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Malian Midwife Champions Respectful Care for Pregnant Women and their Families

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.

The man brings his pregnant wife into the health center and is confronted by the irritated midwife who raises her voice: “I’m too busy, what do you want? Go outside, this is no place for a man!” Later, the man returns for news about his wife’s condition and is promptly told to “go back and sit there.”

This role play session about abuse and disrespect in maternity care was part of a training in Burkina Faso sponsored by MCHIP. Through role play, MCHIP trainers demonstrated to doctors and midwives what not to do when attending to their patients, as disrespectful treatment of pregnant women and their families is all too common in health facilities around the world. This is especially true in developing countries, where doctors and midwives often lack basic infrastructure, supplies, manpower, or even awareness about patients’ rights to be treated with dignity during birth.

Pregnant woman with companion at the renovated maternity ward in Bobo Dioulasso, Burkina Faso. Photo credit: USAID

Training participant Haoua Ba had never heard about respectful care until this MCHIP training, even after 22 years as a midwife in Mali. Haoua and about 30 other midwives, pediatricians and obstetricians are known as Africa “Champions” (or advocates) for improving maternal and newborn health by promoting up-to-date knowledge, practices and attitudes in their countries and region. Mali is one of 10 key African countries—along with Benin, Guinea, Kenya, Liberia, Madagascar, Senegal, South Sudan, Uganda and Zambia—where the MCHIP Africa Champions Program is being implemented over two years (2011-2013).

MCHIP maternal and newborn health trainings have always emphasized “women friendly care,” for example by introducing skills checklists with which providers are evaluated on their ability to provide respectful care. However, given the prevalence of disrespect and abuse—in Africa in particular—and the lack of knowledge about this issue, Africa Champion trainers developed an entire training module devoted to this topic. In this 1.5 hour session, a facilitator helps training participants understand during group discussion that there is evidence that key components of respectful care, such as involving a woman in her care, will make the birth experience go more smoothly for both the woman and the health care provider.

Haoua described how this training session taught her to respect pregnant women and their families by greeting them politely and continually informing them in a soothing voice about everything she is doing. And since the training last year, Haoua has seen a big difference after putting into practice these new skills.

“When you show respect, it really facilitates things,” she said. “If you calmly tell the woman what to do and explain things her, it comforts her. And word gets around so women know who is going to treat them well and they request that midwife when they come into the hospital.”

After participating in three Africa Champions maternal and newborn health trainings on innovative, lifesaving practices, Haoua is uniquely positioned to transfer these lessons learned. She plans to do so with both staff and student interns at the busy Referral Health Center in Bamako, Mali, where she also works as a midwife with 22 other midwives and three gynecologists. In fact, one of her primary goals as a Champion is to help strengthen the health center team by promoting evidence-based care. She described how she and one of the doctors will organize trainings about twice a month on a particular theme and have attendees practice on mannequins under their supervision to ensure they are correctly using their newly acquired skills and knowledge.

Importantly, Haoua has taught her colleagues that a woman should be allowed to have a companion by her side during the birth, which is a central tenant of respectful care. Having a loved one present provides women with essential comfort and support during the birth process, especially when the health center staff are busy or overworked. Evidence supports this practice as one that can help to shorten labor and increase normal outcomes.

A pregnant woman who must give birth without the company of a loved one or who must lie on the floor because there are not enough tables, without the privacy of a curtain, is not receiving respectful care. But even in the worst conditions, said Haoua, “if you have the will to do things well, you can help women.”

She is a perfect example of how the USAID-funded Africa Champions program is helping to prevent the untold suffering of women during one of the most vulnerable but extraordinary times in their lives.

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

USAID in the News

Food Aid Reform

In an op-ed published in the Chicago Tribune, USAID Administrator Rajiv Shah, Secretary of State John Kerry, and Secretary of the Department of Agriculture Tom Vilsack explain “our hallmark food assistance program has not evolved with the times.” President Obama has proposed a number of reforms that could help the U.S.  ”feed up to 4 million more hungry people every year” while reducing costs. From purchasing locally-sourced food to using electronic payments, the officials say such strategies can help the U.S. “carry out its development mission more effectively and efficiently – not to perpetuate dependency, but to advance human dignity.”

