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Archives for Health

Repairing Obstetric Fistula in Nigeria

USAID-supported fistula services in Nigeria began in 2007. USAID’s Fistula Care project works with six hospitals to prevent and repair fistula and/or to train health professionals about fistula case management.

Obstetric fistula is the result of prolonged labor without prompt medical intervention, causing a hole in a woman’s birth canal which leaves her with chronic incontinence and in many cases, the loss of the baby.

Thirty-two-year-old Joy Emmanuel lived with fistula for half of her life. Long after giving up hope of a remedy, she heard on the radio that women could receive fistula surgery at the Faridat Yakubu Fistula Center, in Gusau, Nigeria. Emmanuel’s baby survived, but she was left with the serious medical condition. Women with fistula are stigmatized among their peers and by society in general.

USAID is supporting increased access to quality family planning and reproductive health services. Maternal and child health efforts focus on birth preparedness, maternity services, and obstetric fistula repairs.

The Nigerian National Strategic Framework for fistula prevention and control estimates that between 400,000 and 800,000 women are affected. Nearly half of worldwide fistula cases occur in Nigeria, with between 50,000 to 100,000 new cases each year. USAID is working to address the challenge of obstetric fistula in five states in northwestern Nigeria. During the project’s first three years 2,822 women received fistula repair surgery.

Increasing the Involvement of Men in Family Health

Reducing maternal deaths by 75 percent throughout the world by 2015 will take the involvement of men in countries where it matters most. Many of the countries where USAID works are male dominated cultures. To improve maternal health outcomes for women in developing countries, men must be equal partners since they are the decision makers about health care in the family. These decisions include determining family size, timings of pregnancies, and whether women have access to health care.

In programs around the world, USAID works to integrate men into maternal health activities at the community level. One example is through USAID’s Maternal and Child Health Integrated Program (MCHIP). Special efforts are made to emphasize men’s shared responsibility and promote their active involvement in responsible parenthood, sexual and reproductive health. This means reaching out to community elders, leaders, and religious groups – entreaties that could be rejected because of traditional cultural values and perceptions that maternal health is the responsibility of women only.

In some areas of Nigeria— where a woman can’t leave the home without her husband’s permission— USAID sends in male motivators, community volunteers trained in communications, to help local men achieve their vision for a healthy family.

“In many of the countries where we work, these are male dominated cultures,” said Lily Kak, senior maternal and neonatal health advisor in USAID’s Bureau for Global Health for a feature in Frontlines. “We need to involve men in our programs since they are the decision makers about health care in the family.” These decisions include determining family size, timing of pregnancies, and whether women have access to health care.

To improve maternal health outcomes for women in developing countries—one of the targets of the United Nation’s Millennium Development Goals—men must be equal partners. “Men need to see the advantages for themselves,” Kak said.

African First Ladies Fellowship to Strengthen Leadership on Health and Social Ills

Today I participated in the first RAND African First Ladies Fellowship Program workshop, hosted in partnership with American University.  The fellowship program, together with Women’s Campaign International, is working to strengthen the capacity of Africa’s first ladies and their offices to address health and social problems across Africa.

Participants include chiefs of staff and other advisers to first ladies from Angola, Burkina Faso, Kenya, Lesotho, Mozambique, Namibia, Sierra Leone, Tanzania and Zambia.

Over a two-year period, first ladies and fellows will develop and implement a plan to address one of their nation’s top challenges, such as maternal and child health, women’s issues or education.

Drawing on experience with the African Leaders Malaria Alliance where 26 African Heads of State are positioning their countries to achieve universal net coverage and save millions of lives, I discussed the import policy and advocacy role first ladies can influence with focused participation. While not having statutory authority, African first ladies can raise the profile, funding and country commitment of key areas like improving the health status of women and removing barriers that could prevent women from accessing life-saving health services that are particular to women, such as assisted deliveries for her or her children and family planning for healthy timing and spacing of births.

During the four-day workshop, other presenters included Melanne Verveer, U.S. ambassador-at-large for global women’s issues; Jocelyn Frye, deputy assistant to President Obama for domestic policy and director of policy and projects for First Lady Michelle Obama; Anita McBride, chief of staff to first lady Laura Bush from 2005 to 2009 and currently executive in residence at American University’s School of Public Affairs; and Marjorie Margolies, president and founder of Women’s Campaign International.

