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Inspired and Humbled by Nepal’s Female Health Workers in the Rural Villages of Salyan

After a one-hour prop plane ride from Kathmandu, followed by an 11-hour rocky drive through the stunning hills and valleys of Mid-Western Nepal’s upper hilly region, our team reached Salyan District’s remote and rural villages. We were there to video the successes of the USAID-supported, 50,000-strong Female Community Health Volunteer project.  Working in every district of Nepal, these volunteers are often the only health care providers in such remote and isolated villages.

Female Community Health Volunteers of Marke District, Nepal, work to enhance health awareness, improve health standards, and save lives throughout their communities by utilizing the training they’ve received through the USAID-supported Nepal Family Health Program. Photo Credit: Gregg Rappaport/USAID

I’ve spent the last several days traveling with our group comprised of health specialists, program managers, and communicators (Gregg Rapaport, Senior Communications Manager, and Stuti Basnyet, USAID/Nepal) videoing, interviewing, listening and learning.  The stories are nothing short of amazing, and the volunteers’ passion to fulfill what they consider a calling to serve their communities has been inspiring.

It’s been humbling to hear the stories of these dedicated volunteers giving care under arduous circumstances and to meet the many villagers seeking care – a health volunteer who recently saved a newborn baby’s life minutes after delivery; another who has committed more than 22 years to serving her community through this project; a group of women who, in the last six months, have counseled more than 85 couples on family planning; a man seeking care for severe knee problems who arrived in the village on a stretcher after traveling nearly two hours, carried high above the heads of his four nephews. These volunteers are changing the behavior of their villages, increasing awareness to improve health standards, and most importantly, saving lives.  Of the 500 local children checked for pneumonia in the last six months, 73 were treated with antibiotics, 13 were referred to higher level health care at the district level, and all have made a full recovery.

One woman I spoke with, Laxmi Sharma, a volunteer in Salyan’s Ward 4, said that it’s not a matter of money, but rather a matter of helping her community. “We do this as volunteers,” she explained, “because we can improve the health of our communities.”  The women play a crucial role in providing vitamin A supplementation, immunizations, family planning education, safe motherhood interventions, and community-based integrated management of childhood illnesses, particularly in the detection and treatment of pneumonia and diarrhea – Nepal’s top two childhood killers.

With support from USAID and other donors, Nepal is also one of only a handful of countries poised to meet more than one of the Millennium Development Goals (MDGs) in health by reducing the number of maternal and child deaths by nearly half in only 10 years! A remarkable achievement alone, that it was realized at the end of the nation’s prolonged 10-year internal conflict makes it even more profound.

Our return trip back through the town of Dang this afternoon was marked by a rather serendipitous event – hundreds of women, men, and children marched in solidarity to celebrate the global 100th anniversary of International Women’s Day.  One woman I spoke with explained, “Through this (march) forum  … we can work to ensure women have equity, empowerment, and are at the center of mainstream politics. If all the women come together, this is something that is achievable, we just need to work at it.”

Check out this video on USAID/Nepal and their work on family health.

Around the world today, millions of people will flood the streets in their hometowns to voice their enduring support for the advancement of women and girls as key leaders in the creation of a better world.  As new ideas and innovative ways are introduced, USAID/Nepal continues to incorporate these pioneering initiatives in its program design, placing women and girls at the forefront of building the country’s peace and prosperity.

But USAID/Nepal is not only working in the health sector – it is also leading the way in partnership with the Nepalese people to finding solutions to the toughest challenges to driving economic progress, promoting educational opportunities, promoting political stability, sustaining the environment, and feeding the population.

The Education for Income Generation Activity has trained more than 65,000 disadvantaged youth from the Midwestern region—the most conflict affected and one of the poorest regions of Nepal—in basic and business literacy, vocational training and agriculture productivity and enterprise development in the last three years. Of these, 7,900 youth received vocational training with 80% gainfully employed as a result of the training.

Through the Women’s Leadership Academy program, USAID has provided training on the fundamentals of democratic politics and constitution drafting to over 200 elected women parliamentarians and civil servants, providing them with the tools needed to draft the constitution and participate fully in party and parliamentary proceedings.