In an editorial, the Chicago Tribune says it considers the current Food for Peace program a “terribly expensive and inefficient system. We’re pleased to see the Obama administration make a run at changing that… the administration has proposed a modest reform that can save money and feed more people.” The editorial continues,  ”Food aid can help to lift developing nations out of poverty, promote political stability and economic growth. It must be structured efficiently to achieve its objective. Reforming food aid would enable America to do justice to a large taxpayer outlay – and to save lives.”

USAID, Swedish Ministry for International Development, and African Development Bank launch Agriculture Fast Track at World Economic Forum

Business Day Live reports, the “fund – called Agriculture Fast Track – is the first of its kind and marks a new approach to development aid by western donors, that aims to promote economic growth through commercial agriculture.” In short, “Agriculture Fast Track’s purpose will be to fund some of the front-end costs of developing agricultural infrastructure, such as scoping, project design and feasibility studies, with the aim of leveraging private funding to commit to the projects.”

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.

The Power of Mobile Technology to Save Lives

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.

The development field has been exploring for years ways to harness the power of technology to benefit those in need, especially mobile technology, which can reach people in remote areas who need food, health, education, and other assistance quickly and well.

A health worker refers to her mobile phone for information while making a house visit. Photo credit: World Vision

Health is an area in which the benefits of mobile technology are obvious. One initiative World Vision is especially proud of is our mobile health (mHealth) projects  in 13 countries. Our mHealth projects leverage the ubiquity of mobile phones to deliver information to, and receive information from, patients and caregivers and can address a broad range of scenarios, including announcements, targeted messages, appointment reminders, medical records for patients, treatment reminders, training and tools for front line health workers and volunteers. Key mHealth principles that have been integrated into current and planned projects include: 1. Align closely with Ministries of Health and their partners; 2. Work in partnership with other funders, developers, and implementers to build on and add to global learning; 3. Design to meet the needs of local users but also provide the basis for maturing the evidence base; 4. Be initially affordable yet based on sustainable costing models and scalable technology; 5. Be respectful of data governance issues; 6. Utilize and strengthen government and partner information systems; 7. Emphasize coherence and quality of approach and program/project management; and 8. Favor open source solutions and emerging global standards.

To support mHealth, World Vision has strategically partnered with the Bill & Melinda Gates Foundation, Grameen Foundation, and Dimagi to create and deploy a World Vision version of the Gates-funded MOTECH Suite (MTS), a sustainable, scalable, open source mobile solution. MTS provides a set of capabilities encompassing five key functional mHealth areas: Behavior Change & Demand Generation, Managing Patient Data, Improving Worker Performance, Last-Mile Supply Chain, and Patient Adherence. This partnership allows World Vision’s funded mHealth projects to utilize a common, yet customizable, field-tested mHealth tool.

MTS was piloted in World Vision’s Afghanistan mHealth project (USAID-funded Child Survival Health program 2008-2013), and the evaluation results are encouraging:

  • significant improvement between intervention and control groups in any antenatal attendance (20 percent),
  • skilled delivery at a health facility (22.3 percent),
  • having a birth plan that included improved coordination with the health facility (12.6 percent),
  • saved money and arranged transport (12.9 percent)
  • knowledge of two or more pregnancy danger signs (12.9 percent).

A volunteer health worker refers to her mobile phone for information while making a house visit. Photo credit: World Vision

In World Vision’s Mozambique mHealth project (Gates-funded Grand Challenges 2010-2012), MTS research results indicated that pregnant women in the project’s intervention area had a higher likelihood of accessing antenatal care, prepare better for birth, and have their births assisted by a skilled provider. They were also more likely than those in the control group to know about signs of pregnancy complications and to seek care at a facility for that complication.

The advantages of the shared framework of MTS are numerous, from minimizing software development, operations, and support costs, to making available the source code, best practices, learning, and other assets to the global community to avoid duplication, and ultimately, save more lives. As World Vision rolls out MTS in additional countries and regions, we’ll analyze the complexity and economics of this versus other models, the interface with national Ministries of Health systems, impact, and sustainability.

Deployments of WV’s global version of MTS have begun in Sierra Leone, Uganda, and Zambia, with others to follow in Tanzania, Sri Lanka and India by this August. World Vision aims to increase geographical mHealth reach within these countries while enhancing MTS functionality at the community level. The focus is on creation of a solution that is globally deployable, meeting at least 80 percent of functionality needs for each project, and further customizable for each context. A key characteristic of this effort is collaboration with Ministries of Health and intentional efforts to forge public-private partnership agreements with mobile network operators and other potential private sector partners. This model has already effected notable reductions in duplication of effort and overall costs at the global level, as well as for each project.

