USAID Impact Photo Credit: USAID and Partners

Archives for Health

Business Students Tackle Childhood Pneumonia in Uganda

A collaboration between USAID’s Center for Accelerating Innovation and Impact (CII) in the Global Health Bureau and the Kellogg School of Management at Northwestern University led to teams of business students from around the world competing on ways to reduce child deaths from pneumonia in Uganda.

The 11th annual Kellogg Biotech and Healthcare Case Competition brought together eleven teams representing nine business schools from the US, Canada, UK, and Mexico on January 25th in Chicago. This year’s winning team was from the Haas School of Business at the University of California, Berkeley and the runner-up from the University of Chicago Booth School of Business.

The winning team from the Haas School of Business, University of California, Berkeley.

The winning team from the Haas School of Business, University of California, Berkeley. Credit: Jason Brown

Thirty-two teams applied to participate from twelve different schools around the world. The teams invited to compete had impressive credentials; many of the participants worked at global healthcare companies and several had medical degrees.

Judges of the event were pharmaceutical executives who evaluated the teams’ business-minded supply and demand solutions. Pneumonia is the largest killer of children in the developing world and can lead to death if not correctly and quickly diagnosed and treated appropriately.

“This is business education at its finest,” observed Tim Calkins, clinical professor of marketing at Kellogg and one of the directors of the case competition. “In this competition we have teams of students working to address a major global health issue. In the process, they are learning an enormous about global health, team dynamics and the power of business concepts.”

The case was developed over the course of several months by students and professors at Kellogg in close collaboration with CII. Students performed research and interviews throughout Uganda.

Professor Calkins and Kara Palamountain, Director of the Global Health Initiative at Kellogg, then wrote the case outlining the many barriers to increasing the use of antibiotics in a country with limited resources. At the end of the case students are asked to propose solutions from several options within a given budget to maximize lives saved.

“This case forced students to think both analytically and creatively. The challenges are significant; it isn’t a case with a simple answer,” said Calkins.

CII actively looks to support the already strong work across USAID’s Global Health Bureau by engaging a range of new thinkers and perspectives, many from the private sector. This event demonstrated the value of seeking out these new perspectives; many of the teams proposed promising, well-structured, and feasible solutions based on frameworks and analysis from their business school curricula. Some of the teams will be invited to present their proposals to the Pneumonia Working Group based at UNICEF to inform ongoing global scale-up efforts.

Kellogg Professor Tim Calkins discusses the case following the competition

Kellogg Professor Tim Calkins discusses the case following the competition

Exposing business students to the challenges and opportunities in these developing markets now will likely benefit them in their future healthcare careers. Many countries in Africa and South East Asia are among the fastest growing pharmaceutical markets in the world. Calkins noted, “I was delighted to use a pharmaceutical related case from Africa, since this is where some of the greatest needs and opportunities will be found in the healthcare world.”

In addition to this competition, the case will be a permanent teaching tool in a global health course at Kellogg.

Schools represented include:

  • Carlson School of Management, University of Minnesota
  • Desautels Faculty of Management, McGill University (Canada)
  • Haas School of Business, University of California, Berkeley
  • IPADE Business School (Mexico)
  • Judge Business School, University of Cambridge (UK)
  • Kellogg School of Management, Northwestern University
  • Rutgers Business School
  • Stephen M. Ross School of Business, University of Michigan
  • University of Chicago Booth School of Business

Creating an AIDS-Free Generation through Science and Technology

Last year, the United States government provided testing and counseling for more than 57 million people through the President’s Emergency Plan for AIDS Relief (PEPFAR). The program enrolled more than four million men in voluntary medical circumcision programs and supported more than five million orphans and vulnerable children in countries with some of the highest rates of HIV and AIDS. These are just a few of the remarkable achievements that PEPFAR has made over the past decade—a small testament to the hard work of so many who are committed to and work tirelessly every day to achieve an AIDS-free generation. These great achievements, however, would not be possible without inspiring advances in science and technology.

