The World Bank has approved a budget of $200 million for a project supporting greater access to contraception and improving women's health in the conservative Muslim region of Sahel, Africa. Sahel is a region where the water levels have dropped forty percent per capita over the last twenty years, infant mortality has decreased by twenty-five percent over the last decade, and a quarter of women ages 15 to 19 are pregnant. The goal is to produce a "demographic dividend" in which there is a rise in living standards as a result of falling birth rates, leading to a larger working age population and fewer dependents. By increasing the supply and demand of contraceptives, the project hopes to reduce fertility in Sahel through the empowerment of the community's women. Another tactic is to reduce early marriage and childbirth, increase voluntary family planning and improving access to sexual education for women. Although the project is set to conclude in 2019, it is estimated that it will take ten to fifteen years "of targeted development to see a positive change." This is due in part to the fact that a rise in the working population will take time to achieve, especially in a region where nearly half of the population is under age fifteen.
The empowerment of women is really what it will take to make the project work. According to research I have taken part in in other classes, women's health in Africa is decided by the male figure in the family. Many of the medical clinics that are sent to Africa on mission trips have found efforts to provide women with contraception futile, because the men must approve medications and treatment for the women; if he does not approve of the contraception, the man will often take the birth control pills himself. Because there have been multiple incidences of this, it has been found that birth control shots and IUD's are more effective. Also, in Africa, womanhood is signified by her fertility. If a woman can no longer have children, her role in the community changes, and often the significance she has to her husband changes, as he will leave her to find a younger woman who can have children. Furthermore, because it is the man's duty to have children to pass on the traditions of the families and tribes, they often refuse contraception. So, the education and empowerment of women in these situations will be the most effective way for the project to prove successful, but I do not see that as an easy task, for it will take changing, or conforming, the mind set of many communities to a more sociological and medical perspective that varies much from their traditional views.