Initiatives like MTS are the way forward for NGOs to impact the global health field, including reducing incidence of malaria, improving maternal and child health, and improving child nutrition. Read more about World Vision’s mHealth projects.

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

Earth Matters Workshop Helps Nepali Journalists Link Environment to Socio-Political Dialogue

Given Nepal’s high vulnerability to climate change, one might expect reporters like Mangal Man Shakya, a veteran investigative journalist and chairman of Nepal’s Wildlife Watch Group, to find great demand for his environmental stories. Unfortunately, that isn’t the always the case.

“It has been a long time since I saw an investigative environmental report in the Nepali media,” Shakya said as he spoke at a recent “Earth Matters Workshop” for journalists in Kathmandu. Although many Nepali leaders recognize the need to take action on environmental issues, the preeminence of political and economic stories often means reporting on climate change and conservation gets buried on page 6. The environmental stories that do get published are typically limited in scope, rather than in-depth and linked to broader political, economic, or health issues.

Recognizing the media’s critical role in raising public awareness and influencing public policy, USAID, in partnership with WWF Nepal, organized a media Earth Day workshop called “Earth Matters,” designed to help journalists understand how environmental issues can be linked to broader socio-political issues in Nepal and produce content with more in-depth analysis. The workshop, organized through the USAID-funded Hariyo Ban (Green Forests) Program, invited Nepali journalists to engage with some of the nation’s top conservation experts, high-ranking policy makers, veteran media professionals, and an award-winning journalist from the United States, in sessions that often took on a press conference format.

Former Parliamentarian and Politician Gagan Thapa joined the “Earth Matters Workshop” to discuss the environmental issues and challenges in the Constituent Assembly and reiterated the important role media plays in raising public awareness and influencing policy discourse and action. Photo credit: Fungma Fudong, USAID Nepal

The 12 participants, selected from a large pool of applicants, shared the common challenges they face not only in accessing resources to pursue environmental reporting, but also in getting buy-in from newsrooms that do not care for, or do not understand, the country’s environmental issues. Such challenges make it even more important for journalists to link environmental stories to political and economic issues, which tend to receive greater coverage.

Speaking at the workshop, former Member of Parliament’s Natural Resources and Means Committee Gagan Thapa reiterated the influence that good reporting can have on policy: “Often, it was the media that brought many issues to our attention,” he said, discussing the relationship between reporters and the Parliament and Constituent Assembly. He added that, with Nepal’s current lack of a Parliament, it is all the more important for environmental reporters to be bold and vigilant.

“Environment issues are at the heart of Nepal’s socio-economic present and future problems and solutions, and it is high time Nepali politics recognizes this,” Kashish Das Shrestha, well-known environmental writer and moderator of the workshop, said. “An informed and responsible media is critical in helping to shape the political discourse accordingly.”

By the end of the workshop, one of the 12 participants had produced a radio show on the devastating effects of mining and deforestation in Nepal’s mid hills for Image FM 97.9, one of Nepal’s largest stations, and also published an article on the story. Another participant had produced a radio report for the Community Information Network, which includes more than 100 community radio stations throughout Nepal. These reports are just few of the bright sparks lit by the workshop.

In the second phase of the workshop, participants will head to the field to conduct research in the areas where Hariyo Ban operates. This interaction with those most affected by environmental issues is expected to inform and expand environmental media coverage. The workshop culminates on World Environment Day, June 5, when all participants—Hariyo Ban Champions—will share the work they have produced based on the workshop and field research.

USAID’s Hariyo Ban program has, since 2011, helped Nepalis prepare for and adapt to climate stresses. Hariyo Ban is a cornerstone of President Obama’s Global Climate Change Initiative in Nepal and is implemented by a consortium led by World Wildlife Fund (WWF). Other consortium members include: CARE, the Federation of Community Forestry Users in Nepal, and the National Trust for Nature Conservation.

