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Archives for Sub-Saharan Africa

A Promise Renewed: A Great Global Ambition and Every Father’s Dream

This originally appeared on the Huffington Post Blog

What will you be doing this Father’s Day?

Reading homemade cards? Playing catch with your kids? Grilling in the back yard with the family?

We often take such simple pleasures for granted. But, elsewhere, millions of fathers around the world will struggle to help their children survive and thrive.

In our respective roles, we meet these fathers — in remote villages, bustling cities, and refugee camps. They tell us inspiring stories of their fight to care for their families, but also the heartbreaking accounts of much-loved sons and daughters who have lost their lives to preventable diseases like malaria, pneumonia, diarrhea and HIV.

A mother plays with her infant as she waits outside a health post in Ethiopia. Photo credit: USAID

Every year, 6.9 million children under five die from these and other causes. 19,000 every day. That is equivalent to a stadium like Madison Square Garden filled to capacity.

Even crueler is the geography of fate. A child in sub-Saharan Africa is over 14 times more likely to die before reaching her or his 5th birthday than a child in the United States.

These deaths are more than a tragedy for individual children. They shatter families, diminish communities and hold nations back from progress and prosperity.

But amidst these sad statistics, there is cause for hope. Increasingly, innovations — new products, new technology and new applications of existing technology — help us reach the most disadvantaged communities and the most vulnerable children quickly and inexpensively.

For example, there are groundbreaking long lasting insecticide-treated bed nets that drastically reduce the number of children who die from malaria.

Or the three-drug regimen in one pill daily for pregnant women living with HIV. It protects their own health and helps prevent their babies and partners from HIV infection.

Or new vaccines to prevent pneumonia, diarrhea and cholera.

Thanks to innovations like these, we have an unprecedented opportunity to virtually end preventable child death. And we can do it in a generation.

To reach this goal — one year ago — the Governments of Ethiopia, India and the U.S., with UNICEF’s support, rallied the world behind the Child Survival Call to Action. It inspired a global movement — Committing to Child Survival: A Promise Renewed. Momentum continues to build and, today, 174 countries and over 400 civil society and faith-based organizations have taken up the charge in their own commitments.

In Zambia, First Lady Dr. Christine Kaseba is helping to roll out a plan focused on nutrition and immunization that will save more than 26,000 children each year. In the Democratic Republic of Congo, the Ministry of Health is implementing a plan to save half a million children by 2015. This includes distributing pre-packaged family kits that contain medicines and other supplies to prevent, diagnose and treat malaria, diarrhea and respiratory infections.

Similar initiatives are underway in Ethiopia, Bangladesh, Yemen and beyond, where governments, civil society and the private sector are mobilizing to fulfill the promise to give every child the best possible start in life.

In today’s world, great global ambitions require strong partnerships between the public and private sector. In India, a small pharmaceutical company is developing a new zinc syrup to help get a life-saving treatment for diarrhea into rural communities. Through the Helping Babies Breathe Alliance, private sector entrepreneurs and medical professionals are training and equipping over 100,000 health workers in 54 countries with life-saving tools such as affordable resuscitation equipment. The results are impressive. A study from Tanzania showed that these tools led to a 47 per cent drop in newborn deaths during the first 24 hours of life.

For the first time in history, we have the tools to end preventable child deaths. Now, we need to build the momentum.

Through new partnerships and a relentless focus on results, we can give fathers everywhere the same opportunity that so many of us will have today: to watch our children grow and thrive; to cheer them at a ball game; to nurture their curiosity; to support their dreams and take pride in their achievements. Isn’t that what every father wants for his child?

Co-authored by Rajiv Shah, Administrator for the U.S. Agency for International Development (USAID) and Anthony Lake, Executive Director of the United Nations Children’s Fund (UNICEF).

Follow Anthony Lake on Twitter @UNICEF.
Follow Raj Shah on Twitter @rajshah.

Allowing Women to Nurture Themselves and Their Children Before Giving Birth Again

During the month of May, IMPACT will be highlighting USAID’s work in Global Health. This week we are focused on family planning. 

