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Archives for Sub-Saharan Africa

Pounds of Prevention – Focus on Namibia

Traditional  tilling results in crops that are shorter and less abundant  (left) than those produced using conservation  agriculture methods (right), which include ripping and  furrowing the land, allowing it to retain more rainwater. The next installment in the USAID Pounds of Prevention series (PDF) takes us to Namibia, considered one of the driest countries in the world. By promoting four interlocking principles—known as conservation agriculture—USAID is helping to improve people’s ability to weather and recover from drought. In fact, some crop yields for farmers using conservation agriculture have increased five times over yields for farmers using traditional methods. Read on to learn more.

Fostering Leadership to Eliminate Mother-to-Child Transmission of HIV in Nigeria

USAID is observing World AIDS Day this year by celebrating ten years of ourHIV and AIDS work under PEPFAR.

More than 85,000 infants in Nigeria are at risk of HIV transmission from their mothers every year. While the number of HIV-positive pregnant women who receive antiretroviral treatment (ART) is increasing, robust efforts to improve coverage are needed if national targets (PDF) for prevention of mother-to-child transmission of HIV (PMTCT) are to be met in 2015.

Keziah Samaila, coordinator of PMTCT in Township Clinic, Nigeria, training women on Family Planning and HIV. Photo: Lourdes de la Peza

Keziah Samaila, coordinator of PMTCT in Township Clinic, Nigeria, training women on Family Planning and HIV. Photo: Lourdes de la Peza

Over the past year, the Leadership, Management and Governance (LMG) Project helped support the PLAN-Health Nigeria project, funded by PEPFAR through USAID and managed by Management Sciences for Health (MSH), to pilot Leadership Development Program Plus (LDP+), which focuses on empowering teams to improve PMTCT results. The program also emphasizes new approaches tied in to country ownership, national health priorities, and specific health indicators.

LDP+ was piloted in the town of Gwagwalada, Nigeria. The Gwagwalada Council is one of the five Local Government Area Councils of the Federal Capital Territory (FCT) of Nigeria. LMG and PLAN-Health worked with the Gwagwalada Council, which selected 20 participants—two from each of the 10 facilities providing PMTCT services in the area—to form 10 teams to participate in the LDP+. Together, the teams decided to address PMTCT and focused on improving some standard indicators such as number of new antenatal care (ANC) clients; number of pregnant women tested for HIV, counseled and received their results; and the number of HIV-positive women. The program ran from October 2012 to May 2013. During this time, the teams worked within their facilities to create a vision of improved results around PMTCT, align stakeholders around this vision, implement their action plans, and share learning with other teams to identify the most useful local interventions and activities. The teams also received coaching in the areas of monitoring, evaluation, and reporting.

Keziah Samaila from Township Clinic, left, and Joy Otuokere, right, from Zuba Health Center, singing during the LDP+ training in Gwagwalada, Nigeria. Photo: Lourdes de la Peza

Keziah Samaila from Township Clinic, left, and Joy Otuokere, right, from Zuba Health Center, singing during the LDP+ training in Gwagwalada, Nigeria. Photo: Lourdes de la Peza

Most of the facilities reported encouraging results for their key indicators after participating in LDP+. For example, the Old Kutunku Health Center reported an increase from 17 to 61 new ANC clients per month. At the Gwako health center, the percentage of ANC clients who delivered in a health facility increased from 18 to 42 percent. Prior to LDP+, the Township clinic counseled and tested the partners of only three percent of pregnant women, compared with 20 percent after the program.

Alfa Ndatsu from Gwako Health Center, presenting his team work on the challenge model during LDP+ training. Photo: Lourdes de la Peza

Alfa Ndatsu from Gwako Health Center, presenting his team work on the challenge model during LDP+ training. Photo: Lourdes de la Peza

The Gwagwalada Council’s oversight committee plans to continue the program with its own resources, expanding it to another eight facilities in the area. Through these efforts, this local government agency is furthering Nigeria’s national efforts to ultimately eliminate mother-to-child transmission of HIV.

Follow @USAIDGH on Twitter through World AIDS Day, observed on December 2, for key facts, resources, and photos from our programs and partners and join the conversation using the hashtag #WAD2013.

MCHIP Plays Key Role Introducing Lifesaving Vaccine in Nine African Countries

This originally appeared on MCHIP in recognition of World Pneumonia Day.

