On World Humanitarian Day this week, the world was dealing—or not quite dealing—with multiple humanitarian emergencies: Ebola in West Africa, refugee crises in Syria and Iraq, civil war in the Central African Republic and looming famine in South Sudan. USAID has more disaster response teams mobilized than at any time in its history, and the most “can do” groups, like Doctors without Borders, are sounding the alarm about the need for a larger and faster response.
This is the new normal. Many experts, anticipating a combination of climate disruption and political instability, expect that doing relief work on multiple fronts is something the world has to get used to—and has to learn to do better with the $5+ billion mobilized from public and private donors each year. There are more problems and they are more complex than in the past, and more money will be going to the immediate needs of displaced, hungry, sick, and traumatized people around the world.
Believe it or not, in this dark space there is a tiny glimmer of light, and it’s not just the glow from the halos of the amazing people who dedicate their lives to helping others. It’s the light from more systematic learning.
The humanitarian community—funders and implementers—is demonstrating an impressive appetite for using evidence from rigorous evaluations to provide more effective (and cost-effective) responses the next time around. A recent blog post by Oxfam’s Ellie Ott describes this well: “If we fail to examine the evidence, then we fail in our duty to help communities and individuals get back on their feet, and can even potentially cause harm.” She highlights the value of systematic reviews and new impact evaluations coming out of EvidenceAID, the Abdul Latif Jameel Poverty Action Lab, the Campbell Collaboration, and the International Initiative for Impact Evaluation.
The more I think about it, the more obvious it is that evaluation can be a huge benefit to humanitarian activities, as long as it’s focused on questions that matter. The outcomes are often more observable and measurable than most long-term development programs. More importantly, within global development, broadly defined, humanitarian aid is one of the most centralized and well-coordinated types of activities. Key features of humanitarian aid include chains of command with designated lead agencies, standard protocols, and a few dominant funders (including the U.S.)—all characteristics that make it reasonably likely that practices can change pretty quickly if a new approach is shown to be superior to the status quo.
One example illustrates the point: Unsure how best to treat the mental health problems stemming from rape in the war-torn Democratic Republic of Congo, the International Rescue Committee teamed up with Johns Hopkins University and the University of Washington a couple of years ago to conduct a randomized evaluation of “cognitive processing therapy,” a form of group therapy to treat anxiety, depression, and post-traumatic stress disorder. The study was funded by the USAID and the World Bank. The researchers found that after six months, only 9 percent of women participating in group therapy were suffering from feelings of shame and anxiety, while 42 percent of women who had been offered an alternative form of care were still suffering. They’d found a dramatically better way to provide care for problems that affect almost half of the women in eastern Congo where rape has been used as a weapon. Findings published in the New England Journal of Medicine and widely disseminated in the field are helping to change practice both within IRC’s work and more broadly.
We don’t fund humanitarian aid efforts ourselves, but we do support many organizations working to build a better base of evidence about what works. And we applaud loudly when aid organizations with lots of priorities to balance, like USAID, the World Bank and the UK Department for International Development, have the wisdom to invest in serious evaluation. In a small way, we’re working with others to make sure that the hardest kind of international work is also the most effective.
I almost always ask grantees what’s missing from their ecosystem. Understandably, they look at me blankly. Then I explain: What could other organizations do that would make your work have greater impact? No one organization can do it all, so what else should we support to complement your efforts?
It turns out this is a hard question for most people to answer. Everyone recognizes that creating positive social change takes varied skills and strategies, but people are focused almost exclusively on their own organization. Mostly, they want to expand the scope and scale of their own activities. It’s tough to endorse funding others when their own organizations never seem to have enough.