Glass Half Full in this “Almost Revolution”

Larry Garber serves as deputy assistant administrator for Policy, Planning and Learning

Last week I participated in two panel discussions organized by the Carnegie Endowment for International Peace that addressed two important development issues: 1) “Closing Space for International Assistance,” a roundtable discussion that included over 20 participants from various U.S. Government agencies, implementing partners, and think-tanks; and 2) the role of politics in the work of development agencies as described in a new book Development Aid Confronts Politics: The Almost Revolution.

USAID confronts the issue of closing space in a number of different country settings. Recently, Agency efforts have catalogued the diverse and creative Mission responses to the problem under the rubrics of prevention, adaptation, and continuing support. In addition, we have engaged implementing partners–both those involved in Democracy, Rights and Governance and in more traditional development sectors–and donor counterparts regarding the challenges we all face.

The second panel discussion involved the launch of a new book by Tom Carothers and Diane de Gramont, entitled Development Aid Confronts Politics: The Almost Revolution. As I stated in my remarks at the launch, the book is a must-read for all USAID staff, whether they are in policy making or operational positions, and whether they are based in Washington, D.C. or serving in the field.

The book describes how the development community shifted over a period of 50 years, from a generally apolitical, technical orientation during the 1960s, 70s and 80s to a recognition in the 1990s that both political goals and political methods are essential for achieving development results. The book acknowledges the progress that many donor agencies, including USAID, have made in introducing democracy and governance programs into their portfolios and in encouraging robust political analysis as part of their strategy and project design processes.

Carothers and de Gramont include many examples from USAID. There is an extended quote from the 2010 Ethiopia Country Development Cooperation Strategy (CDCS) (PDF), which forthrightly describes the “competing objectives of engaging and assisting Ethiopia as a high profile example of poverty and vulnerability to famine, and addressing the major challenges and constraints to democratic space, human rights abuses and severe restrictions on civil society.” There is also a wonderful quote from a Mission Director serving in Africa, who extols the virtues of political economy assessments and “insists that all newcomers read the report as part of their briefing materials.”

And yet, the authors conclude that this transformation is only an “almost revolution.” I share their view that the glass is half full, yet also hope that the book will motivate a profound debate within the broader development community as well as USAID regarding the proper relationship between politics, political methods, and political goals on the one hand, and an emphasis on the achievement of traditional development results on the other hand.

Let the debate begin!

Adding Vaccines to Intensify the Assault on Malaria

David Kaslow, MD, serves as Director of the PATH Malaria Vaccine Initiative. Photo credit: David Kaslow

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.

At the turn of the last century, the call to action to bring to bear tools such as insecticide-treated bed nets, malaria rapid diagnostic tests and artemisinin-based combination therapies, was heard. Governments, foundations, non-profit groups, and the commercial sector mobilized to stem the tide against an ancient scourge—the result has been an estimated 274 million malaria cases and 1.1 million deaths averted between 2001 and 2010.

And yet, the fight against malaria is far from over and new tools will be needed to continue to build on these initial impressive gains.

Given these gains the World Health Organization (WHO) has undertaken an update of the 2006 Malaria Vaccine Technology Roadmap—a document developed through a consultative process to align the malaria vaccine development community toward common goals. In 2006, the Roadmap set a shorter-term goal—by 2015, develop and license a first-generation malaria vaccine that has a protective efficacy of more than 50% against severe disease and death and lasts longer than one year—which is expected not to change. However, the long-term goal will be updated to better reflect the global health community’s desire to eradicate malaria altogether and targets vaccines that interrupt malaria transmission (VIMTs) and that support the elimination/eradication agenda, including transmission-blocking vaccines (TBV). TBVs are designed to break the cycle of transmission, preventing the malaria parasite from passing from humans to mosquitoes. When used in conjunction with other technologies, a transmission-blocking vaccine could help a country push across the threshold from control to elimination and ultimately help achieve global eradication.

Although there is not an approved malaria vaccine today, several lines of evidence indicate that it is biologically feasible to develop one. A recent update by the WHO of the global malaria vaccine pipeline identified more than two dozen active vaccine candidates in clinical development. This list includes the most clinically advanced candidate, GlaxoSmithKline’s RTS,S, which is in the midst of late-stage Phase 3 trials in Africa. Results to date show that RTS,S cuts cases of malaria in half in toddlers and by one-third in infants, on top of the protection provided by bed nets.