Pneumonia is the deadliest disease among children under the age of five, killing an estimated 1.2 million children annually. Fortunately, Pneumococcal Conjugate Vaccine (PCV) can protect susceptible children, preventing against severe forms of pneumococcal diseases—mainly pneumonia, meningitis, bacteremia and sepsis.

Today, on World Pneumonia Day, MCHIP celebrates that this disease is preventable with safe, effective and affordable tools. Our team has played a key technical role in nine African countries to assist the introduction of this lifesaving vaccine, including in Senegal, where we introduced the vaccine most recently.

Mother and child at the launch ceremony. Photo credit: MCHIP

Mother and child at the launch ceremony. Photo credit: MCHIP

On November 5th, the Government of Senegal celebrated the launch of PCV13, which protects children against the 13 most virulent strains of pneumonia, a welcome innovation in a country where an estimated 13% of deaths under the age of five are attributed to pneumonia. The launch ceremony featured speeches by dignitaries—including Senegal’s President and its Minster of Health—as well as representatives from the GAVI Alliance.

The President emphasized the importance of reducing child mortality in Senegal by providing free health care for children under five, and strengthening partnerships. According to the November 6th edition of Le Soleil newspaper: “The introduction of this new vaccine as a preventative measure will strengthen and streamline all initiatives that support the well-being of the child.”

MCHIP in Senegal has been working with the National Expanded Program on Immunization (EPI) and partners to prepare the country’s immunization system for the introduction of new vaccines including (including PCV13, Meningitis A, and Measles-Rubella) while also strengthening the routine immunization system in poor performing districts to deliver these and traditional vaccines. In collaboration with partners, MCHIP has played a key technical role in the Senegal PCV13 preparation and rollout through national level technical assistance and as a member of the Interagency Coordinating Committee.

As part of a multi-partner collaboration, MCHIP has provided technical assistance to the EPI/Ministries of Health to prepare, plan and implement the introduction of new vaccines in 12 countries in the last five years. This assistance includes preparations of applications to GAVI for these new vaccines, immunization program readiness, post-introduction evaluation, and capacity building for health professionals.

Globally, MCHIP has now supported the introduction of PCV in Benin, the Democratic Republic of the Congo, Kenya, Malawi, Rwanda, Uganda, Senegal, Tanzania and Zimbabwe. Moreover, the Program has ensured that, once introduced, these new vaccines are incorporated into a routine immunization system that can provide safe, timely, equitable and affordable protection against some of the major contributors to child death, such as pneumonia.

 

Expanding Access and Choice for Family Planning

Next week more than 3,000 political leaders, scientists, health care professionals, advocates and young leaders from around the globe will gather in Addis Ababa, Ethiopia, for the third International Conference on Family Planning or ICFP2013. A year ago, the global community came together to launch Family Planning 2020, which has generated unprecedented political will and financial support to reduce global unmet need for family planning by giving 120 million more women access to modern contraceptives, information and services by 2020.  Conference participants in Addis will share the latest data, research and program findings to help achieve Family Planning 2020’s goal.

Organized around the theme “Full Access, Full Choice,” ICFP 2013 will call attention to the wide range of health, social, and economic benefits of helping couples plan and space their pregnancies. Holding the conference in Ethiopia is an opportunity to celebrate and showcase the success Ethiopia has had in greatly increasing access to family planning in a few short years. In 2005, 15% of married women used a form of modern contraception, and today nearly 29% are modern family planning users. However, there is still more to be done to ensure women’s needs are met.

Women gather at a health post in Ethiopia. USAID trains and supports health extension workers across Ethiopia's health system in the most populous regions of the country. Photo credit: Nena Terrell, USAID Ethiopia

Women gather at a health post in Ethiopia. USAID trains and supports health extension workers across Ethiopia’s health system in the most populous regions of the country. Photo credit: Nena Terrell, USAID Ethiopia

Women know what they want and when they demand it, we must listen: The ability to make important decisions about childbearing is one of the most basic human rights. Women deserve family planning options that are effective, affordable, available, and accessible and they need to be able to make their reproductive decisions freely and with full information. USAID is committed to developing new, affordable contraceptives and to supporting countries as they strengthen their health systems as part of an effort to fulfill full access and full choice for family planning. We’ve made great progress, but we must do more to ensure that everyone has true access to voluntary family planning information, services and methods that meet their needs.