We know that supporting investment in women and girls can be compelling force multiplier for development and innovation. At the heart of Nepal’s advancement, women will continue to advocate on behalf of their communities, and promote advancements in education, economic growth, politics, climate change, and initiatives to improve access to food.  USAID/Nepal will continue to move this agenda forward, and advance this priority by standing in solidarity with by the women and girls of Nepal.

Helping the First Elections to Succeed

USAID 50th anniversary banner

Today I work at USAID/Indonesia as a development specialist in the Office of Democratic Governance. But during the popular uprising that led to the downfall of Suharto and the return of democratic government to Indonesia I was a student activist.

After the popular, student led uprising in Indonesia – similar to what recently occurred in Cairo, Egypt — the government agreed to early elections in 1999. I joined the Indonesian Rectors Forum (Forum Rektor), an NGO that was formed in support of democratic elections, and organized a group of individuals to develop manuals and forms for election monitoring. I was subsequently trained as a national trainer for voter education by the American Center for Labor Solidarity (funded by USAID) and as a national trainer for elections monitoring. I was also the head of division for election monitoring training in the Bandung office of Forum Rektor. This led to a position at the national office in which I managed about 300,000 volunteers for voter education, vote monitoring, and parallel vote tabulation, and eventually to a position in the Executive Office.

I knew USAID/Indonesia FSN Mimi Santika (who continues to work at the Mission today) as the Forum Rektor contact at USAID and met her several times in 1999. My first contact with the American Embassy was actually in 1998 with Ining Nurani. Today she is a colleague in the Democratic Governance Office at USAID, but then she was with the Political Section of the Embassy. I met with Ining because the Embassy wanted to know more about the student movement in Indonesia. We talked about the Forum Rektor Task Force strategy on fighting the New Order regime of President Sukharto. We, in turn, were curious about the US perspective.

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Moving Forward: Development in Conflict-Affected Mindanao

I recently returned from a 10-day trip to the Philippines where I had the opportunity to visit a number of USAID-assisted projects in Mindanao.  The second largest island in the Philippines, Mindanao is graced with stunning natural beauty—towering mountains and verdant plateaus—but is also the location of a protracted conflict that has held back the region’s development.  As a result, Mindanao is a central focus of our peace, stability, and economic growth programs in the Philippines.

Along with USAID/Philippines Mission Director Gloria Steele, Asia Bureau economist Dany Khy, and the outstanding technical staff of USAID/Philippines, I visited Cagayan de Oro in Mindanao to gain a better understanding of our programs’ history, successes, and challenges—and to explore new opportunities for accelerating broad-based economic growth.  We viewed a variety of projects that are supported by USAID, including the Misamis Oriental State College of Agriculture and Technology, the Northern Mindanao Vegetable Producers Association, the Opol Emergency Clinic and Birthing Home, and a branch of the First Valley Bank that participates in USAID’s Microenterprise Access to Banking Services Program.

During my time on the island I also had the unique opportunity to meet with a number of local government representatives, civil society groups, and private sector officials at an event that was organized by the Cagayan de Oro Chamber of Commerce.  We engaged in a dynamic and fruitful debate about the key constraints to economic growth in Mindanao and brainstormed on strategies to unlock the primary choke points.  I was deeply impressed by the visionary leadership of the local government and the strong working relationship they had established with so many different components of the community.  I was fortunate to have Secretary Luwalhati Antonino, the Chairperson of the Mindanao Development Authority, accompany me throughout the visit, and gained the benefit of her insights and plans to accelerate economic growth in close coordination with USAID.

I left the island with a clearer vision of the many opportunities ahead for USAID and the people of Philippines to build peace, promote good governance, increase economic opportunities, protect the environment, strengthen health services, and improve basic education.  I also look forward to returning soon to work with the incredibly skilled and committed staff of USAID/Philippines and our partners.

Real Results in Afghanistan

By: Louisa Bargeron and Lars Anderson

During the USAID delegation to Afghanistan, Administrator Rajiv Shah, Mission Director Earl Gast, and Alex Their, head of the Office of Afghanistan and Pakistan,  visited the Hesa Awal Community Development Council (CDC)—an initiative made possible through Afghanistan’s National Solidarity Programme (NSP)—located in Dakoy Payan Village, Kabul.  Also present was Deputy Minister Wais Ahmad Barmak for Programmes, Ministry of Rural Rehabilitation and Development, Government of the Islamic Republic of Afghanistan.

