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FrontLines Releases January/February 2013 Issue

Read the latest edition of USAID’s FrontLines to learn how the Agency is helping communities become more resilient to new and long standing crises, and how training and other assistance to journalists and media organizations in developing countries helps create well-informed citizens. Some highlights from the Risk, Resilience & Media edition:

A Maasai father and son tend to their cattle in Kitengela, Kenya. Photo credit: ILRI/Stevie Mann

  • Carrying a paralyzed neighbor to safety on her back was just one of the heroic moves by a Bangladeshi grandmother whose USAID disaster training kicked in during 2007′s Cyclone Sidr, one of the strongest storms of its kind on record.
  • Since men with rifles uprooted their lives in 2000, the Afro-Colombians who lived in Mampujan have been hoping to reclaim their land — and now a ruling from the country’s high court is paving the road for their return.
  • Senegalese farmers are worrying less about fickle rains that lead to drought and instead embracing “conservation farming” to grow the food they and their country need to thrive.
  • Purchasing insurance seems an ideal tool for building resilience in developing countries — if insurers are willing to take a chance on you. That is slowly happening in places where a perfect storm of recurring weather disasters and stubborn poverty has made insurers skittish to enter the market.
  • A hip, hero hacker with a huge following is setting Kenyan youth on notice that they have the power to change not only their own lives, but the trajectory of their country. Though DJ Boyie is a comic book character, his out-sized influence has attracted high-level support, including from USAID.
If you want an e-mail reminder in your inbox when the latest issue of FrontLines has been posted online, please subscribe.

Photo of the Week: Building Peace Along Borders in East Africa

USAID has supported peace-building along Kenya’s northern borders for over a decade. The current program focuses on communities on the Kenya-Uganda and Kenya-Somalia borderlands and enables residents to take peace into their own hands. USAID helps communities on opposite sides of the border select, plan, build and manage projects for joint use. These “peace dividend” projects include schools, marketplaces, and clinics.

All photos by Aernout Zevenbergen and Abraham Ali from Pact.

USAID Promotes Good Farming Practices in Azerbaijan

Azerbaijan is proud of its exotic fruits, and the pomegranate is definitely one of them. Pomegranate production has strategic importance for domestic trade and exports.

Azerbaijan’s Pomegranate Festival is a great way for growers to learn new techniques, showcase their products, and build sales networks. Since 2006 it has been a popular autumn festival held in November in the Goychay region of Azerbaijan.

This year, USAID’s Azerbaijan Competitiveness and Trade (ACT) Project set up its own stand at the Festival to provide information about ACT project activities and achievements in the pomegranate sector. The Project’s stand offered training materials on 25 agriculture topics and displayed 100 kgs. of the seven different varieties of pomegranates produced by the farmers who received USAID assistance. Training materials were particularly in demand by Festival attendees. The Project distributed over 2,000 pamphlets and booklets.

A local TV channel interviews USAID’s pomegranate expert at the USAID stand during the annual Pomegranate Festival in Goychay. Photo credit: Anar Azimzade/ACT

For the last couple of years, USAID has been supporting pomegranate farmers and processors with technical assistance and training. The ACT Project has provided training on good agricultural practices to approximately 2,250 farmers who have subsequently rehabilitated about 200 hectares of pomegranate orchards in the Kurdemir, Goychay and Sabirabad regions. This support has resulted in a 33% increase in productivity, a 28% increase in overall production and a 21% increase in farmer profit in the three regions. Azerbaijan’s pomegranates do not compete with U.S. agriculture.

National and local media covering the Festival expressed strong interest in the ACT Project. ELTV, a local TV channel, interviewed the experts, guests and exhibitors for a TV program dedicated specifically to the development of the pomegranate sector in Azerbaijan.

Two farmers from the Goychay region praised the Project’s technical assistance and training in an interview with ELTV. They expressed their gratitude to USAID and proudly displayed high-quality pomegranates at the Festival as fruits of this cooperation.

Success in India Paramount to Ending Preventable Child Deaths Globally

Ariel Pablos-Mendez, PhD, is the Assistant Administrator for Global Health

I just returned from India‘s “Call to Action Summit for Child Survival and Development“, which took place in Mahabalipuram, Tamil Nadu.

India accounts for the largest number of deaths of children under five: nearly 1.5 million per year. This number is staggering, but there is good news. There has been a steady rate of decline in child mortality — even ahead of the global rate of reduction. As I told DevEx during the Summit, “success in India is paramount to see the global success and vision of ending preventable child deaths in this generation.”

