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Archives for Health

A Renewed Focus on Institutional Strengthening in Kenya

Under its 2010 constitution, Kenya’s major reforms include a devolved government in which civil society organizations (CSOs) have an enhanced contribution to strengthening health and social systems. The reforms are timely, as other donor mandates, such as USAID Forward, also place greater emphasis on country-led, country-driven development assistance, with more direct investment in partner governments and local organizations, and stronger public-private partnerships. To achieve these mandates, local capacity must be developed so that these institutions can play their part.

Lisa McGregor-Mirghani, Local Capacity Team Lead for USAID in Kenya, speaking at the Institutional Strengthening Symposium in Nairobi. Photo credit: USAID

Lisa McGregor-Mirghani, Local Capacity Team Lead for USAID in Kenya, speaking at the Institutional Strengthening Symposium in Nairobi. Photo credit: USAID

At the invitation of the FANIKISHA project, nearly 200 people gathered in Nairobi June 10-12, 2013, for a three-day symposium on institutional strengthening for Kenya’s civil society organizations. This was the first major forum where donors, civil society, and other health stakeholders in Kenya came together to focus on this topic. Presentations made the case for the importance of strong, local CSOs that can compete with and complement their international counterparts and have sustainable impact on the health and well-being of Kenyans. Bringing together major donor agencies fostered the understanding of complementary activities the international community is supporting and presented new opportunities for networking and partnerships. CSO participants left the meeting with concrete plans to strengthen their institution’s capacity across critical domains, from governance and leadership to resource mobilization and advocacy.  They signed on to the “Nairobi Declaration on Institutional Strengthening,” to illustrate the commitment of civil society to fulfill its role in achieving national health priorities.

USAID’s rich history of developing local capacity in Kenya has resulted in a number of successes in strengthening local institutions. One such example comes from the FANIKISHA Institutional Strengthening Project, which works with ten national health CSOs. FANIKISHA has been providing assistance to one of these CSOs—Omega Foundation–to enhance its skills in governance, financial management, human resources, monitoring and evaluation, and communications. In 2011, Omega Foundation was facing all-too-common organizational challenges, including systems and structures that had not kept pace with growth and staffing that did not reflect organizational needs. Having already committed to overcoming these challenges, Omega applied for and received a grant from FANIKISHA to partner in an institutional strengthening program that has helped to transform the organization. Today, Omega Foundation has a revitalized governance system with an active board. Omega has reached out to new donors with renewed confidence, receiving modest funding in new grants from three local banks and another donor to help support existing community programs that include the integration of family planning and HIV services. Improved data collection tools that support evidence-based decision making, as well as a new communications strategy that is reaching more than 600 stakeholders, reinforce this new trust and confidence that donors have in Omega Foundation.

The Omega Foundation story is a good example of the potential that institutional strengthening has for advancing health and development. By supporting the strengthening of local institutions, USAID is helping to realize the vision of sustainable, country-led, and country-driven development in Kenya.

Dr. Daraus Bukenya of Management Sciences for Health is the Chief of Party for the USAID FANIKISHA Institutional Strengthening Project, launched in 2011 to strengthen the capacity of national-level CSOs in Kenya.

USAID in the News

Devex featured a piece about USAID’s new approach to tackling urban policy through the use of crowdsourcing. A public comment period will be made available on November 7 as a part of the Sustainable Service Delivery in an Increasingly Urbanized World program. By soliciting public opinion, USAID hopes to find new ways to encourage the formation of local solutions that will allow the agency to partner with city governments and community groups to build on expertise and bolster development efforts.

The Times of India reported on a USAID grant that was awarded to three Indian companies to help them share successful low-cost agricultural innovations with African countries. The grants come through the USAID India-Africa Agriculture Innovations Bridge Program, which seeks to improve food security, nutrition, and long-term sustainability by sharing Indian innovations with farmers in Africa who will benefit from them.