Dr. Rajiv Shah, Administrator for the United States Agency for International Development, visited a Community Development Council Health Clinic in Mirbacha Kot, north of Kabul, Afghanistan. Dr. Shah was accompanied by USAID Mission Director Earl Gast and Minister of Rural Rehabilitation and Development Jarullah Mansoori. Photo Credit: Lars Anderson/USAID

Created in 2003, the solidarity program develops the ability of Afghan communities to identify, plan, manage and monitor their own development projects.  NSP empowers communities to manage resources transparently during all stages of the project-cycle and make decisions affecting their own lives and livelihoods.  In Hesa Awal, the CDC serves 482 families totaling 2,802 people.  Sometimes the men and women of this village come together, at the same time, to discuss what matters to them most and on this day the villagers agreed that their clinic was a top-priority.  The clinic serves an average of 70 patients a day, most of them children and soon-to-be mothers.  For parents, the biggest impact has been the enhanced quality of maternal health care, as well as the improved health of their children as a result of vaccinations.

Administrator Shah was enthusiastic with the development council’s capacity to come together on a weekly basis and connect with the people to address local issues.  Shah noted how much of a huge difference and positive impact this program has had on the community, most notably the CDC’s work in establishing a well-stocked  and run clinic and completion of a local road project, which combined, cost less than sixty thousand dollars.

Click here to see video from the Administrator's trip to Afghanistan.

Minister Barmak reinforced the NSP’s goal of fostering a sense of local ownership and leadership and was grateful for USAID‘s support.

Both Earl Gast and Alex Thier recognized the programs proven results in connecting the local government to the provincial level.

The CDC, supported by USAID, is the largest component of Afghanistan’s National Solidarity Program.

Midwives and Roses

By Amie Batson, Deputy Assistant Administrator for USAID’s Global Health Bureau

I’ve just returned from my first ever week in Pakistan and what a week it was.  Working with my colleagues in the US embassy and USAID offices, and with their Pakistani counterparts, I came to appreciate that development work in Pakistan is exceptionally hard but also very rewarding.

On Monday, I visited to Peshawar, a 2 ½ hour drive from Islamabad, to meet with the health authorities and to visit a public health school for Lady Health Visitors, Community Midwives and other paramedical staff.  You might know Peshawar from the news as one of the areas close to the Afghan border where lots of refugees have settled in camps to escape the violence in Afghanistan.

Although I’ve worked in global health for 20 years, this is the first time I’ve ever needed an armored vehicle to visit a field site.   Once we arrived in Peshawar we changed cars, picked up both US and armed Pakistani security escorts –– and continued driving ahead through the confused traffic of cars, bicycles, donkey carts and people. After a hair-raising journey through downtown Peshawar, we finally arrived at our destination – the school of public health that trains women to be deliver babies and health care in the most remote areas of Pakistan – and I was given the all clear to open the car door.

Re-arranging the head scarf and long coat that I wore to show respect for local customs, I cautiously went to meet the school’s director.  She was already waiting on the front step with a big smile and bouquet of roses in her hand.  After introductions to her all-female teaching staff of doctors and midwives, she gave me a tour of the school.

First we visited two classrooms with 60 young women, each of whom had been selected from over 600 applicants from around the country.   These women were in their 2nd year of the two-year Lady Health Visitors program, and would soon be accredited as midwives and medical personnel.  After they complete their training, these women will return and work in health clinics that provide the only medical care that many in their community will ever receive.  Most clinics serve up to 10,000 people – and the Lady Health Visitors provide services ranging from vaccinating infants and children to protecting them from diseases like measles, whooping cough, polio and hepatitis, to providing care for pregnant women to delivering babies and educating families about the importance of nutrition and spacing of pregnancies.

