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C h a p t e r 1 4 Philanthropy and Its Impact on Urban Women’s Health Katherina M. Rosqueta and Carol A. McLaughlin If I had a million dollars to spend philanthropically, how could I spend these funds to make the greatest social impact? For impact-focused donors, this is the central question. Though straightforward to pose, it is a difficult question to answer in a way that is both informed by the evidence and actionable. Yet if philanthropists and the organizations they support are to achieve the social impact both seek, answering this million -dollar question is critical. Philanthropy in Urban Women’s Health Each year billions of dollars of philanthropic funding go to address issues related to health in the United States and other developed countries and in developing countries worldwide. In the United States, health represents approximately 7 percent of charitable gifts domestically , totaling $22.46 billion dollars in 2009 (Giving USA Foundation 2010). U.S.-based foundations also donated more than half of the $4.5 billion given worldwide to address health issues in developing countries in 2008 (The Foundation Center 2010a). That year, approximately 80 percent of all U.S. foundation giving to global health came from the Gates Foundation, which awarded an estimated $2 billion in global health grants (The Foundation Center 2010c). A quick scan of the top fifty global health gifts made by U.S. foundations reveals that twelve of those grants, or over $361 million, made explicit reference to women or urban health issues, with all of those grants given by the Gates Foundation (The Foundation Center 2010d). Philanthropy and Its Impact on Urban Women’s Health 259 While many philanthropists share the same aspirations for impact, few can match the Gates Foundation’s capacity to give. However, compared with aid from government and multilateral and bilateral aid organizations, even Gates funding can seem small (Figure 14.1). The aspirations of philanthropists and the relative size of their funding make it even more important that they spend their funds wisely to have lasting impact on women’s lives. Philanthropy’s Potential for Impact Much is at stake. Recent analysis estimates that each year 358,000 women (or one woman every 1.5 seconds) die in pregnancy and childbirth, often from causes that are treatable and preventable (WHO, UNICEF, UNFPA, and the World Bank 2010). In addition, earlier studies estimate that 10 million women each year suffer from illnesses and lifelong disabilities due to complications in pregnancy and childbirth (The White Ribbon Alliance n.d.). Dollars in Millions $0 $1,000 $2,000 $3,000 $4,000 $5,000 OECD DAC Official Development Assistance U.S. Official Development Assistance U.S. Foundation Giving for Developing Countries $4,628 $1,240 $2,483 Figure 14.1. Government aid and foundation giving to support health in developing countries, 2008. OECD DAC, Organisation for Economic Co-operation and Development, Development Assistance Committee. Source: The Foundation Center 2010b. Copyright © 2010 The Foundation Center. Used by permission. 260 Katherina M. Rosqueta and Carol A. McLaughlin The disparities between rich and poor countries are great. For example , a woman’s lifetime risk of dying in pregnancy and childbirth in Niger is 1 in 7; in the United States, the risk is 1 in 4,800 (UNICEF 2010a, 2010b). Even within cities in wealthy countries such as the United States, great disparities exist. For example, poor people living in U.S. urban communities have disproportionately high rates of HIV. A recent study by the Centers for Disease Control and Prevention (2010: para. 10) found that “within the low income urban areas included in the study, individuals living below the poverty line were at greater risk for HIV than those living above it (2.4 percent prevalence vs. 1.2 percent), though the prevalence for both groups was far higher than the national average (0.45 percent).” The stakes are great not only for these women but also for their children , their countries, and the global community. Since women are children’s main caregivers, their health is critical to children’s health, well-being, and future prospects (Figure 14.2). Children up to 10 years of age whose mothers die are three to ten times more likely to Percent Dying 12% 10% 8% 6% 4% 2% 0% No Parent Dies Father Dies Mother Dies 1.3 2.1 1.5 3.0 7.9 11 Sons Daughters Figure 14.2. Child deaths when a parent dies. Source: Strong...


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