The final set of data from the Phase 3 efficacy trial is expected in 2014, and will provide decision-makers with important information about RTS,S, including vaccine effect in different malaria endemic settings and the impact of a booster dose. And anticipated modeling outputs will illustrate how the vaccine candidate’s efficacy may translate into public health impact—another important input for decisions about the possible role of RTS,S in the future. Experience from vaccines to combat other diseases, such as rotavirus, has shown that the relationship between vaccine efficacy and public health impact is not always straight forward. Rotavirus vaccine efficacy is higher in South Africa than in Malawi (77 percent versus 49 percent – 60 percent greater in South Africa), but the vaccine’s impact in terms of cases averted is actually 60 percent greater in Malawi.

Building on the key learnings from RTS,S, and using unique tools, such as the malaria “human challenge model”, revolutionary new ways to accelerate vaccine development are being used to hunt for additional vaccine targets. The US Government, through multiple cross-sector collaborations, is at the center of much of this research. Initial breakthroughs in malaria vaccine science came from the Department of Defense and the National Institutes of Health—often with the support of USAID. And key elements of the global malaria vaccine pipeline are supported by USAID’s Malaria Vaccine Development Program, which, along with the President’s Malaria Initiative, has been integral to the successes made to date in the fight against malaria. Indeed, it is only through strong partnerships that the overall battle against this disease will be won.

The international community has made phenomenal progress against malaria, but the gains are fragile. More than 650,000 people still die from malaria each year, almost all of them young African children, and history tells us that when support for control programs wanes, the parasite resurges with a vengeance. Over the years, malaria vaccine development has progressed from a pipe dream to a pipeline, and adding a vaccine to the arsenal is more important than ever to vanquish this parasite. At the turn of the next century, malaria should exist only in the annals of eradicated infectious diseases.

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

Feeding Africa’s Future

This originally appeared on the World Economic Forum Blog.

Today, we have the tools and knowledge to end extreme poverty and hunger by working together to transform agriculture. This isn’t just a development hypothesis; it’s actually happening.

Earlier this year, I had the opportunity to see firsthand the dramatic results of an emerging agriculture transformation on a visit to Tanzania. In just one year, rice yields have increased by over 50% and horticulture yields by 44% – early progress being reflected in farms and fields across Africa.

Across the continent, African nations are taking concrete steps to make agricultural development like this a priority, lifting families out of poverty and increasing their participation in the global economy.

A farmer picks coffee beans in Nyeri. Photo credit: REUTERS/Stringer

More than 20 countries in Africa have developed country-owned investment plans and at least seven have increased expenditures in agriculture. African nations have come together under a common vision to make progress like this possible and reduce underinvestment in agriculture to put their continent on a new course towards sustainable, inclusive development.

Grow Africa is helping that vision become reality.

Grow Africa is a partnership of the African Union, the New Partnership for Africa’s Development, and the World Economic Forum. After only one year, it is already seeing results by working with eight African countries to engage governments, civil society, and the private sector to advance sustainable agricultural growth. These partnerships have already invested more than US$ 60 million in agriculture and reached more than 800,000 smallholder farmers, connecting them to markets and innovative tools and opportunities.

We are excited to be a part of this progress, supporting Grow Africa and the Comprehensive Africa Agriculture Development Programme (CAADP) through Feed the Future, President Obama’s global hunger and food security initiative. Feed the Future targets investments in countries that have demonstrated a commitment to their own agricultural development. This past year, we helped more than 7 million farmers around the world apply new technologies and practices, four times the number we reached the previous year.

To expand this progress and reach more people across the continent, President Obama announced the New Alliance for Food Security and Nutrition at the 2012 G8 Summit. Much like Grow Africa, this global partnership brings together African governments, the private sector, and donors to accelerate investment in agriculture through market-oriented reforms and new private sector commitments.

African nations are leading progress on this effort. Tanzania has removed its export ban on staple commodities, Mozambique eliminated permit requirements for inter-district trade, and Ethiopia no longer imposes export quotas on commercial farm outputs and processed goods. At the same time, more than 60 companies – half of them local African firms – have committed US$ 3.7 billion towards African agriculture, with plans to lift 50 million people out of poverty in the next 10 years.

This week, we will announce with our partners new efforts that will catalyze private sector investments in agricultural infrastructure in Africa and strengthen capacity in African agriculture sectors. These efforts align with our commitments through Feed the Future and the New Alliance to help reduce poverty, hunger and undernutrition.