The women were excited to meet someone from the US and to thank our country for supporting their school.   For only about $24 each month, our US government supports a range of small upgrades to the school to help improve the learning environment and the quality of education provided.  These items included training materials, models for anatomy class, and structural upgrades to the classrooms and students hostels. For the Community Midwives that were trained there, basic equipment was provided for the girls to take to their health post once they graduated – equipment like a birthing table, safe delivery equipment, sheets, a sterilizer, a stethoscope and small stipends for the women to live on.  The Director showed us the “anatomy room” with plastic models of the human body, the delivery room and labor room – a room with 5 beds, the immunization and consultation rooms and the dormitories.  The tour finished in the kitchen – where the delicious smells of lunch (which couldn’t be eaten until we left) came from an enormous pot sitting on a fire.   As we said our goodbyes in the courtyard we spotted an old Dodge school bus, a gift from decades ago that was carefully cajoled into starting every now and then.

I’m grateful for the opportunity to contribute to the work our government is doing to improve health around the world and for the opportunity to witness first-hand the impact U.S. assistance has in Pakistan.  I’m confident that the lives and impact of the Pakistani health workers I met have been forever changed by our assistance.  In 20 years of development work – I’ve never had the armed escort  – but I’ve also never been greeted with a bouquet of roses.

To read more, go to http://www.usaid.gov/pk/newsroom/news/disaster/101220.html

Providing Safe Water to Cities in India

By: USAID/India

For many Indian cities and towns facing the challenges of growing populations and urban expansion, providing direct access to clean, affordable, and reliable drinking water is a significant challenge. Currently, only a fraction of the urban population has direct access to clean piped water, often because of inadequate and inefficient supply systems. The delivery of water and sanitation services in cities is particularly important because of the direct impact on human health and productivity. To help address the urgent need for investment in water and sanitation infrastructure across the country, the USAID Financial Institutions Reform and Expansion (FIRE-D) project tested two sustainable models for providing affordable and equitable access to safe drinking water and sanitation in the Indian states of Orissa and Madhya Pradesh.

Children collect water from a hand pump in an urban slum in Agra, Uttar Pradesh. Most slums in India lack clean water, electricity, sanitation and other basic services. Photo Credit: Sukhminder Dosanj

In the state of Orissa, FIRE-D provided technical assistance, training, and capacity building to the state government’s water utility to help restructure operations, institute operating and financing reforms, and move toward full cost recovery to allow it to expand services to all urban residents, including the poor. The Japan International Cooperation Agency offered to continue the institutional strengthening process after the FIRE-D project ends in January 2011.

In addition, FIRE-D brokered a public-private partnership agreement between a Bhubaneswar, Orissa NGO; a microfinance institution; the Michael and Susan Dell Foundation; and the Bhubaneswar Municipal Corporation (BMC) for the provision of water and sanitary toilets in seven slums of Bhubaneswar which benefited approximately 3,500 residents. As part of the project, FIRE-D also provided technical assistance to the BMC to formulate a comprehensive strategy for all of Bhubaneswar’s 377 low-income settlements, with a focus on how water and sanitation are linked to improved health and hygiene.

FIRE-D helped the Madhya Pradesh Urban Infrastructure Fund plan and prepare bankable water and sanitation projects, which will be financed through municipal bonds and other sources of private sector capital.  FIRE-D also partnered with the UK Department for International Development to design and construct improved water and sanitation infrastructure in 12 slums in Dewas, an ancient town in Madhya Pradesh. The slums will be connected to a new city-wide water project that is currently under construction.  The lessons from this initiative were used to develop a citywide sanitation plan, which provides a comprehensive roadmap for a cleaner and healthier city.

Afghanistan and Pakistan – The Year in Photos

January

USAID sponsors Afghan participation in Domotex—the premier international carpet trade show, featuring some of the best internationally produced hand-made carpets and kilims. For three years, USAID’s role in promoting Afghan carpet dealers has generated millions of dollars in exports. Photo: USAID/ASMED

February

More than 32 million Pakistani children under the age of 5 are immunized against polio during February’s National Immunization Days. Since 2003, USAID has contributed $1 million per year to both the World Health Organization (WHO) and UNICEF to fund their participation in National Immunization Days. Photo: USAID