Women can use this ARV-based vaginal gel to protect themselves against HIV. International Partnership for Microbicides

Credit: International Partnership for Microbicides

For the first time, the U.S. Agency for International Development (USAID) – through its Office of Science and Technology - has created an awards program that embodies the agency’s commitment to supporting innovation in science and technology applications. The Pioneers Prize pays tribute to technological advances that offer innovative solutions to critical issues facing global development. By utilizing science, technology and innovation, USAID is working toward its mission to end extreme poverty and promote resilient democratic societies.

As a key implementer of PEPFAR, USAID’s work in HIV and AIDS was well-recognized with this year’s Pioneer Prizes. Awarded three grand prizes, the Office of HIV/AIDS, along with its partners, has been able to share the transformative nature of its work with the rest of the global health and development community.

Among the grand prize winners is the Delivery Team Topping Up (DTTU) program, which uses vendor-managed inventory principles to “top up” supplies, such as condoms and HIV test kits, at public health facilities. To date, the program has serviced 1,800 clinics in Zimbabwe.

The PLACE Method, also a recipient, applies new technologies in HIV and STI testing, spatial mapping, epidemiologic theory and empiric evidence to address the problem of obtaining valid information that can prevent the spread of infections in sex workers and injecting drug users. It targets geographic areas with high rates of infection and the venues where people at high-risk meet. It then uses low-cost GPS receivers and Google Earth to identify gaps in prevention programs.

Finally, Tenofovir gel, a vaginally applied antiretroviral microbicide used to prevent HIV infection, gives women an alternative method to keep themselves safe during unprotected sex. Tested in the CAPRISA 004 trial, Tenofovir gel reduced HIV acquisition by an estimated 39 percent overall and by 54 percent in women with high gel adherence. While still awaiting the results of an ongoing confirmatory trial, regulatory approval, and scale-up, the CAPRISA 004 trial demonstrated for the first time that a microbicide has the potential to drastically reduce HIV infection for women.

With these awarded innovations, it is clear that USAID’s work toward HIV and AIDS prevention through PEPFAR remains essential to achieving our mission of ending extreme poverty. With the commitment, innovative spirit, creativity and hard work of our partners, USAID is continuously using science and technology in unprecedented ways to make great strides toward an AIDS-free generation.

Let’s Stand Up For Inclusion, Not Exclusion

The stigma and discrimination faced by people living with HIV/AIDS continues to be a roadblock for access to critical prevention and care. Yet every day I see significant steps that are being taken to overcome this obstacle, especially efforts led by USAID.

I was invited to speak at the USAID-funded Panos Caribbean media launch of its latest publication, “Speaking Out! Voices of Jamaican MSM.” This publication is a compilation of oral testimonies from the men having sex with men (MSM) community in Jamaica and an important product by the Panos Caribbean/World Learning project which works to strengthen and improve the livelihoods of these men. Through this publication, Panos Caribbean develops public awareness about the issues affecting the MSM community and promotes through the media, tolerance and accountability for MSM who are impacted by HIV/AIDS.

Denise A. Herbol

Denise A. Herbol

The social complexities surrounding the MSM community in Jamaica is often polarizing to the public.  There is serious stigma attached to any activities by this community. This is compounded by the fact that HIV remains a complex issue among the most-at-risk populations in Jamaica, including the MSM community. Current statistics on HIV prevalence rates in Jamaica are 1.7% in the general population, or roughly 32,000 persons living with AIDS. Figures are significantly higher in a number of high risk groups: for the MSMs, the prevalence rate is 32%, which in many cases can be directly attributed to the stigma, discrimination and fear of violence or legal sanctions.

In an effort to achieve an AIDS-free generation, breaking down the barriers for all individuals is essential. With support from the President’s Emergency Plan for AIDS Relief (PEPFAR), USAID is allocating significant resources to reach populations most at risk for transmitting or becoming infected with HIV/AIDS. PEPFAR seeks to promote an enabling environment of supportive laws, regulations, policies and social norms in order to facilitate meaningful access to HIV services for these populations at both the facility- and community-level.

