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Family Planning Accelerates Improvements in Child Survival

This blog post is published in conjunction with the Child Survival Call to Action, which was convened June 14-15 by the Governments of the United States, India, and Ethiopia, and organized in close collaboration with UNICEF.

On a recent visit to northeast Bangladesh, I had the opportunity to visit rural postpartum women in their homes. My colleagues and I were undertaking site visits to a USAID program that provided integrated newborn, maternal and family planning services at the community level.  After we entered the home of our first visit, we congratulated the new mother, who was holding her newborn wrapped in a blanket in her arms. We asked her how many children she had.  She replied quietly, “This was my twelfth pregnancy — it is my fifth living child.”  She explained that three children died as newborns, two were stillborn, and she had two miscarriages. The woman was only 32 years old. We heard similar stories from other women whom we interviewed.

The first step to ensure that a child reaches their 5th birthday starts even before they are born. USAID promotes Healthy Timing and Spacing of Pregnancy as a vital family planning intervention that helps ensure that pregnancies occur at the healthiest times in a woman’s life.  Mothers and children are then more likely to survive and stay healthy.

A USAID analysis found that, by preventing closely spaced births, family planning could save the lives of more than 1.6 million children under five annually.

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Video of the Week

You’re invited to join Powering Agriculture: An Energy Grand Challenge for Development, which is a multi-year initiative focused on promoting affordable, clean energy solutions for farmers and agribusinesses throughout the developing world. Powering Agriculture: An Energy Grand Challenge for Development supports market-driven approaches that link modern energy service providers with farmers, processors, input suppliers, and traders. These approaches aim to further integrate clean energy technologies in the agricultural sector to increase production, employ new value-added processing techniques, and reduce post-harvest loss. This Energy Grand Challenge for Development was launched last week at the Frontiers in Development conference and includes an online ideation community that you’re encouraged to join through www.PoweringAg.org– find it by clicking on “Join the Community.”

Powering Agriculture: A Grand Challenge for Development is implemented under the Grand Challenge for Development program that invites innovators everywhere to apply science, technology, and creative business models to address obstacles in the path of human development. USAID and its partners – the Swedish International Development Cooperation Agency (Sida), Duke Energy, the US Department of Agriculture (USDA), the African Development Bank (AfDB) and the Overseas Private Investment Corporation (OPIC) – seek to catalyze a movement of solvers to identify clean energy solutions to intensify the agriculture sector, enhance food security, and decouple food production from the use of fossil fuels. For more information on how to join the community now, share ideas, review the pre-solicitation notice, and apply for a grant starting July 12th, please visit: www.PoweringAg.org.

USAID in the News

Still can’t get enough USAID? Here’s a lot more. We were in the news quite a bit this week. National Journal and Politico both reported on our new mobile money partnership with Citi. We spoke to the Global Pulse blog about the need to focus efforts on the five countries that have 50 percent of all preventable child deaths.USA Today reported on the newly released report about global childhood deaths in the Health Policy and Planning medical journal.

And don’t Ben Affleck and Administrator Shah make a great team? We think so, read their joint op-ed in Politicoon ending child mortality and more about Ben Affleck and Secretary Clinton’s commitment in Foreign Policy Magazine. Finally, Administrator Shah chatted with Andrea Mitchell on MSNBC about child survival.

Strategic Help for Global Health Care

This post originally appeared in Politico

People often ask me what the global health community can do to have more impact. The answer is easy: We could be more like Tsion Berhanu.

I met Berhanu the last time I visited Ethiopia. My colleagues and I drove to the end of the road, then kept going for 15 more minutes, until we reached the Wuye Gosee Community Health Post, a tiny, three-room, concrete structure with an outhouse.

Berhanu lived in one room and worked in the other two — caring for 1,500 people in her kebele. Women came to her for contraceptives. When they stopped using birth control and got pregnant, they came for pre-natal care. When their babies were born, she gave advice about proper nutrition. When children got a little older, she immunized them. When people were sick, she treated them if she could and referred them to the district hospital if it was serious. She also advised families on how to store clean water and build sanitary pit latrines.

This is how health care is experienced and addressed on the ground. The community of donors, agencies and NGOs dedicated to better health for the poorest— including our foundation— has access to many more resources than Berhanu. What we don’t always do is drive conversation and innovation that can reflect her experience and perspective.

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Faith in Future Generations

Originally posted to the Washington Post.

We are on the front lines of one of the quietest—but most compelling—revolutions in human history. It is not marked by upheaval, bloodshed, frantic news coverage or impassioned debate. In the last 50 years, child mortality has dropped by an astonishing 70 percent globally. This revolution of helping children reach their fifth birthday and beyond has brought about happier parents, smaller, more prosperous households, and children with much brighter futures.

America’s legacy here is proud one: With strong bipartisan support, the U.S. government’s support of global health has saved many millions of lives. As current and former assistant administrators of global health at the U.S. Agency for International Development (USAID) during Republican and Democratic presidential administrations, we know the critical importance of accelerating support for child and maternal health programs.