In too many places around the world, women lack the access to contraception or the decision-making ability to seek services.

Mother in Ethiopia. Photo Credit: Jhpiego

Eighty million unintended pregnancies were estimated to have occurred in developing countries last year. Of these, 63 million occurred among the 222 million women with an unmet need for modern contraception.[1]And in sub-Saharan Africa, one in four women in is unable to decide when and how many children she will have.

The importance of healthy timing and spacing of pregnancies cannot be underestimated. According to the World Health Organization, short birth-to-pregnancy intervals—the time between the date of a live birth and the start of the next pregnancy—greatly affect maternal, newborn, and child health and mortality outcomes. In low-resource settings, preventing another pregnancy by using family planning and waiting to get pregnant again for 36 months can reduce under-five child mortality by 25%.  For neonates in the developing world, this number is even greater—findings indicate that mortality is reduced by approximately 40% for preceding birth intervals of 3 years or more, compared with intervals of less than 2 years.[2]

The likelihood of miscarriages and stillbirths are also much higher for extremely short birth-to-pregnancy intervals. Women who become pregnant 15 to 75 months after a preceding pregnancy are less likely to miscarry or have a stillbirth baby than those with shorter or longer inter-pregnancy intervals.1

Family planning can help women ensure that pregnancy occurs at the healthiest times of their lives. Research shows that positive health outcomes for both mothers and newborns occur when pregnancy happens:

  • 24 months after a live birth (an almost three-year birth-to-birth interval);
  • 6 months after an induced abortion or miscarriage;
  • To women who have had fewer than four live births; and
  • To women between the ages of 18 and 34.

Family planning, including healthy timing and spacing of births, has been recognized as one of the most cost-effective global health interventions. For every $1 spent on family planning, $6 are saved on other interventions. And with a better-spaced family, there are more opportunities for members to grow, remain healthy, and be better educated.

Here at USAID’s flagship Maternal and Child Health Integrated Program (MCHIP), we are working around the world to save and improve lives through increased use and understanding of family planning. In India, for instance, the Program has worked with the Ministry of Health to help prevent nearly 100,000 unintended pregnancies during the extended postpartum period through our work with the postpartum IUCD.  This is just one example of our work in more than 50 countries, but is illustrative of our efforts to scale up results to reach as many women as possible.

And in Africa, where the PPIUD has been slower to gain acceptance, we’re seeing signs of hope. At a regional PPIUD meeting co-hosted by MCHIP last month in Zambia, 60 enthusiastic champions from professional societies, service delivery, INGOs, donors and governments representing 10 countries[3]convened to share their successes and challenges implementing PPIUD programs. But while these international and regional experts will surely help to advance integration of PPIUCDs into maternal health services in their respective contexts, we must multiply this number by a factor of 10—or even 100—to reach all the women who need PPFP to space their pregnancies at the safest intervals. Given the lack of understanding of return to fertility after a birth or miscarriage in much of Africa, as well as elsewhere, coupled with early return to sexual activity after delivery and short periods of amenorrhea, the role of PPFP/PPIUCD is critical to healthy timing and spacing of pregnancies. Raising awareness to dispel myths and misconceptions among clients and service providers is also key to improving PPIUCD uptake.

In our own lives, many of us have had the luxury to determine when and if we will have children. We cannot forget the millions of women in developing countries who do not have this same freedom—and who desire more time before becoming pregnant again, facing the risk of death with every pregnancy. Healthy pregnancy spacing is a cost-effective intervention that can reduce both maternal and childhood mortality and excessive population growth. Investing in women’s reproductive health and autonomy improves not only the health of the individual, but also the welfare of the whole family and, ultimately, the larger society. This investment is modest in relation to the dramatic returns it yields.


[1] UNFPA World Population Report, 2012

[2] Setty-Venugopal V, Upadhyay UD. Birth spacing: three to five saves lives. Baltimore: Johns Hopkins University, Population Information Program, 2002.

[3]Ethiopia, Kenya, Liberia, Malawi, Mozambique, Rwanda, Tanzania, Uganda, Zambia and Zimbabwe

 

Task Shifting to End Preventable Maternal/Child Death in Kenya and Zambia

During the month of May, IMPACT will be highlighting USAID’s work in Global Health.