USAID is proud to co-sponsor the International Conference on Family Planning, which is jointly organized by the Ministry of Health of Ethiopia and the Bill and Melinda Gates Institute for Population and Reproductive Health at Johns Hopkins Bloomberg School of Public Health. A number of USAID’s technical experts will present at the conference on the latest progress and challenges around increasing access to family planning.

Visit USAID’s ICFP webpage to access a calendar of USAID-sponsored events, the latest news and updates from the conference, and useful technical resources for participants.

Follow USAID for Global Health on Twitter for live updates and use the hashtag #ICFP2013 to join the conversation.

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!

From the Field in Madagascar: USAID Food Security Program Improves Livelihoods

As part of USAID’s 52nd birthday celebration, USAID/Madagascar shares a story of one woman who has benefited from a food security project. 

Sitting in the shade of an old mango tree, a group of villagers is intently listening to a middle-aged woman reading aloud from a booklet in her hands. The woman is Philomène, the ‘Treasurer’ of the local Village Savings and Loans association, and she is making her weekly report to the members.

Philomène (4th from left) volunteered to keep the VSL association’s books Photo credit: CARE International/Madagascar

Philomène (4th from left) volunteered to keep the VSL association’s books
Photo credit: CARE International/Madagascar

We heard about Philomène during a field visit to a food security project implemented by our partner CRS. The team was in a small village called Ampasimbola, in eastern Madagascar. Philomène is a farmer and she has been tilling the land for as long as she can remember. She is a single mother of six children, four of which are still in school.

Although Philomène puts a lot of effort into her work, she hardly produced enough food to feed her family. It was a challenge for her to make ends meet; on occasion, her children missed school to stay home and help her do farm work, her only source of income.

When USAID’s food security program started in Ampasimbola in 2010, Philomène did not think twice about joining the Village Savings and Loans association. She even volunteered to keep the books for the group. These village-level savings banks allow members to contribute some amount on a regular basis. They can then request loans with soft repayment terms and conditions. Philomène seized the opportunity to take out a loan and start a small restaurant offering doughnuts, coffee, fish, and even second-hand clothes to increase her income.

With hard work, Philomène’s restaurant quickly thrived. She soon had to choose between continuing farm work that brought home hardly any money, or focusing on a more lucrative and rewarding activity. She decided to drop farming— a savvy decision, because not only did she make substantial profits from the sale of food but she also received payments of interest from investing her savings back into the Village Savings and Loans association.

Philomène’s livelihood has improved and she is now able to send her children to school regularly, and pay for the annual school fees, Ariary 43,000 or about $22 dollars without any problem. The hungry season, which she had earlier coped with eight out of the twelve months per year, is today but a bad dream. Thanks to her contribution to the Village Savings and Loans association, Philomène extended her hut after two years and added a kitchen and a bathroom. She proudly bought new kitchen utensils and other household equipment, and was able to decorate her home.

I’m no longer alone. In our VSL group, we’re like brothers and sisters. We counsel one another, and we share knowledge and experiences. It’s a real new life for me!” says a proud Philomène.  In her spare time, Philomène engages in development and other social activities, and the community seeks her help for advice or assistance when visitors come to the village and seek accommodation for the night. Philomène can help because her hut is now large enough to put up guests. She is now, more than ever, an important member of the community.

Follow USAID Madagascar on Facebook and Twitter for ongoing updates in the region.

Join the #USAIDProgress conversation on Twitter and learn about our other successes!

Empowering Africa’s Next Generation Through Education

Education, equal opportunity, empowering women and youth, these ideas form the foundation of our program in the Office of American Schools and Hospitals Abroad. In a recent trip with two of my colleagues to South Africa, we experienced firsthand how powerful a marriage of American and African ideas and values can be in propelling not only South Africa, but the entire continent forward.

The American writer and historian, James Truslow Adams described the American dream as one where, “life should be better and richer and fuller for everyone,” and while that is part of the American dream, is it part of the African dream as well? Half an hour outside the bustling city of Johannesburg, the African Leadership Academy (ALA) is instilling American values by providing its students the base for becoming entrepreneurial leaders. Each year, 100 gifted students between the ages of 15 to 19, from over 40 African countries, are accepted into ALA where they are empowered and given the tools to become the next generation of African leaders.

