A woman smiles during a visit from a Marie Stopes International mobile clincial outreach team in Laniar, Senegal. (Photo Credit: Jonathan Torgovnik/ Reportage by Getty Images, licensed under CC BY NC 4.0)
We live in an increasingly visual world. A hundred hours of video are uploaded to YouTube every minute. Over 20 billion photos have been shared on Instagram to date, and one in four teens consider it their favorite social network. So if pictures were valuable before, today they are critical for communicating and connecting with others.
Yet I was struck by how few compelling images I could find that tell the stories of our international reproductive health grantees. They’re doing amazing work—from providing services to women living in remote areas in sub-Saharan Africa to empowering young people to take charge of their sexuality and reproductive health. But coming up with just six photos to include on the Hewlett Foundation website last year was a far harder task than I thought it would be.
And what photos I could find were focused on the need for the grantees’ services rather than the impact of their work. Instead of women waiting in long lines for reproductive health services or empty shelves where contraceptive supplies should be, we wanted to show the transformative power that family planning can have on women’s lives. Queues and stock-outs certainly are the reality on the ground and challenges that must be addressed. But photos can do more than document a challenge. They can inspire. We wanted photos that would inspire policymakers to support these services, and that would inspire women and girls to seek out and demand better care. We needed photos that show what empowerment looks like.
That’s why we commissioned Getty Images to travel to Kenya, Uganda, and Senegal last summer to document the work of a number of our grantees in pictures. The results—some 400 openly licensed images—speak for themselves. And because they’re openly licensed and have full releases from all subjects, anyone is free to download and share them.
Here are just a few examples.
A woman laughs during a visit from a Marie Stopes International mobile clincial outreach team in Laniar, Senegal. (Photo Credit: Jonathan Torgovnik/ Reportage by Getty Images, licensed under CC BY NC 4.0)
This woman’s laughter as she’s waiting at a clinic with her child, and her beaming smile, tell me she’s genuinely happy to be there. We speak a lot about voluntary services in our field, about the importance of choice. Pictures like these really bring that home, in a way that reading a report about how providers are ensuring quality services simply can’t.
Community outreach services—providing services closer to where women live—are considered a best practice. But we don’t often get to see these interactions between community health providers and the women they serve. It’s touching to see these relationships up close, to be a part of these important, intimate conversations. I am grateful that these brave women let a stranger wielding a camera into their lives this way. I hope these images will convey the value of ensuring access in even the most remote areas, of speaking with individual women about their lives and needs, and of offering them choices.
Women participate in the Tostan Community Empowerment Program in Sahre Bocar, Senegal. (Photo Credit: Jonathan Torgovnik/ Reportage by Getty Images, licensed under CC BY NC 4.0)
A community health worker visits a woman in her home to discuss family planning services in Mbale, Ugandal. (Photo Credit: Jonathan Torgovnik/ Reportage by Getty Images, licensed under CC BY NC 4.0)
A community mobilizer visits a member of the Help Women Group Alita Kole in Ayala, Uganda. (Photo Credit: Jonathan Torgovnik/ Reportage by Getty Images, licensed under CC BY NC 4.0)
Our grantees are helping women and their families achieve their full potential by addressing a clear need: reproductive health. These pictures show that they are helping to build a community of shared understanding and mutual support. And it’s clear that giving women the chance to exercise reproductive choice is one way to empower them.
There are many intractable challenges that remain in our field. But being able to imagine—and see—the possibilities provide a reason to continue the work. If we’re trying to convince other people, from policymakers to women not currently using modern contraception why reproductive health is good and important, these pictures go a lot further than any amount of written words could.
An outreach worker discusses family planning options with young women from the Baroma school in Busia, Uganda. (Photo Credit: Jonathan Torgovnik/ Reportage by Getty Images, licensed under CC BY NC 4.0)
Members of a young mothers group supported by DSW (Desutsche Stiftung Weltbevoelkerung) during a self-empowerment session in Nairobi, Kenya. (Photo Credit: Jonathan Torgovnik/ Reportage by Getty Images, licensed under CC BY NC 4.0)
The summer season means a steady stream of Hollywood blockbuster premieres. Many of these will be in the form of sequels—there are over 20 planned for 2014, including Spiderman 2, Transformers 4, and 22 Jump Street. Evidently, past success at the box office is indicative of future returns; so why not bet on the sure thing instead of taking risks on new ventures?
With grant-making too, past success is a big factor in deciding whether to continue investing in an organization or a project. But the metrics we have to measure success often aren’t as clear as box office sales. Evaluations can be a useful tool to assess how well things are going (or not), and how future investments should be directed. In Hollywood speak: should we greenlight the sequel, and if yes, what plot line should it follow?
