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Archives for Global Health

Protecting the Lives of Women and Girls: London Summit on Family Planning

Today I joined leaders from around the world at the London Summit on Family Planning to commit to the goal of providing 120 million women in the world’s poorest countries with lifesaving contraceptives, information, and services by 2020. This Summit comes at a crucial time, following up to last month’s Child Survival Call to Action. Convened by the governments of the United States, Ethiopia and India, the Call to Action brought over 1,000 representatives from around the world to Washington, DC to rally behind the goal of ending preventable child death. We know that this effort begins even before a child is born. By enabling mothers and families to time and space the birth of their children, family planning could save the lives of more than 1.6 million children under five annually.

To support the aspirations of the London Summit, the United States commits the power of its voice and example, as well as resources, technical support and leadership that will lead to new and innovative ways of substantively reducing unmet need for family planning. Over the course of several decades, the U.S. has provided roughly 50 percent of total donor funding in family planning.

In the last four years alone—during the Obama Administration—we’ve increased our commitments 40 percent, going from $470 million in 2008 to $640 million today.This past year, we reached more than 84 million women—helping to prevent 15,000 maternal deaths and save the lives of more than 230,000 infants.
I recently took a trip to Yemen where I saw the great challenges the nation faces in terms of both high rates of fertility and mortality. In Yemen, seventy-five percent of the population is younger than 30. Driven by a fertility rate of about 5.5 children per woman—nearly twice the regional average—each new generation is larger than the last. At best, these demographic challenges pose a roadblock for economic growth and global health gains. At worst, they interrupt the stability of societies—putting regional security and prosperity at risk. We need to make strategic investments today to get ahead of the curve and seize unprecedented opportunities in development. One of the biggest opportunities comes when you couple family planning with real reductions in child mortality—leading to an important shift in population that, with appropriate investments in education and job creation, can fuel as much as two percentage points of GDP growth for years.

Today, we’re building on our legacy of research and development to create a new generation of contraceptive methods that are easier to provide, easier to use, and more affordable. For example, we’re partnering with DFID, the Bill and Melinda Gates Foundation, and others to expand access to the popular “depo-in-uniject” contraceptive in five to six countries.  Packing an all-in-one, single dose, this innovative contraceptive can be provided right in the home.

USAID currently runs the largest and most effective global supply chain system in family planning commodities. But we need to work closely with our private sector partners and country governments to drive even greater efficiencies so we can avoid stock-outs and reach particularly vulnerable women in rural and urban settings. And we need to strengthen our partnerships, working closely with local actors, private firms and faith based organizations to fully integrate family planning services into HIV and maternal and child health programs.

Over the next eight years, our work to support more than 84 million women annually across 42 countries will provide for 675 million user-years of coverage. This is in addition to all the extraordinary commitments made at the Summit today. But combining our efforts, our support will ensure that, in 2020, 380 million women in the poorest countries of the world will have the power to determine the size of their families. By 2020, our work together will be helping prevent the deaths of 1.3 million children under the age of five—more than 15 percent of all preventable child deaths.

Alongside critical investments in education and economic opportunity for women and girls, voluntary family planning paves the way for peaceful, more prosperous communities. Ultimately, we know that long-term, sustainable development will only be possible when women and girls enjoy equal opportunity to rise to their potential.

I am excited with the level of energy and commitment surrounding this Summit and look forward to working together to lay the foundation for a brighter future.

Learn more about USAID’s work in family planning.

London Summit on Family Planning

Tomorrow, on World Population Day, world leaders will meet in London to discuss expanding access to family planning for millions of women around the world.  Many people have been asking me why the London Summit on Family Planning is important.  This brings me to think back to when my wife and I first thought about having children.  It was an exciting time; much thought went into planning our family.  We decided to have two children, spaced two and a half years apart, as that was the number we thought we could provide enough support, attention, and education.  For more than 40 years USAID has worked to enable millions of couples from around the world to plan their families like my wife and I did.

The London Summit on Family Planning is important because despite all the many advances in family planning, with countries that no longer need assistance in this area, for all the millions of couples who are now using family planning services, there remain millions who want to space or limit their families, but do not have access to the clinics, the commodities, or the services they need to do so.

In fact, the statistics tell the story:

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Taking Stock of Improvements in South Sudan’s Health Sector

As South Sudan celebrates the first anniversary of its independence on July 9, the new nation is taking stock of what it has accomplished over the past year.