If you ask researchers what’s needed, for example, you often get a list of the research projects they themselves would like to tackle with available household survey data, rather than a wish list of types of data that would permit them to answer core questions with more precision and fewer assumptions, if only others were funded to collect and share it. If you ask advocates what would make it more likely for their work to make a difference in real-world policy, you usually get ideas about larger and more elaborate campaigns that their own organizations could undertake, rather than suggestions about funding more relevant research or enhancing the media’s ability to understand and communicate about their field. Organizations delivering health services or educating kids are more likely to highlight the need to cover larger populations instead of emphasizing the value of investments in new products, financing arrangements, quality certification systems, or the development of a stronger evidence base.
The ecosystem or field-level view is precisely what we try to have when we’re thinking about grant making. We can make the case for supporting a given organization not only because of its intrinsic importance or brilliance, but because it plays a distinctive role: the impartial source of cutting-edge analysis, the edgy advocate, the trusted insider. Few things make us happier than seeing different organizations we support spontaneously working together toward a common end, because it’s validation that we guessed right about the complementary nature of the work. And we are much, much more likely to make the right guesses—and contribute in the most high-impact ways—when we get advice from the trenches.
It’s easy to come up with reasons not to evaluate the impact of a program: We don’t have enough money. There’s no time to collect baseline data because we’ve got to get the program up and running. The pathways from what we’re doing to impact are so complex we can’t trace causation. It’s unethical to withhold this program from people, even if by doing so we’d be able to compare the experience of participants with non-participants and estimate the program’s net impact.
Over the years, I’ve tried, along with others, to overcome these excuses because they stand in the way of learning how to use precious dollars to do the greatest good.
But while there are many bad reasons to avoid an evaluation, there is one very good reason, and it’s not recognized often enough: If the findings from the evaluation won’t make a difference, don’t do it.
Here’s the set of questions that together can help us all figure out if an evaluation might make a difference:
What are the decisions that the findings from the evaluation could inform? Sometimes these have to do with renewing or increasing funding for the program, and sometimes they have to do with program design or organization. These future decisions should drive the evaluation questions. If no one can articulate what decisions will be made, it’s time to question whether an evaluation is worth it.
Are those decisions going to be based on evidence about program effectiveness? Funders have diverse motivations. Not all of those have to do with whether a program is achieving its stated goals. If a program is going to be expanded or killed regardless of what the data say, then think hard about the value of doing an evaluation at all—or at least make sure it’s done so transparently that decision makers have a hard time ignoring the facts.
When are those decisions going to be made? Far too often, the evaluation is started so late or will take so long that the findings will be available only after funding and other decisions have been made. The evaluation report ends up as an awkward afterthought.
Can the evaluation change anyone’s mind? Both funders and implementers usually have strong views about the effectiveness of a program based on experience, observation, or gut feelings. Sometimes the label “success” or “failure” has already been applied. If the data and methods for the evaluation are not strong enough to potentially change the minds of decisionmakers, what’s the point? Either invest in more robust methods or drop the ceremony of evaluation altogether.
If these questions were applied systematically and early in program design and implementation, we’d have more good and useful evaluations—ones that are well-timed and use appropriate methods. We’d have better clarity about the purpose of the evaluations we conduct. The timing and methods would match the needs of the decision makers, and greater transparency could mitigate against political influences. At the same time, we’d end up with fewer evaluations that are purely symbolic.
Can evaluations lead to better use of money? Yes. Will they if the conditions are not right? Absolutely not.
The first week of August is usually sleepy in Washington, DC, as Members of Congress head back home and staff collapse from exhaustion. The think tank and lobbying crowd slow down, too, storing up energy for whatever September might bring.
This year, though, it’s a whole different story. Next week more than 40 African heads of state and their entourages are expected to converge on downtown DC for the U.S.-Africa Leaders Summit, convened by President Obama. Can you say “motorcade mayhem”?
The three-day event has been billed as “Investing in the Next Generation”—a worthy if challenging imperative for leaders who are some of the oldest in the world. Among the expected attendees are President Paul Biya of Cameroon (80), President Hifikepunye Pohamba of Namibia (78), President Jacob Zuma of South Africa (72), President Teodoro Obiang Nguema Mbasogo of Equatorial Guinea (72), and President Yoweri Musveni of Uganda (69)—all leaders of countries where more than half the population is younger than 21 years old. In other words, most citizens in those countries are the age of the presidents’ great-grandchildren.
