Climate Change, Health, and Population Dynamics: A View From Tanzania

This article was originally posted on Cool Green Science, a blog by the Nature Conservancy.

As people around the world celebrate the remarkable Paris Agreement to address climate change, there’s a genuine opportunity for countries to act on their financial pledges to help the world adapt to climate change—especially people in developing countries who are most vulnerable.

One progressive way of helping at-risk people adapt to climate change is to improve their health. Voluntary family planning, which greatly improves women’s health, could play a part in a rights-based strategy that advances adaptive capacity and women’s health simultaneously. In addition, more scientists and governments have made the connection between population growth and global carbon emissions and have recognized the multiple benefits that family planning provides.

Research supports the linkage by showing that slowing global population growth could lead to substantial long-term climate-related benefits by lowering carbon emissions. From a rights-based perspective, approximately 225 million women in the world have an unmet need for family planning, meaning they would like to plan the number and spacing of their children, but currently are not using modern contraception. Meeting their needs through providing voluntary, rights-based family planning information and services could be a global hat trick—for women, their children and the climate.

Family Planning and Climate Change: A Ground-Level View in Tanzania

Far removed from the negotiations that took place in Paris, some 900 million vulnerable rural people around the world —including resource-dependent communities along the shores of Lake Tanganyika in western Tanzania—are relying on decisions made at the negotiation table to pave the way for policies that will help them adapt to the realities of climate change.

Tanzania is acutely vulnerable to climate change: mean annual precipitation has decreased significantly across the country from 1960 to the present, and seasonal rainfall patterns have already changed. With 80% of the population relying on agriculture and pastoralism for their income, livelihoods, and employment, ensuring that the country and its people are able to adapt to a changing climate is essential. And family planning is a critical component of building resilience.

In August 2011, I visited the Buhingu regional health center in western Tanzania to meet the head doctor and see the facilities. Despite its magnificent location on a promontory overlooking a beautiful bay on Lake Tanganyika, the health center seemed more like a low-level clinic than a referral center. The empty operating room had a fancy light, but no electricity. The walls were crumbling, shelves were bereft of medical supplies, and the rooms were empty. Except for one, where two women lay on metal beds with decrepit foam mattresses; one of the women was nursing a newborn.

The doctor said that he’d done Cesarean surgeries on both women the night before. One baby survived; the other didn’t. The empty-handed young woman had walked, while in labor, for almost two days to reach the hospital; unfortunately, by the time she arrived, it was too late to save her baby. I took a deep breath, crossed the room to grasp the grieving woman’s hand, and spoke the only Kiswahili I knew how to say, “pole sana.” I’m sorry.

The moment encapsulated why projects that address health and voluntary family planning as well as conservation and natural resource management in remote regions are not so far-fetched after all.

Twenty-four villages are now participating in the Tuungane Project (Kiswahili for “Let’s Unite), a partnership between TNC and Pathfinder International that holistically address reproductive health, the environment and livelihood needs of these communities in this region.

Western Tanzania: Tops for Biodiversity, Poor Health, and Rapid Population Growth

Lake Tanganyika is the world’s second largest lake by volume, and the lake and surrounding forest are mega hotspots of global biodiversity, from a freshwater and terrestrial perspective, boasting endemic cichlids and chimpanzees. It’s all contained within an environment that is still, remarkably, largely intact—a blessing for conservation and a bit of a curse for local people, whose only highway is the lake. And when women face health emergencies, such as obstructed labor, getting a boat and fuel to travel to the nearest hospital, several hours away in Kigoma, is a real challenge. Furthermore, inaccessible western Tanzania is not an appealing placement for most government health workers, extension agents, and teachers, and the communities struggle to develop without adequately staffed and supplied facilities.

Tanzania is a large country; it’s about the size of Texas and Colorado combined. Tanzania’s population is quite young: as of 2014, 45% of the population was under the age of 15. It’s the 6th most populated country in Africa, with 52.3 million people. By 2030—only 15 years from now—the population is projected to rise to 79.4 million, and by 2050, unless the birth rate slows substantially, there will be 2.5 times as many people in Tanzania as there are today, 129.4 million, which would make it the 15th largest country in the world.

What is driving the rapid population increase? Only 26% of married women use modern contraception, compared with 53% next door in Kenya. In the Kigoma region of western Tanzania, the rate falls to 14%, among the lowest in the world. Forty one percent of women in Kigoma have an unmet need for contraception. The total fertility rate in western Tanzania is 7.1, among the very highest in the world. Having babies in rapid succession is often accompanied by high maternal mortality. There is an urgent need to make voluntary contraception more available in places like rural western Tanzania so that women and their families are able to live healthier, productive lives and space and plan their families.

Early marriages also play a key role in birth rates by extending the length of childbearing years, and they pose high health risks for adolescent girls. In Tanzania, girls have a higher chance of being married than completing school by their 18th birthday: almost 40% of girls in Tanzania are married before the age of 18, whereas only 33% of girls are enrolled in secondary school.

Western Tanzania’s intertwined challenges of population dynamics, natural resource management, and climate change adaptation need to be addressed in an integrated way.

I hope that additional headway will be realized as the goals of the Paris Agreement are translated into actions that tangibly help vulnerable people adapt to climate change. Jointly addressing climate adaptation, reproductive health, and conservation would build resilience and help countries achieve the new Sustainable Development Goals in an integrated way. Acknowledging the compound benefits of rights-based voluntary family planning for women and children at the individual level and for the planet would benefit millions of people—in Tanzania and around the world.