Earlier this year, during the State of the Union address, President Obama called on the United States to help end extreme poverty in the next two decades. The President spoke from the belief that even in a time of tight budgets around the world, we can still come together to accomplish incredible goals.

We can’t do it without our partners. We look forward to continuing to support country-led efforts like Grow Africa, building momentum towards a future free of extreme poverty and hunger.

Rajiv Shah is Administrator of the U.S. Agency for International Development. Follow him on Twitter @RajShah

The Power of Mobile to Improve Women’s Health

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.

Last month, I had the chance to visit a clinic in Nigeria just outside of the Federal Capital Territory where approximately 70 pregnant women were waiting to receive prenatal care. Being a big fan of impromptu focus groups, I asked the women to raise their hands if they had a cell phone. Hands shot up around the outdoor meeting space, many of them proudly clutching mobiles phones of all shapes, sizes and varieties. This was an exciting moment for me, a clear representation of just how ubiquitous mobile technology has become in low-income countries. The GSM Association estimates that the mobile penetration rate in developing countries is now 89%.

There is no doubt that the pervasiveness of mobile technology has made possible innovative new ways to deliver health information and services. mHealth projects throughout  the world are harnessing the power of mobile to do everything from registering births to supporting health workers to raising awareness about disease prevention (and a great deal in between!). Mobile phones have also become valuable tools for empowering women: more than 1 billion women have access to a mobile phone in developing countries, and 9 out of 10 women who use mobile phones say they feel safer and more connected with friends and family.

With a mobile phone, this mother has access to health information and services. Photo credit: VillageReach

Women, as mothers and health workers, are commonly the beneficiaries of mHealth projects. But even as we acknowledge the potential power of mobile phones to improve their health and wellbeing, it’s important to recognize that they are rarely equal participants in the development of these interventions or the policies that govern access and use.

I believe firmly that mHealth projects, especially those related to reproductive, maternal, newborn and child health, must take into account social, cultural and gender norms in order to produce improved health outcomes. This belief led me to work with my colleague, Madhu Deshmukh, who is seconded to the mHealth Alliance from CARE – a leader in the movement to promote the empowerment of women and girls – to develop a Gender Analytical Framework (PDF). Through this framework, mHealth implementers can better understand the nuances and implications of gender issues, and then design or modify their projects accordingly.

When developing the framework, we interviewed a number of organizations working on mHealth projects, including VillageReach, one of our grantees bringing a toll-free maternal health hotline to scale in Malawi. What VillageReach told us is that they have experienced first-hand the challenges of taking gender into account when designing mHealth programs, for instance when they realized men were calling into the service on behalf of their families. By creating this framework, the mHealth Alliance is providing mHealth implementers like VillageReach with a powerful tool that will help ensure women and men not only have access to mobile technology but that it is being harnessed in a way that truly benefits the health of pregnant women and their families, as well as the male and female health workers that serve them.

Returning to my unofficial Nigerian focus group, my second question to the women was how many had used their phone to obtain some sort of health information. Remarkably about half of the hands went up. When I probed, many shared that they used their phones to either call a family member or a health worker to seek advice about their pregnancy, though it wasn’t necessarily through a formal service.

In Nigeria, the government has recognized this power of mobile phones to empower citizens, health workers, and the health system through the Saving One Million Lives initiative.  They have also highlighted equity and gender, specifically, as key to ensuring that the full potential of mobile is realized to reach targets for significant reductions in maternal and child deaths and improvement in health and wellbeing.

As more services to provide access to health information are implemented by programs such as VillageReach and the Mobile Alliance for Maternal Action (MAMA), I fully anticipate that more women will be empowered to better care for themselves and their children. On my next visit to Nigeria, I hope to see the number of raised hands rise dramatically, due in no small part to mHealth implementers and designers applying a gender lens to their work.