Almost certainly, someone will bring up the fact that 43 percent of Africans are under age 15, which implies both the threat of restive youth in the streets and the potential of a young workforce for decades to come. It’s this hoped-for economic boost that will likely get the most play. (What leader wants to think about street protests when they’re out of the country?) In fact, if you attend both the official and side events, you can keep yourself occupied counting the number of times you hear "demographic dividend" or "demographic bonus.”
A demographic dividend is not, contrary to some suggestions, an automatic result of having a large number of productive young people. It’s a term coined to describe what can happen during the 20- to 30-year window following a population boom, when fertility rates fall. This creates a “bulge” in the population, where there are fewer older people (due to shorter life expectancies) and fewer younger people (due to reduced fertility rates). As the bulge reaches productive age, a country can benefit from having a large share of the population (potentially) contributing to economic growth through their own productivity, consumption, and savings. As that “potentially” indicates, though, realizing the benefits of a demographic shift depends on much more than youth; it also depends on wise policies. Three make a particular difference.
First, you only get a chance at a demographic dividend if fertility rates decline rapidly following a period of high birth rates. That’s what makes the difference between just a young population—like the ones that virtually all African countries now have—and the set-up for a demographic dividend.
How to make that happen? Fertility rates drop when investments are made in good education, family planning and other health services, and in opening economic opportunities for women. In most African countries, there is pent-up demand for family planning services that has yet to be met—that’s a good place to start.
Second, you have to focus on work for young people. If countries with a youth bulge are plagued by high unemployment or underemployment, that’s a recipe for trouble when those youth reach productive age. This may mean economic diversification to labor-intensive sectors, as well as investment in education and training programs that focus on the needs of the economy. This also means countries should invest in greater employment opportunities for women, who contribute to the economy and, when they earn income outside the home, tend to have fewer kids.
Third, you’ve got to keep your eye on policies that support economic growth, including maintaining macroeconomic stability, keeping trading relationships going, and providing opportunities for saving. This is the part that, by now, is the bread-and-butter of many economic policymakers in the region.
Next week, a young president from an aging country will talk with old presidents from youthful countries. Let’s see if they can, together, look at the bottom of Africa’s population pyramid—the young people—and realize the potential within.
A commonly voiced critique of foundations is that our goals and strategies are hard to understand. Fair enough. Many of us could do a better job of explaining ourselves.
Within the Global Development and Population Program, we’ve certainly found it difficult to describe our strategies in compelling and concise ways. Each line of grantmaking has its own logic, specific to the subject matter as well as to the niche we believe can fill within a community of nonprofits, official agencies, and other private funders. We can and do write down the theories of change underlying our grant choices, but even with the presentational polish—Look! Boxes and arrows!—these are less like architectural drawings and more like sketches roughed out in the midst of construction. Our written strategy documents, let alone the text on our website, rarely give a full feel for what we do or how we think about it.
The challenges we face are not unique to foundations. They’re shared by virtually everyone whose work involves any degree of abstraction. Once one gets beyond an enterprise that can be described as, “We buy textbooks for schools in poor communities” or “We vaccinate children,” you’re in the land of abstraction – and it’s tricky terrain to navigate with bullet points. Just try to put “women’s economic empowerment” or “transparency and accountability” into plain language.
This problem is compounded when a foundation or any other organization covers a broad scope of subject matter. The unifying thread can seem banal—“we make information available to improve lives” —and understanding the strategy, activities, and intended outcomes requires real time and effort. We certainly don’t expect to figure out the strategies underlying our grantees’ work just from reading the documents available on their websites.
