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Netbooks Empower Community Health Workers to Improve Health in Bangladesh’s Poorest Communities

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.

With a population of 150 million, Bangladesh is a bustling country filled with vibrant people. On a recent trip to Dhaka and Chittagong we experienced first-hand the kindness and welcoming spirit of the country. The goal of our trip was to meet with various USAID implementing partners, and several units within the Ministry of Family Health and Welfareto find out more about their behavior change communication work. Developing high quality, evidence-based communication campaigns that promote healthy behaviors is quite a challenge for Bangladesh with their large population, numerous rural communities, and with so many health issues that need to be addressed. These health areas range from improved antenatal and postnatal care, family planning, nutrition, and child health. USAID implementing partners and the Ministry of Family Health and Welfare are now streamlining their health communications work, making sure their messages are in agreement, effective, and accessible to a range of people of all ages and educational backgrounds.

Community health workers receive training on the new netbooks. Photo credit: Bangladesh Knowledge Management Initiative

A key part in this new effort was the launch of a three-month eHealth pilot program, developed by Johns Hopkins University – Center for Communication Programs in partner with Eminence, the Bangladesh Center for Communication Programs, and the Ministry of Health and Family Welfare, with funding from USAID. The pilot will take place in Sylhet and Chittagong where 300 community health workers have received a netbook computer loaded with several eToolkits that contain a digital library of communication materials in maternal and child health, family planning and nutrition, and eight eLearning courses. The eToolkit includes 116 materials and tools which were selected by a team after a detailed assessment and review. The eToolkit will improve the quality and effectiveness of counseling visits that the community health workers have with their clients, while replacing the heavy materials they previously carried from house to house. The eight eLearning courses on the netbooks are meant to supplement the training that community health workers currently receive. Each course also includes an assessment designed to measure changes in the knowledge and skills of community health workers.

Puspa Rani Paramdar, a community health worker, said she felt empowered with information and knowledge after she received the netbook. Photo credit: Bangladesh Knowledge Management Initiative

The eHealth pilot is one of the first large steps towards achieving a Digital Bangladesh by 2021. The use of digital resources will help extend the reach of key messages for health, population, and nutrition. In early April, colorful balloons and banners welcomed guests to the launch event for the pilot program in Chittagong. Here we witnessed the ceremonially hand-off of ten netbooks to community health workers before an audience of more than100 guests who were excited and engaged, asking interesting technical questions and offering suggestions for future iterations of the project.

On April 20-21, the first 30 community health workers attended an orientation, learned to use the netbook, and navigate the eToolkit and eLearning courses. Facilitators led an interactive orientation to ensure the community health workers felt comfortable operating the netbooks. There was much enthusiasm for the eHealth pilot program from the field workers during the orientation, who shared they felt empowered, informed, and energized to continue their important work.

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

The Promise of MPTs: An Integrated Approach to 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.

In recent years, the global community has intensified its focus on women’s health and rights. This reflects a universal recognition that women and girls are fundamental to the health and well-being of societies worldwide — and that we still have significant challenges to overcome before reaching essential development goals.

HIV and maternal mortaility, and their frequent intersection, are  among the greatest obstacles to women’s health and development. Together, they consisitute the two leading causes of death among women of reproductive age.

A woman holding a ring. Photo Credit: USAID

Women are disproportionately affected by HIV/AIDS due to a combination of biology, gender inequality and sociocultural norms. In sub-Saharan Africa, the epicenter of the AIDS epidemic, young women are twice as likely to become infected with HIV as young men.

At the same time, a lack of access to modern contraceptives in developing countries remains a major contributor to global maternal deaths. An estimated 222 million women worldwide want to delay or avoid pregnancy but aren’t using a modern method of family planning. Contraceptives allow women to space and limit their pregnancies,  leading to better health, education and economic outcomes for women and families.

Women in areas with high rates of HIV often have the greatest unmet need for contraception. New multipurpose prevention technologies (MPTs) now being developed address these dual risks, and may give women tools they can use to protect their health and better their lives.

While existing MPTs such as male and female condoms are extremely effective when they can be used, many women cannot negotiate condom use. New MPTs in development — including vaginal gels, long-acting rings and new types of barrier devices — could expand options for discreet, female-initiated prevention methods. In addition, because women’s perceived risk of HIV is low compared to their perceived risk for pregnancy, and given potential stigma around receiving HIV services, combined technologies may be widely used. As such, new MPTs may also help promote increased integration in health care delivery.

With leadership and support from USAID, the International Partnership for Microbicides is applying its experience in HIV prevention to the development of a 60-day MPT vaginal ring that would offer protection against HIV and unintended pregnancy. Now in preclinical stages, the ring would deliver an antiretroviral drug called dapivirine along with the hormonal contraceptive levonorgestrel. Clinical studies are planned for 2014.

The contraceptive field has long taught us that no single product will address women’s unique needs and preferences. While some women may prefer to use a gel around the time of sex, others may find that a longer-acting ring is more convenient and encourages consistent use. USAID is working on a number of new technologies to expand contraceptive options for women and couples across the globe. Learn more about these new contraceptives and multipurpose prevention technologies under development in this slideshow.

While at least several years away, new integrated solutions like these could result in significant health gains for women by reducing rates of HIV transmission, STIs, and maternal and newborn death associated with unintended pregnancies. As a result, MPTs could help advance progress on multiple development goals related to health, poverty and gender equality — and give women and girls a chance to reach their full potential.