Bonga, a recent graduate, discusses his time at the Academy. Photo credit: Caitlin Callahan, USAID

Bonga, a recent graduate, discusses his time at the Academy. Photo credit: Caitlin Callahan, USAID

My colleagues and I were lucky to spend part of our morning with Bonga, a recent ALA graduate. It was evident in the way Bonga spoke how central the African Leadership Academy was in motivating him to continue his education, innovate, and bring economic prosperity to his community. Bonga, like most of his peers, plans to attend a four-year university and dreams of an integrated and affluent Africa. USAID assistance helps improve campus security, purchase learning resources for its library, and upgrade dormitories for student housing to prepare students like Bonga for success.

Encouraging hands on experience and service to the community, the Academy provides students with the tools and knowledge base to work towards transforming the African continent.  ALA harnesses the entrepreneurial spirit and encourages its students to create and manage their own business ventures in a safe and comfortable environment. Since its inception in 2008, graduates of ALA have started 38 non-profit and for profit enterprises, addressing community challenges while furthering Africa’s long term stability and economic prosperity.  In support of USAID goals to promote inclusive development, this fall, the majority of students enrolled at ALA will be female. Educating a girl means that as a woman, she is empowered and more likely to participate in development efforts in political and economic decision-making.  It has also been shown that with each ten percent increase in the number of girls who attend school, a country’s gross domestic product (GDP) increases on average by 3 percent.

Through its innovative approach and integration of American ideas, the African Leadership Academy is well on its way to making a difference in Africa and USAID is proud to be a supporter. Watch the video below to learn more.

Video of the Week: Partnering to Feed the Future in Ethiopia

As part of USAID’s 52nd birthday celebration, we highlight a Feed the Future partnership that is helping to improve nutrition in Ethiopia. 

Ethiopia has the highest cattle population in Africa, at 52 million, including 10.5 million dairy cattle.

In 2011-2012, Ethiopia produced 3.3 billion liters of milk but only about five percent of it was sold in commercial markets. Despite an active dairy sector, individual consumption of milk in Ethiopia is only 19 liters per year and child undernutrition rates are among the highest in the world.

About an hour and half drive outside of Addis Ababa, Project Mercy, a faith-based relief and development organization, owns a 350-acre dairy farm in Cha Cha, Amhara Regional State. Through its Dairy Cattle Breeding Program, Project Mercy has a vision to help improve the nutritional status of men, women and children and generate new incomes by cross breeding Ethiopian indigenous cattle with the local British Jersey breed.

Currently, Ethiopian indigenous cattle only produce one to two quarts of milk per day, which is not enough for the typical Ethiopian family of eight. As a result, the majority of children in Ethiopia do not consume milk, leading to malnourishment and other complications such as stunted growth.

As part of the U.S. Government’s Feed the Future initiative, the USAID Agricultural Growth Program-Livestock Market Development project is partnering with Project Mercy to help the organization achieve its vision.

Through this partnership, the project is providing technical assistance to beneficiaries before and after the dairy cows are transferred to local families. Technical assistance includes activities such as developing a farm management plan, hosting training sessions and improving animal feed production. All of these ensure that the crossbreed will achieve its highest levels of production and will increase milk production up to 12 quarts per day. In addition, the project is linking targeted households to new markets where families will be able to sell their milk products.

This project contributes to the goals of Feed the Future, which works to reduce poverty, hunger and undernutrition in 19 focus countries around the world. USAID is the lead agency for this whole-of-government initiative.

Watch the short video below to learn more about this partnership.

Behind the Scenes: Interview with Andrew Hoell on Dryness Conditions in East Africa

This blog is part of an interview blog series called “Behind the Scenes.” It includes interviews with USAID leaders, program implementers, Mission Directors, and development issue experts who help fulfill USAID’s mission. They are a casual behind-the-scenes look into USAID’s daily effort to deliver economic, development and humanitarian assistance around the world — and the results we’ve seen.

When did you first become interested in climate research?

New England snow storms sparked my interest in weather at a young age. As an undergraduate, I attended the University of Massachusetts to study Meteorology. During my second year as an undergraduate, I became interested in how weather patterns behaved over the entire globe on longer timescales, climate time scales. I attended graduate school at the University of Massachusetts and worked on projects that linked Central Asia climate to the tropical Indian and Pacific Oceans. The regional atmospheric circulations of Central Asia, the Middle East and East Africa are intertwined, so those are now my regions of focus.

Can you talk a little bit about how UC Santa Barbara and FEWS NET work together to explain the broader concept of food security?