Administrator at at The George Washington University’s Feeding the Planet Summit, where he announced the Feed the Future Innovation Labs. Photo credit: Joslin Isaacson, HarvestPlus

Administrator at at The George Washington University’s Feeding the Planet Summit, where he announced the Feed the Future Innovation Labs. Photo credit: Joslin Isaacson, HarvestPlus

AllAfrica covered USAID Administrator Rajiv Shah’s announcement of 10 new Feed the Future Innovation Labs that will partner with American universities to tackle the world’s most challenging agricultural research problems. A part of the U.S. Government’s global hunger and food security initiative, these labs will work to address the challenges of climate change in agriculture and research ways to produce food in an environmentally sensitive manner to ensure global access to nutritious and safe foods.

Zawya reported on a joint effort between USAID and the Caterpillar Foundation, which seeks to provide intensive technical training to youth in Jordan. The program equips trainees with the skills to fill technician-level positions in key industrial sectors of the Jordanian economy. Rana Al Turk, the International Youth Foundation (IYF) Jordan Country Director says that the program aims to fill job positions, “while providing youth with a comprehensive employability approach that includes the technical training and soft skills they need to enhance their employment prospects and lead successful lives.”

Citizen News featured a story on a USAID-funded program that provides students in Kenya with laptops to enhance their educational experience. According to Jaribu Primary School headmaster Mohamed Gedi, the project has triggered a spike in the performance of the 300 hundred students that benefit from the laptops.

The Express Tribune reported on USAID’s hand over of a state-of-the-art Expanded Program on Immunization Coordination and Planning Resource Center to the Ministry of National Health Services, Regulation, and Coordination in Pakistan. The center is equipped with technology and software that will allow the government to track vaccine supplies throughout the country. USAID Health Office Director Jonathan Ross, who inaugurated the center, reaffirmed the U.S. Government’s commitment to improving health indicators in Pakistan through continued health development assistance.

What Does It Take to Get Contraceptives to Clients in Rural Nigeria?

Many of our clients learn about family planning from routine visits to rural health facilities. The health workers in this facility help patients and their families choose appropriate contraception methods and teach new clients how to use these methods correctly. The same health workers who are responsible for treating patients are often also responsible for monitoring the supply of contraception methods in the facility. When torn between caring for a waiting room full of patients and filling out paperwork to order new supplies, health workers discovered that they were stocking out of essential contraception supplies. This meant that they had to turn away patients—many of whom had traveled considerable distances to get these family planning services. The discouraged clients lost confidence in the health system and were less inclined to seek out family planning services if products they wanted were not available when they needed them.

DDIC truck delivering commodities at a rural health facility in Nigeria. Photo credit: USAID | DELIVER PROJECT

DDIC truck delivering commodities at a rural health facility in Nigeria. Photo credit: USAID | DELIVER PROJECT

To rectify the stock-out situation and improve access and availability to family planning commodities in Nigeria, the USAID|DELIVER PROJECT is piloting a system called Direct Delivery and Information Capture (DDIC) in Ebonyi and Bauchi states. Through DDIC, the project currently delivers 24 public health commodities, including contraceptives, antimalarial medications, and maternal, newborn and child health products to 365 selected service delivery points in the selected states.

The DDIC system utilizes a vendor-managed inventory model, whereby products are delivered from state warehouses directly to the health facilities on trucks that serve as mobile warehouses. The trucks arrive, carrying predetermined quantities of health commodities, based on the facilities’ past consumption data. By investing in reliable transportation, DDIC ensures that truck drivers and team leaders are available to deliver commodities to health facilities according to an established delivery schedule. A team leader traveling with the truck inspects the facilities’ storage space, counts stock-on-hand for the different health commodities, and enters this inventory data into a specifically-designed inventory management database. The database calculates the quantity of products to be issued to the facility to bring the quantity of stock of contraceptives back to the pre-determined levels. Data obtained from each facility are synchronized with a sister software to generate logistics reports that help monitor system performance and prepare for the next resupply period.