Since 2005, the Hewlett Foundation has invested more than $25 million in the Population and Poverty Research Initiative (PopPov), a body of research on the relationship between population dynamics and micro- and macroeconomic outcomes. As part of the initiative, researchers looked at the effects of obstetric complications on long term economic and social well-being of women and their families in Burkina Faso, and estimated the quantitative impact of reductions in fertility on a country’s long-term output per capita, to take just two examples. The funding provided by the Hewlett Foundation stimulated another $10 million of support for the Initiative from several European research councils and the World Bank, and the sheer amount of research undertaken to date is impressive: PopPov has supported 56 doctoral fellows and 61 research projects, which have resulted in 260 papers. About 70 of these have been published in peer-reviewed journals, and another 30 are in pre-publication review.
Numbers alone can’t truly measure the impact of the initiative, of course. The primary objective of PopPov was to advance and re-energize the field of economic demography, which had lost some of its earlier salience in social science research and in international development policy debates. The initiative was premised on the idea that attracting top talent and supporting cutting-edge research on population and economic development would yield compelling results that could help policymakers, particularly those in sub-Saharan Africa, to make informed policy decisions. In late 2012, we decided to evaluate PopPov in order to draw some summative lessons from our investment in the initiative, and selected the RAND Corporation to conduct the evaluation through an RFP process.
The evaluation was designed to help guide decisions about the PopPov network, as well as future investments in other policy-relevant research. The evaluation focused on four questions: 1) To what extent did PopPov strengthen the field of economic demography? 2) What contribution has PopPov made to the evidence base? 3) To what extent did PopPov yield policy-relevant research? And 4) How did the design and implementation of PopPov affect outcomes? The final evaluation report, completed in 2014, is based on document review, key informant interviews with nearly 100 individuals, and an online survey of research grant recipients.
The report provides a comprehensive summary of the PopPov network, insightful observations about the four questions above, and valuable recommendations about the various aspects of PopPov. The Hewlett Foundation will likely pursue a more focused research agenda in the future. Based on the strategic objectives of the Global Development and Population Program, we plan to prioritize recommendations in the three areas below. The Hewlett Foundation Board approved a renewal grant to the Population Reference Bureau, the Secretariat for PopPov, at its meeting last week to help carry out these activities.
A new year seems like a good time for a fresh start. This is probably why so many of us make resolutions this time of year to eat healthier, exercise more, spend more time with family and friends. A recent article in the New York Times suggests that behavioral economics can help us stick to these resolutions.
Behavioral economics is gaining attention these days. From individuals to workplaces to government agencies, behavioral economics is being embraced as a way to steer us to make better choices. Perhaps mainstream books like Nudge and Thinking Fast and Slow have popularized the discipline. The idea that people aren’t rational beings who do the right thing all the time certainly resonates with our sense of reality and our own recognition that good intentions don’t always lead to positive action.
While refreshing the Hewlett Foundation’s grantmaking strategy for its International Population and Reproductive Health portfolio last year, we honed in on behavioral economics as a possible tool for improving family planning services in sub-Saharan Africa. For example, if a woman’s contraceptive choices are heavily influenced by her peers, family planning counselors could propose first the birth control methods most likely used by her age cohort. If an unintended pregnancy is a future risk that seems disproportionately low compared to current consumption needs, there might be a way to make the trade-off seem more balanced.
The Foundation’s Global Development and Population Program has made two grants so far to help us test out some of these ideas. The Center for Effective Global Action at UC Berkeley has awarded pilot grants to behavioral economists to include behavioral components to ongoing research, and plans to help researchers team up with implementing organizations to design joint projects. The other grantee, ideas42, is also planning to work with service delivery organizations to identify some behavioral problems that could be addressed with a tweak or a different approach to the way services are currently provided.
Moreover, a panel discussion on behavioral economics at the recent International Conference on Family Planning in Addis Ababa generated both enthusiasm and dialogue.
It’s too soon to tell if behavioral economics can help a young woman in Uganda avoid an unintended pregnancy, or help a mother in Senegal better space her children. But the enthusiasm from both behavioral economists and service providers about working together to test out its potential is encouraging. We hope these partnerships will result in innovation that makes people’s lives measurably better—if I can borrow from the Foundation’s tagline.
As for my personal New Year’s resolution, it’s something I might actually be able to keep: to embrace imperfection. With a new baby in the house, this means living with a bit of a mess and outsourcing cooking more. It’s interesting to think about the kind of behavioral nudges that will make me stick with this.