USAID Impact Photo Credit: Nancy Leahy/USAID

Archives for Global Health

Integrating Family Planning, HIV, and MNCH Services in Ethiopia and Kenya

Posted by  on Thursday, December 30th 2010     

By Ed Scholl, AIDSTAR-One Project Director,  AIDSTAR-One is funded by USAID’s Office of HIV/AIDS, and provides rapid technical assistance to USAID and U.S. Government country teams to build effective, well-managed, and sustainable HIV and AIDS programs and promotes new leadership in the global campaign against HIV.

Alice arrives at a health center in Western Province, Kenya, with her nine-month-old baby girl, who has a recurrent fever. Alice suspects malaria, which is endemic in the area. Two hours later, she leaves with malaria medication and a free insecticide-treated bed net. To the casual observer, Alice got what she came for and had her health needs met. She even received a bed net she wasn’t expecting.

A nurse in Meshualekia Health Center, in Addis Ababa, explains how to use the injectable contraceptive, Depo-Provera. The client will also be offered an HIV test as part of the Ministry of Health's efforts to integrate HIV and family planning services. Photo Credit:Ed Scholl, AIDSTAR-One

But consider what Alice didn’t receive. Had her daughter been weighed, the nurse would have noticed that her growth was faltering because Alice is not yet supplementing her diet with nutritious weaning foods. Her daughter also missed the measles immunization she was due for. Alice was not offered an HIV test, which would have revealed that she is HIV-positive. Finally, no one asked Alice, who has six children and does not want to get pregnant again, if she is using a family planning method or would like information about contraceptives available at the health center. In short, Alice’s immediate need was met, but multiple underlying health needs went undetected by the health center staff.

Alice’s story is unremarkable. Similar scenes play out every day in health care settings around the world. In sub-Saharan Africa, where the burden of HIV, unintended pregnancies, and infant mortality is highest, missed opportunities to meet health care needs, such as those of Alice and her baby, can be deadly.

Fortunately, programs in Kenya and Ethiopia are leading the way in integrating family planning, HIV, and maternal/neonatal and child health (FP/HIV/MNCH) services. In Kenya, the government has made integration of FP and HIV a national policy. USAID/Kenya’s AIDS, Population and Health Integrated Assistance II (APHIA II) project promotes integrated service delivery throughout the country in public, private, and faith-based facilities. Visiting the APHIA II project in Western Province (implemented by PATH), I noted that the Ministry of Health trains nurses and health officers to deliver both FP and HIV services. The project has supported FP/HIV/MNCH integration at 276 health centers and hospitals in Western Province. USAID/Kenya’s new APHIA Plus Project will expand integrated services in 2011.

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Maternal Death Preventable and Treatable with Low-Cost Interventions

Posted by  on Wednesday, December 22nd 2010     

Submitted by Deborah Armbruster, Sr. Maternal and Newborn Health Advisor

In September, the World Health Organization (WHO) reported that fewer women die each year from complications during pregnancy and childbirth than previously estimated, but efforts to sharply cut maternal mortality by 2015 are still off track. A new report found that 358,000 women died during pregnancy or childbirth in 2008, mostly in poor countries of sub-Saharan Africa and South Asia. While the number of deaths is disturbing enough, it is estimated that an additional 15-20 million women suffer debilitating consequences of pregnancy.

Despite the challenges faced in reducing maternal mortality, USAID has helped to demonstrate that real progress can be made.  Our work proved that many of the major causes of maternal death are substantially preventable and treatable with low-cost interventions.  USAID has sharpened its focus on a set of effective interventions targeting high-mortality complications of pregnancy and birth – hemorrhage, hypertension, infections, anemia, and prolonged labor.  Together, these complications account for two-thirds of maternal mortality.  Hemorrhage alone accounts for almost one-third, and USAID has been in the forefront of promoting “active management of the third stage of labor (AMTSL),” a highly-effective technique for preventing postpartum hemorrhage.

The active management of the third stage of labor is a combination of actions to speed the delivery of the placenta and prevent up to 60% of postpartum hemorrhage cases. Through these simple actions, trained providers can prevent postpartum hemorrhage and play a vital role in saving women’s lives.

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How You’re About to Help Save the Lives of 4 million Children

Posted by  on Tuesday, December 21st 2010     

By Amie Batson, Deputy Assistant Administrator, Global Health Bureau

You may not know that the leading killers of children in the poorest countries are diarrhea and pneumonia.  You almost certainly don’t know that your contributions can help save the lives of 4 million children – many because of the introduction of two new vaccines to protect against those diseases.