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

Why Open Data Matters: G-8 and African Nations Increase Open Data for Food Security

Jimmy Wambua, a social justice worker and young entrepreneur in Nairobi, Kenya, saw a problem. In a country where smallholder farmers grow the food that feeds the Kenyan people, crop yields were not reaching their full potential and growers were not getting a fair price. Decisions about what crops to plant and when were made on speculation and instinct, and farmers sold their crops based on prices offered by middlemen and traders. A solution seemed evident: increase access and sharing of information that already exists and is public, but is not in-use by the farmers. Jimmy joined the M-Farm organization that set up a text-message based mobile phone application for farmers to gain a better price by accessing market price for their crops- rather than relying on the word of the buyer- and provide a platform for farmers to sell their goods online. USAID contributed to the work of M-Farm- not through a grant or loan or other financial capital- but with information capital. With the release of an open data set from the Famine Early Warning System (FEWSNet) M-Farm now has access to ten years of historic data about market prices of crops, which show trends in crop price fluctuation, and enables better decision making on which crops to plant to yield the highest income.

Kenyan farmer shows her crops. Photo credit: Jimmy Wambua

M-Farm’s story was just one of dozens that took the stage April 29 & 30 at the G-8 International Open Agriculture Data Conference and showcased innovative organizations that use open data to support global food security. Dr. Howard-Yana Shapiro of Mars Global shared progress on mapping the genomes of over 100 crops that are vital to food security, but are overlooked because they are not commercially viable. Palantir Technologies and Grameen Foundation displayed their open data app that they developed at USAID’s Hack for Hunger,which uses community knowledge worker-collected data and Palantir analytics to build a crop-specific food security early warning system for farmers in Uganda.

The concept of open agriculture data fuses transparency and technology to improve food security worldwide; farmers, entrepreneurs, and researchers recognize the impact and potential of increasing access to information and are increasingly receiving high-level support. USDA Secretary Tom Vilsack touted the U.S. Government’s leadership role in increasing open data for development impact and for global growth. Bill Gates, co-chair of the Bill and Melinda Gates Foundation, highlighted the use of open genomic data to leapfrog development of new agricultural products. Dr. Kathryn Sullivan, acting NOAA Administrator and the first American woman to walk in space, delivered an inspiring perspective of the role that data can play in transcending and unifying an Earth without country borders or sector divisions. Four hundred food security specialists, data scientists, and technology experts gathered with policy makers from G-8 and the six African New Alliance for Food Security and Nutrition countries to work together to increase available information and launch G-8 country action plans to get more data open from both the public and private sector. U.S. Chief Technology Officer and Special Assistant to the President Todd Park cheered the work of the conference stating that, “by liberating data from the vaults of government and the private sector, we can accelerate the use of open agriculture and nutrition data to advance global food security while also fueling the growth of new businesses and jobs.”

The G-8 Heads of Delegation Valery Khromchenkov (Russia), Robert Turnock (Canada), Hideaki Chotoku (Japan), Tim Wheeler (United Kingdom), Guillou Marion (France), Martin Koehler (Germany), and Giulio Menato (European Union) listen to Agriculture Under Secretary Research, Education and Economics (REE) Dr. Catherine Woteki (U.S.) announce the action plans developed at the G-8 International Conference on Open Data for Agriculture 2013. Photo Credit: USDA photo by Bob Nichols.

USAID has been consistently demonstrating its role as a leader in increasing open data. Multiple G-8 conference speakers joined because of products they had made as a result of the December 2012 Development DataJam that USAID’s Innovation & Development Alliances (IDEA) office co-hosted with the White House Office of Science & Technology Policy. At the DataJam, USAID leadership joined with other issue experts, innovators, data scientists, and entrepreneurs to commit to developing prototypes that use open data to improve international. Continuing the support of these and other data innovators and social entrepreneurs, last week USAID launched www.usaid.gov/developer with new datasets and tools that had previously not been available to the public, including some we support through Feed the Future the U.S. Government’s global hunger and food security initiative. Each of these datasets are useful on their own, and when compared and applied with other datasets from USAID and other organizations, they have the growing potential to dramatically increase the impact and efficiency of international assistance.

In an increasingly networked and tech-savvy world, open data has the potential for more people to use information for social good, and USAID and global development goals directly benefit from increasing access to information.Like any technological tool, open data is useless without the people applying and engaging with it. Only through active and consistent participation can we ensure that information is timely, useful, and used. We can expect that these changes will come. Let’s get that information online and useable. Let’s get data open. Food security data is just the beginning.

For more information on USAID’s open data work, visit www.usaid.gov/developer or email OpenAgData@usaid.gov.

Katherine Townsend serves as Special Assistant for Engagement in USAID’s office of Innovation & Development Alliances. Follow her on Twitter @DiploKat.

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