USAID Celebrates World Contraception Day

Submitted by Ryan Cherlin

Every year on 26 September,  World Contraception Day draws attention to the importance of contraception and the role of the individual. This year’s World Contraception Day theme is “Take Responsibility”.

Choosing whether to use contraception is a deeply personal decision that each individual is responsible for making.  USAID works with countries and communities to develop strategies that ensure every individual who wants to use contraceptives is able to receive them for family planning (FP), and HIV/AIDS prevention purposes.

Pakistani mother Mozamman holds her 2-year old twin sons Amanollah (R) and Samiollah (L) at her house in a poor neighborhood of Islamabad on July 21, 2010. Pakistan has the sixth largest population in the world. Photo Credit: Behrouz Mehri/AFP

Modern contraceptive methods offer tremendous benefits through improved health and economic well-being.  They help ensure that every pregnancy is wanted, and subsequently reduce the number of abortions that result from unintended pregnancies, and also reduce the risk of spreading disease.  Ensuring the availability of these commodities is a priority not only because of the health and economic benefits, but also because of changes in demographic trends and the increasing demand for family planning. To ensure that women and men can choose, obtain, and use the contraceptive method they want, programs must be responsive to the needs of each individual client. Our programs work to ensure there is a wide range of methods available to choose from that suit each individual’s unique needs and lifestyle.


From the Field

In Albania, we are promoting World Contraception Day (September 26th). USAID’s two maternal and child health programs have partnered with Albania’s Institute of Public Health to raise awareness of using modern contraception to mark World Contraception Day. USAID will send out 20,000 text messages to Albanian adults 18-35 years old with the message, “It’s your life, it’s your choice – Use modern contraceptive methods to avoid unplanned pregnancies”. According to the 2009 Demographic Health Survey, Albania has one of the lowest levels of modern contraceptive use in the world; with only one in nine married women age 15–49 using a modern method of family planning. Modern contraceptives not only prevent unwanted pregnancies but are better for women’s reproductive health.

In Paraguay, we will recognize 90 municipalities improved performance under a local government assistance program. Since 2006, around 100 municipalities in Paraguay have been participating in a performance improvement process developed with local NGOs and the support of USAID. The project, called MIDAMOS (Let’s Measure in Spanish) aims at having municipalities open their institutions to to evaluate their performance and identify areas that must be improved in order to offer better services to citizens.

In West Sumatra, Indonesia, we will commemorate the Padang Earthquake Anniversary on September 28th. We will hold a brick laying event as part of the first anniversary of the West Sumatra Earthquake reconstruction efforts in which we have partnered with both the Australian and Indonesian Governments to support a large education program. The event will be located in a primary school in Kota Padang. USAID/ AusAID have committed to rebuild 34 primary schools in the area.

USAID @ UNGA: Malaria Efforts Are on Track to Meet to Reduce Malaria Deaths to Near Zero by 2015

By Rear Adm. (ret) Tim Ziemer, U.S. Global Malaria Coordinator

Prominent leaders in global health and development joined several African heads of state yesterday to announce new commitments to accelerate progress toward ending deaths from malaria, a disease that claims the lives of more than 850,000 Africans each year.

Participants included: Prime Minister Mizengo Pinda of Tanzania; Minister of Information Ibrahim Kargvo representing President Ernest Bai Koroma of Sierra Leone; President Ellen Johnson Sirleaf of Liberia; Andrew Mitchell from the UK representing Deputy Prime Minister Nick Clegg; Bill Gates, Co-chair and Trustee, Bill & Melinda Gates Foundation; Margaret Chan, Director-General, World Health Organization; Robert B. Zoellick, President, the World Bank Group; Michel Kazatchkine, Executive Director, the Global Fund to Fight AIDS, Tuberculosis, and Malaria; Ray Chambers, U.N. Secretary-General’s Special Envoy for Malaria; and Dr. Ezekiel J. Emanuel, special advisor for health policy at the White House’s Office of Management and Budget.

I had the honor to attend and read a letter from Secretary of State Hillary Clinton to participants and members of the African Leaders Malaria Alliance (ALMA). In her letter, she wrote … “African Heads of State have stood at the forefront of promoting malaria control for more than a decade.  I commend members of ALMA for leading by example. You are on the leading edge of health in development, in your countries and across the world.  It is vital that you share your experiences with the entire global health community.  Working together we will achieve better health outcomes and sustain those gains for many years to come.