Led by India’s Ministry of Health and Family Welfare, the Summit called for an accelerated response to decrease child mortality across the country. This event was a direct outcome of the Call to Action held in Washington, DC last year — where India joined Ethiopia and the United States with UNICEF to launch a global roadmap to end preventable child deaths globally. About 300 policymakers, public health practitioners, private sector, civil society and media representatives attended India’s Summit, including 27 international and 35 national experts. Notably 20 State delegations were present. U.S. Ambassador Nancy Powell, a stalwart advocate for child survival, addressed the opening plenary on behalf of the United States.

The Summit had several main themes related to child survival and development: quality of newborn care, interventions for preventing diarrhea and pneumonia, social determinants of child survival, nutrition, strengthening health systems, improving accountability, communication for child survival, partnerships for improved maternal and child health, and leadership dialogue. The complete agenda and speakers can be found on the Summit’s website.

There was a rich discussion at the Summit along with solid deliverables. The Government of India launched the Reproductive Maternal Neonatal Child Health Adolescent health strategy (RMNCH+A), which serves as a roadmap for the States. Also released were several guidance documents including implementation of newborn care as well as management of pneumonia and diarrhea.  A National Child Survival Scorecard was showcased, and States were encouraged to develop their own scorecards and to monitor progress.

India’s Call to Action is the beginning of a national movement. Attendees demonstrated a passionate commitment to mobilize on behalf of India’s children — and to hold each other to account. India’s leadership and programmatic success will help galvanize the global response. USAID will continue to be a steadfast partner of “A Promise Renewed”, the sustained effort led by UNICEF to reach our global goal. Working together, ending preventable child deaths will be one of the greatest moral victories of our time.

Accelerating Innovation and Impact in Global Health

This originally appeared on the Stanford Social Innovation Review.

Sad examples abound of inexpensive, lifesaving health solutions failing to reach the most vulnerable in the developing world. Whether it is amoxicillin treatment that is out of reach for the 1.3 million children under five who die each year from childhood pneumonia, or a simple and effective $0.50 oral rehydration salts or Zinc treatment inaccessible to the 1.5 million kids dying each year from dehydration stemming from diarrhea, it is clear that new solutions and approaches are needed. Given this reality, global health practitioners are recognizing the need to look beyond their traditional operating models and seek new solutions to reach the world’s most vulnerable.

At the same time, the private sector, faced with slowing economies in the US and Europe, is increasing investment and experimentation in the more challenging emerging markets as a source for new growth. These firms—whether they are medical device, pharmaceutical, or consumer-packaged goods companies—stand to learn much from global health and development practitioners who have operated at the bottom of the pyramid for years. Similarly, global health practitioners can learn much from these private sector efforts by, for example, better leveraging the rigor and well-defined processes involved in designing, introducing, and scaling products. Given the increasingly aligned incentives, the time is right for more effective and consistent collaboration between these two groups.

A child peers around the corner in the waiting room of the HIV Comprehensive Care Clinic of Meru District Hospital in Kenya’s Eastern province as two pediatricians stand in the background. Photo credit: Mia Collis, Elizabeth Glaser Pediatric AIDS Foundation

The Center for Accelerating Innovation and Impact in USAID’s Global Health Bureau launched last year with these shared incentives in mind; it aims to promote and reinforce innovative, business-minded approaches to bottlenecks in global health. An important piece of this strategy is bringing together thought leaders and frontline practitioners from both the public and private sectors to share proven and tested practices, and then collaboratively develop new global health models.

IDEO’s work developing products and services in India and Africa, for example, has demonstrated an important relevant learning for the global health community and private sector alike: innovation needs to be holistic and strategic. It’s about evaluating and targeting specific gaps in the surrounding ecosystem, with a square focus on empathizing with all stakeholders. While new technologies and products are needed, often times re-evaluating (or evaluating for the first time) the true bottlenecks in the health ecosystem can uncover new opportunities for innovation in training and education, operating/business model design, demand generation, behavior change, and other areas.

An example: In Africa, IDEO worked on a project to develop a low-cost toilet but quickly realized that developing the toilet itself wasn’t enough. To be practical and to succeed, it had to be designed for the unique constraints that existed there, including the lack of centralized plumbing. As such, IDEO designed a system with a separate container to trap the waste. Most importantly, though, the toilets, instead of being sold directly to customers, are instead sold to franchisees that then rent the toilets to customers. The rental fee covers not only the toilet but also a fee to collect and dispose of the waste properly. This way everyone wins. Customers pay a lower amount per month rather than an expensive, one-time, fixed fee. Franchisees earn an attractive return on their investment, and the system ensures that waste is removed and disposed of properly—not on some street corner where it becomes a public nuisance and health hazard. Above all, the incentives are aligned to make the system sustainable.