Commodities are supplied to the health facilities every two months. After just four consecutive supply trips, the availability of commodities at participating facilities has drastically improved. Stock-out rates of contraceptives and other common health products have been reduced from above 70% before DDIC was implemented to below 5%. Additionally, 100% of the targeted health facilities have received a bi-monthly visit with the team leader. Furthermore, essential logistics data are now readily available for public health supply chain experts to use in future decision making about future health commodity needs.

Though still in the pilot phase, DDIC has improved the availability of contraceptives and other commodities in rural health facilities in supported states. It has also relieved many of the health facility staff of paperwork duties, so they can focus more on providing better quality care to patients. Consequently, clients’ confidence in the health facility’s ability to provide health services is increasing.

So, what does it take to get contraceptives to clients in rural Nigeria?

Through DDIC, USAID is improving availability of contraceptives at rural health facilities on a regular bimonthly delivery schedule, thereby increasing families’ patronage and uptake of family planning services. DDIC has come to the rescue ensuring commodities availability at facilities and data for planning in Nigeria!

Learn more about how USAID is working towards ensuring safe motherhood and healthy families around the world.

Learn more about our Mission of the Month: USAID Nigeria. Follow @USAID for ongoing updates in the region and join the conversation with the hashtag #MissionofMonth!

MCHIP Spurs Action to Protect Women from Excessive Bleeding After Childbirth

Dr. Vikas Yadav, the National Program Manager for Jhpiego’s India program, described his frustration during visits to birthing rooms in health facilities early in his career: “Lifesaving drugs were not correctly used or, in some cases, not used at all.” During childbirth, women may suffer from potentially life-threatening conditions, such as excessive bleeding. Known as postpartum hemorrhage (PPH), excessive bleeding can be prevented with a uterotonic—a drug to make the uterus contract.

According to Dr. Yadav, “You would see health care staff that didn’t know which uterotonic to use and when, because they lacked clear guidance. It is such a simple intervention, yet these staff didn’t have needed information to properly use drugs that could save lives.” Oxytocin is the uterotonic of choice for preventing PPH, but in certain situations, such as home birth, another uterotonic drug known as misoprostol has been recommended.

Women waiting for newborn care at a nursery. Photo credit: MCHIP

Women waiting for newborn care at a nursery. Photo credit: MCHIP

Dr. Yadav was happy to report that the situation has improved quite a bit in Jharkhand State since those early days. In fact, maternal deaths have decreased dramatically in recent years thanks to the increasing focus of the government and its development partners on training health facility staff and improving the quality of maternal care.

Despite recent improvements, PPH still causes 35% of maternal deaths in the State. And while providing uterotonic drugs is a well-known intervention to prevent PPH, the number of births that receive this intervention is unknown. As in most developing countries, there is no regular or reliable data available on whether uterotonic drugs are provided to women.

It was in part due to this lack of information that staff from USAID’s flagship Maternal and Child Health Integrated Program (MCHIP) partnered with the Directorate of Health Services in Jharkhand state to pilot an innovative approach for estimating the number of women who use a uterotonic drug after birth to protect them from PPH.

Dr. Jeffrey Smith, MCHIP Maternal Health Team Leader, helped the team estimate uterotonic coverage in the State. “In many developing countries, there is more reliable data to measure whether children are receiving lifesaving drugs,” he said. With this knowledge, health experts can design better programs. “Why can’t we also track which women are receiving uterotonic drugs when so many are dying of PPH?” Dr. Smith asked.

Dr. Yadav welcomed the chance to participate in this valuable activity. During a stakeholder meeting, maternal health experts, officials from the state Ministry of Health, private and public hospitals, nongovernmental organizations, development partners, and key policy makers came to a consensus about their estimate after careful discussion and analysis. Using the guidance and worksheets developed by MCHIP, many were surprised to learn that relatively few women—only 43.5%—were protected from excessive bleeding. “This exercise was eye opening for program managers, since they realized that many women were not getting the care they are supposed to get,” Dr. Yadav said.