USAID, in partnership with Panos, is leading positive efforts to promote tolerance and accountability in response to HIV through constructive use of the media.  Panos continues to equip these men with effective tools to expand their voices and concerns so that they can be heard across Jamaica.

Progress will continue to be hampered until we include all people to achieve an AIDS-free generation.  Each of us must do our part to promote inclusivity, celebrate diversity, and eliminate stigma and dehumanizing stereotypes.

Adventures in Wildlife Screening: Monitoring Wildlife Farms to Prevent Disease

Ever tried porcupine? How about wild boar? While such unusual fare may not be to everyone’s taste, there is a huge demand for wildlife meat in Vietnam, and farming of wildlife for human consumption is becoming more common. This brings wildlife into close proximity with humans and domestic livestock, resulting in a greater risk of disease crossover. Approximately 75 percent of the diseases which affect humans were sourced from animals, and of these, 72 percent originate from wild species. Recognizing the potential threat of new pandemics, USAID partners with Vietnam’s Ministry of Agriculture and Rural Development to build capacity for monitoring diseases in wildlife farms.

A Predict project trainer advises how to properly collect samples at a wildlife farm in Vietnam’s Dong Nai province. Photo credit: USAID Vietnam/Laurel Fain

A Predict project trainer advises how to properly collect samples at a wildlife farm in Vietnam’s Dong Nai province.
Photo credit: USAID Vietnam/Laurel Fain

I recently participated in a surveillance training conducted by USAID’s Predict project in Dong Nai province, one of Vietnam’s top wildlife farming provinces with more than one thousand wildlife farms housing hundreds of individual wildlife species. Myself, wildlife farmers and participants from the Department of Forestry Protection (Vietnam’s park rangers) and the Department of Animal Health (farm inspectors), whose job it is to inspect farms and restaurants to make sure they’re not illegally farming or killing endangered species, gathered to learn about the most common and dangerous diseases affecting wild animals when they are enclosed, how to protect ourselves and the public from contamination when monitoring farms, and proper biosafety precautions that should be in place on livestock farms. We also learned how to collect and prepare samples for analysis by the regional laboratory. I was struck by the enthusiasm and commitment of the training participants, who all demonstrated a strong understanding of the importance of this work in protecting against infectious diseases.

As part of the training, we went out into the field to practice our new skills. My team visited one farm that produced non-endangered species of wildlife to be served in the family’s restaurant next door, including wild boar, turtles, porcupines, civets, snakes, and rats. Farm owner Mai Thi Thanh was very interested in hearing advice from the team on improving her systems, and expressed pride and concern about keeping her stock healthy. The trainees excitedly collected samples from every animal present, with some expert supervision from our trainers. The second farm we visited belonged to one of our own group of trainees, who was eager to show us his farm and to hear our suggestions for improving hygiene on his farm. He raised mouse deer, porcupine, and wild boar that had been interbred with domestic breeds.

Finally, back to classroom to compare notes: between both groups, we collected 162 samples from bears, several types of primates, rats, two species of porcupines, boars, deer, and civets. We learned from the regional laboratory specialists how these samples will be analyzed for a wide variety of infectious diseases, and brainstormed on future training needs and next steps.

I feel quite fortunate to have been able to observe this process up close, and could honestly congratulate the group on their dedication to keeping the rest of us safe from emerging pandemic threats. The participants from the Animal Health and Forestry Protection departments can now add this health feature to their normal surveillance for illegal wildlife trade. We’ll all be very interested to hear the results of the tests done on these samples and on the more than 5,400 samples previously collected by the USAID-supported project in Vietnam this year.

Read more about USAID Vietnam’s work to prevent infectious diseases.

Empowering Moms Through mHealth

This blog post originally appeared on The Huffington Post.