Another often cited yet supremely relevant example is Jaipur Foot in India. Founded in 1975, Jaipur Foot has fitted more than 40,000 Indians with leg prostheses. To reach such massive numbers, in addition to innovating on a low-cost “product” (in this case, a $45 artificial lower limb), the organization developed an entirely new operating model. It has flipped the traditional healthcare service model on its head, and it now takes diagnoses and treatment to the patient. The organization regularly organizes health camps outside of its centers in more rural locations—where most Indians live—to help patients who have financial and physical difficulty traveling to larger cities. Jaipur Foot sends everything required for treatment to the camps, including doctors, assistants, and equipment. They can even fabricate, fit, and deliver limbs on the spot.

These are just two of a growing number of examples that both global health and private sector practitioners can learn from and collaboratively put into practice. USAID’s new Center for Accelerating Innovation and Impact hopes to enable this best practice sharing as one avenue to more efficiently and effectively deliver healthcare to those at the bottom of the pyramid.

Dheeraj Batra is head of business design at IDEO Mumbai. Over the last three years, Dheeraj has worked extensively in the medical device industry in India having spent the majority of that time incubating businesses and piloting new initiatives for some of the largest companies in the sector. He was a key architect and led the on-the-ground implementation for Healthy Heart for All, a nationwide initiative by Medtronic in India.

David Milestone is senior advisor at USAID, Center for Accelerating Innovation and Impact. In this role, David leads the Market Access team in the development and implementation of market-based strategies to accelerate the adoption of priority health solutions. Prior to joining USAID, David held various strategic marketing roles at Stryker, including innovation and strategy initiatives in India.

USAID Visits U.S. Navy “Comfort” and Continues Joint Support of Disaster Response

On Friday, February 1, I hosted a group of USAID staff aboard the USNS Comfort—one of the U.S. Navy’s (USN) two hospital ships. The Comfort is a state of the art, fully equipped floating hospital, with 12 operating rooms and capacity for 900 patients. While her primary mission is to provide rapid, flexible, and mobile acute medical and surgical services to support the U.S. military, she can also be called in to support in disaster or humanitarian relief. In 2010 the Comfort supported the USAID-led disaster response mission after the Haiti earthquake; her sister ship, the USNS Mercy, provided assistance after the 2005 tsunami in South East Asia. USAID personnel, Dr. Clydette Powell and Dr. Bob Ferris traveled on the Comfort for Operation Unified Response: Haiti.  This was the first time USAID had sailed with a mission. Their knowledge of Haiti and contacts with the Embassy and USAID mission were instrumental in the successful care and transfer of Comfort patients.

CAPT Colleen Gallagher explains the capabilities of the blood bank to USAID colleagues on board the USNS Comfort hospital ship. Photo credit: USAID

In addition, both ships provide humanitarian and civic assistance every two years on goodwill missions—”Continuing Promise,” which travels to South and Central America, and “Pacific Partnership,” which tours the South Pacific. These deployments provide training for U.S. military personnel and partner nation forces while providing valuable services to communities in need. Later this month, the Comfort will embark on Continuing Promise ’13, and take part in medical, dental and civic engagements in eight countries.

In my capacity as the Navy Liaison Officer at USAID, I help facilitate coordination between USAID and the U.S. Navy in the design and implementation of field activities—such as the Continuing Promise and Pacific Partnership ship visits. I also help to keep the lines of communication open between the Navy and the agency in global health activities, disaster response and conflict prevention. As a Nurse Corps Officer, I’m focused on helping to ensure that USN international health activities are coordinated with USAID missions and align with U.S. development objectives. My home within the agency is within the Office of Civilian-Military Cooperation, but I work with many colleagues throughout the agency, including the Global Health Bureau and the Office of U.S. Foreign Disaster Assistance, which is responsible for leading and coordinating U.S. Government’s humanitarian response to disasters overseas.

USNS Comfort hospital ship. Photo credit: USAID

Visiting the Comfort provided the opportunity for a firsthand view of the capacity and capabilities of the hospital ship, knowledge that provides USAID staff with a foundation for future decisions on crisis or disaster response. In a disaster, the Comfort can be called on to support the USAID’s lead in a response. While many have read about what it can do, sometimes seeing is believing. It also marked a return for me to the ship—in 2009 I had the privilege of  sailing with the Comfort for Continuing Promise 09, and  less than six months later I served again on the Comfort in support of the Haiti earthquake response.