A mother and her baby. Photo Credit: USAID

 Follow USAID for Global Health (@USAIDGH) on Twitter and use #GHMatters to join in the conversation.

Bondo, Kenya — Babies Gabriel and Mary show the progress that Kenya is making in moving towards an AIDS-free generation. Although their mothers are HIV-positive, the two babies were born free from the virus that causes AIDS thanks to a team of determined community health workers who recruited their young mothers into a project funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Agency for International Development (USAID). The project, carried out by USAID’s flagship Maternal and Child Health Integrated Program (MCHIP), which is led by Jhpiego, connects women to—and keeps them enrolled in—high-quality health care to prevent the transmission of HIV from mother-to-child.
Mothers Beatrice and Grace are grateful they met community health worker Jane Akoth. After recruiting them into the project, Akoth saw both women regularly, through home visits or appointments at the clinic, to ensure that they remained healthy during and after their pregnancies. “After I delivered my baby, Jane advised me on how to take care of my child by exclusive breastfeeding for six months and to continue taking my medication,” adds Grace, the mother of baby Mary. “I want Jane to continue doing what she is doing so that she can help other mothers.”

 

In Africa, HIV and AIDS affects women and mothers at a greater rate than men, creating a heavy disease burden among families. When parents die of the disease, children are left orphaned or given to the care of relatives who may not have the means to raise them. Pregnant and breastfeeding women who are infected with HIV also run the risk of transmitting the disease to their children but antiretroviral drugs can dramatically reduce the risk of vertical transmission. [AE1]

 

The experience of Beatrice and Grace shows that the transmission of this life-threatening virus is indeed preventable. The success of the MCHIP project was due in part to an innovative strategy that was originally developed to improve immunization of children, which links pregnant women to care and keeps them enrolled.

 

More than 300 community health workers like Jane are working in Bondo District to keep the next generation alive and healthy. Since 2010, coverage through this project has expanded so that women in the most hard to reach areas are being connected to health services. As a result, the percentage of expectant mothers going to all four antenatal care visits increased from 25 percent to 41 percent in two years, and the percentage of HIV-exposed infants who were tested for HIV increased from 27 percent to 78 percent.

We know that follow-up by community health workers is key to saving lives—getting mothers into care, keeping them there, and providing them with the lifesaving medications that they and their children need.

 

Community-based Approach Prevents HIV in Children and Keeps HIV+ Mothers Healthy in Bondo, Kenya

During the month of May, IMPACT will be highlighting USAID’s work in Global HealthFrom May 18-27 we will be focusing on an AIDS-Free Generation. 

Bondo, Kenya — Babies Gabriel and Mary show the progress that Kenya is making in moving towards an AIDS-free generation.

Beatrice, holding Gabriel, and Grace, with baby Mary, listen as CHW Jane Akoth (right) counsels them on their health choices. Photo Credit: USAID

Although their mothers are HIV-positive, the two babies were born free from the virus that causes AIDS thanks to a team of determined community health workers who recruited their young mothers into a project funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Agency for International Development (USAID). The project, carried out by USAID’s flagship Maternal and Child Health Integrated Program (MCHIP), which is led by Jhpiego, connects women to—and keeps them enrolled in—high-quality health care to prevent the transmission of HIV from mother-to-child.

Mothers Beatrice and Grace are grateful they met community health worker Jane Akoth. After recruiting them into the project, Akoth saw both women regularly, through home visits or appointments at the clinic, to ensure that they remained healthy during and after their pregnancies. “After I delivered my baby, Jane advised me on how to take care of my child by exclusive breastfeeding for six months and to continue taking my medication,” adds Grace, the mother of baby Mary. “I want Jane to continue doing what she is doing so that she can help other mothers.”


In Africa, HIV and AIDS affects women and mothers at a greater rate than men, creating a heavy disease burden among families. When parents die of the disease, children are left orphaned or given to the care of relatives who may not have the means to raise them. Pregnant and breastfeeding women who are infected with HIV also run the risk of transmitting the disease to their children but antiretroviral drugs can dramatically reduce the risk of vertical transmission.