So what to do? We rely on that most old-fashioned form of communication: conversation. To understand the strategy of a grantee or prospective grantee organization, we ask questions—a lot of them. What are you trying to do in five years, two years, next year? Whose actions are you seeking to change? Why do you think that’s possible? How do you know you’re heading in the right direction? What do you see as the major obstacles? Where do you see the overall field heading? And those are just the warm-up—there are many more. In hearing the answers to all those questions we start to understand the thought processes behind a nuanced and dynamic strategy. It is so much more satisfying than reading any strategic plan or website copy, no matter how well written.
We’d be happy to have the tables turned on us, but honestly it just doesn’t happen very often. While we systematically consult with experts, including current and potential grantees, as we’re developing new strategies, typical conversations with grantees and grant-seekers have a different feel. In part because of the intrinsic power dynamics of funder-grantee relationships, and in part because prospective grantees often want to hear only enough about our strategy to ascertain whether their work is a fit for it, we just don’t get that many questions about our strategies during those conversations—and no, “When is the proposal due?” doesn’t count.
When current or prospective grantees do inquire about our strategic direction, they seem quite satisfied to hear a superficial answer. We almost never see a quizzical look, let alone hear questions like, “When you talk about policies that affect women’s economic empowerment, are you thinking about active labor market policies like job training, or macroeconomic policies that expand growth in sectors that tend to employ women?” It’s those sorts of questions that uncover the thinking behind the words, and help explain why we might fund one project or organization and not another.
The cost of having a conversation where only one side is asking questions is high. We’re not getting enough feedback on whether our strategies makes sense to others with different perspectives and experience. In the absence of specifics, people may spend time proposing work that we’re unlikely to fund. We get comments through anonymized surveys that we are opaque, and we spend hours writing and rewriting website text that in the end doesn’t clarify much at all.
Am I asking for an inquisition in every conversation? No. But I am suggesting that there is only one way to truly understand why we do what we do: Ask.
We award grants to organizations, but it’s people who have the ideas and who do the work. So when the people we’ve come to depend on retire or move to new opportunities, we can’t help but wonder what the change will bring. That is never truer than when the chief executive departs, and recruiting for his or her successor begins.
We’ve seen that a lot recently. Among the organizations in our portfolio that have gone through leadership searches in the past year are the International Initiative for Impact Evaluation, the Population Council, the Guttmacher Institute, and the Population Reference Bureau. I’m sure 2015 will bring more—every year does.
Leadership transitions are often filled with stress and uncertainty, but they can also afford opportunities to strengthen the relationship between a nonprofit organization and its funders. Here’s how:
Have an answer when we ask about a succession plan. A standard question we ask, particularly when working with a nonprofit organization that is led by its founder, is whether there’s a succession plan. What’s going to happen when the person with the initial vision moves on? Who’s responsible for recruiting a new leader and how will it happen? Who will keep the organization running in the interim? The more forethought the board has put into this, the more likely it is that the disruption inherent in such transitions will be minimal.
Make sure there are no surprises. Absent extenuating circumstances, we expect to be informed about the departure of a chief executive very soon after staff and before the public. Ditto for information about a successful recruitment. This is not the kind of news funders should hear second-hand.
Give us a chance to weigh in. Funders have a lot to contribute when a search gets underway. We don’t just know the organization itself, but we see how it fits into the broader ecosystem of similar organizations. On good days, we also might have some smart things to say about where the field is going, or could go. This is valuable for developing a position description. Even better, with a field-wide view, we know some of the rising stars who might be ready to stretch into a leadership role.
Let us see how the leadership team is stepping up. Many of the best organizations depend on a leadership team, not just a single person, to set and maintain a strategic direction. It’s often during times of leadership transition that we get a picture of how well the folks who are in charge of operations, finance, and other key functions work, individually and as a team.