My heart smiled the moment the four women entered the meeting room where I had been waiting. I stood to greet them and the babies they carried, eager to hear their stories. The young mothers sat in the chairs across from us and soon the babies were all up on the table, their proud moms making certain that we could see their precious little ones. The youngest baby was 4½ months old, the oldest 14 months. They were all adorable.

USAID harnesses the power of mobile phones to achieve results.

Credit: USAID

The conversation was lively. One young mother, Letty, described her pregnancy. Living in Johannesburg, she was far from her home country, Zimbabwe, and far from her mother,aunts,grandmother or anyone she trusted to give her the advice and information she craved.The cost of phoning these trusted relatives was prohibitive, so Letty found support when she enrolled to receive text messages via her mobile phone from MAMA, the Mobile Alliance for Maternal Action. “I’m here. I’m alone. The SMS messages helped me a lot. They helped me feel that someone is there,” Letty told me.

MAMA South Africa was launched with the support of global partners USAID, Johnson & Johnson, the United Nations Foundation, the mHealth Alliance, and BabyCenter. In addition, Vodacom joined the South Africa partnership, offering MAMA’s mobile website, askmama.mobi, free-of-charge to its 25 million customers. The goal of MAMA is to deliver health messages that moms need at specific milestones during pregnancy and during the first year of their baby’s development.

An existing South African mHealth partnership helped bring MAMA South Africa to life: Cell-Life, Praekelt Foundation and WRHI at the University of the Witwatersrand. Through MAMA, new and expectant mothers receive messages that address important topics such as nutrition during pregnancy, how to prepare for childbirth and recognizing signs of trouble which, if unheeded, can lead to difficulties in labor and delivery.

I sat across from these four women who had benefited from the MAMA partnership and listened carefully as they described their experiences. For these mothers, the SMS messages calmed their fears. One of the women, Faith, said that she had enrolled in the program when she was five months pregnant and had found reassurance in the MAMA texts. “The messages sometimes tell you, ‘This is normal’ and then you don’t worry,” she said. Letty added that when her baby was up all night, she received a message that said “Your baby may be teething” and this convinced her that nothing was wrong with her baby.

Another mom, Ntando was seven months pregnant and already had one child when she enrolled in the MAMA program. On the day of our meeting, her baby boy was already five months old. “The way we raised the first one is different from the way we raise this one.” She looked at her son and then added a comment about MAMA. “They’ll help me raise this one,” she said.

The third woman, Memory, signed up to receive MAMA messages when her baby was five months old. She said that she appreciated the help in “how to say ‘no’ to my son.” Memory also told us that she found the messages so helpful that she shares them with a friend who does not have a phone.

Faith visits the MAMA website with her husband and they learn together. Her praise for MAMA struck a particular chord for me – “I like them because they don’t just take care of the baby, they also take care of the moms.”

As our time together drew to a close, I thanked Letty, Memory, Faith and Ntando for taking the time to meet with us. Many of their comments have stayed with me, but none more than this one: “You feel like you are alone, and these SMS messages make you feel loved.”

The MAMA partnership is based on the power and promise of mobile phones in empowering mothers to make healthy decisions for themselves and their babies. What a wonderful added – and unexpected — benefit that MAMA also makes moms feel loved.

How Data Drives Decisions at USAID

This post originally appeared on Impact magazine

Impact magazine interviews Ellen Starbird, Director of the Office of Population and Reproductive Health, USAID.

IMPACT: How does USAID assess the effectiveness of its health investments?

ELLEN STARBIRD: USAID assesses the effectiveness of its health interventions by looking at trend data in health indicators that are related to the programmatic interventions that we support. For our family planning and reproductive health programs, contraceptive prevalence, improvements in birth spacing and increasing age at marriage are all measured by surveys, including the Demographic and Health Survey. Changes in these indicators can be related to our investments. USAID uses evaluation findings to inform decisions, improve program effectiveness, be accountable to stakeholders, and support organizational learning. Research tests the effectiveness of possible interventions and is used to identify high-impact practices for our family planning and reproductive health programs. Pilot studies and introduction studies test the effectiveness of interventions in specific contexts or countries. Those interventions that best “fit” a particular context (i.e., level of program development, epidemiological context, resources available, etc.) are selected.