Captain Colleen Gallagher is a Nurse Corps Officer with the U.S. Navy. She is the first Navy Liaison Officer to serve at USAID, a position she has held since 2011. 

India’s Leadership Furthers Global Child Survival Movement

At the forefront of the fight against child mortality and morbidity, India is leading the global community in placing a renewed emphasis on this important mission. India’s Call to Action demonstrates leadership and commitment to both the global community and the children of India.  India has an opportunity to make great gains on child survival with increased commitment and funding for the most effective life-saving practices. Moreover, India’s unique culture of social entrepreneurship, innovation, and technological advances present a historic opportunity to accelerate progress in reducing childhood illness and death.

William Hammink speaks at opening press conference for India’s Call to Action on February 3, 2013. Photo credit: U.S. Embassy

India is a regional leader and can guide and support other countries in several ways.  We commend the progress India is making in tackling child survival and strengthening India’s health sector.  India is one of the countries to have significantly reduced the incidence of HIV – from 0.41 percent in 2002 to 0.27 percent in 2011.  India has reduced its maternal mortality by more than 50 percent – from 570 in 1990 to 212 in 2009 per hundred thousand live births – and child mortality by 45 percent from 119 in 1992 to 59 per thousand live births in 2012.

The United States has been a longstanding partner of the Government of India, and our relationship dates back more than six decades. The U.S. Government through its agencies including the United States Agency for International Development, and the Centers for Disease Control and Prevention has been actively engaged in working alongside the Government of India as it endeavors towards ending preventable child deaths within a generation. In recent years, USAID has made significant investments in the area of reproductive, maternal, newborn, and child health, nationally and in key Empowered Action Group States.

USAID is currently developing its five-year Country Development Cooperation Strategy, while continuing to provide targeted assistance to support flagship national health programs, it will increasingly adopt methods focused on innovation and partnerships: more directly engaging local partners; leveraging co-financing instead of fully funding agreements; and developing platforms and alliances to generate development outcomes that encompass multiple organizations.

The U.S. Government is proud to be a part of this initiative and to give our unwavering support to India’s Call to Action. In the coming months, USAID will look at opportunities for newer partnerships with multi-stakeholder engagement including the government, private sector, entrepreneurs, and civil society to identify, and scale up solutions to address the challenges in accelerating child survival efforts.

As USAID Administrator Raj Shah said in his welcome letter to Summit participants: “An investment in India’s children is an investment in India’s future.” We stand ready to be part of India’s tomorrow.

USAID Contest to Recognize Pioneers in Science and Technology for Development

Many of the great development challenges – water, infectious diseases, food insecurity, energy, climate change, connectivity, and biodiversity loss – have at their origins or find their solutions through science, technology and innovation. Many of the biggest leaps forward in development over the last decades were possible because of major breakthroughs in science and technology (S&T). Today, through investments in S&T, USAID is harnessing the same forces that yielded the great breakthroughs of the past to transform more lives than ever before. S&T is now a core component of USAID Forward, the Agency’s ambitious reform agenda launched in 2010.

USAID-related science and technology programs create accessible solutions to global development challenges.  Photo credit: Zahur Ramji (AKDN)

In USAID’s Office of Science and Technology, our goal is to use the transformative power of science and technology to deliver innovative, results driven, efficient, cost effective, and accessible solutions to global development challenges. To recognize and celebrate USAID-supported projects and activities that successfully apply S&T to the development challenges of our age, the USAID Office of Science and Technology (OST) is excited to announce the Agency’s first-ever Science and Technology Pioneers Prize contest.

We know that throughout the world, many projects and activities funded by USAID are demonstrating a commitment to achieving results through the successful application of science and technology. This prize will champion the excellent S&T work already being done in the field by USAID and our partners.

We recognize that some of the best and most innovative ideas come from our development partners – from host country governments to local NGOs, to innovators on the ground. If your organization is working on a USAID-supported project that uses S&T to advance development, we want to hear about it! We are particularly looking for new and technologically sophisticated ways of delivering services and achieving development outcomes – and then celebrating and recognizing them.

Winning projects will receive special recognition from USAID and public visibility through USAID platforms. Both the project or activity and the team of people responsible for the design and implementation of the S&T innovation (including USAID personnel, staff from implementing partners, government counterparts, and private sector organizations, both local and international) will be recognized for the achievement.

