| Melinda Gates: Eliminating Bias in Family Planning |
 | | Melinda Gates meets with women and their children in Burkina Faso. Gates Archive | |
| By Melinda Gates |
| I am not used to thinking that a story about a person treating someone else unjustly is anything but bad news. But in my more optimistic moments, I think it’s actually a positive thing that we are hearing so much about bias these days. Every time bias makes the headlines — when two young men in a coffee shop are arrested for trespassing or a programmer in Silicon Valley is fired for a sexist memo — we have an opportunity to get better at recognizing it, naming it and, I hope, fighting it. |
| Lately, I’ve been thinking a lot about how this applies to our foundation’s work on adolescent family planning. As the largest generation in history enters its reproductive years, the evidence tells us that bias is one of the biggest barriers standing between these 1.8 billion young people and the tools and information they need to protect themselves and their futures. |
| When I travel with our foundation, I hear a lot of stories like Miriam’s. As a first-year university student, Miriam made the trip to a clinic near her home in Burkina Faso to ask about contraceptives. Instead of answers, she got a lecture about premarital sex and propriety. Miriam remembers exactly what the outraged provider told her: “You don’t have the right.” |
| Technically speaking, Miriam does. Fifty years ago, the 1968 International Conference on Human Rights affirmed that the ability to plan and space pregnancies is indeed a human right. |
| But as important as a public declaration from the international community may be, what happens in private conversations between patients and providers matters, too. Recent history has underscored just how much. |
| In the last two decades, Britain has cut its teenage pregnancy rate — once the highest in Western Europe — in half. One of the factors cited most often in this stunning reversal is the country’s successful efforts to connect its young people to high-quality, nonjudgmental counseling. |
| How do we make that kind of counseling available to more young people in more places? One of our foundation’s partners may have a solution. |
| Pathfinder International’s Beyond Bias program takes an innovative, data-driven approach to strengthening empathy and understanding between providers and their patients in Burkina Faso, Tanzania and Pakistan. Its methods include sending young adult “mystery shoppers” into clinics to see how they are received when they ask questions about contraceptives and reproductive health. The information they gather is used to design interventions that encourage providers to examine how their biases show up in their work. |
| When I was in Burkina Faso earlier this year, I spent a morning with a midwife named Carine who had recently participated in a Beyond Bias program. Carine told me that she became a midwife for one reason: to help as many women as possible. She also admitted that she “had prejudices” in the past about providing contraceptives to young women, especially unmarried ones. |
| The program, she explained, helped her see things differently. Now, when she is asked to counsel a teenager about family planning, she reminds herself, “That girl knows why she came.” Out of respect for that young woman, Carine suspends her own feelings and offers the best care that she can. “Good morning,” she tells them, “I am all yours.” |
| When Miriam walked into that clinic, it took courage. Carine’s choice to challenge her own biases did, too. And while today I hear a lot of stories like Miriam’s, I think that will change after we start hearing more stories like Carine’s. |