Yet, tragically, more than 7 million children still die each year of largely preventable causes.

For most of history, families were often powerless to ensure the survival of their children. We now understand what causes children to die needlessly, and we know how to save them—in relatively simple and inexpensive ways. It starts with ensuring girls do not get married too young, and when they do get married, that they appropriately space their children. While mothers are pregnant, we help them get proper nutrition to ensure their babies will be born healthy and strong, and we protect their unborn children from HIV and malaria. Once the baby is born, we provide an extremely effective cadre of vaccines that provide immunity from a host of deadly diseases–reaching more than 100 million children a year.

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1,000 Photos

Dr. Rajiv Shah serves as the 16th Administrator of USAID and leads the efforts of more than 8,000 professionals in 80 missions around the world.

Dr. Rajiv Shah serves as the 16th Administrator of USAID and leads the efforts of more than 8,000 professionals in 80 missions around the world.

As of today, 1,000 people around the world have posted photos of their 5th birthday in support of the Every Child Deserves a 5th Birthday awareness campaign. From Secretary Hillary Clinton and Kay Warren to Tony Hawk and Mandy Moore, government representatives, faith-based and civil society leaders, celebrity activists and athletes have uploaded photos of themselves at age five to help rally the world around the goal of ending preventable child death and ensuring all children get to celebrate their 5th birthday.

Age five is an important time. It’s when we start going to school, learning to read and making our own decisions. Age five is also an important milestone in the health and development of children.  Over the last 50 years—especially in the last two decades—child mortality has fallen by 70 percent thanks to high-impact interventions like new vaccines, improved health care practices and community health workers.

Despite this progress, more than 7 million children will die this year from largely preventable causes before they turn five.  In Africa alone, 1 in 8 children will die before they celebrate their 5th birthday.  In order to change this devastating narrative, we must do more.

Today, we have the scientific, technological and programmatic advances to dramatically accelerate progress.  Today, the Governments of the United States, Ethiopia and India are working in close collaboration with UNICEF to launch a Call to Action in Child Survival.  Designed to end preventable child death by focusing on the survival of newborns, children and mothers, the Call to Action will convene 700 prominent leaders from government, the private sector, faith-based organizations and civil society to kick off a long-term, strategic effort to save children’s lives.

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Saving Mothers & Children: The Importance of Providing a Continuum of Care

Dr. Flavia Bustreo is the Assistant Director-General - Family, Women's and Children's Health, World Health Organization

The Millennium Development Goals (MDGs) brought needed and increased attention to child survival.  Globally, significant progress has been made in reducing child mortality.  The number of under-five deaths declined from 9.6 million in 2000 to 7.6 million in 2010. Under-five mortality fell from 73 per thousand in 1990 to 57 per thousand in 2010. On average, under-five mortality has been falling at a rate of 2.5 per cent per year compared with 1.9 per cent per year over 1990–2000.

The rate of reduction doubled in Sub-Saharan Africa when compared with the previous decade.  There is evidence that this rate of decline is accelerating as we approach 2015.  New initiatives, such as the UN Secretary General’s Global Strategy for Women’s and Children’s Health, have added guidance and resources to the achievement of the goals.  The subsequent establishment of  the Commissions on Information and Accountability and on Life-Saving Commodities will add to the benefits for women’s and children’s health.

Still, despite accelerated progress, the global burden of maternal and child mortality is still unacceptably high.  Over 280,000 maternal lives and 7.6 million under-fives’ lives were lost in 2010.  Most of these losses would have been preventable with interventions that already exist.  We know what these interventions are and what they require to be implemented. Unfortunately, we still fail to reach a large proportion of mothers and children with them, particularly in sub-Saharan Africa and South Asia, where most of maternal and child deaths occur. We need to find the ways to ensure that every mother and child has access to these interventions and can benefit from them. 

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Faith Communities: The Untapped Resource for Development

Kay Warren is an evangelical leader, author, and founder of the HIV/AIDS Initiative at Saddleback Church. Elizabeth Styffe is the Director of Global Orphan Care Initiatives of the PEACE Plan at Saddleback Church. Gil Odendaal is the Global Director for the HIV/AIDS initiative at Saddleback Church. Below is an excerpt from their contribution to the Frontiers in Development essays.

Engaging, Equipping, and Mobilizing Untapped Resources

Celeste doesn’t know much about for­eign aid or development, but she’s an expert on hunger, stigma, and disease. Sitting alone on a hand-woven mat in the African sun, Celeste is covered with lesions, having been expelled from her village due to her HIV-positive status and waiting for death.

Down the road, a local church resonates with the sound of 50 people singing, clapping, and dancing. The pastor preaches passionately to his small congregation about Jesus’ call to care for the poor and hurting in His name. A church member leaves the exuberant worship service and makes her way toward Celeste’s mat under a tree. Soon, Celeste will feel the volunteer’s soothing touch, receive needed medications from a church-based clinic or a government hospital linked to the local congregation, and begin to rebuild her life.

