Resilient Women: Improving Health and the Environment Simultaneously
Resilient Women: Improving Health and the Environment Simultaneously

Resilient Women: Improving Health and the Environment Simultaneously

As Bill and Melinda Gates so accurately asserted in their 2020 annual letter: “The best thing we can do to help people in poor countries adapt to climate change is make sure they’re healthy enough to survive it.” We couldn’t agree more.

That’s why Pathfinder International has worked in several Sub-Saharan African countries to improve the health of communities most vulnerable to climate change, while working simultaneously with partners to improve the health of the surrounding ecosystems in which those communities live.  

Our approach, women-led community resilience, integrates voluntary family planning and health care with other key approaches such as livelihood creation, climate adaptation, and natural resource management to make communities more resilient to economic and environmental shocks. At the center of this approach are women — made more resilient through improved access to healthcare, eco-friendly livelihoods, and economic independence.  

At 15, Fausta Ngjjuuko (“Fausta”) gave birth to her first child. By 23, she had four. Like many girls on Uganda’s Bussi Island, Fausta felt pressure to marry young and grow her family fast. Today, with support from the HoPE LVB project, she is using family planning and the sustainable agriculture skills she’s learned to earn an income – to live a healthy live in balance with her environment. (Photo Credit: Linda Suttenfield)

Helping Gertrude Thrive

One of those women is Gertrude.  

 Gertrude faced many of the same setbacks as other women in her community on Uganda’s Bussi Island. She often had to miss school when she got her period because she had no access to sanitary products. Gertrude then officially dropped out of school when her family also could not pay her school fees.  

Without any resources, she got married, hoping her husband could support her. She soon became pregnant, and because she had never visited a health center for antenatal care and did not know about the importance of immunizing her baby, she did not have her baby vaccinated and the baby died of tetanus. 

Yet, today, Gertrude thrives because of her engagement with Pathfinder’s Health of the People in the Lake Victoria Basin (HoPE-LVB) program, a community resilience program implemented in Kenya and Uganda from 2011 to 2019.  

Gertrude is now a role model in her community with her own business. Soon after the baby died, she joined a women’s group in her community on Bussi Island, supported by HoPE-LVB. She learned about the antenatal care she should have had, contraception, and how to contribute to improving the environment in which she lived while earning an income — specifically by making energy-saving cookstoves 

Young mothers club, Bussi Island (Photo Credit: Linda Suttenfield)

 She began saving her own money, increasing her independence and her decision-making power within the household. She now runs her own business selling fish, vegetables, and fruit. She even bought a piece of land jointly with her husband.  She and her husband now have two children, spaced three years apart. 

 “If it was not because of Pathfinder HoPE-LVB Project, at my age, I should be having seven children because before then I knew that when a woman is married her role is just to produce children.”    

Addressing the Health-Environment Nexus

Our integrated community resilience programs, like HoPE-LVB, and the ongoing Tuungane program in Tanzania’s Greater Mahale Ecosystem, a partnership between Pathfinder International and The Nature Conservancy, use a multisectoral approach that addresses the natural interconnection between humans and their environment. This approach improves health and access to family planning, helps households meet their needs through income generation and access to clean food and water, and encourages the adoption of sustainable practices for managing natural resources and changes they are experiencing due to climate change. These interventions, when paired with interventions to improve infrastructure for health care and environmental management, are central to building women-led community resilience – for example:  

Community conservation banks: Community members pool their money, creating community conservation banks to start environmentally-friendly businesses while simultaneously receiving information on family planning and reproductive health, natural resource management, and water, sanitation, and hygiene (WASH). 

Model households: Households model positive health and natural resource management behaviors to diffuse throughout the community, encouraging better attitudes in their communities toward conservation and family planning, and increasing community participation in efforts to improve health and use natural resources sustainably. The model household enabled families to see these links more clearly – such as how good WASH practices affected their health and their clean water supply.    

VHT and Model Family member Maxensia Nakabirwa (L) discusses family planning with members of her community, Harriet Wamera (C) and Richard Musisi (R) on Bussi Island, Uganda. (Photo Credit: Jake Lyell)

Integration that has Impact 

 Through this integrated approach, remote communities in the Lake Victoria Basin and Greater Mahale Ecosystem have become more resilient to environmental, economic, and health-related shocks.  

Some illustrative results from Tuungane show the impact of the program: 

  • 62,000 couple years of protection (contraception given to a couple for a year) have been generated to address the unmet need for family planning.  
  • 216,000 hectares of forest have been protected.   
  • 8 villages are earning money by selling carbon credits through project partner enterprise. 
  • 9,124 farmers are practicing climate-smart agriculture, increasing crop yields, combatting sediment run-off into the lake, and using organic fertilizers and seed varieties. 
  • 23 Beach Management Units have been established, effectively monitoring and protecting 39,734 acres of fresh water in Lake Tanganyika.  

Multisectoral programs like HoPE-LVB and Tuungane are essential to reaching the Sustainable Development Goals 3 (Ensure healthy lives and promote well-being for all at all ages) and 13 (Take urgent action to combat climate change and its impacts). They also contribute to SDG 5 (Achieve gender equality and empower all women and girls) by investing in women like Gertrude as leaders and entrepreneurs. Development partners and governments need to work together to scale up these approaches and reach last-mile communities who are the most vulnerable to climate change.  

 Our world depends on it.