A woman in Carmen del Paraná, a small town in rural Paraguay works at a social pharmacy program at the local hospital. This program implemented by local health councils with technical assistance from USAID/Paraguay helps pharmacies keep prices for medicine affordable for low-income communities who do not normally have access to medical supplies and often cannot afford regular prices of basic medicines. Money for the pharmacies is channeled through a revolving fund managed by the local health councils in each community, in coordination with the municipal and departmental governments and the departmental health council.
Archives for Global Health
Story submitted by Millennium Relief and Development Services/Partner Aid International
When Ikhlas was a young girl in El Fasher, North Darfur, her life took a tragic turn when she contracted polio. The disease has been nearly eradicated worldwide following the advent of safe and effective childhood vaccinations, but in a few pockets of the world, poor access to health care means that children become disabled or die from preventable causes.
Throughout her life, Ikhlas has battled others’ misguided perceptions that because she is disabled, she is unable to hold a normal job or do anything of value. Although she was an active member of the Darfur Disability Society, people only focused on her handicap when she interviewed for jobs.
In 2010, Ikhlas interviewed with USAID partner Millennium Relief and Development Services/Partner Aid International (MRDS/PAI) in North Darfur to become the supervisor of rural clinics. Many MRDS/PAI staff were concerned that she would not be able to travel to villages or would be a burden to others during field trips, but some saw in Ikhlas a spark with great potential. Ikhlas’ first assignment was to help start a new clinic in Grawid Besham, a village with no health care services within 20 kilometers. Ikhlas organized a village health committee to oversee the work of the clinic, involving all relevant government organizations.
Ikhlas spent several months traveling to rugged rural areas, working with the community to remodel the clinic and to build residential facilities for medical, monitoring, and support staff. After months of hard work mobilizing the community and government agencies into action, the clinic opened in 2010 and the community celebrated the arrival of health care services to the village.
With USAID support, the clinic in Grawid Besham is providing health care for up to 8,000 rural Darfuris. Ikhlas is now helping to prevent other children from contracting a disease that has created so many challenges in her own life. Grawid Besham is the first of four clinics that Ikhlas has helped USAID and its partners open in the area.
“I am really fortunate to show that I am able to work in spite of my disability,” Ikhlas said. “The stigma is still very high in people thinking disabled people can’t do anything. So I thank God, my family—for giving me permission to work outside of town—and I thank my employers for not seeing only the outside and my inability but encouraging me to show my abilities. To me, this is real partnership and it has changed my life and I hope the lives of many others not only in health care but also in their attitude towards other people living with disabilities.”
As we headed out for a health-focused field trip in Timor-Leste’s central highlands, we were treated to almost all the geographical delights of the country. Along the coast road, the dry season winds were whipping up the sea into the biggest waves I’d seen since I arrived in Timor-Leste. As we turned inland, the brown fields among the rising hills attested to the end of the harvest. Driving ever higher—along narrower and narrower roads—the altitude brought back the green of forests.
We were headed through the district of Ermera to the “sub-village” of Hatugeo, tucked just below the peak of Timor-Leste’s highest mountain. This district has some of the country’s worst health indictors:
- Infant mortality is 70 babies per 1,000 births, far higher than the national average of 45/1,000, and higher than in neighboring Indonesia (34/1,000).
- Only 3 percent of mothers deliver their babies in a health care facility, compared with 22 percent across the country.
- A higher percentage of children show signs of malnourishment and illness than in the rest of Timor-Leste.
Why is that? I’ve been told there are four main reasons (and I suppose that there are more). First, the district is very mountainous; second, there are few roads; third, there is a shortage of professional health staff; and fourth, this district is known for its festivals and parties—people spend what little money they have on these, not on nutrition and health, so says the Deputy Director of the District Health Service Florindo De Araujo. This is a big problem, and Mr. De Araujo and his staff are wracking their brains to figure out what to do about it.
In March 2011, the Kenyan National AIDS Control Council prepared a Cabinet memorandum that outlines ways to raise funds for HIV programming. Through innovative solutions, Kenya is looking for sustainable ways to combat the AIDS epidemic in country.
Two government staff who helped prepare the memo tell us how it will help Kenya’s 1.5 million citizens living with HIV.
Regina Ombam, head of strategy for Kenya National AIDS Control Council (NACC), leads planning, implementation and evaluation of HIV programs. As part of the Cabinet memo initiative, she managed the process of gathering relevant health financing data on behalf of the director of NACC. Ms. Ombam holds master’s degrees in economics and public administration.
Irene Mukui is the antiretroviral therapy (ART) program manager for the National AIDS and STI Control Programme. She oversees the provision of ART and other associated care (i.e., nutrition, TB/HIV integration, etc.) for both children and adults in Kenya. Dr. Mukiu was a member of the technical working group that developed the Cabinet memo. She is a licensed medical doctor.
HS20/20: What does the Cabinet memorandum propose to raise funds for HIV programming?
RO: The Cabinet memo proposes that the Ministry of Finance create a HIV/AIDS Trust Fund that would support scaling up prevention, treatment, care and support in Kenya. If approved, the government would contribute 1% of its annual revenue to the fund. In addition, the fund would receive contributions from partners and the private sector through initiatives such as airtime and airline levies, levies on remittances from abroad, corporate and NGO donations, the national lottery system, and leveraging unclaimed financial assets (i.e., monies that are dormant or abandoned often as a result of death, name change, or relocation). The Ministry of State for Special Programmes, the Ministry of Public Health and Sanitation, and the Ministry for Medical Services would implement HIV programming supported by the fund.
IM: The Cabinet memo aims to establish long-term, sustainable financing through the existing National Health Insurance Fund and increase government funding to meet the Abuja target of allocating 15% of the annual budget to health.