February

The U.S. and Afghan governments sign a memorandum of understanding to train Afghan civil servants to improve the delivery of government services. The one-year, $84 million program will train up to 4,000 civil servants in Kabul and 12,000 more over the next two years in all 34 provinces. Training focuses on five core public administration functions: financial and project management, human resources, strategic planning, and procurement. Photo USAID/Afghanistan

March

Administrator Rajiv Shah meets with Pakistan government officials on the best role for USAID and development during a Pakistan development roundtable. At the event, Shah and Shahid Rafi, secretary of Pakistan’s Ministry of Water and Power, sign implementation letters confirming joint efforts to upgrade three Pakistani thermal power stations in Guddu, Jamshoro, and Muzaffargarh. Refurbishing the power stations will increase power to Pakistan by 315 megawatts, enough to power nearly 400,000 homes. Photo: USAID

Salam Watandar, a USAID-funded Internews media service, launches a new Pashtu-language television channel targeting audiences in south and east Afghanistan. The service offers news, current affairs, and cultural programming in two 90-minute peak-hour blocks. In addition, the first 22 Kabul Education University students receive master’s degrees in education.

April

During his first official visit to Pakistan from April 11 to 15, Shah emphasizes “a commitment that USAID, and on behalf of our entire portfolio of foreign assistance here, that we would do things differently going forward in order to be better partners, deeper partners, and more respectful partners of the government of Pakistan and the people of Pakistan and Pakistani institutions.” Among the trip’s highlights are a meeting with Pakistani President Asif Ali Zardari, and a press conference that draws more than 80 Pakistani and international media outlets. Photo: USAID

April

USAID hands over the National Women’s Dormitory at Kabul University to the Ministry of Higher Education. The dormitory will provide safe and secure living space for 1,100 women and girls. Around the same time, another 40 midwives graduate from the Hirat Institute of Health Sciences. USAID trained midwives to help the country address what is estimated to be the second highest maternal mortality rate in the world. Photo: U.S. Mission, Kabul

May

After their shops and inventory were destroyed by insurgents earlier in the year, 81 shopkeepers at the Foroshgah-e-Borzorg Shopping Center in Kabul receive USAID grants ranging from $2,000 to $4,000.

June

Responsibility for the 105-megawatt Tarakhil Power Plant is officially transferred to the Afghan government. Completed on May 31 by USAID, Tarakhil has the capacity to provide electricity for up to 600,000 residents in Kabul whose houses are connected to the North East Power System. Photo USAID/AIRP

Late July

U.S. Ambassador to Pakistan Anne W. Patterson issues a disaster declaration in response to extraordinarily heavy rainfall and flooding that begins in northern Pakistan in late July. The flooding drifts south to Sindh province, affecting an estimated 18 million people in every province. More than 75 percent of affected families are located in Sindh and Punjab provinces, and 1.7 million homes are destroyed. Widespread flooding is reported in 82 of Pakistan’s 122 districts.

In coordination with the Pakistan government and other relief agencies, USAID responds quickly to the devastation wrought by the floods. USAID’s Office of U.S. Foreign Disaster Assistance (OFDA) immediately sends water treatment units and Zodiac boats to help rescue stranded people. A Disaster Assistance Response Team (DART) soon arrives to assess conditions, transport relief supplies, and help meet the immediate needs of millions of people affected by the floods in Pakistan. Photo: AFP

July

The Agricultural Development Fund is established through a $100 million USAID grant to the Ministry of Agriculture, Irrigation, and Livestock to lend to financial and non-financial intermediaries, who in turn will lend the funds to farmers for agricultural inputs to expand production. Kabul University officially opens a herbarium, providing Afghanistan a new research tool for studying the country’s vulnerable botanical heritage. Photo: Texas A&M University PEACE Project

August

Shah visits flood-ravaged Pakistan to assess the situation on the ground and determine the next steps for USAID. The first high-level U.S. government official to visit Pakistan, he travels on a C-130 airplane packed with plastic sheeting and other humanitarian commodities from OFDA, observes the USAID-supported World Food Program distributing meals, meets with donors, and consoles flood victims, including women and children who tell Shah that they have “lost everything.” Photo: Farooq Naeem/AFP