Last week, I was in Rwanda, helping the Global Alliance for Vaccines and Immunization plan the introduction of vaccines for rotavirus and pneumococcal diseases, major causes of diarrhea and pneumonia.  With your support as well as corporations, foundations, and countries rich and poor, GAVI, will save the lives of 4 million children in the next five years.

That sounds ambitious, but it’s very doable – and you’re a big part of the reason. With your help, GAVI supported childhood immunization in poor countries over the last 10 years, saving the lives of 5.4 million children, and shielding millions more from the long-term effects of illness on growth and development.

The U.S. has been a leader in immunization, but we can’t do it alone. Working with and through groups like GAVI helps ensure that other donor countries, companies and foundations, as well as developing countries themselves, all contribute their share: a global solution to a global problem. In addition to the U.S., fourteen other countries and the European Union are donors, and The Bill & Melinda Gates Foundation is also a generous supporter.

People have been a big part of that success as well. GAVI has had strong, high-level leadership – the Rwanda meeting marked the last for Mary Robinson, the former president of Ireland who served as chair of GAVI’s board, who deserves thanks for her advocacy. Norway has been a global leader in the fight to immunize children in the poorest countries, and its former health minister, Dagfinn Hoybraten, took over as chair – underlining Norway’s continuing commitment.

U.S. leadership isn’t just a matter of money.  The expertise of people at USAID has been crucial as well.  Since the ‘70s, USAID professionals have worked with partners across the globe to confront the challenge of vaccine-preventable diseases and help immunize children in remote parts of the world.  Working with an efficient partner like GAVI that mobilizes resources from other countries, foundations and companies multiplies the impact of U.S. expertise, as well as dollars.

GAVI is a model for the new approach the U.S. is taking through the Global Health Initiative: an innovation approach, a public-private partnership seeking innovative sources of finance for vaccines for poor countries, investing in children, with a clear focus on measurable results.  GAVI is a true partnership, accomplishing more than any nation could do on its own, and doing it efficiently, with a small staff.

As the U.S. expands the life-saving impact of our global health assistance through the Global Health Initiative announced by President Obama, our support for immunization will continue, because it is one of the most cost-effective ways to save lives and promote health.  Reaching children with this simple, affordable intervention is one of the smartest investments in global health – and the right thing to do.  And we can do it in a way that builds national systems, so they won’t need help forever.

These times demand that we provide more health for the money we invest in global health. Despite the success of immunization programs, vaccine-preventable diseases are still estimated to cause more than 2 million deaths every year.

We will help because compassion is a fundamental American value — and so is efficiency in using the resources we have, innovation to make those resources go further, and realism to know we can’t do it all by ourselves.  Working with and through GAVI, we have changed the future of millions of children and families. That’s effective, efficient realistic compassion, and it’s worth doing more.

Zambia: Where the Roads End, Logistics Continue

Posted by  on Tuesday, December 21st 2010     

During the rainy season, an ox cart is the only reliable way to get health commodities across the flooded plains to rural health centers in Zambia’s Western province. Photo Credit: USAID/Zambia

Mwanawina Rural Health Center is located approximately 80 kilometers from Mongu, the capital of Zambia’s Western province. Each year, during the rainy season, the facility becomes inaccessible by motor vehicles.

To get drugs and medical supplies to the health center, the District Health Office hires an ox cart—the only reliable transport through the flooded plains between December and June. The journey takes no less than six hours.

With its expertise in logistics, particularly in challenging environments, the USAID | DELIVER PROJECT is partnering with Zambia’s Ministry of Health (MOH) to help bring drugs and medical supplies to patients by strengthening the supply chain.

In the Western province, the project trains health center staff in logistics and provides technical guidance and mentorship to MOH staff in provinces and districts, and at individual health centers.

The project is also enhancing the computerized systems in all hospitals and major health centers to include important logistics information. The new information will help improve systems performance and increase commodity security in the province.

The USAID | DELIVER PROJECT works in all of Zambia’s provinces to improve access to health commodities. For more information, please visit http://deliver.jsi.com.

U.S. Provides Equipment To Female Health Workers in Pakistan

Posted by  on Tuesday, December 21st 2010     

More than 1,500 Lady Health Workers who work in areas in the areas of Punjab and Sindh provinces in Pakistan will receive kits of basic equipment to help them as they offer vital health care services to families in their communities. This donation is part of the United States’ continuing support for Pakistan’s flood relief and recovery efforts.

Deputy USAID mission director Rodger Garner is speaking to the lady health workers; Sakina Shanwari, supervisor of the lady health workers, thanks the American people. Photo Credit: USAID/Pakistan

The kits were donated by the U.S. Agency for International Development (USAID) to Pakistan’s National Program for Family Planning and Primary Health Care.  Kits include blood pressure monitors, scales, thermometers, blankets, tents, and basic furniture.  This equipment will enable Lady Health Workers to set up health houses to provide basic services in flood-affected communities.