The experience of Beatrice and Grace shows that the transmission of this life-threatening virus is indeed preventable. The success of the MCHIP project was due in part to an innovative strategy that was originally developed to improve immunization of children, which links pregnant women to care and keeps them enrolled.

More than 300 community health workers like Jane are working in Bondo District to keep the next generation alive and healthy. Since 2010, coverage through this project has expanded so that women in the most hard to reach areas are being connected to health services. As a result, the percentage of expectant mothers going to all four antenatal care visits increased from 25 percent to 41 percent in two years, and the percentage of HIV-exposed infants who were tested for HIV increased from 27 percent to 78 percent.

We know that follow-up by community health workers is key to saving lives—getting mothers into care, keeping them there, and providing them with the lifesaving medications that they and their children need.

Follow USAID for Global Health (@USAIDGH) on Twitter and use #GHMatters to join in the conversation.

Women’s Involvement in Voluntary Medical Male Circumcision for HIV Prevention

During the month of May, IMPACT will be highlighting USAID’s work in Global HealthFrom May 18-27 we will be focusing on an AIDS-Free Generation. 

Kawango Agot works to scale up voluntary medical male circumcision in Kenya. Photo Credit: USAID

I work as part of a team dedicated to scaling up voluntary medical male circumcision (VMMC) in Kenya. In 2007-2008, clinical trial results confirmed that VMMC has the potential to dramatically reduce men’s risk of acquiring HIV from their female partners. While Kenya and 13 other African countries have made great strides in rolling out VMMC (Kenya has circumcised about 500,000 men since VMMC was endorsed by the World Health Organization as an effective intervention against HIV), there has been a glaring gap that many of us have not paid attention to: how to get women fully on board as stakeholders, guardians, and partners. For all practical purposes, we as VMMC program implementers run our business as if this is solely a man’s affair. We forget that involving female partners is critical to turn this procedure into a successful intervention for HIV prevention.

In 2010, a small, unique group of young women in the lakeside city of Kisumu, Kenya, blew my mind away. One challenge we experience in VMMC programs is finding a way to support men through the six weeks of sexual abstinence recommended after surgery. In my attempt to encourage women to look beyond the usual topics surrounding VMMC (for example, that it reduces their risk of cervical cancer if their male partners are circumcised), and broach more difficult topics, my attention was drawn to some young women who accompanied their husbands/boyfriends for circumcision at one of our VMMC service sites. I called some of the couples for a casual chat, and was amazed at how perceptive they were in making decisions about their health.

The young women described how they discussed VMMC with their partners ahead of going for services – benefits, risks, fears, and interestingly, sexual abstinence. Each one of them narrated how, ahead of time, they agreed on sleeping arrangements that would enable them to observe the 42 days of abstinence. Some separated beds, others separated rooms, some slept on the same bed, but fully clothed, some simply dressed unattractively or avoided bodily contact or seductive talk while others took time off to visit with their families. Many reported to have successfully abstained for the recommended period, and attributed this to the fact that their partners involved them in their decision to be circumcised. As a bonus, most also tested for HIV together.

This experience shows us how crucial women’s participation is in the VMMC process, and how female partners might improve adherence to the post-operative abstinence period. These women deserve praise – ordinary women who have the courage to step out into the extraordinary and claim their space in VMMC, who recognize that their partner’s health is their health too.  To such, I bow in respect… and call on many more to come forward and claim their space in VMMC – it is your right!

Follow USAID for Global Health (@USAIDGH) on Twitter and use #GHMatters to join in the conversation.

 

Building Capacity: Racking Warehouses in Ethiopia

During the month of May, IMPACT will be highlighting USAID’s work in Global Health. From May 18-27 we will be focusing on an AIDS-Free Generation. 