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USAID @ UNGA: International Alliance Launched to Support Country-Led Advances in Reproductive, Maternal and Newborn Health

For the past ten years, the UN Millennium Development Goals have provided a blueprint to build stronger nations by setting aggressive goals from halving extreme poverty to significantly reducing maternal and child mortality to promoting gender equality.  The ambitious agenda and relatively short time period galvanized unprecedented collaboration among governments, international organizations and private partners to achieve results by the year 2015.

With five years remaining until the target date, new alliances are being formed to ensure real progress is made.  Today the U.S. Secretary of State Hillary Clinton, U.K. Deputy Prime Minister Nicholas Clegg, Australia Foreign Minister Kevin Rudd, and Melinda Gates, co-chair of the Bill & Melinda Gates Foundation announced a five-year public/private global alliance to contribute to the goal of reducing the unmet need for family planning by 100 million women, expand skilled birth attendance and facility-based deliveries, and increase the numbers of women and newborns receiving quality post-natal care by 2015.

The Alliance will specifically address aspects of Millennium Development Goals (MDGs) 4, Reduce Child Mortality,and 5, Improve Maternal Health,where progress has been especially slow. Currently, it is estimated that more than 200 million women want to use contraceptives but don’t have access. In addition, only half of the 123 million women who give birth each year receive the antenatal, delivery and newborn care they need; and progress in reducing deaths has been slower for newborn deaths than for deaths among children ages one month to five years.

The Alliance includes the U.S. Agency for International Development (USAID), the UK Department for International Development (DFID), The Australian Agency for International Development (AusAID), and the Bill & Melinda Gates Foundation.

Watch Karin Slowing Umaña, Secretary of Planning and Programming, Republic of Guatemala, and Hon. Prof. David Mphande PhD, Minister of Health, Malawi, talk about maternal and child mortality in their respective countries and how the Global Health Initiative is a key partner towards meeting MDGs 4 & 5.

USAID @ UNGA: Addressing the Global Water and Sanitation Challenge

Submitted by Chris Holmes

This morning at an event at the UN Summit titled, “Addressing the Global Water and Sanitation Challenge: The Key to the MDGs,”  USAID Administrator Dr. Rajiv Shah discussed the United States’ efforts and renewed attention to ensure water security world-wide. Perhaps no single issue is as important to achieving all of the MDGs as water and sanitation.

Today, one and a half million children die each year from preventable water and sanitation–related diseases. Water scarcity is becoming a growing impediment to food security and economic growth; Floods and droughts continue to kill thousands and displace millions; and there are increasing signs that water is becoming a greater factor in violent conflicts throughout the world.

At this year’s summit, USAID will rededicate itself to building a water-secure future – a future where people have the water they need, where they need it, when they need it. A future where no child dies from a water related disease, where food security and economic growth are not limited by the availability of water resources, and where no one has to fight to secure the water they need for their families.

1,000 Days: Partnering to Reduce Child Undernutrition

Child undernutrition has historically been – and continues to be – one of the most serious health and development issues we face today. The good news: This problem is preventable.

This morning, I joined leaders of governments, international organizations, civil society groups, and private sector companies in creating a collective global commitment to improve child nutrition during the 1,000 Days: Change a Life, Change the Future event in New York City.

The 1,000-day window, beginning from a woman’s pregnancy until her child is two years old, is critical to a child’s ability to thrive for a lifetime. We know that healthy children are more likely to get an education and to contribute to their communities when they become adults. The Scaling Up Nutrition (SUN) Framework, which I helped launch in April this year, points to strong evidence that interventions during this critical time can save lives. The Framework seeks to accelerate the international community’s efforts to combat undernutrition through strengthening partnerships.  Today’s event was an opportunity to highlight the SUN Framework and outline a way forward through the SUN Roadmap, which United Nations Secretary-General Ban-Ki moon launched this morning.

U.S. Secretary of State Hillary Rodham Clinton co-hosted today’s event with Ireland’s Minister for Foreign Affairs Micheál Martin. They voiced their strong support for the SUN Roadmap and called on leaders across the globe to act on specific targets toward improving nutrition – and thus the health, education, and economic opportunities – for people most in need.