Read more here.

Microbicide Gel Offers Protection Against HIV Transmission

Posted by  on Tuesday, December 14th 2010     

By Lee Claypool, USAID Biologist

Microbicide. That’s kind of a funny-sounding — perhaps even scary — word for something pretty powerful. It certainly has a scientific “ring” to it, and that tends to turn people off. It’s complicated, it’s detailed, and it’s… boring, right?

If you think something that can empower women, save lives, and possibly change the course of history is boring, then yes. Here at USAID, we actually think it’s pretty exciting. For nearly 50 years, we’ve been investing in science, research, and innovation to enable game-changing interventions and breakthroughs to reduce poverty and improve livelihoods. This year, such an investment provided the first-ever proof that a microbicide, Tenofovir 1% vaginal gel, can safely and effectively protect women from HIV transmission.

An estimated 33.3 million people are living with HIV globally. Nearly 23 million of these individuals, 60 percent of whom are women, live in sub-Saharan Africa. In many countries, women lack the power to negotiate the use of prevention tools and approaches to protect themselves from exposure to HIV through conventional methods such as condom use, partner reduction, and negotiating delay of sexual debut.

The results of the USAID and South African-supported Center for the AIDS Program of Research in South Africa (CAPRISA) 004 trial are encouraging, and provide hope that a new method that will enable women to have greater control over HIV prevention will soon be available.

The next steps are to confirm these results in further studies; once this happens we could have on our hands a unique HIV prevention tool for women who are not able to negotiate other HIV prevention methods with their male partners. Once this new technology is ready, USAID will work with all our partners to make it available to vulnerable women and girls as soon as possible.

But, since everyone is different, we know that we need a variety of HIV prevention methods to choose from. For just this reason, other next-generation ARV-based product leads are in the pipeline and will be tested clinically if they continue to show good results in preclinical testing. We will continue to support clinical studies of promising products.

We are thrilled our Administrator thinks microbicide is an exciting word as well. Just two weeks ago he convened a meeting to determine the next steps following the success of CAPRISA. There will also be an additional meeting with technical experts in the field to discuss how to aggressively roll out microbicide treatments to those most in need.

Microbicide: Does one word say it all? Perhaps not. Is the word off-putting? Even a little too scientific? Perhaps. We just see it as the future of HIV prevention.

Want to know more about USAID-supported innovation and breakthroughs for global health? Stay tuned to www.usaid.gov and the IMPACT blog! We’ll be posting updates to highlight a variety of new research findings over the next several weeks as we roll out the 2010 Health Research Report to Congress.

200 Years of Global Health in 4 Minutes

Posted by  on Monday, December 13th 2010     

By: Ryan Cherlin

Let’s be honest, statistics can be boring and oftentimes intimidating. It’s unfortunate because behind every statistic there is an incredible story to be told. While statisticians are not generally known for their charismatic personalities, Hans Rosling has done the impossible—he discovered a way to unearth compelling stories that are often lost in a vast sea of hard data.

Photo Credit: Ryan Cherlin/USAID

Through his non profit venture Gapminder, Rosling is dedicated to telling the story of global health by converting numbers into exciting presentations with stunning animated and interactive graphics. In order to change mindsets with datasets, he relies on credible sources to supply him with the raw materials he needs.

Rosling pulls data from several sources, including the USAID funded Demographic and Health Survey (DHS), to create his animated presentations that have captivated global health professionals, government officials, policy makers, as well as audiences unfamiliar with global health issues. For the past 25 years, DHS has proved to be the gold standard of high quality and reliable data on health in developing nations. This data provides critical insight that helps decision makers establish evidence-based priorities and policies to progress the global health agenda.

The DHS program works with countries’ health ministries and has conducted some 260 surveys in over 90 developing countries measuring key indicators including infant and child mortality, fertility, family planning use, maternal health, child immunization, and malnutrition levels. Beginning in 2001, DHS began measuring HIV prevalence in national surveys, leading to an international reassessment of both the extent and epidemiology of the AIDS epidemic.

Check out more of Hans Rosling’s videos on the Gapcast YouTube channel.

The Ability to Plan Your Family Is a Game Changer

Posted by  on Friday, December 10th 2010     

By: Ryan Cherlin

Having seven children would be a challenge for any woman. In a developing nation like Mali, where the average number of children per woman is 6.6, calling it a challenge may be an understatement. Because they fall pregnant at an early age, young mothers don’t have the opportunity to finish their education, they aren’t able to work outside the home, and they face an increased risk of pregnancy-related health complications that could be fatal. Without contraceptives to plan how many children to have and when to have them, this scenario becomes reality for billions of women in the developing world and feeds the cycle of poverty.