Ethiopia has the second largest population in Africa, and the thirteenth largest in the world. The current population of 84 million is expected to reach 120 million by 2030, and 145 million by 2050. Ethiopia will play a large role in meeting the global goal of putting 15 million people on HIV treatment by 2015 and in helping create an AIDS-free generation. To do so, the population of Ethiopia needs reliable and consistent access to medicine. At present, however, the ability to acquire medicine is limited due to challenges of access, supply, distribution and cost.

The Ethiopian government is undertaking a bold initiative to ensure that medicinal supply and access are available throughout the country. A major challenge is reaching a population whose majority lives in rural areas. Through a series of centralized and regional hubs, this initiative aims to serve thousands of health centers all over the country and overcome the hurdle to reaching patients. Achieving this aim is a complex undertaking, which is becoming increasingly more so as the diversity and volume of medicines regularly expands.

The Supply Chain Management System (SCMS), a project of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) administered by USAID, has stepped in to support this nation-wide initiative. At ten warehouse sites across Ethiopia, the physical warehousing capacity has greatly increased due to the introduction of a warehouse racking system. Warehouse racking allows for vertical storage without damaging stacked products due to weight.

An Ethiopian warehouse, before. Photo credit: SCMS

The racking system enables improved material organization, as products are stored and sorted by rack location. This ensures that short shelf-life products can be located and distributed in a timely manner. It also helps prevent stockouts as regional hubs can respond faster to need requests. Thus, warehouses become more efficient in terms of space utilization, organization and loss-prevention.

Improved warehouse distribution also enhances the ability of warehouses to reduce and prevent product expiry and handle emergency situations, such as product recalls. Furthermore, a better ability to respond to the supply and demand of the population, as well as reduce loss, facilitates for a reduction in product cost.

In Adama, for example, the warehouse capacity was increased by 35 percent, to 880 pallets (the platforms that boxes of commodities sit on for shipping and storage) with the introduction of racking. Organizational improvement is evident, which facilitates for improved cost-efficiency as the products can be stored, located and distributed in a more systematic manner. That, however, is just the beginning.

An Ethiopian warehouse after support from SCMS, USAID and PEPFAR. Photo credit: Jiro Ose, SCMS

The government, with support from PEPFAR and the Global Fund, is constructing ten new – and larger – warehouse facilities to greatly increase warehouse capacity.

SCMS will outfit these new warehouses and expand upon existing facilities. When Adama’s new warehouse is complete, and racked, the pallet capacity will increase from 880 to 5,160. Across the ten sites, the existing pallet capacity of 6,039 will increase to 27,007.

The outfitting of racking in warehouses is only one contribution of many mechanisms that SCMS has provided to enhance and support the Ethiopian government in their aims of providing reliable and consistent access of medicine throughout the country. SCMS is not only meeting the needs of today, but planning for the needs of tomorrow.

Follow USAID for Global Health (@USAIDGH) on Twitter and use #GHMatters to join in the conversation.

From Haiti to Kenya – Honoring the Wisdom & Contributions of Moms

During the month of May, IMPACT will be highlighting USAID’s work in Global Health. From May 11-17, we will be featuring the important role of mothers and partnerships in Global Health.

While visiting Haiti last month, I met with a group of farmers to discuss how they were using micro-loans from a local cooperative association. During the conversation, a woman mango grower spoke about using credit to pay her kids’ school fees prior to harvest and then using profits from the sale of her fruit to pay off the loan. It reminded me of a conversation with Maasai women during a trip to Kenya where they recounted the use of proceeds from their cattle fattening business to pay school fees for kids in their community. Both exchanges brought to life the critical role that mothers—and women generally—play in promoting development around the world.

A woman and her baby. Photo Credit: Adriane Ohanesian

Mother’s Day provides a special opportunity for us to reflect on the role moms play in our lives and in the lives of people around the world. In the home, mothers are often the primary caregivers. They are important in ensuring that children receive the food, health care and education needed to grow into healthy, productive adults. They are educators, teaching children skills that will last a lifetime. The American Sociology Association estimates that moms spend 10 more hours a week multitasking than fathers, mainly doing housework and taking care of kids. At the same time, they are often also generating income for the family. That income is critical to kids’ well-being because girls and women have been found to spend 90 percent of their earned income on their families, while men only spend between 30-40 percent that way. Given their multiple, critical roles, we need to think about how we can support moms and leverage their contributions. Invest in mothers and we can grow economies, alleviate poverty and create the foundation for sustainable growth and development.

