Leona D’Agnes et al., “Integrated Management of Coastal Resources and Human Health Yields Added Value: A Comparative Study in Palawan (Philippines),” Environmental Conservation, vol. 37, no. 4 (December 2010), pp. 398–409. DOI: 10.1017/S0376892910000779. URL (abstract): journals.cambridge.org/action/displayAbstract?fromPage=online&aid=7944204&fileId=S0376892910000779. This paper was collaboratively assessed.
Despite some research barriers and setbacks, this effort to conduct a comparative experiment on an ongoing community-based project in the area of population, health, and the environment (PHE) led to a clear finding. The researchers concluded that integrating community-based efforts on coastal resource management (CRM) and family planning produced better outcomes for local marine conservation, human health, and poverty alleviation than pursuing either conservation or reproductive health on its own.
In a Philippines municipality where efforts to improve both conservation and reproductive health were combined, 8 of the 12 outcome indicators reflected desirable trends.
Twelve indicators of conservation, food security, and reproductive health yielded statistically significant trends. In a Philippines municipality where efforts to improve both conservation and reproductive health were combined, 8 of the 12 outcome indicators reflected desirable trends (in the areas of conservation, population, health, and overall sustainability). One indicator reflected an undesirable trend, and three were neutral. In another municipality that received help only on reproductive health, and in a third municipality that received help only in CRM, most outcomes were neutral or reflected undesirable trends.
The authors speculate that greater community participation and “buy-in” in the first municipality, where development efforts were integrated, contributed to better outcomes in this group. Opposition to family planning also seemed to weaken when the topic was linked to food security. Youth sexual activity fell and contraceptive use rose solely in the integrated group, although fertility fell equally in the integrated and reproductive-health-only groups.
Key quotes: “[P]opulation factors are often overlooked in conservation strategy formulation. The Philippine National Biodiversity Strategy and Action Plan, for example, recognizes population pressure as a root cause of biodiversity loss, but does not propose actions to address that threat. . . . The IPOPCORM model [described in this paper] uses a holistic approach to achieve food security by simultaneously (1) improving management of coastal resources; (2) supporting alternative livelihoods among fishers to reduce fishing pressure; and (3) easing population pressure by expanding access to family planning services.”
FPESA assessments (seven total) were mostly favorable, with some dissent and more-detailed commentaries than usual both pro and con. There was disagreement, even among generally favorable assessors, on whether the methodology employed was sound enough to justify the study’s conclusions and whether author bias toward integrated development efforts might have affected the study results. Assessors applauded the study authors for conducting innovative research while also needing to manage program operations; for clarity in their presentation and writing (including methodology and tables); and for creative efforts to compensate for study limitations. Given the expense of such research, one assessor worried that it might be difficult to go much further in studying the effectiveness of PHE programs.
One assessor felt that the findings were too uncertain for usefulness in supporting the FPESA hypotheses that family planning can contribute to environmental sustainability. Another noted that the project and study’s foundation in human rights is “essential for any intervention on reproductive health in developing countries.”
We identified this paper as the most empirical and strongest in evaluating outcomes of a population-health-environment project.
Overall assessment: We identified this paper as the most empirical and strongest in evaluating outcomes of a population-health-environment project. Randomized controlled trials are the gold standard in empirical research, and it would be useful to find such trials in research connecting family planning to the environment. This study stretched for that objective and, given real-world obstacles, fell short. Assuring equivalent conditions and program efforts in each of the three municipalities, for example, would have been challenging in the best of circumstances. A planned control site receiving neither CRM nor family planning interventions had to be dropped because development investments during the study period from local government and other sources disqualified it as a pure control. The authors noted study limitations frankly but were unable to assess their impacts on the strength of the study’s findings. In our assessment, such limitations are common in social-science research and do not invalidate carefully gathered evidence.
The results are helpful in developing an evidence base… on the overall linkage of family planning to conservation and environmental sustainability.
Despite the drawbacks, the effort to design and execute even a quasi-experimental study of the outcomes of PHE projects is commendable and, in both its failures and successes, could model future research on this development strategy. The results are helpful in developing an evidence base, not just on PHE but on the overall linkage of family planning to conservation and environmental sustainability. The fact that birth rates fell similarly in both the integrated and reproductive-health-only interventions helps demonstrate the value of family planning services in reducing fertility rates. Obvious common themes connect the FPESA project’s mission with those of the PHE concept, so we watch it carefully. We can recommend this paper, along with a few less-empirical ones on PHE in our database, to advocates of both family planning and conservation as evidence that integrating both may yield a whole greater than its parts.
The following annotation and assessment is excerpted from the forthcoming report of the Family Planning and Environmental Sustainability Assessment (FPESA) project. The report will contain selected annotations from more than 930 peer-reviewed articles reviewed for potential relevance to the hypothesis that family planning supports environmental sustainability. The annotations are written by project director Robert Engelman with input from members of the project team and, where indicated, members of the project’s international network of research assessors.