Oxytocin can be kept at room temperature for only a couple of months before it loses potency. Unlike oxytocin, misoprostol does not require refrigeration and it has also been proven effective at preventing excessive bleeding. Additionally, misoprostol comes in pill form and does not need to be injected using a needle and syringe by a skilled provider. As such, misoprostol is ideally suited for preventing PPH at home births and in resource-poor settings like Jharkhand due to its stability, ease of use, effectiveness and safety.

Distributing misoprostol to women in advance of the birth, enabling them to take it just after delivery, is known to be an effective method of PPH prevention. However, there is currently no program in Jharkhand State that ensures women who give birth at home receive misoprostol. And despite recent increases in facility births, there is still a sizeable portion of women (more than 45%) who choose to give birth at home. Sadly, when women give birth at home, they often do not have assistance from skilled health care workers or access to lifesaving drugs like oxytocin, and are therefore more likely to die of complications.

This estimation exercise came at the ideal time, as the government of India is currently developing guidelines for advanced distribution of misoprostol for women who give birth at home. Given the large population in Jharkhand State, efforts to make misoprostol widely available for use at the community level—especially if adopted nationally—could protect thousands of women from PPH.

USAID/MCHIP’s innovative estimation tool makes it possible to build an accurate picture of whether a country is doing everything it should to stop women from dying of this preventable condition. If there is strong political leadership, as in Jharkhand State and places like Mozambique, this estimation tool has the potential to help governments’ strengthen programs to prevent PPH. Such programs would ensure that oxytocin is available to women who give birth with trained health care workers, and that misoprostol is available to women who give birth at home. These combined efforts could save the lives of countless women, no matter where they give birth.

The Question is King – Turning Princely Investments into Practical Solutions

“The question is king,” states the Implementation Research in Health: A Practical Guide (PDF), a new World Health Organization resource from The Alliance for Health Policy and Systems Research/Implementation Research Platform. Launched this month, the guide strives to answer a critical question facing public health today: As we invest increasingly princely sums for health interventions throughout the world, why do we continue to stare down statistics such as an estimated 2.5 million people getting infected with HIV and over 7.6 million children succumbing to preventable deaths each year?ImplementationResearchInHealth

For some, terms such as implementation research, implementation and delivery science are the language of the day. Many more, we suspect, use the terms with a degree of hesitation. The basic underlying principle is clear. Promising programs and research – those with exciting results from a proof of principle study or small stage implementation – may not be readily replicated on a larger scale, or demonstrate similar impact in a different location.

Implementation Research in Health provides a rigorous approach to addressing these gaps. The guide offers researchers and program implementers the rationale for implementation science, and an introduction to its practical mixed methodological approach – drawing from epidemiology to market research, health services research and even political science. Some may recognize much of the content – the guide updates the 2003 Implementation Research in TDR: Conceptual and Operational Framework, for example. But, the easy-to-use-format (key points are summarized for each chapter; helpful graphics summarize everything from implementation science strategies, outcome variables and the research continuum) makes the guide a welcome new addition.

At a recent Investigators’ Meeting for USAID partners supporting implementation science studies to improve PEPFAR programs, participants discussed the importance of publishing not only on the results of these studies, but the rigorous approaches used to generate the results. We applaud such efforts. We encourage more researchers to publish on the rigorous implementation science methods they’ve used – it can only help build a common understanding of the underlying rigor that is the hallmark of quality implementation science research (read a description of USAID’s implementation science portfolio to support PEPFAR programs and on USAID’s implementation science related to maternal, newborn, and child health).

Implementation science can look beyond the impact of individual interventions to evaluate interventions aimed at improving broader health systems. As we ask questions in our increasingly complex global health world – from “how to best integrate previously separate programs?” to “how do we measure impact as we increasingly work through and with our partner governments and donors?” – implementation research plays a critical role in helping us address these issues. We encourage future editions of this and other implementation science resources to share how rigorous implementation science has helped address these broader questions.