In the past twenty years, mothers have been instrumental in helping reduce the mortality rate for children under five years old by almost fifty percent. Unfortunately, today, every two minutes, a mother dies during childbirth. A staggering 80 percent of those deaths could be prevented by providing access to basic health services. Similarly, almost 19,000 children under five still die daily from preventable causes. Sub-Saharan Africa and South Asia bear 75 percent of the global disease burden, and mothers and children continue to suffer disproportionately from these illnesses borne of poverty. USAID is working hard, in partnership with country governments and non-governmental organizations globally, to reduce these preventable deaths.

Through continuous improvements to monitoring and evaluation, we are  directing resources toward increasing services for underserved populations; concentrating on the primary causes of child deaths in the hardest hit countries.  We are being strategic with taxpayer dollars by investing in programs that yield the greatest results. Our development efforts are increasingly focused on educating girls, empowering women, and promoting inclusive economic growth. That’s because we know that educated mothers are less likely to die in childbirth, more likely to send their kids to school, and provide better nutrition and health care at home. In fact, data suggests that each additional year of schooling reduces the likelihood that a mother’s child will die as an infant by 10 percent.

At USAID, we are supporting mothers worldwide. Since June 2012, the agency has been helping lead the U.S. Government’s push to renew the global effort to end preventable child death. We are committed to utilizing resources, technology, and expertise to achieve the A Promise Renewed for Child Survival goal of reducing the under five-mortality rate to below 20 deaths per 1000 live births by the year 2035. Reaching this target is a team effort by governments, civil society, the private sector, innovators, and the global health and faith-based community. Workings together, the international community can help ensure a promising future for all women and their children.

We know the statistics and we know what we need to do. We know that investing in mothers pays dividends for children, families, communities and nations. The data is clear but it’s the stories from the women in Haiti, Kenya, and around the world that bring those numbers to life. This Mother’s Day, let’s honor their wisdom and their contributions.

Follow USAID for Global Health (@USAIDGH) on Twitter and use #GHMatters to join in the conversation.

 

Harvest, Meet Market: How a New Fund Will Accelerate Agricultural Infrastructure in Africa

Since 1964, the African Development Bank (AfDB) has worked with African countries to develop their economies and progress socially.

This week, with AfDB and the Government of Sweden, we launched a first-of-its-kind effort to expand this progress and growth. The Agriculture Fast Track will encourage private sector investment in agricultural infrastructure projects to advance food security in Sub-Saharan Africa. In doing so, it supports Africa’s agriculture transformation agenda.

Incentivizing investment in agriculture

Historically, the private sector hesitated to invest in agriculture in Africa—and for good business reasons. Investing in agriculture has inherent risks, including drought, crop and livestock diseases and fluctuating crop prices. Agriculture projects can have high start-up costs because systems and facilities must be developed before they can begin making a profit. Given these challenges, it can be difficult for African countries and their development partners to create lasting improvements in food security.

That’s why we are so excited about renewed efforts to tackle these challenges in order to catalyze private investment that can spur economic growth while reducing hunger and undernutrition. Following the lead of African nations, efforts like the New Alliance for Food Security and Nutrition have coupled tough regulatory policy reforms with private investment commitments in agriculture. African leadership has driven these efforts forward, with governments undertaking transparent market-oriented reforms that encourage private investment and reduce barriers to agriculture-led economic growth.

USAID, the African Development Bank, and the Government of Sweden launch Agriculture Fast Track Fund for infrastructure projects in Africa. Photo credit: USAID

Bridging the last mile

But the last mile linking farms to markets still needs to be strengthened.

Smallholder farmers in Africa are some of the poorest and hungriest people in the world. And while the world has worked to reach them with the tools, skills and knowledge they need to increase their crops, farmers also need infrastructure.