I can only speak to the climate side at UC Santa Barbara. At UC Santa Barbara, we’re interested in how rainfall has recently changed over East Africa, the Middle East and Central Asia and what climate features have forced those changes. We take the lessons that we’ve learned from the recent changes and we draw conclusions about how the climate will change in the future.

When you first began researching climatic weather patterns in the Western Pacific Ocean, did you have any idea that your work would help guide future international development decision making?

I’ve been researching the links between the tropical western Pacific Ocean and the global climate since about 2006, my first year of graduate school. Initially, graduate students, including me, are usually focused on learning or pleasing their advisor. In 2008, I met Chris Funk of the Climate Hazards Group at UCSB, and we collaborated on a paper that investigated the links between the Indian Ocean sea surface temperatures and East African climate and how those links influence food security. This was the first time I considered that my work might guide international development and decision making.

What was the motivation for writing about drying conditions in the East Africa Horn? What did you and your team seek to explain?

Our overarching goal is to understand how climate variability influences East Africa. This paper is a very brief review that links recent changes in East African climate (since the late 1990s) to an abrupt warming in west Pacific sea surface temperatures. The video below explains more.

What sorts of technology and techniques did you use in this study?

In the beginning of our study, we show how the climate from 1999 until recently has behaved in terms of East African rainfall and tropical Indo-Pacific Ocean sea surface temperatures. From this, we were able to show that (at least) superficially that East Africa rainfall and tropical Indo-west Pacific Ocean sea surface temperatures could be related.

In the second part of our study, we use an atmospheric model forced by observed sea surface temperatures to confirm that west Pacific sea surface temperature changes were influencing East African rainfall. The study can be found here (Article 15).

What’s next for you and your team? How will you continue to work with FEWS NET to explain climate patterns and its effects on food security?

Our team will continue to investigate what factors influence climate variability over East Africa, the Middle East (specifically Yemen) and Central Asia. We focus on a wide variety of time scales, from individual seasons to multiple decades. We are most concerned with changes on decadal time scales because they are most important to long-term food and water security. However, our understanding of climate variability for individual seasons is also very important because it is this climate variability that primarily forces short-term droughts and famines (e.g. 2010/2011 over East Africa).

Interested in learning more about one of USAID’s programs or want to hear from one of USAID’s leaders? We want to know! Please provide your suggestions below.

Communities in Cote d’Ivoire Benefit from USAID’s Investments

USAID is helping communities in rural Cote d’Ivoire develop economic resiliency. Through our partners SAVE the Children and AVSI, we are supporting several types of economic strengthening activities, all of which increase the productive resources available for families. Through this work, we target the families and caregivers of children orphaned or made vulnerable by HIV/AIDS.

As they gathered for their savings group meeting, group members met us with a traditional welcome. Andrea Halverson. Photo credit: Andrea Halverson, USAID

As they gathered for their savings group meeting, group members met us with a traditional welcome. Photo credit: Andrea Halverson, USAID

In the mountainous, western city of Man, near Cote d’Ivoire’s border with Liberia, we met women gathering for their regular community savings group meeting. This region was one of the hardest hit during Cote d’Ivoire’s civil unrest. With poverty rates increasing over the past decade, savings groups combat a common problem in developing countries: lack of access to credit. Through these self-selected groups, members (usually all-women) will share a small portion of their money at each bi-monthly meeting, and are eligible to take loans, with interest, from this shared pool. At the end of the group sharing cycle, the amount saved is paid out to the group members. The additional money is making a difference in their lives and the lives of their children. Almost every woman uses her savings for school fees and school uniforms for her children.

Children watch as the community members cook the Attiéké, the final step in its production. Photo credit: Andrea Halverson, USAID

Children watch as the community members cook the Attiéké, the final step in its production. Photo credit: Andrea Halverson, USAID

In addition to savings groups, we also visited a community who had received start-up capital to fund a small business activity, producing a local delicacy called attiéké. Similar to couscous, attiéké is a fermented Ivoiran side dish, highly sought after in the region. Through the donation of a mill and a creative cassava partnership, the women had what they needed to start their small business. They are now making and selling attiéké. With pride, women told us of their informal distribution channels that stretched all the way to Mali. These and other investments are helping shape the future of Cote d’Ivoire, and reducing the vulnerability of Ivorian children by using profits to ensure they can enroll in school.

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