Implementation Research in Health calls its subject “new” and “neglected.” Yet, people have been doing implementation research (or variants of it) for decades. The guide is a promising resource to bring implementation research into the spotlight where we think it belongs – we encourage you to read the guide and decide for yourself.

Harnessing S&T for Global Development

This originally appeared on the White House Blog

Recently, I interviewed Dr. Andrew Sisson, the U.S. Agency for International Development (USAID) Mission Director in Indonesia, who is leveraging science and technology (S&T) and innovation to help tackle development challenges in Indonesia.

Why is USAID focusing on S&T and innovation in Indonesia? What are some of the economic and societal challenges that S&T can help address?

Science, technology, and innovation have the potential to solve important global development problems. S&T can help communities and governments control the impact and spread of infectious diseases; protect marine environments; strengthen resilience to natural disasters and climate change; and much more. In just one example, we are working with the Indonesia National Tuberculosis Program (NTP) to test a new, simple and rapid tuberculosis (TB) diagnostic called GeneXpert. The goal of this technology is to increase the rapid detection and treatment of TB in HIV patients. The results of pilot testing in 17 locations across Indonesia will be published soon and, with support from the Global Fund and TB REACH, the Indonesia NTP has already expanded  use of the new diagnostic to private-sector hospitals.

Indonesia Laboratory technical at Hasan Sadikin Hospital in Bandung (West Java) performs multi-drug resistant TB tests using GeneXpert as part of a pilot project supported by USAID. Photo credit: Roni Chandra

Indonesia Laboratory technical at Hasan Sadikin Hospital in Bandung (West Java) performs multi-drug resistant TB tests using GeneXpert as part of a pilot project supported by USAID. Photo credit: Roni Chandra

What is the mission’s strategy around S&T over the next few years?

USAID is partnering with the Government of Indonesia to use new and innovative approaches to achieve Indonesia-specific development goals. We’ve also decided together to focus part of our investment on developing components of Indonesia’s “scientific ecosystem,” including by developing merit-based research systems and strengthening the scientific evidence-to-policymaking cycle. Our joint work also includes scholarship opportunities, joint research between Indonesian and American scientists, and private-sector partnerships to adopt advanced technologies for development goals.

What are some opportunities to strengthen collaboration between Indonesian and American scientists?

Indonesia and the United States have many overlapping scientific interests: climate change, marine conservation, healthcare diagnostics, renewable energy, disaster risk reduction, and more. And so we’d like to open more doors for scientific collaborations to take root in these areas. The State Department has established an official dialogue with Indonesia on making scientific exchanges a top priority. But, it can’t only be a government-to-government effort. For scientific collaboration to flourish we’ve got to place it in the hands of our top scientists and students – and so networking among students and universities in both countries has also been a promising area of partnership.

Can you give an example of an individual or project that exemplifies USAID and Indonesia’s collaborative work in S&T?

What’s been incredible to see is how quickly an international network of scientists can come together to create something big when given the opportunity. One great example is the broad network for biodiversity research that has been created by the University of California, Los Angeles (UCLA), Udayana University in Bali, and the State University of Papua through the support of USAID and the National Science Foundation. Some of the researchers that are part of this network converge at the Indonesian Biodiversity Research Center – a facility in Indonesia where American and Indonesian students come together every summer to get trained in the latest genetic techniques for applications in marine biodiversity and conservation.

What advice do you have for other USAID Missions that are interested in elevating S&T efforts?

We’re still on the early part of the curve so there is a lot to learn, but we’re eager to share as we move forward. What’s been very important in our strategy development are the ongoing conversations and consultations with Indonesian counterparts who are helping define what areas of science and technology we can work on together. For this to be a successful and sustainable part of the U.S.-Indonesia long-term relationship means that Indonesia will be an equal partner each step of the way, as a collaborator and co-investor – and I believe we are making good progress down that path together.

Tom Kalil is Deputy Director for Technology and Innovation at OSTP

FrontLines: What is Open Development?