Stressing action and accountability, Secretary Clinton said, “The Scaling Up Nutrition roadmap, the so-called SUN roadmap, that is unveiled today will be a critical tool for coordinating our efforts, and it will be up to us to follow that roadmap to our destination.”

Nutrition is key to the success of the Millennium Development Goals.  It is also a major objective of both Feed the Future and the Global Health Initiative.  Nutrition is integral to USAID’s development programs across sectors.  We create and support agriculture programs that not only improve access to food, but also aim to improve the quality of food produced.  We are implementing humanitarian assistance programs for the most vulnerable that aim to prevent undernutrition—rather than treat it when it might be too late.  And through our health programs, we deliver a package of nutrition interventions—and maximize the benefits to women and young children by coupling these packages with clean water, sanitation, and hygiene programs, infectious disease interventions, and efforts to strengthen health systems.

To be successful, global efforts require engagement from all levels – from donor governments to the private sector, from civil society to international organizations. Today’s event was evidence of the enormous momentum across the international community to break the cycle of hunger and undernutrition. Our collective challenge is to harness this momentum and translate it into concrete actions and support countries at the implementation level. We know this challenge is large, but we also know that global action and strong partnerships produce tremendous results: We have seen the incidence of polio drop by over 99 percent since 1988; we are making significant strides against HIV/AIDS; and we have celebrated remarkable gains in maternal mortality reduction.

It is our responsibility to seize this moment to help children—at a time before they can help themselves—to realize their potential.

USAID @ UNGA: Thank you for Saving the Lives of Millions of Children

Submitted by Amie Batson
Deputy Assistant Administrator, Global Health

Today as the United Nations General Assembly begins its review of progress on fighting poverty and disease, I took part in a meeting about something great you did: You helped save the lives of more than 5.4 million children all over the world in the past 10 years.

Here’s how: you stopped accepting that parents in African and other developing countries must wait up to 15 years to protect their children with vaccines – if they ever got them.  Because of that stand, a new partnership, the Global Alliance for Vaccines and Immunization (GAVI), was formed to take action.

GAVI has made a successful, life-saving difference, paid for by you — whether you’re in the U.S., fourteen other countries, or the European Union.  The Bill & Melinda Gates Foundation is also a generous supporter. And the U.S. Agency for International Development is a major partner in the field.

In its first 10 years, GAVI and its global partners, including the U.S., provided support to countries which delivered vaccines against life-threatening childhood diseases to more than 250 million children, saving the lives of more than 5 million, and shielding millions more from the long-term effects of illness on growth and development.

This success makes for a safer world for all of us. As a public health professional who has worked in immunization for much of my career, this is an exciting development. And as a mother, I think it’s the right thing to do.

As the U.S. expands our commitment to global health through the $63 billion, six-year Global Health Initiative announced last year by President Obama, our support for immunization will continue and increase.

Immunization is critically important in the world’s effort to achieve Millennium Development Goal 4: reducing child mortality.  When children escape disease, they have a fighting chance to thrive and attend school. As they grow into healthy adults, they can then contribute to the development of more vibrant and productive societies.

Since the 1970s, USAID has worked with partners across the globe to confront the challenge of vaccine-preventable diseases and help immunize children in remote parts of the world.

At today’s meeting hosted by GAVI and UNICEF, global health leaders took stock of current efforts to save the lives of children.

My message to the group was simple – we know a lot, but achieving the Millennium Development Goals  will require creative new approaches to reaching the millions of children who aren’t immunized – or receiving any real care, to accelerate the access to life saving vaccines, and to ensure sustainable systems are established to serve children today and in 5 years.

These innovations come from the countries – doctors, nurses, health workers –who have found innovative ways to reach into communities and provide services and from scientific and technological innovations in development where we need to ensure these breakthroughs in the science translate into lives saved.

Research, development, and the use of vaccines and immunization are top priorities for USAID. As USAID Administrator Dr. Raj Shah has said, “Humanity demands an AIDS and malaria vaccine to prevent these scourges, and low-cost pneumonia and Rotavirus vaccines that will eliminate hundreds of thousands of child deaths every year.”

Despite the success of immunization programs, vaccine-preventable diseases are still estimated to cause more than 2 million deaths every year.  Together with the GAVI partners, we can prevent more of them.

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