Offer mutual commitment. Both parties to the funder-grantee relationship can, if they choose, reduce the uncertainty by making commitments that transcend a specific hiring decision. The nonprofit’s board, for example, can articulate the strategic questions they want any incoming leader to think through. This gives us confidence that the board is taking its role seriously, an indicator of a healthy institution. For our part, we are sometimes able to arrange the timing of grant decisions and the duration of funding so that a new chief executive has some time to settle in before facing a new round of fundraising. (The earlier we know about pending transitions, the easier it is for us to do this.) Occasionally, we can also commit new, just-in-time money for the leadership search itself, or for a strategic planning process that might prove valuable to an organization’s new head.
Like all funders, we have a big stake in the health, productivity, and success of the organizations we’re able to support—regardless of who is at the helm. A leadership transition can be a time for us to gain even more confidence that we’ve placed a smart bet.
In the world of global development, a remarkable amount of intellectual energy is being expended trying to influence the post-2015 development agenda, the set of goals to be agreed by the member states of the United Nations in September 2015. Those goals are seen as important because their predecessor, the Millennium Development Goals, affected how donors and national governments allocated money. They also stimulated policy change at national level. For instance, governments in East Africa eliminated school fees to dramatically increase primary school enrollment. So a lot of people are paying attention because they think a lot of more powerful people will pay attention.
Deliberations leading up to the final agreement of a post-2015 framework, a classic “action-forcing event,” have focused attention on truly fundamental questions: Should international goals apply to all countries, rich and poor? How can the perspectives of resource-poor countries and people be reflected in the goals? How can social and economic development aims be reconciled with environmental limits? What matters more: the right orientation in health, education and agriculture, or governments that can effectively respond to citizens’ needs and wants? What’s the relationship between how we collect data and how we design inclusive social policy? How much should donor nations shoulder the responsibility for paying to progress toward ambitious targets?
It’s a rich discussion about poverty and inequality, problems and solutions. It is also a surprisingly inclusive discussion, informed by many local and national consultations, public opinion polling, and innovative work by Southern think tanks. To get a flavor for the quantity and quality of the commentary, just tune in to the Overseas Development Institute’s Post2015.org website, which serves as a hub for a grand (and not bland) conversation.
That international conversation – in meetings, blogs, research papers, politicians’ speeches and more – has been novel not just in its depth and breadth, but also in the extent to which people interested in one set of issues have listened to others. Everyone paying attention to the construction of the post-2015 development agenda knows there will be tradeoffs and negotiations; we all are conscious that broad-based coalitions will gain more purchase than single-issue advocates. As a consequence, we all have an incentive to listen to and understand what people with different agendas and perspectives are saying. We’re even seeing a growing appreciation of how different issues – health, water, climate – interact with each other.
This is why I’m starting to worry about post-post-2015. Once the goals are agreed, there will be a tremendous temptation to return to whatever silos we crawled out of. Health people may stop paying attention to gender or inequality people, those working on reducing poverty may cease being interested in climate change, and progress toward defining problems shared across all countries may fade away. This would be a major loss.
Tell me: Is there a way to keep the dynamic post-2015 conversation going in the post-post-2015 era?
Not long ago, during a discussion about progress for girls and women around the world over the past twenty years, I found myself doodling on a napkin. The conversation was organized around the twelve areas of action articulated in the 1995 Fourth World Conference on Women in Beijing, China. Since I have trouble keeping twelve things in my head at once, I was doodling to see if I could make some sense by lumping, sorting and sequencing the items:
women and poverty
education and training of women
women and health
violence against women
women and armed conflict
women and the economy
women in power and decision-making
institutional mechanism for the advancement of women
human rights of women
women and the media
women and the environment
Pen in hand, I first tried to rank these in order of importance. But that was plainly impossible. How could it be more important to be healthy than to lead a life free of poverty? Is it more important to take part in political life or to have access to the media? These are all important in fundamental ways, and intertwined.
Ah, intertwined. I tried a Venn diagram, the refuge of the “everything’s connected” school of understanding the world. I tried to depict the areas where, for example, the incidence of poverty among women intersects with education, health, and economic opportunity. With a few pen strokes I had an impressively tangled set of overlapping bubbles, but no clarity at all.