August

The Kabul Women’s Farm Service Center opens as one of seven centers in Afghanistan, the only one tailored for women farmers. More than 10,000 Afghan women will benefit, and the center will offer high-quality seed, fertilizer, animal feed, tools, machinery, greenhouse supplies, and other products. Photo: USAID

September

The U.S. government signs an agreement with the government of Pakistan to begin using the first tranche of funds under the Kerry-Lugar-Berman Act, which pledged a $7.5 billion, five-year assistance package for Pakistan. The agreement also launches USAID’s new business model to increase the role of local organizations in carrying out U.S. assistance programs. Over the lifespan of the Act, USAID expects to increase the share of programs implemented by local organizations to approximately 70 percent. Photo: USAID/Pakistan

September

On Sept. 18, Afghanistan holds the first Wolesi Jirga (parliamentary) polls since 2005. At stake are 249 seats in parliament in the country’s first Afghan-led parliamentary polls since the fall of the Taliban. Over 6,000 Afghan observers are mobilized to monitor all provinces. Photo: USAID

October

October marks the 5th anniversary of a devastating 7.6 magnitude earthquake that struck Pakistan’s Azad Jammu and Kashmir region in 2005. USAID’s Earthquake Reconstruction Program has been critical in helping the region recover. USAID rebuilt 21 schools and 15 health-care facilities that provide basic health care to approximately 200,000 people in Bagh District. Photo: USAID

October

The 2010 national wheat seed distribution begins for the first of 260,000 farmers in 31 provinces, funded through USAID’s Afghanistan Vouchers for Increased Production in Agriculture project. Local farmers receive vouchers entitling them to significant discounts on and access to certified wheat seed and fertilizer in an effort to improve the quality and production of Afghanistan’s wheat. Photo: USAID/ASAP

November

USAID and the U.S. government have delivered more than $579 million in emergency relief to the flood-affected communities. Assistance includes materials for shelter, food, medical care, potable water, rescue operations, and basic commodities. As the flood waters begin to recede and communities start returning to their areas, USAID focuses on restoring livelihoods. Flood-affected people receive seeds and fertilizer for the planting season, cattle, cash for work, and a variety of other assistance to restore jobs, businesses, key services, and homes. Photo: USAID/Pakistan

November

On Nov. 24, the IEC announces parliamentary election results for 34 out of 35 constituencies (33 of Afghanistan’s 34 provinces plus the Kuchi constituency). Certification for one constituency (Ghazni) is deferred by the IEC. USAID continues its support to both the IEC and the ECC throughout the process. Photo: USAID/Afghanistan

December

USAID completes its six-year maternal and child health program that reduced neonatal mortality in Pakistan by 23 percent. The $93 million Pakistan Initiative for Mothers and Children (PAIMAN) improved the health of more than 5.7 million Pakistani women and children from 2004 to 2010. The program trained more than 18,000 health specialists and upgraded 103 health facilities as well as 57 training facilities. Photo: USAID/Pakistan

December

The Obama administration publishes an annual review of its military strategies in Afghanistan and Pakistan. In Afghanistan, the administration references an “urgent need for political and economic progress” to match what is described as significant military success in offensives to clear Taliban strongholds in the southern part of the country. Photo: White House

Learn more about our work in Afghanistan and Pakistan in this month’s issue of Frontlines.

USAID/Nepal Supported Women’s Football League Tournament Comes to a Glorious End

By: Stuti Basnyet, USAID/Nepal

On January 12, Jed Meline, USAID’s Acting Mission Director in Nepal, and I flew down to Dhangadi, a district in Nepal’s far-western region, to attend the championship of an eight-day women’s football (soccer) league tournament. This was a unique outreach opportunity. Most field trips we embark on are meant to either monitor the programs or to showcase the impact of our programs. This time we were going to attend a USAID-supported football tournament – an exciting rarity – with Jed scheduled to speak and present awards to the winning teams.

Designed to build the confidence, leadership, team building and networking skills of local, rural women, the sports activity was part of USAID program’s youth leadership efforts to expand the participation of youth and vulnerable populations in the development process of their communities. With the large youth bulge, almost 50% of Nepali population under the age of 35, USAID encourages all partners to find innovative ways to positively engage youth.