After suffering through civil war for most of its history (since before Sudan’s independence from the United Kingdom in 1956), South Sudan remains one of the world’s least developed nations. Part of this underdevelopment stems from the fact that South Sudan had an informal health system during the war, which was supplemented heavily by relief agencies.  With a lack of skilled health professionals, vast distances between service delivery points, and a dearth of basic health education, the world’s newest country has some of the worst global health indicators, including one of the world’s highest rates of maternal mortality.

Overcoming the vast logistical, technical, political, and social roadblocks to improving health for the population of more than 10 million South Sudanese seems nearly insurmountable.  Deficiencies in infrastructure, human resources, supply chains, pharmaceutical management, education, and health policies produce challenges and delays at every step.

In addition to health and development needs, South Sudan continues to be challenged by conflict, instability, and population movements, including refugees fleeing conflict in Sudan and the return from Sudan of more than 400,000 people of South Sudanese origin since October 2010.  These conditions are taxing an already strained health system and exacerbating the existing deficiencies.

Despite these challenges, progress is being made. South Sudan’s child mortality rate dropped from 135 per 1,000 in 2006 to 106 per 1,000 in 2010. Infant mortality saw a similar decline from 102 per 1,000 in 2006 to 84 per 1,000 in 2010.

To sustain and expand these positive health trends, USAID is funding the Sudan Health Transformation Project, Phase II (SHTP II).  Led by Management Sciences for Health, SHTP II is working closely with South Sudan’s Ministry of Health and local partners to improve access to and demand for health services, while building the skills and knowledge of South Sudanese health workers.  One element of the project is the Leadership Development Program, which focuses on teaching health workers and managers how to identify challenges and seek solutions to overcome barriers to providing health services.  The program teaches teams to look at areas where they are underperforming, and find ways to achieve measureable progress.

At a recent workshop, Marco Agor, who works in the County Health Department in Tonj South, Warrap state, praised the program, saying, “The Leadership Development Program is very important. In my office, we had a lot of organization problems.  Those who had known Thiet in Tonj South before [the program] would say it is a different place. Now, Thiet is the best-run facility.”  The program has been so successful in SHTP II-supported facilities that the Ministry of Health is now assessing its own operational challenges using the Leadership Development Program. The Ministry is also currently working to develop a strategy for training even more of the nation’s health workers in this leadership development program.

Video of the Week: 5th Birthday Campaign

We can work together to end preventable child deaths.  Learn how at http://5thbday.usaid.gov.

Picture of the Week

Health workers practicing Helping Babies Breathe (HBB) techniques. HBB is an evidence-based educational program to teach neonatal resuscitation techniques in resource-limited areas. Since September 2010, the USAID-funded Health Care Improvement project has trained 691 providers in 9 out of 34 provinces on essential newborn care and resuscitation using the HBB curriculum. Implementing Partner: Health Care Improvement (HCI) Project Photo Credit: USAID/Afghanistan

 

 

From the Field: Imams Encourage TB Treatment in Tajikistan

As a community health specialist with USAID’s Quality Health Care Project in Dushanbe, Tajikistan, I educate community members, medical workers, patients, and their families about tuberculosis (TB) diagnosis, treatment, and infection control.  My job involves being constantly available and responsive to the needs of patients and their families, and I tend to work unusual hours in order to fit into their schedules.  Still, I was a bit surprised when I received a call from Safarov Khudodod in the middle of the night last month.  Khudodod is an imam, a religious leader at his mosque, and he was so excited about a TB testing referral he made after his sermon that he couldn’t wait until the morning to share it with me.

“I heard the man coughing and approached him to ask him about his symptoms.  I encouraged him to get tested.  He just reported back to me that he tested positive for TB and will begin treatment immediately,” he said.

Imams in Tajikistan play a major role in the lives of their congregations.  They lead ceremonies such as weddings and funerals and provide religious advice to those seeking it.  USAID is working with religious leaders in Tajikistan to inform them about the causes and treatment of TB.  USAID workshops are helping participants like Imam Khudodod to encourage known TB patients in their communities to get treatment and teach them how to avoid transmitting the disease to others.  I meet with workshop participants several times a year to help them complete self-designed outreach plans.  The 62 people we’ve trained have already reached approximately 20,000 community members.

Before he attended USAID’s TB workshop, Imam Khudodod told us he knew very little about TB.  “Before, we thought that TB was a genetic disease, but now we know it isn’t.  Many people in my community think that TB isn’t curable, so they don’t get treatment.  I share information about TB at all of my meetings with my congregation, even at weddings and births.  I have already reached out to over 5,000 people.”