IMPACT: USAID has a long history of using a “logical framework of results” to monitor health programs. Could you describe this framework and how it is used to facilitate decision-making?

ES: The logical framework is an important part of project design, as it identifies and briefly describes the problem the project intends to address and the expected outcomes of the project. The framework includes inputs, outputs, outcomes and impact. USAID uses Project Monitoring Plans to monitor at each step in this process. These plans examine answers to questions such as: Are inputs being delivered as planned? Are inputs leading to the anticipated outputs? Are outputs leading to the desired outcomes? If not, is the problem failure to deliver the input, or is the problem that inputs are delivered but for some unanticipated reason are not leading to the expected outcome?

IMPACT: USAID recently conducted a thorough review of its evaluation practices and developed a new policy on evaluation to guide the organization. What does USAID want to learn through implementation of this policy, and what does this mean specifically for health programs?

ES: USAID conducted this review to ensure that effective evaluations were taking place and guiding programmatic decisions. There was a concern that over the last several years fewer evaluations were being done, and the agency wanted evaluations to play a more prominent role in program decision-making. By implementing the new policy, USAID hopes to get a better understanding of the success with which its programs are implemented (process evaluations) and the impact of those programs (impact evaluation). This means that our health programs will put more focus on the implementation and impact of its projects, and that this information will guide future programming decisions. Ultimately, this creates a quality-improvement process, capturing experience to develop increasingly effective programs.

IMPACT: Can you share a recent example of receiving surprising results from work our office has been supporting? How did these results shape the decisions you and your colleagues had to make?

ES: In recent years, results from the DHS, especially those from Africa, showed an unexpected level of interest in and demand for long-acting contraceptive methods. These findings led us to expand our efforts to make these methods more widely available in an acceptable, accessible and affordable ways. Another example is that survey and qualitative research have identified a substantial demand for contraceptive information and services among youth in developing countries. M-Health is providing access to information on methods and source of supply to youth via electronic communication. Information collected on these programs indicated that youth are interested in a wide variety of methods, including natural methods, injectables and longer-acting methods.

IMPACT: What are some challenges you anticipate in generating meaningful data for decision-making post-2015?

ES: As we continue to make progress, what and how we measure will also have to change. In the area of family planning and reproductive health, for example, we’ll need better measurement around costs, as well as better understanding of how to measure choice and rights. The current data collection mechanisms in place will need to be adapted for such advances, or new ones will need to be developed.

Webinar to Highlight How Extension, Technology, and Behavior Change Combine to Improve Agriculture and Nutrition

This blog post is by John Nicholson, SPRING Knowledge Management Manager, JSI Research and Training Institute, and Kristina Beall, SPRING SBCC Project Officer, The Manoff Group.  SPRING is funded by the United States Agency for International Development (USAID) and helps to strengthen country efforts to scale up high-impact nutrition practices and policies.

Leveraging the power of social capital and technology, Digital Green has pioneered the use of low-cost, community videos as an agriculture extension tool that allows farmers to record and share successful techniques with other farmers in their community. The work began as a part of Microsoft Research India’s Technology for Emerging Markets team in 2006, eventually spinning off into the non-governmental organization (NGO), Digital Green. This young, dynamic NGO has already helped produce over 2,600 videos that have been shared with more than 150,000 rural households across India, Ethiopia, Tanzania, and Ghana. Digital Green’s grassroots approach — producing context-specific videos by the community and for the community—improves the efficiency of existing agricultural development efforts by a factor of ten times, per dollar spent.

