Since 1986, when the MacArthur Foundation began supporting work in the population field, philosophical and demographic changes have reshaped the prevailing approach to population issues. Where concerns about population pressures once led principally to policies focused narrowly on incentives for the acceptance of fertility control technologies, typical strategies today reflect a comprehensive reproductive and sexual health and rights approach.

The Foundation was an early supporter of this comprehensive framework. It was adopted by 180 countries at the International Conference on Population and Development in Cairo in 1994, and it continues to inform and orient the Foundation's work. This approach places women's well-being at the center of population policy and emphasizes the rights of individuals to determine and plan family size.

Two themes form the core of the area's grantmaking:

• Reducing maternal mortality and morbidity; and
• Advancing young people's sexual and reproductive health and rights.

The Foundation's work on maternal mortality will increase the chances that women will have safer pregnancies and deliveries, a worthy goal in itself, but also an indicator of the availability of services that are needed for women to make informed reproductive choices.   The focus on young people is expected to increase the likelihood that they will make wise choices about their sexual activities. Given the effects of population momentum and the large cohort of young people, any delay in childbearing will have a major effect on population growth rates.

Geographic Priorities
For its work on maternal mortality and young people, the Population and Reproductive Health area focuses its work (and has offices) only in three countries - India, Mexico, and Nigeria.  The countries were chosen because they represent different conditions and are influential within their respective regions.  Within each country the Foundation has also selected priority states where grantmaking will be concentrated.  Limited national level activities that support maternal mortality and morbidity and young people's sexual and reproductive health and rights, such as research and leadership development, will also be supported.

More details on the Population and Reproductive Health thematic and geographic priorities in Mexico, India, and Nigeria are available.

Maternal Mortality and Morbidity
Maternal mortality is an area in which little progress has been observed in the last decade; it is also the area in which the most dramatic differences exist between richer and poorer countries. Most maternal deaths are preventable, given sufficient resources.

Strategies
In the three countries, the Foundation supports efforts of civil society organizations that are effective in analyzing how public funds are allocated and in providing a sound basis for budget allocations for health. While a solution in this area lies partly in the hands of the health system, it is also dependent on the educational and legal systems. Women need access to good care, but they also need an enabling legal environment to avoid unsafe abortion, one of the major causes of maternal death and morbidity. Women's health needs must be recognized in the first instance by their partners and their immediate families. Comprehensive sexuality education programs that foster gender equality can cultivate this recognition. The Foundation supports civil society organizations that work for changes needed in health, education, and legal policies and help to create the political will needed for their implementation. Special attention is given to activities that focus on increased budgets for maternal health, decreased deaths from abortion, and improved access to quality emergency obstetric care.

Young People's Sexual and Reproductive Health and Rights
The sexual and reproductive decisions made by today's youth will have great impact on their personal lives and on society. Indeed, the largest contribution to the size of the world population in the future comes from population momentum, and an important way to diminish its effects is to increase the interval between generations - that is, by postponing the birth of the first child. From a reproductive health standpoint, adolescents are especially vulnerable. They have extremely high rates of maternal mortality, are targets of sexual assault, and have STD and HIV infection rates that are higher than among adults.

Strategies
The Foundation supports initiatives in India, Mexico, and Nigeria that increase the availability of gender-sensitive sexuality education and confidential youth-friendly health services.  For example, the Foundation will support model sexuality programs for in and out of school youth, improve young people's access to reproductive health services, and promote an enabling environmental for young people to seek those services.

In addition to our efforts on maternal mortality and morbidity and young people's sexual and reproductive health and rights, the Foundation also supports projects that are not specific to the three focus countries; this portion of the Population and Reproductive Health portfolio is referred to as the international portfolio. The international portfolio funds selected international organizations in the population and reproductive health field whose work forms the basis on which innovations in policy, programs, and services emerge. An organization funded in this portfolio makes a substantial contribution to maternal mortality and morbidity and young people's sexual health and rights, either by producing new concepts and data or by advocating new or modified policies. Alternatively, it may offer the opportunity to explore the applicability of lessons from other fields to PRH, or may shape knowledge and practice on a cross-cutting PRH topic. Please note that additional thematic topics for this portfolio are currently undergoing review. While most grants during the exploratory phase have already been planned, potential grantees may choose to submit a letter of inquiry if their proposal represents significant new learning opportunities in the population and reproductive health field.

Funding
Grants are awarded only to organizations that define clear objectives for their work and measures of progress toward those objectives. Typically, we provide multi-year support.  Proposals must fit clearly within the geographic and thematic priorities of the Population and Reproductive Health area to be considered.

Organizations interested in applying for support should submit a letter of inquiry to the Foundation. The format for these letters can be found in How to Apply for Grants.

Questions about this grantmaking area can be e-mailed to population at the MacArthur Foundation.