Frontlines-Open-Dev-Banner_Web

Read the latest edition of USAID’s FrontLines to learn how the Agency is embracing open development to further its work. Also in this issue, read about some of the places where USAID’s interests intersect with those of the U.S. military. Some highlights:

 

  • “What we are trying to do is be a global one-stop shop for a good idea.” Jeff Brown has more to say about the projects USAID’s three-year-old Development Innovation Ventures is backing and how those projects are faring in countries around the world.
  • Diving for lobster in Honduras’s Miskito Coast has left more than 1,000 divers disabled or dead since the 1970s and 1980s when the crustacean became popular on dinner menus. However, a large American restaurant chain is doing its part to ensure that practice ends alongside more than 80 local and international groups, businesses and government agencies
  • What’s next for USAID’s Saving Lives at Birth million dollar winners? Four inspired doctors talk about the innovations they’ve helped devise and their hopes for saving new moms’ lives as a result. 
  • A bustling secondary school farm in Jamaica can trace its roots of success to a collaboration between local police, U.S. soldiers and a group of determined parents and educators.
  • With half of Afghans living in a disaster belt studded with earthquakes, landslides and flooding, USAID and the U.S. military are helping the country’s citizens acquire the skills they need to survive natural disasters and save the lives of their neighbors.

If you want an e-mail reminder in your inbox when the latest issue of FrontLines has been posted online, subscribe here.

Knowledge-Sharing in MHealth is Critical to Providing Life-Saving Solutions for Moms

This originally appeared on the Mobile Alliance for Maternal Action Blog

Every minute at least one woman dies from complications related to pregnancy or childbirth and every year 6.6 million children die before the age of five. We know what interventions make a difference on maternal and infant mortality. We now know that one billion women in low to middle-income countries own a mobile phone – a tool that can be used to engage, educate, and empower mothers. In order for mobile to be scaled to address health issues, global communities must come together to openly share lessons learned, failures, best practices and introduce new solutions to help underserved populations – women in developing countries.

Participants looking pleased with access to health information on their mobile phones. Photo credit: Living Goods

Participants looking pleased with access to health information on their mobile phones. Photo credit: Living Goods

Mobile health (mHealth) is a solution for women, providing immediate, life-saving services to address dire maternal, newborn, and child health (MNCH) challenges. This emerging field – a global movement – is reaching mothers, who need health services the most. No one organization, ministry of health, or company can do it alone, which is why knowledge-sharing through a global, mobile community is needed more than ever.

In a new report, Sparking a Global Movement with MAMA (PDF), commissioned by Johnson & Johnson, a partner of the Mobile Alliance for Maternal Action (MAMA), over 230 organizations, from almost 60 countries downloaded MAMA’s free, adaptable vital health mobile messages. Organizations continue to use these messages to guide mothers through pregnancy and now up to their baby’s third birthday.  As a result, more organizations using these messages are sharing back their key findings and translated the messages in 20 languages. Because of these organizations, which include social enterprises, health organizations, and governments, we all have a new resource in the mHealth space focused on MNCH. MAMA, founded by USAID, Johnson & Johnson, UN Foundation, BabyCenter and mHealth Alliance, is getting critical health information out to mothers through partnerships around the world.

Having access to these culturally sensitive, vital health mobile messages is like “having a hospital at home,” said Nahura Sharon, a new mother in Uganda, receives mobile messages through Living Goods, an organization that empowers women and operates networks of micro-entrepreneurs, who provide life-changing products and services.

Other organizations like Liga Inan in Timor-Leste translated mobile messages in Tetum, a local language and are reaching mothers, family members and community health workers. In Tanzania, Wazazi Nipendeni, a national multi-media campaign on health pregnancy, is using vital health mobile messages in partnership with the Ministry of Health. In less than six months, Wazazi Nipendeni reached 150,000 active subscribers and delivered over nine million text messages.

The desire for knowledge-sharing continues to grow as well as the need for mobile content like messages for family planning and for mothers with children ages 1-3 years old.