Example of Digital Green video production

Example of Digital Green video production

USAID’s global nutrition project, Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING), is partnering with Digital Green in Odisha, India, to test the feasibility of adapting this video-based methodology specifically to promote high-impact maternal, infant and young child nutrition, and hygiene practices. Under the SPRING/Digital Green model, a local NGO partner – VARRAT – has worked in Keonhjar District of Odisha to produce 10 videos that showcase key nutrition and hygiene behaviors, often celebrating early adopters of these important nutrition practices. Videos are shared among small community women’s groups on a weekly basis using portable, battery-operated pico projectors. A robust suite of analytic tools, coupled with feedback from community members, then provides Digital Green and its partners with timely data to better target both production and distribution of videos. The collection of 10 nutrition- and hygiene-specific videos produced under this collaboration can be viewed along with the corresponding adoption analytics on the Digital Green website.

On December 17th, SPRING will host a webinar examining the Digital Green work through a multispectral lens, focusing on their unique approach and the growing partnership to scale-up technology to improve both agricultural and nutrition outcomes. Visit the SPRING website for more information and to register for the webinar.

This webinar is part of SPRING’s continuing collaboration with the Bureau for Food Security and Bureau of Global Health to identify promising approaches to better link nutrition and agriculture.

Saving Lives of Children, Unburdening Economies & Shrinking the Malaria Map (for Good)

Global efforts to control and eliminate malaria have saved an estimated 3.3 million lives since 2000, reducing malaria mortality by half in sub-Saharan Africa, according to the World Malaria Report 2013 published by the World Health Organization (WHO).  Nearly 70% of these lives saved were in the 10 countries with the highest malaria burden, and among children under 5 years of age – the group most affected by the disease.

A girl is protected from malaria by an insecticide treated net.  Photo by Maggie Hallahan

A girl is protected from malaria by an insecticide treated net.
Photo by Maggie Hallahan

We celebrate the dramatic progress that has been made in reducing the burden of malaria in sub-Saharan Africa.  This progress is due to partnership — of national governments, international donors including the U.S. and U.K., The Global Fund, The World Bank, the private sector, non-governmental and faith-based organizations, local leaders, civil society, philanthropists, and many others.  But host country governments, the President’s Malaria Initiative (PMI), and The Global Fund deserve special praise for fueling this remarkable progress against malaria.

The United States malaria program through PMI continues to be a “game changer” in the global fight against malaria.  Launched in 2005 by former President George W. Bush, PMI has been embraced and expanded by the Obama administration. A collaborative interagency effort that is led by USAID and implemented together with the Centers for Disease Control and Prevention, PMI has supported malaria activities through more than 200 nonprofit organizations, approximately one-third of which are faith based. These groups often have strong and effective bases of operations in underserved rural areas where the burden of malaria is greatest.

In the eighth year of the initiative, the financial and technical contributions made by the USG are major catalysts in the remarkable progress that has been achieved in many countries to reduce the devastating burden of malaria on child mortality.

The Global Fund and PMI’s commitment to effective coordination maximizes our impact on the global malaria burden. Each program has its own unique strengths which contribute to the effectiveness of the partnership and significant success on the ground.

While we celebrate the good news revealed in the WHO World Malaria Report which states that the risk of malaria is declining and more children are surviving, the gains are fragile and could be reversed without continued support. More needs to be done. Millions of people with suspected malaria still do not receive a diagnostic test, and many people with confirmed infections do not receive appropriate treatment with a quality assured antimalarial drug.

Our goal must be to continue to shrink the malaria map and ensure our successes are not reversed, even as we continue to face challenges such as artemisinin-drug resistance and insecticide resistance. In malaria endemic countries, we must leverage higher domestic investments from the public and private sector. And we must engage regional banks to support investment for regional Global Malaria Action Plan needs.

We must continue to engage the private sector in endemic countries in sub-Saharan Africa to identify opportunities for corporate engagement in support of domestic malaria prevention, control, and elimination needs.  And we must continue to use smarter and more creative financing to maximize the impact of our investments and promote innovative approaches to address key bottlenecks in the development, introduction, and scale-up of global health technologies and interventions.