Agriculture infrastructure reduces the risks farmers face—for instance by providing irrigation so farmers don’t rely solely on erratic rainfall to water their crops. It also provides ways for farmers to get their harvests to markets (and buyers, and ultimately to tables) quicker, like on nicely paved roads, and helps preserve harvests longer, using electricity and modern preservation and processing facilities.

The Agriculture Fast Track addresses this challenge head on. It is the first and only fund exclusively focused on infrastructure for agriculture and food security. As a New Alliance deliverable aimed at addressing barriers to agricultural development, it defrays front-end development costs and risks the private sector is unwilling to shoulder alone.

Operationally, the Agriculture Fast Track will fund technical assistance for public and private sector organizations seeking to create agricultural infrastructure projects. By providing grants for activities like scoping assessments, feasibility studies, market analyses, and social impact investments, the Agriculture Fast Track will help create a pipeline of projects able to garner the private capital needed to start and complete them.

Learn more

Along with our colleagues at AfDB and the Government of Sweden, we’ve developed a variety of materials for you to learn more about Agriculture Fast Track and the vision we have for it.

Catching Mosquitoes, Not Fish: Returning Bed Nets to their Proper Use in the DRC

During the month of May, IMPACT will be highlighting USAID’s work in Global Health. From May 1-10, we will be featuring the role that Science, Technology & Innovation plays in Global Health.

It is 1 p.m. in the village of Kavimvira. The sun is high over Lake Tanganyika, at the foot of the Mitumba Mountain, in scenic South Kivu. Frank Baraka has packed the bounty of the morning fishing trip and folded his nets, when his cell phone chimes to signal an incoming text message: : “Sleep every night under an Insecticide-Treated Net (ITN), to protect your family from malaria,” he reads out loud, amused, to his fishing companion.

Frank Baraka sewing a bed net that he will use as a fishing net. Photo Credit: USAID

“This is exactly the message my wife has been pounding at home lately,” Roger Amisi responds. “She says that she heard it at the ETL (Education-Through-Listening) meeting, with Nathalie, you know, the primary school teacher.”

Delaying his lunch, Frank hurries to Nathalie Niéla’s compound to find out about the messages.  ”Malaria kills children in our community,” Nathalie says. “Sleep under a net every night, to live safe from malaria,” she confirms.

This is the call to action of the Malaria 3+1 Campaign implemented by USAID’s Democratic Republic of Congo-Integrated Health Project (DRC-IHP), in partnership with C-Change. An estimated 140,949 Congolese from 194 villages were exposed to campaign messages on malaria awareness and prevention. In a country where only five percent of pregnant women receive proper preventive malaria therapy, and malaria accounts for nearly 40 percent of child deaths, prevention is a critical priority.

Nathalie is one of 37 women ETL facilitators recently trained in the DRC-IHP’s field office of Uvira.  ”Thanks to ETL, our husbands no longer use the nets to fish or to protect vegetable gardens,” she affirms proudly. “Nets now serve their purpose of protecting children and pregnant women from mosquito bites.”

ETL is one pillar of IHP’s Tuendeni-Kumpala Behavior Change Communication strategy which empowers communities to adopt health-seeking behaviors. Tuendeni-Kumpala which means “moving forward” in Swahili and Tshiluba (two local languages), is an integrated strategy in which ETL facilitators work in synergy with other innovative communication approaches such as mobile technology, to increase the reach and enhance the behavioral impact of project interventions such as malaria prevention and use of reproductive health services.

Through this partnership between USAID, DRC-IHP and C-Change, a total of 64,584 ITNs were distributed across Bukavu, Kolwezi, Uvira, and Kamina, supporting the effort to boost the number of people using insecticide-treated nets.  Campaign results from two health zones point to the value of ETL, in terms of actual ITN use. After four months, 89 percent of the 9,471 households exposed to campaign activities in Uvira slept every night under an ITN.  By contrast, 82 percent of the 12,965 households involved in Kamina (Katanga province) reported adoption of the preventive behavior. When the campaign was launched in June 2012, ETL was not yet rolled out in Kamina.

For the project’s communication team, the difference illustrates the powerful effect of ETL. “ETL truly shows results here,” said Donat Ngoyi, DRC-IHP Communication Expert in Uvira.  ”This approach will, no doubt, help us meet our malaria prevention and treatment goals.”