Causes of Maternal Death Pie ChartThere are an estimated 215 million women who wish they had the ability to plan their family but don’t have access to contraceptives.  In some developing nations where health care systems are grossly inadequate, or in rural areas where they may be non-existent, the availability of something as simple as contraceptives can be a matter of life and death.  Women understand the grave risk that comes with pregnancy when there are no trained health professionals or doctors to consult and provide care.  The ability to mitigate that risk is a right that should be afforded to every woman.

A World Health Organization report in 2005 stated that 1 in 75 women in developing countries risk facing maternal death in their lifetime versus 1 in 7,300 in developed countries. At the extreme, in Niger a women’s lifetime risk of dying from pregnancy-related complications is 1 in 7 versus 1 in 48,000 in Ireland. Behind each of these statistics is a story of a mother who died giving life. Behind each statistic there are heart wrenching stories of broken families that lost a loved one. The stories are all the more tragic when the woman had hoped to avoid the pregnancy, but didn’t have access to contraceptives.

The 16 Days Campaign to End Violence Against Women: From 25 November to 10 December, USAID will post a blog each day that aims to prove a single point: The human race cannot progress when half of the world population lives without the same rights and respect afforded to its male counterpart. If you are moved by what you read and want to share, we’ve made it easy for you. Click here to find out how.

Digital Birth Control On Your iPhone

Posted by  on Thursday, December 9th 2010     

By: Ryan Cherlin

Just when you thought there was an application for everything, now you can download birth control to your smart phones. The ability to plan or prevent pregnancy is something most couples in developed nations take for granted. In poor countries where health systems are often weak and individuals can’t afford to see a health professional this luxury is wanted and needed, but not easily attained.

iCycleBeadsIconAn estimated 200 million women wish they could plan for or prevent pregnancy because having more children poses a health risk to the woman or an economic challenge for the family.

The product, iCycleBeads, is now available at the iTunes store. It’s a natural birth control method that enables a woman to track her menstrual cycle and know if she is on a day when pregnancy is likely or not. Many women and couples prefer this method because it is:

  • More than 95% Effective
  • Side-Effect Free
  • Easy to Use
  • Inexpensive
  • Educational & Empowering

Since 1985 USAID has supported the use and development of natural family planning methods that give couples the tools they need to plan for the future health and stability of their families. It was a USAID-funded study that originally developed the science and methodology behind Cyclebeads which has helped couples in developing countries plan their families for decades.

This new trend towards digitizing birth control through smart phone applications or similar services offered on regular cell phones means more couples will have access to the family planning services they want.

CycleBeads is a color-coded string of beads that represents the days of a woman’s cycle and helps her use a natural family planning method called the Standard Days Method®. To use CycleBeads, a woman simply moves a ring over the beads to track each day of her cycle. The color of the beads lets her know whether she is on a day when pregnancy is likely or not and whether her cycle length is in the appropriate range for using this natural family planning method.

One Man Can

Posted by  on Wednesday, December 8th 2010     

Submitted by Ryan Cherlin

There may be one major factor overlooked in the struggle for women’s rights: men. Skeptics are being won over by the preponderance of evidence proving that unless men are actively engaged in supporting the empowerment of women, progress will remain painfully slow and women will remain vulnerable to health threats, including gender-based violence.  While this may seem obvious, the findings demonstrate a need to incorporate educating males as a key function of women’s rights organizations and programs.

Years ago, women’s health activists fighting for limited resources believed involving men would take away from the women. Today, studies clearly show that is not the case, and activists now see men as playing a central role in achieving their goal.

Programs like USAID’s “One Man Can” focuses efforts on changing the attitudes of men to create an equitable balance of power, privilege, responsibilities and resources that men and women possess. These programs are proven more effective when men see the advantages for themselves, their partners, and children.

Traditionally, men are prone to take more risks with their health, are less likely to seek professional healthcare services, and often choose to remain emotionally distant from women and children.  These norms are detrimental for both men and women, and provide a poor example to children who then perpetuate this cycle.

Reaching boys and young men in their formative years helps to shape their view of women as equals. This approach at the community level must be reinforced by policies that establish this equality as a social norm. By educating men about the consequences of their actions, and enforcing policies that favor equality, traditional ways of thinking can be challenged and changed.

The 16 Days Campaign to End Violence Against Women: From 25 November to 10 December, USAID will post a blog each day that aims to prove a single point: The human race cannot progress when half of the world population lives without the same rights and respect afforded to its male counterpart. If you are moved by what you read and want to share, we’ve made it easy for you. Click here to find out how.

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