The winning team with their trophy. Photo Credit: USAID/Nepal

When we reached Mahendranagar, the venue, it was late in the afternoon, cold and foggy, but more than 10,000 people were present at the tournament. The women in the two final teams had been playing for an hour plus and were a little tired but enthusiastic and dedicated. For most this was their first experience with football and also first opportunity to display a skill in public. Tulsi Gurung, the captain of the winning team told me, “This has been such an amazing experience. It’s built my confidence so much. I really believe, we, the young people, are the potential energy of the country. When we come together, we can do something special. This tournament has been a proof of that.”

“After playing in the tournament I have gained confidence to pursue my effort to be a national football player, just like the boys,” shared Basanti Rana another player from the winning team.

To me, what made the tournament so remarkable – other than seeing young, rural women with no prior football experience, confidently display their newly learned skill in front of thousands – was the partnerships forged to organize the league. While USAID designed the program, trained the women, funded the tournament, and purchased equipment and gear, the effort and support that came from the local public and private sectors was inspiring.

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“Helping Babies Breathe” Global Development Alliance Results in New Innovative Company

Sixty seconds – that is all it takes to breathe life into a newborn that is gasping for air.  This is the golden minute that can mean the difference between life and death for a newborn who is not breathing.  Jubaida, the community midwife, from Bangladesh was trained and equipped to act rapidly and appropriately when she heard no cry and felt no breathing when Baby Shifa was born.  Jubaida gently dried and rubbed the baby and, as the family looked on, she used a bag and mask and helped Baby Shifa breathe as the hands of the clock ticked by.

Helping baby Shifa breathe in Bangladesh. Photo Credit: Tore Laerdal

Every year, 10 million babies require help to breathe immediately after birth. Simple means to stimulate breathing, including drying and rubbing, and ventilation with bag and mask, could save the majority of these babies. Such lifesaving care is currently only available for less than one out of four newborns.  Scaling up newborn resuscitation is challenging because it requires provider skills, appropriate equipment, and systems strengthening.  In order to meet the Millennium Development Goal 4, birth attendants in large numbers must acquire the basic skills and equipment to help newborns breathe.

Challenged by this, USAID searched for a feasible and effective approach to scale up newborn resuscitation and found the answer in the Global Development Alliance model.  On June 16, 2010, USAID launched a Global Development Alliance (GDA).  The objective of the GDA is to reduce newborn mortality by expanding access to high-quality, affordable newborn resuscitation training materials and devices, improving the competence of birth attendants to resuscitate newborns, strengthening health systems and promoting global commitment and resources for life-saving newborn care.  A seemingly impossible task of scaling up newborn resuscitation became programmatically possible by bringing together diverse partners in an alliance.

This partnership is ground-breaking in many ways. The GDA model is a new way of doing business in the field of newborn health and has now become a key USAID strategy to roll out newborn resuscitation globally.  The approach is not without risks since, except for the long-standing partnership between USAID and Save the Children, it has forged a partnership between other organizations who had not previously worked together.  The GDA has also brought two USG Agencies – NICHD and USAID – together in a concrete and actionable way that took advantage of each Agency’s comparative advantage, i.e., NICHD’s research capacity and USAID’s program implementation capacity.  The individual partners of the GDA are themselves creators of innovative solutions: Laerdal developed a very low cost, life-like manikin (NeoNatalie) and a transparent suction bulb in response to the global need for a low-cost, resuscitation training simulator and an easy-to-clean and boilable device to clear the newborn’s airway; these life-saving technologies are available on a not-for profit basis to all 68 Millennium Development Goal countries.   AAP developed the “Helping Babies Breathe” curriculum that simplified the resuscitation action algorithm so that it can be implemented even in peripheral health facilities and communities.

Within six months of launching the GDA, 17 countries are planning to integrate “Helping Babies Breathe” within their newborn programs, AAP has pledged to train one million health providers by 2015, and Laerdal decided to spin off a new company called Laerdal Global Health to focus on developing new technologies at the base of the pyramid to address maternal and child health.

Picture of the Week: Agricultural Boost in Vietnam

vietnamAgricultural research helps farmers in Vietnam grow more rice and counteract the impacts of climate change on food security. Photo is from Philippe Berry/USAID.

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