and also over using the available land without allowing it time to rest between seasons. This caused soil to lose its fertility and the birds also lack where to nest and people don’t have enough land and enough food.”

Male in FGD of men aged 29-77, most of whom were involved in local councils

Respondents in our study have clear ideas about solutions to these challenges – they needed better family planning and child health services, but they also needed resources to implement traditional farming practices to restore damaged upland soils and dig trenches to combat flooding.

Can COP26 help?

COP26 provides a critical opportunity to form effective new partnerships between health, environment and conservation organisations and provide important new funding opportunities to inspire change. In Glasgow this November, the UK government has the chance to reverse the reputational damage it caused by slashing aid to women and children’s health and education programmes by pushing for a motion to be passed that will enable climate funding to be used for related health programmes and research.

At COP26 high-income countries are expected to deliver on their commitment, first made at COP15 in Copenhagen in 2009, to provide low-income countries with $100 billion per year to help their efforts to respond to the climate crisis. Only 0.5% of this amount would meet all currently unmet needs for family planning for women like those in Uganda, empowering them to make their own life-choices, feed and educate their children hence reducing pressures on their local environments. This is a small price tag for giving women and girls – and our world - a future.

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