Investing in malaria has a powerful return on child survival. Healthy kids are at the heart of every nation’s prosperity and its sustainable development. Healthy children are more likely to live longer, stay in school, and be productive members of their society, generating benefits that reverberate through future generations.

In the Washington Post, Michael Gerson wrote, “In much of sub-Saharan Africa, the American image is now defined by the Peace Corps, PMI and by PEPFAR, the American AIDS relief plan. It is a form of influence that is hard to measure or weigh. But people remember when you help to save their children.” I can attest to this powerful truth.

Empowering Health Workers to Improve Service Delivery in Uganda

Agnes Masagwayi has a fierce determination to give her community the best possible care. But as a clinical health officer in Mbale District, Uganda, she knows how difficult it can be.

Agnes Masagwayi. Photo Credit: Sarah Dwyer, IntraHealth International

Agnes Masagwayi. Photo Credit: Sarah Swyer, IntraHealth International

Until recently, Agnes’s working conditions were very challenging. Her health facility often lacked running water. Essential drugs ran out. Space for maternity care was so limited that women often had to deliver their babies on the floor. And there weren’t nearly enough health workers to meet the community’s demand for care. (In Uganda there are only about 14 doctors, nurses, and midwives for every 10,000 people, yet the World Health Organization recommends a minimum threshold of about 23 per 10,000 people.)

However, working conditions started to improve when Agnes and her district health officer joined 18 other districts in the Human Resources for Health (HRH) Leadership and Management Program, a six-month course aimed at improving health services in Uganda. This training was just one part of Uganda’s efforts to improve health services by focusing on health workers.

Two USAID-supported projects led by IntraHealth International—the Uganda Capacity Program and CapacityPlus—lent a hand. In addition to improving health workforce leadership and management, the projects are working with country stakeholders to strengthen health workforce information and use the resulting data to advocate for more health workforce funding.

Agnes provides integrated HIV and family planning counseling to client. Photo credit: Carol Bales, IntraHealth International.

Agnes provides integrated HIV and family planning counseling to client. Photo credit: Carol Bales, IntraHealth International.

These efforts are paying off. Not only did the Government of Uganda allocate funds to hire more than 8,000 new health workers across the country, thanks to successful advocacy, but existing health workers like Agnes are making key improvements in their facilities. Newly empowered by the leadership training, Agnes realized that “really it is ourselves who need to plan, prioritize, know what problems we have and the available opportunities for addressing them.” Here are a few of the changes Agnes and her colleagues made at their facility:

  • Running water is always available. “We acted as a team and lobbied with the district and partners,” Agnes says, proudly pointing to some big tanks outside the clinic.
  • A new maternity ward provides space for women to deliver. Agnes and her team prioritized the construction of a building to accommodate mothers.
  • Drug management helps prevent stockouts. A new system provides key data for Agnes and her colleagues. “You can forecast for your drugs using the available data,” she says.
  • New housing is available for health workers. Nearby housing constructed by the district will help attract new health workers to the area.
  • Service delivery improved. ”Client care has improved in this facility so much,” Agnes beams.
Happy clients at Agnes’s facility. Photo Credit: Carol Bales, IntraHealth International

Happy clients at Agnes’s facility. Photo Credit: Carol Bales, IntraHealth International

The district as a whole has made progress. Out-patient services have doubled, and over half of all mothers in the district (56 percent) are now delivering in the health facilities, up from 39 percent. The district even rose in the national rankings for health service delivery, from 22 to 6 (out of 111 districts in the country in 2012). And perhaps one of the greatest successes is that more health workers have joined Agnes. “The district has recruited 205 health workers,” she says.

Meet Agnes in our new video, “That’s Improvement!”: Uganda Focuses on Health Workers. Check out our special website section to learn more and access tools that Uganda has successfully used. And join the conversation—follow CapacityPlus on Twitter and like us on Facebook.