The DRC-Integrated Health Project (DRC-IHP) — a five-year USAID cooperative agreement led by Management Sciences for Health in partnership with the International Rescue Committee, and Overseas Strategic Consulting, Ltd — is strengthening the leadership and governance capacity of people working in the health sector to improve the access, availability, and quality of services within 80 target health zones.

Follow USAID for Global Health (@USAIDGH) on Twitter and use #GHMatters to join in the conversation.

A New Partnership with South Sudan, A New Way of Promoting Development in Fragile States

Earl Gast serves as assistant administrator for Africa

Last month, USAID helped to spearhead a New Partnership between the government of South Sudan and the international community—including donor nations, the African Development Bank, the International Monetary Fund, and the World Bank—based on mutual commitments to focus international assistance and host country resources on strengthening governance, political inclusiveness and sustainable development in South Sudan.

As the world’s newest nation, South Sudan is also one of the least developed countries and therefore, has been highly reliant on donor assistance. Following its independence in July 2011, the international community’s high hopes for the new nation’s future were quickly tempered by an escalation in tensions between South Sudan and Sudan that led to the January 2012 suspension of oil production from South Sudan and transit through Sudan. Given that oil represents 98 percent of Juba’s revenue, the impact of this cessation was immediate and devastating.

The last year of living in austerity and diminishing government services has been a difficult time for the people of South Sudan, who have suffered high food and fuel prices, inflation, displacement from internal conflict and floods. South Sudan also hosts 200,000 refugees from Sudan, who fled fighting and a severe humanitarian crisis in that country.

In early April 2013, Sudan and South Sudan resumed cooperation on oil production, and oil is beginning to flow again. Nonetheless, South Sudan would do well to remember the tough lessons learned over the past year without oil revenues. Despite the hardships, this time of austerity has also been an opportunity to put in place tough, but necessary, economic reforms and fiscal discipline that will help grow the economy and improve transparency.

To help get South Sudan on a sustainable path for development, more than 40 governments and international organizations attended the South Sudan Economic Partners Forum in Washington on April 16. This year, donors have committed to provide approximately $1.3 billion to South Sudan—part of the continuing effort to help the new and underdeveloped nation get on its feet and provide emergency humanitarian assistance where needed. They also indicated a willingness to add new support—up to $300 million—to their existing assistance to South Sudan should the government continue on the right path. The United States is South Sudan’s largest donor. In fiscal year 2012, USAID and the State Department provided $680.4 million in assistance to South Sudan, including emergency (PDF) and development assistance, as well as peacekeeping and security sector programming.

However, donor assistance alone cannot be the solution to South Sudan’s long-term challenges—good governance and private sector growth are equally critical for sustaining the new country’s future. We know, based on decades of hard-earned experience in other parts of the world, that coun­tries with strong economies and sta­ble gov­ern­ments tend to pro­vide more access to ser­vices for cit­i­zens, and oppor­tu­ni­ties for employ­ment. As part of the New Partnership, South Sudan’s partners—including the United States, United Kingdom, Norway, European Union, the World Bank and others —agreed to help the government of South Sudan organize a Private Sector Investment Conference in Juba later this year. As a critical first step, USAID organized a South Sudan Investment Forum in Washington on April 17, 2013 to introduce U.S. companies in South Sudan’s priority sectors (agriculture, petroleum, energy, infrastructure and mining) to government ministers to explore potential investment opportunities. Demonstrating U.S. Government’s commitment to supporting private sector investment in South Sudan, the Overseas Private Investment Corporation (OPIC) signed an Investment Incentive Agreement supporting U.S. private sector investment in South Sudan.

To complement these efforts, USAID has offered its expertise to help the government of South Sudan complete investment agreements based on transparency and responsible stewardship of South Sudan’s public resources, to grow and diversify the economy, and to help the people of South Sudan realize their potential. With this assistance, we believe USAID and other donors’ collaboration in South Sudan in close partnership with the government will put South Sudan on a better path to deliver on its independence promise.

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