This report and other knowledge-sharing resources help foster global learning and build alliances with a growing community interested in working together, aiming to save lives through mobile technology.

Kirsten Gagnaire is the Global Director of the Mobile Alliance for Maternal Action (MAMA). Prior to MAMA, Gagnaire was the Ghana Country Director for the Grameen Foundation and led the initial implementation of MOTECH.  She was the Founder of the Social Enterprise Group (SEG) and Sustayne, and has a depth of experience and passion for addressing social and environmental issues through profitable business ventures. Gagnaire was a consultant with KPMG Peat Marwick, specializing in management, technology, and organizational development consulting for health and human service agencies.

USAID Applauds Launch of the 2013 WHO Global Tuberculosis Report

I applaud the World Health Organization (WHO) today on the release of the Global Tuberculosis Report 2013, which includes among its recommendations, a call to action to reach millions of people still awaiting quality tuberculosis (TB) care and a stronger approach to fighting the emerging threat of multidrug-resistant TB.

While this year’s report is an important reminder that TB continues to claim millions of lives globally, it also demonstrates that significant progress in preventing, detecting, and curing people of the world’s second biggest infectious killer can be made through strong political will, adequate resources, and a focus on the poorest and most vulnerable communities around the world.

On the positive, we are seeing a steady decline in TB mortality rates since 1990, bringing us closer to the UN Millennium Development Goal to halve TB prevalence and deaths by 2015, with fewer people now falling ill from the disease. However, as the report warns, large numbers of individuals with TB still remain undetected and untreated, and hard to treat multidrug-resistant (MDR) TB is now on the rise.

The WHO recommendations are based on new data from almost 200 countries and territories around the world. The report includes the most recent numbers on people who became sick or died from TB, MDR-TB and TB/HIV, as well as lives saved, treatment successes and gaps, and recent progress in roll-out of new TB diagnostics.

Out of the five priority actions recommend in the report, I would like to highlight two key challenges in particular. First, we should make every effort to reach the 3 million people a year (“missed” patients as the report calls them) who get ill with TB but don’t receive the quality care they urgently need. Many of these people are among the most vulnerable and stigmatized, often at the bottom of the social spectrum.  Universal health coverage and poverty alleviation are critical for bridging this gap and providing better access and quality TB services to those at risk.

Second, the global health community must have a strong plan of attack for addressing the alarming increase in MDR-TB. Data in the WHO report show that progress towards targets for diagnosis and treatment of MDR-TB is far off-track. Worldwide, and in most countries with a high burden of MDR-TB, less than 25% of the people estimated to have MDR-TB were detected in 2012.   MDR-TB is not only a tragedy for the patient, the effects can be disastrous, as an entire community can become infected with the drug-resistant organisms.

USAID is leading the charge in both of these areas by expanding access and quality of TB services including further prevention of the disease through interventions such as contact tracing and infection control.  We are also collaborating with countries and partners to introduce and scale-up MDR-TB programs in countries with the highest burden. If successful, The USAID-funded STREAM study will be a significant win in the fight against MDR-TB.   This innovative study will not only reduce the treatment regimen for MDR-TB from the current 20+ months to 9 months, it will also result in considerable cost savings to the health care system and in alleviating suffering by the patient. Until then, we must optimize DOTS programs and improve infection control to prevent the creation and transmission of MDR-TB.

The United States has a strong record of success in partnering with local governments, civil societies and the private sector to harness the power of science, technology and innovation to deliver health better, more effectively, and at lower cost.  Rapid acceptance of new tools, through technology transfer, and support for path breaking research will be essential in ensuring that at-risk communities can benefit from new innovations in our fight against TB.

The U.S. Government remains a major contributor to the Global Fund to Fight AIDS, TB, and Malaria, a unique partnership of governments, the private sector, civil society and affected communities joined together, unanimous in their desire to fight TB. Many low-income countries rely heavily on international donor funding, with the Global Fund providing around 75% of these financial resources. We need to ensure continued leadership in financing for high burden TB programs while advocating for increases in domestic resources to close the resource gaps, estimated at about US $2 billion per year. Commitment from the international community is crucial for addressing this funding gap.