LGBT Rights in Jamaica: A Conversation with Maurice Tomlinson

From November 25th (International End Violence Against Women Day) through December 10th (International Human Rights Day), USAID joins the international community for 16 Days of Activism Against Gender Violence. During this time IMPACT will highlight  USAID’s work to combat gender-based violence.

Regina Jun, Gender Advisor for the Bureau of Latin America and the Caribbean, spoke with Maurice Tomlinson, who is an Attorney-at-Law, law lecturer on sexual rights, and HIV/AIDS advocate. He is leading an initiative, on behalf of AIDS-Free World, to have the region’s anti-sodomy laws repealed.

In 2012, Maurice was awarded the inaugural David Kato Vision and Voice Award. Maurice is featured in the Abominable Crime, a documentary that explores the culture of homophobia in Jamaica. 

Photo of Maurice Tomlinson. Credit: Maurice Tomlinson.

Photo of Maurice Tomlinson. Credit: Maurice Tomlinson.

Q1: How have the situations for the LGBT persons changed in Jamaica?

For the past 4 years, AIDS-Free World has been working to eliminate homophobia in Jamaica. This includes working with civil society groups on the island to document and respond to human rights violations against the local LGBT population. In that time, we have seen a near 400% increase in the number of reported homophobic attacks. In the last few months alone there have been several brutal assaults, including murders and home invasions.

Q2: Why is the violence against LGBT persons such an important issue in the Caribbean?

Violence against LGBT persons in the Caribbean has been identified as a significant reason that the region has the second highest HIV prevalence rate in the world. This violence drives LGBT citizens underground, away from effective prevention, treatment, care and support interventions. Jamaica, where homophobic violence is most acute in the region, has the highest HIV prevalence rate among men who have sex with men (MSM) worldwide at 33%.

Q3: What projects are you currently working on in the Caribbean?

I am working on several court cases challenging anti-gay laws across the region. These include the first ever domestic challenge to Jamaica’s anti-sodomy law, as well as a case before the region’s most senior tribunal, the Caribbean Court of Justice, to strike down the sections in the immigration laws of Belize and Trinidad which ban the entry of gays.  As part of a team, I conduct LGBT sensitivity training with police across the region and also train civil society groups on how to effectively document and report human rights violations against LGBT citizens.

Q4: What are some of the positive changes you have seen so far?

We have seen unprecedented editorial support for LGBT rights by the major newspapers across the Caribbean. There have also been positive statements from politicians — especially Minsters of Health — who underscore the need to repeal homophobic laws in order to address the region’s HIV epidemic. Mainstream civil society groups are also taking greater interest in and actively advocating for the human rights for LGBT persons.  Further, the polling pioneered in the region by AIDS-Free World on the levels and drivers of homophobia points to a small but important movement towards greater tolerance for LGBT citizens.  Finally, while the number of police attacks against LGBT persons has decreased, they still occur too frequently, especially involving LGBT citizens from the lower socio-economic strata.

Q5: In your opinion, what can be done to increase acceptance of greater sexual diversity in the Caribbean?

The visibility of LGBT persons will help to dispel some of the myths and misconceptions about sexual minorities. Once persons realize that someone they know and quite possible care deeply about is gay, this will help to humanize the issue of homosexuality.  It is easier for people to hate what they do not know. That is why AIDS-Free World has produced and tried to air tolerance ads showing positive images of LGBT persons.

Furthermore, political leaders continue to be very influential in the young nations of the Caribbean region. They can help to encourage more rational discussions about homosexuality by making unequivocal statements condemning homophobia.  Such statements would help neutralize some of the more virulent anti-gay pronouncements being disseminated by powerful religious fundamentalists across the Caribbean.

Like Maurice, USAID is committed to advancing the rights of the LGBT community, including providing support to local LGBT advocacy organizations to extend democratic governance and respect for human rights to all individuals, and creating blueprints for increased access of comprehensive healthcare services to transgender and transsexual persons. Learn more about USAID’s work against gender-based violence

Page 4 of 57:« First« 1 2 3 4 5 6 7 »Last »