Time for a new napkin. The next attempt was to array them along some imaginary axis of “progress achieved.” We’ve made more progress in ensuring equality of educational opportunities than in protecting girls and women from violence, for example, so maybe I could find some pattern that way.
That’s when I found myself drawing two axes to represent two distinct dimensions: On the x-axis, the degree to which progress depends on changing social norms; on the y-axis, the degree to which progress depends on changing the economic order. This sounds abstract, but bear with me and you might see an interesting pattern emerge.
Think about gender parity in primary school enrollment, for example. The tremendous gains we’ve seen over the past two decades have not been easy, and it’s still an uphill battle to make sure girls make it through primary school and into secondary school. But as economies have become less dependent on family labor on farms, sending young children to school is not fundamentally disruptive to the social or economic order. So, notionally, let’s start with primary education plotted on the part of the graph closest to the origin. For the heck of it, let’s put gender parity in secondary education a little further along the “change in social norms” axis and a step or two up along the “change in economic order” axis, because with secondary education women are better able to compete in the labor market.
Now, where to put preventing gender-based violence? That’s a heavier lift, and requires a recalibration of power and vulnerability within society, and particularly within households, where much of the violence occurs. While there are economic aspects to violence—women whose movement is restricted have less ability to work outside the home—progress requires more of a change in social norms than in productive opportunities that are afforded women. So let’s put it further along the “change in social norms” axis.
One more: women and the economy. More specifically, how about something really tough: opening up traditionally male occupations to women. What constitutes “women’s work” and “men’s work” is among the most deeply held beliefs in any culture, so we’ve got to put that toward the extreme end of “requires a change in social norms.” And “men’s work” is almost invariably better paid, so a breakthrough on occupational segregation by gender requires major changes in the economic order in a society—changes that mean women are not cast in the role of the reserve labor force, the invisible producers. So I’d put that way up in the far right-hand corner of my diagram: difficult in both dimensions.
This is by no means a perfect framework for understanding why some aspects of women’s lives and livelihoods progress faster than others. But it helps me think about what some of the barriers to progress are. And it inspires me to work harder, with Data2X, the WORLD Policy Analysis Center, WIEGO, and other partners, to measure just how far we have to go, and how fast we’re making gains.
Grant makers are very good at asking questions. We ask prospective grantees about everything from theories of change to potential leadership transitions to progress indicators. And while we’re tireless in expressing curiosity about grantees’ work, we do not spare ourselves from interrogation. We continuously ask ourselves and our colleagues: Why these priorities? Is this the right strategy? The right set of tactics? Could we get more impact if we allocated dollars differently?
Healthy as all this questioning is, I have to admit: Sometimes I find it exhausting. After all, this isn’t just an academic exercise. Our job is to make grants and to learn from them so we make better grants the next time around. Somehow, we have to get from questions to actions.
That’s why I’ve started to think about grants as ways to test hypotheses—statements of our belief that money spent in a particular way will yield a particular result. Scientists use hypotheses to translate big questions into discrete experiments, and to focus their attention on whether what happens is what they expected to happen or something else entirely. If grant makers think in terms of hypotheses, it permits us to ponder without becoming paralyzed.
If you’re still with me: Each grant represents an educated guess. Only through observing how the grant plays out do we figure out if our guess was mostly right or mostly wrong. The guesswork is unavoidable because we operate within a context of tremendous complexity and uncertainty. We don’t know, for example, whether the political and economic environment is going to be friendly to what we’re trying to achieve. We don’t know what combination of building evidence, supporting advocacy at elite or grassroots levels, supporting innovative organizations, and funding demonstrations activities is going to result in meaningful progress.
So we make our educated guesses, and we observe.
Thinking about a grant as a hypothesis has helped me identify what we should be trying to observe and how we’re going to learn. To test a hypothesis, you have to look for both the evidence that confirms your beliefs and the evidence that might challenge them. That second part—looking for the things that will prove you wrong—is the hardest. But it’s also the most important, and the most informative. We should always try to disprove our own hypotheses, so that we learn whether our strategies were, in fact, good ones.