Investing in global health is not only the smart thing to do – it is the right thing to do. We stand together with WHO and our international partners to save lives from TB and other diseases, and to develop healthier societies in the countries with the most need. We are also pleased to support the documentation and analysis of trends in diagnosis, treatment, and outcome. These data are essential to informing national programs and donor strategies.

I congratulate WHO, our other global partners, and the governments of high burden countries around the world for their leadership in global TB control and look forward to continued progress in this area.

Learn more about USAID’s tuberculosis programs.

Get details on the 2013 WHO Global Tuberculosis Report.

Empowering Mothers to Save Lives

Leading global health soap brand Lifebuoy is harnessing the power of women to make handwashing with soap an everyday habit. Mothers, health providers and birth attendants can be influential advocates. In particular, motherhood is one of the most profound and lifechanging events in a woman’s life irrespective of culture or geography. Mothers hold the key to instilling positive handwashing behaviours in their homes and communities.

Children benefit from handwashing. Photo credit: Lifebuoy

Children benefit from handwashing. Photo credit: Lifebuoy

Lifebuoy joined forces with the U.S. Agency for International Development  and its Maternal and Child Health Integrated Program (MCHIP) to create a neonatal programme to raise awareness of the link between newborn survival and handwashing with soap.  Help a Child Reach 5 uses innovative videos to share the importance of handwashing.

Lifebuoy has an ambitious target of changing the handwashing behaviour of one billion people by 2015, thereby reducing preventable deaths of children under 5 from diseases like diarrhoea and pneumonia. It is this profound cause that helps us to get persuasive advocates- distinguished Indian actress Kajol supports the cause of handwashing with soap and Help a Child Reach 5. She is calling on people, governments, UN agencies and policymakers to scale up handwashing as the most cost effective intervention to save child lives.

Over 40% of under-five deaths occur within the first 28 days of a child’s life, the neonatal period. Simple, low-cost health interventions – such as handwashing with soap at key occasions- can reduce this figure by up to 70 per cent. Despite this, handwashing with soap is not universally practiced. We know that a simple solution- handwashing with soap- can make a drastic difference in stopping preventable newborn deaths. Lifebuoy is passionate about saving child lives and has the global scale to do something about it.

The program targets new mothers and birth attendants through antenatal clinics and health workers. We communicate the potential of handwashing with soap to reduce neonatal infections, but do not stop there. The Help a Child Reach 5 campaign makes a health appeal to the most powerful of all emotions- the maternal instinct. ‘Helping your child survive’ – is the sole message to initiate long lasting changes. Handwashing messages are delivered to generate awareness, but also get commitment to handwash, habitual routine practice of handwashing, and positive reinforcement for handwashing. It builds in the motivators of behaviour change among new mothers such as the desire to nurture and for social recognition. It empowers mothers to keep their babies protected, which is of ultimate emotional significance to mothers.

Public private partnerships are critical to deliver messages to new mothers. Health organizations and governments have on the ground expertise to ensure health workers deliver the messages to new mothers in a scalable and sustainable way. This programme draws on Lifebuoy’s marketing and consumer expertise as well as MCHIP’s ability to reach and scale up outreach to millions of new mothers achieve maximum impact.

Building healthy habits among mothers means changing behaviours and choices. Lifebuoy aims to be much more than just a soap and stand in women’s minds as something positive and meaningful for life. Once a new mother’s mindset is changed, habitual handwashing with soap will become a naturally ingrained behaviour. This can have a ripple effect to other new mothers and the entire community and will help fulfil Lifebuoy’s vision of bringing health and hygiene to 1 billion people.

Learn more about USAID’s work in water, sanitation, and hygiene.

For more information on the Help a Child Reach 5 campaign, please watch some of these videos: www.youtube.com/helpachildreach5

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