This church member does not have a medical degree—in fact, she is just learning to read
and write—but she understands community ­development because her church has provided extensive, yet simple, training in how to be a volun­teer community health worker. The humble church member calls herself a “Community PEACE Servant.” She represents more than 3,000 volun­teers in the Western Province of Rwanda who are improving health, inluencing development, reduc­ing poverty, and changing the world, one family at a time. More than 22,000 home-health visits will be made in this rural region this month because churches are taking the lead. Empowered U.S. and indigenous churches are connecting with each other and partnering with governments and other organizations to engage and equip ordinary people in local churches to actively address development issues in the lives of real people everywhere.

Read the complete article in USAID’s Frontiers in Development publication.  

Foreign Assistance, Innovation, and Progress

Bill Gates is the chairman of Microsoft, U.S.A. and the co-founder and co-chair of the Bill & Melinda Gates Foundation.  The following in an excerpt of the essay he wrote for USAID’s Frontiers in Development publication

As I write this, my wife, Melinda, has just returned from a visit to Tanzania with members of a congressional delegation, led by Senator Lindsey Graham, to learn more about global health and development programs.

Reflecting on the trip, Melinda said the high point was meeting Joyce and Raymond Sandir, small farmers who eke out a living growing maize and a few other crops and selling milk from their single cow. When Melinda asked them about their experience with a new, higher-yielding, diseaseresistant maize seed, Joyce said their income had more than doubled. Although the Sandir family lives without running water or electricity, Joyce didn’t hesitate when one Senator asked what she planned to do with the extra money. She said she would pay for more education for her children.

For Melinda, the visit was another reminder of why we do this work. For members of the congressional delegation, it was a chance to see first-hand the impact that development aid has on people’s lives. A few pounds of healthy seed that wouldn’t be given a second thought in wealthy countries can trigger a virtuous cycle of health and productivity in poor countries. Farmers can feed their families. Children can go to school and become valuable members of the community.

Local economies grow, strengthening the social and economic fabric of nations. Eventually, these countries are in a position to offer development assistance to other poor countries.  Some, like Korea, have made the full transition and no longer rely on official development assistance (ODA). Others, such as Mexico, Brazil, India, and China, are following a similar path. These aren’t isolated examples in a few lucky countries. In the past 50 years, advances in agriculture saved a billion people from starvation. Vaccines and other medical advances reduced childhood deaths by more than 80%. The proportion of people in extreme poverty has been cut in half. The Sandir family is one example among many millions.

Read the full article in USAID’s Frontiers in Development publication.

Pressures on the Plundered Planet

Director, Centre for the Study of African Economies, Oxford University

Director, Centre for the Study of African Economies, Oxford University

Paul Collier, Professor of Economics at Oxford University, spoke earlier today at USAID’s Frontiers in Development Forum, and will speak again tomorrow morning. Below is an excerpt from his contribution to the Frontiers in Development essays.

As the world economy grows, it increasingly faces natural constraints. These provide both new opportunities and new risks for the poorest countries; managing them well will be central to their exit from poverty. These were the themes of The Plundered Planet. Here I bring out some of the key current issues. Industry needs natural resources, for energy and material inputs, but many of the natural resources we use for these purposes have a fixed endowment, which we are depleting. A growing global population needs food, and food needs land, but land suitable for agriculture is finite.

Both industry and agriculture emit carbon dioxide into the atmosphere, but the stock that can be safely absorbed by the atmosphere is finite, and as it builds up it gradually changes the climate. How concerned should we be about these constraints, and what do they imply for development?

I think that the concerns about industrialization grinding to a halt because of shortages of vital natural-resource inputs are misplaced. As any particular resource becomes depleted, its price rises. In turn, this induces fresh investment in prospecting and so furthers discoveries, and ultimately research into innovation. This has happened so many times across such a wide range of activities that we can be fully confident of it. The past decade of rising prices for natural resources has already triggered these waves of investment. Currently, by far the highest-valued natural resource is carbon-based energy, from oil, coal, and gas. The high prices of the past decade have triggered an astonishing wave of new technologies that enable us to tap into endowments that were previously inaccessible: The United States has already discovered enough additional resources through these new technologies to be self-sufficient for several decades. Beyond technology-based discoveries are technology-based
substitutes: For example, in the 19th century, nitrates were considered vital and finite; then we discovered modern fertilizers.

Similarly, the global population will not face hunger because of land shortages. There are still huge areas of grossly underutilized fertile land; beyond that are drip-feed and greenhouse technologies that open up lands that are currently too dry or cold. Nor will we face a stark choice between energy shortage and overheating. Although global supplies of carbon-based energy are finite, there are many non-carbon sources of energy waiting to be developed. Indeed, modern physics tells us that the endowment of other forms of energy is infinite: The challenge of permanently sustained energy supply is entirely technological, and we can be confident that innovations will be forthcoming. But although we are not facing a natureimposed Armageddon, natural resources, climate, and food are interconnected in ways that pose new opportunities and new risks for the poorest developing countries.

Read the full article in USAID’s Frontiers in Development publication.

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