Let me take one example: We’ve made a series of grants to help ensure experts from the Global South have a hand in setting the post-2015 agenda—defining the international development goals that the member states of the United Nations are expected to adopt in September 2015, as a successor to the Millennium Development Goals. The hypothesis underlying those grants was that participation of public intellectuals from Africa, Asia and Latin America would help ensure that the goals are better informed by on-the-ground realities, are more reflective of the priorities of low-income countries, and are seen as having greater legitimacy.
We might well be wrong. It’s possible that scholars from southern think tanks and heads of non-governmental organizations in Dar es Salaam or Kathmandu are no more in touch with on-the-ground realities than people sitting on Massachusetts Avenue in Washington, D.C. It’s also possible that funding people to attend meetings and undertake research, or to write blog posts and op-eds, makes their ideas more visible but doesn’t change the fraught negotiations at the United Nations.
So as we watch these grants unfold, we’re not just looking for the evidence—although there is plenty of it—about the broad and diverse “conversation” about the post-2015 development agenda, some of which has resulted from our funding. We also are training a skeptical eye on that evidence, and questioning whether any real difference is resulting from all the input. We are pushing ourselves to challenge our own hypothesis. What we learn will help us decide whether to make future grants to increase the influence of southern civil society organizations on international policy, and how to best structure them.
There’s one other great benefit of thinking about grants as testing hypotheses. In science, no experiment fails if you’re able to learn something from it. People in our line of work could take a lesson from that.
Let’s hear it for the teens! With a little help from a few grownups, the teenagers of America seem to be figuring out how to keep their futures on track—or at least keep them from going off the rails by having a baby when they should be doing homework.
The National Center for Health Statistics just released new data showing that the number of births to girls 15-19 years old is the lowest it’s been since 1933, the year the government started tracking it. In 2013 alone, both the number and the rate of teen births dropped by an astounding 10 percent. This means that since the peak year for teen childbearing in the 1970s, the rate of teen pregnancy has plummeted by 57 percent. The best news is for the high school-age kids; among girls ages 15-17, there’s been a 68 percent drop in the pregnancy rate.
When a major social problem starts melting away, you’ve got to ask what’s going on—and how we can keep the momentum going.
One side effect of the Great Recession that began in 2007 was a drop in the overall birth rate, but that doesn’t come close to explaining these numbers. Our friends at the National Campaign to Prevent Teen and Unplanned Pregnancy have sliced and diced the data, looked at the research, and come up with a handful of reasons for the dramatic improvement:
Better birth control. While still nowhere near as popular among young people as the pill, teens are increasingly choosing long-acting contraceptive methods like IUDs and implants. No muss, no fuss, no babies.
Fewer teen moms beget fewer teen moms. With the teen birth rate declining steadily since the 1990s, fewer of today’s teens have mothers who got pregnant at a young age. This is what a virtuous cycle looks like.
Medicaid pays. For 18- and 19-year-old women, Medicaid has covered family planning services in 26 states since the 1990s. In the U.S., as around the world, making family planning affordable to all pays off.
Media messages. Teen Mom and 16 and Pregnant have shown their huge audiences how hard it is to have a baby when you’re young. Combined with factual, no-nonsense information about sex and contraception, most of today’s teens are no longer in the dark.
Teenage boys. You wouldn’t think teenage boys would be on the list of explanations for a drop in teen pregnancy, but boys and young men have been having less sex and using more condoms. Prevention of HIV/AIDS is having broad benefits.
If these are the ingredients that go into preventing teen pregnancies, then we know what to do. In particular, we need to make sure that teens—both boys and girls—have the information they need to make choices about whether to have sex and how to prevent pregnancy and sexually transmitted diseases. And we need to ensure that reproductive health services are affordable, convenient, and focused on the needs of young people. While the kids are busy with their homework, that’s the assignment we’re working on.