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The average Guinean woman will have six children during her lifetime, but due to the lack of obstetric care, many develop fistula, a painful injury that is especially traumatic due to the stigma associated with it. During obstructed labor, a baby’s head may be pressed against his mother’s pelvic bone, cutting off circulation to tissue in the area and literally creating a hole or “fistula” in her bladder or rectum. Aside from the physical pain, many also suffer psychological trauma, as they are often shunned by their families and communities due to the foul smell resulting from their injuries. The internationally renowned Hamlin Fistula Foundation says that although this condition was eradicated in the United States over a century ago, more than 2 million women in developing countries still suffer from it today.
USAID is helping more than 1,500 women in Guinea access treatment for fistula and working with communities-women and men, secular and religious leaders-to understand, prevent, and treat fistula while better supporting those who have suffered from it. In addition, USAID is strengthening the national health system by training doctors, nurses, and midwives in fistula prevention and care.
It is well-documented that contraception has multiple individual, national and global health and development benefits, including reductions in maternal and child mortality and maternal to child transmission of HIV, and increased opportunities for women in the workforce and global economy. World Contraception Day, commemorated every year on September 26, highlights the growing need for improved access and awareness of modern contraception.
Seven out of 10 women in Sub-Saharan Africa, South Central Asia and Southeast Asia who want to avoid pregnancy but are not using modern contraceptives report the major reasons they don’t use contraception include: concerns about health risks and side effects (23%), infrequent sex (21%), being postpartum or breastfeeding (17%), and opposition of their partner (10%). In other words, the currently available methods do not, necessarily, meet their needs. It is imperative that we continue to work to develop innovative technologies, both adaptive technologies that improve current methods and totally new methods to ensure women and men use and have access to a wide range of modern contraceptive methods.
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Last night, the Saving Lives at Birth partnership announced three award nominations for transition-to-scale grants that have the potential to save the lives of mothers and newborns in rural areas of the developing world at the time of birth. We couldn’t be more excited about the announcement.
The award nominees – a mobile technology initiative in Ghana, an HIV and syphilis testing device in Rwanda and a treatment to prevent newborn infections in Nepal – have provided the most compelling evidence that their innovative and promising solutions are ready to be tested on much larger platforms.
USAID Administrator Raj Shah made the announcement at the high-level Every Woman, Every Child reception hosted by Ray Chambers, the UN Secretary-General’s Special Envoy for Malaria and MDG Advocate. These $2 million grants will be implemented over four years. The partners – USAID, the Government of the Norway, the Bill & Melinda Gates Foundation, Grand Challenges Canada, and The World Bank – all congratulated the nominees for their ongoing efforts to reduce maternal and newborn deaths in rural areas of the world and encouraged them to keep going.
JSI, Columbia University, and Grameen Foundation – the latest Saving Lives nominees – are all eager to advance their work. Read the rest of this entry »
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Global maternal mortality has dropped by one third since 1990, but still every day an estimated 1,000 women lose their life in childbirth. For the past year, USAID, the UK Department for International Development, Australian Agency for International Development and the Bill and Melinda Gates Foundation have worked in partnership to accelerate progress in improving maternal and child health. Launched at last year’s UN General Assembly Summit on the Millennium Development Goals, the Alliance for Reproductive, Maternal, and Newborn Health has supported the UN Secretary-General’s Every Woman, Every Child effort.
As director of USAID’s Office of Population and Reproductive Health, I’ve seen firsthand how this unique partnership has enhanced our efforts to improve the lives of women and children in the countries we work. Through shared planning and funding, coordinated implementation, joint problem-solving, and joint learning, we’ve seen results that have far exceeded what any one organization could have achieved on its own. For example, in Ethiopia, more women will have access to contraceptive implants and the government will save an estimated $2 million per year because Alliance partners worked with manufacturers to reduce the price of reproductive health commodities.
And in Pakistan, Alliance members helped increase the number of trained community midwives from 2,795 in 2010 to 7,764 in 2011, promising to reduce maternal and newborn death rates. These are just examples from two of the ten countries in which the Alliance is focused on in its first year.
What makes the Alliance partnership different is that it brings added value, not added work, through smarter application of resources. Through our joint efforts, by 2015, the Alliance aims to contribute to:
- 100 million additional users of modern methods of family planning to reduce unmet need.
- 67 million more women giving birth with the help of skilled attendants to reduce the maternal mortality ratio.
- 80 million more infants exclusively breastfed through the first six months of life to reduce newborn mortality.
You can learn more about the Alliance’s work over the past year and our achievements in a one year progress report (pdf, 2.3mb) submitted this week to the UN Secretary-General’s Every Woman, Every Child effort. In the coming year, the Alliance intends to expand to include additional partners and countries.
The U.N. High Level Meeting on Prevention and Control of Non-communicable Diseases marks only the second time in history the UN has held a special meeting on a health issue: the first was for HIV/AIDS in 2001.
Non-communicable diseases (NCDs) represent an urgent and growing global public health concern. In 2008, NCDs — diseases such as cardiovascular disease, respiratory disease, cancer and diabetes — claimed the lives of more than 39 million people, according to the World Health Organization (WHO). And we know that the majority of poor people, the bottom billion, bear most of this burden in lower- and middle-income countries.
As the world’s epidemiology evolves, preventing NCDs will help to prolong life expectancy, reduce disability and extend opportunity. A healthier lifestyle delivers the biggest dividend.
The Agency’s significant investments in health systems strengthening (pdf, 3.15mb) underpin the foundation for integrated, country-led NCD prevention and control programs.
This means our current programs are building the foundation upon which future NCD efforts can be based. The same approaches that strengthen health workforces, ensure reliable supplies of vaccines and contraceptives, collect and analyze health information, and promote more effective governance, can also be adapted and applied to addressing NCDs.