Submissions will be judged using the following criteria:

Effective application of Science and Technology: What specific development problem was the intervention designed to address, and how?

Evaluation and learning:  What evidence, reports, or assessments was the project design based on? Was there a systematic effort to understand the extent to which the project/activity was effective?

Alignment with USAID and Mission Strategy: How did science and technology play a direct role in achieving the development objectives?

Replicability: Could this approach (or elements of it) be implemented in other regions or countries?

Leveraging funding:  How has the project leveraged funding from other donors, governments, and/or the private sector?

If you have an eligible project, work with your counterparts at USAID to submit an application by March 22.

For contest details and eligibility, please email: STpioneers@usaid.gov

Photo of the Week: Saving Children in India

Did you know that almost 7 million children under five died in 2011 from largely preventable diseases? In India, 1.7 million children under five died in 2011. February 7 marks the start of the the National Summit on “Call to Action for Child Survival and Development“, to be held in Mahabalipuram, Tamil Nadu.

Organized in partnership with UNICEF and USAID, the Summit is a critical platform that will strategically engage over 200 delegates including 27 international and 35 national experts, key policy makers, planners and implementers from the health sector representing all states of India, representatives and heads of UN and development agencies, global health experts and practitioners, civil society members and private sector, to discuss and debate on child survival and development in India. The Summit will be an opportunity for sharing experiences and challenges; celebrate successes in maternal, newborn, child survival & development programmes; and pledge to meet India’s child survival and development goals. Photo is from UNICEF.

 

International Day of Zero Tolerance to Female Genital Mutilation/Cutting

February 6th marks the tenth observance of the International Day of Zero Tolerance to Female Genital Mutilation/Cutting (FGM/C), an internationally recognized day to foster awareness of the devastating effects of FGM/C and renew the call for the abandonment of this harmful traditional practice. FGM/C is a practice that ranges from nicking to total removal of the external female genitalia. Some 140 million women around the world have undergone this brutal procedure and three million girls are at risk every year.

This 10thanniversary, I’d like to take a look back over progress achieved in the past decade. Significant efforts have been made at the community, national, and international levels to address the issue of FGM/C. Studies have looked at the physical, emotional and mental impacts of FGM/C. Research has deepened our understanding of the diverse reasons for the continuation of the practice, providing a frame for theories about the origins and social dynamics that lead to its continuation. Reflecting the work of dedicated advocates, today most practicing countries have passed laws banning the practice, and prevalence is beginning to decline in some countries.

An estimated 140 million girls and women worldwide have undergone female genital mutilation/cutting. Photo credit: Panos

In September 2000, USAID officially incorporated elimination of FGM/C into its development agenda and created the official U.S. Government policy toward FGM/C.  In 2002, the Donors Working Group on Female Genital Mutilation/Cutting was formed to bring together key international actors, including representatives from USAID, U.N. agencies, European donors and private funders.

In February 2003, the Inter-African Committee on Traditional Practices Affecting the Health of Women and Children held its landmark conference in Addis Ababa, Ethiopia. Many first ladies of Africa, led by the first lady of Nigeria, officially declared “Zero Tolerance to FGM” to be commemorated every year on February 6th. Drawing from this energy, UNICEF’s Innocenti Research Center organized a consultation in 2004, resulting in a seminal publication, “Changing A Harmful Social Convention: Female Genital Mutilation/Cutting.”

In 2008, the Donors Working Group ultimately produced A Platform for Action Toward the Abandonment of FGM/C (PDF).  That same year, UNFPA and UNICEF formed a strategic partnership known as the UNFPA-UNICEF Joint Programme on FGM/C’s “Accelerating Change“. They have been working together, in headquarters and field offices, to develop, fund, and implement policies and programs to accelerate abandonment of FGM/C. The result of this program should inform the work of programs and governments for years to come.

In December 2012, the 67th session of the United Nation’s General Assembly passed a wide-reaching resolution urging States to condemn all harmful practices that affect women and girls, in particular Female Genital Mutilation/Cutting.

While we have made tremendous progress over the past decade, work still lies ahead.  We must all work together – men, women, grandfathers, grandmothers, community and religious leaders, government, civil society, and multilateral organizations – to overturn deeply entrenched social norms that are not only harmful to women and girls, but to our communities and societies.

Join us on February 6th at 9:30am EST for a live webchat discussion at the State Department. The event will include a panel of experts and practitioners, as well as a discussion on programs and solutions to address this issue. Follow @USAIDGH on Twitter and join the conversation using the hashtag #EndFGM/C.

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