Tajikistan has the highest rate of TB incidence in Central Asia and one of the highest multi-drug resistant TB rates in the world.  Encouraging individuals to complete treatment and teaching them basic rules of infection control are key steps in eradicating TB in countries like Tajikistan.

Imam Khudodod is optimistic about the future of TB in his country:  “I think that the next generation will be healthy and will know about TB.”

Rio+20: The Demographic Dividend and Sustainable Development

Some of the fastest growing economies in the world today are in East Asia and Latin America – countries that were among the poorest in the world just 40-50 years ago. A distinguishing common feature of these countries today is that the working age population—those between 15 and 64—is larger than the dependent population—the very young and old.

The demographic dividend  is an opportunity that arises when a country transitions from high to low rates of fertility and child and infant mortality. This transition creates a generation that is significantly larger than the generations immediately preceding and following it.  As this cohort enters working age, they have the potential to enter into productive economic activities and invest savings at relatively high rates, thus spurring heightened economic growth.

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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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An Oasis for New Moms

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 is organized in close collaboration with UNICEF.

The new mothers I met at the Regional Maternity Hospital in Kyzylorda, a province in southern Kazakhstan, were as weathered as the salty desert earth all around us. Their young faces appeared determined but exhausted, hinting at the many hundreds of kilometers they had to travel to reach the hospital in time to give birth.

The newborns these mothers cradled in their arms weighed less than a handful of apples. This region historically has suffered from the country’s highest newborn mortality rates. Kyzylorda suffers from many unhealthy environmental factors, like the Aral Sea pollution crisis and toxic mining, which the local doctors tell us contributes to poor health outcomes for mothers and infants. Prematurity accounts for about 37 percent of newborn deaths worldwide.  Asphyxia and infections are other leading causes of newborn deaths.

If these babies had been born before 2008, they would probably not be alive today.  Before 2008, when USAID started helping the regional health department adopt World Health Organization (WHO) live birth criteria, these babies would not have received the life-saving interventions such as neonatal resuscitation that kept them alive in those precious hours after birth. In the four years since the Kyzylorda Oblast Health Department introduced neonatal care technology and adopted a 500 gram (1.1 pound) live birth definition, doctors here have saved around 200 babies’ lives. The WHO live birth criteria state that all babies showing any signs of life, such as muscle activity, a gasp for breath, or a heartbeat should be included as a live birth and provided with interventions to keep them alive. Under the Soviet-era definition, infants who were born before 28 weeks, weighing less than 1,000 grams, or measuring less than 35 centimeters, were not counted as live births if they died within seven days.

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Saving the Lives of Newborns in Indonesia

Dina, age 27, delivered her first baby Diandra at an Indonesian hospital in Central Java. Hospital staff kept Diandra away from her mother in the newborn care unit and fed her formula until they deemed Dina ready and strong enough to feed the baby. Diandra fell sick with severe diarrhea and died at the hospital ten short days later.

Each year, more than 80,000 newborn babies die in Indonesia within the first month of life from treatable conditions, the most common of which are prematurity, low birth weight, birth asphyxia, and neonatal sepsis.

“Every family has a sad story about a baby or mother they know who lost their life from complications during pregnancy, delivery or immediately after child birth. Many attribute the deaths to God’s will but with the right technology, equipment, and training for health care professionals, it can be stopped,” said Evodia Iswandi, Jhpiego deputy director for provincial operations in Indonesia. “Good hospital administration and policies can also go a long way to enable staff to work at their full technical capabilities.”

Through Expanding Maternal and Neonatal Survival (EMAS), a U.S. Agency for International Development (USAID) – funded program in Indonesia, local health care providers receive training from one of Indonesia’s premier maternal and child hospital and other organizations on best practices in neonatal and maternity emergency services. Hospitals and community health centers learn how to prevent and treat hemorrhaging, premature delivery, low birth weight, high blood pressure, birth asphyxia, and other causes of death. USAID’s EMAS program also helps reform Indonesia’s referral system so that mothers and babies get to the right place, at the right time, in order to receive the right medical treatment.

“USAID is partnering with Muhammadiyah, one of the largest and most respected Islamic organizations in Indonesia committed to diversity and pluralism, to save lives and sustain EMAS even after the program ends,” said USAID/Indonesia Mission Director Glenn Anders.

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