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

Photo of the Week: Administrator Shah in North Colombia

Last week, Administrator Shah met with displaced families in Corozal, Sucre in Northern Colombia at a land titling event, and received a warm “thank you” from one of the community members. Photo is from USAID.

Video of the Week: LAUNCH Systems Challenge 2013

Last week, USAID and partners NASA, NIKE Inc., and the Department of State, held a LAUNCH 2020 Summit to kick off a new LAUNCH focus on systems innovation. LAUNCH is aimed at identifying, showcasing, and accelerating innovative approaches to specific global challenges. LAUNCH searches for visionaries whose world-class ideas, technologies, or programs show great promise for making tangible impacts on society. On April 24, the LAUNCH 2013 Systems Challenge went live, calling innovators to come up with programs and processes that will transform the system of fabrics to one that advances equitable global economic growth, drives human prosperity and replenishes the planet’s resources. The challenge closes on July 15.  We will also soon be opening our first LAUNCH “nano-challenge,” a call for solutions specifically aimed at university students.

Please visit www.launch.org for more information about the program. You can view the current challenge statement and submit an application.

VIDEO: Twitter Chat on Mobile Money on May 9

Join Nandini Harihareswara on Thursday, May 9th at Noon EDT for an #AskUSAID Twitter Expert Hour.  She will answer all your questions about USAID’s work with mobile money and electronic payments. Tweet @MSolutionsUSAID your questions using the hashtag #AskUSAID.

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.

Saving a Syrian Student’s Life

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Ghassan* was leaving his university classes when he was injured in the crossfire in Rif Damascus Photo Credit: USAID NGO Partner *Name changed to protect identity

The United States has provided nearly $409 million in humanitarian assistance to help those affected by the ongoing crisis in Syria. Since February 2012, USAD has provided support to over 144 field hospitals, medical clinics, and medical points across Syria that have saved countless lives, including Ghassan.

Ghassan, a university student from Rif Damascus, was heading home from classes when fighting broke out between regime and rebel fighters. Ghassan was not able to take cover in time and was hit by shrapnel in both legs.

When the fighting died down, he was taken to a nearby USAID-supported field hospital, where doctors found a closed fracture in his right leg and shrapnel wounds in his left foot. Luckily, the femoral artery in his leg was not hit and he only suffered a bone fracture, but no displacement. The doctors removed the shrapnel, cleaned the wounds, and cast his right leg.

Ghassan stayed at the hospital for nine days while the doctors treated his injuries. He continues to visit the hospital when he is able and sometimes receives USAID-supported doctors at his home.

Ghassan thanks the doctors and those who support them for their help in treating his injuries. His father was killed in crossfire six months ago, but Ghassan says he still wishes to follow in his father’s footsteps and continue studying for his business degree when his injuries have healed.

To learn more about our assistance to those affected by the ongoing crisis in Syria, visit our website.

 

USAID in the News

In a recent editorial, the New York Times says that President Obama’s budget proposal to redirect some U.S. food aid funds to “buy food in bulk in countries in need or to provide individual recipients with vouchers or debit cards for local food purchases” rather than purchase the food in the U.S. and ship it overseas may be unpopular with domestic food producers, but it “will feed more people for the same amount the United States spends now.” The Times says “there is no excuse” for not enacting the change.

In another piece, “Proposal for Changes in Food Aid Sets Off Infighting in Congress,” the New York Times reports that the proposal “has set off a jurisdictional fight among” lawmakers, “threatening to derail the most significant change to the program since it was created nearly 60 years ago.” USAID Administrator Rajiv Shah says, “This new reform would give us the flexible tools we need to get food to people who need it now, not weeks later,” adding that “we would still buy from U.S. farmers. But this way we can help feed two to four million more people without additional costs.”

LAUNCH, a series of forums to identify, showcase and support innovative approaches to global challenges, was recognized by Harvard’s Ash Center as a Top 25 Innovations in GovernmentWashington Post reported that “among the projects that made the cut is a public-private collaboration between NASA, USAID, the State Department and sportswear company Nike called Launch. The project, through a series of forums and networks, seeks to surface and accelerate the development of strong, innovative ideas.”

The Financial reports, “USAID announced the release of exciting new datasets and tools that increase transparency and provide the fuel for innovators and decision makers to solve problems.” The conference, “convened countries from the G-8 and New Alliance for Food Security and Nutrition to discuss the potential of open data for agriculture and develop action plans to open and apply food security relevant datasets. To demonstrate the power of open data to deliver solutions, the conference also featured technologists and entrepreneurs who use USAID and U.S Government data to develop products to bring real solutions to the developing world.”

LAUNCH: Addressing Development Problems Through Systems Innovation and Collaboration Across Boundaries

Will Schmitt serves as the LAUNCH program manager for Office of Science and Technology. Photo credit: Will Schmitt

Last week USAID and its LAUNCH partners held a very successful “LAUNCH 2020 Summit” at Nike World Headquarters in Beaverton, Oregon. We are also excited and honored that the Ash Center for Democratic Governance and Innovation at Harvard University’s Kennedy School just named LAUNCH one of its Top 25 Government Innovations. To mark the start of an exciting new phase of LAUNCH and to celebrate our success, we would like to provide a short overview for those not familiar with the program, as well as some news about where we are taking the program next.

What is LAUNCH?

LAUNCH, a collaborative public-private partnership between USAID, NASA, NIKE Inc., and the Department of State, is aimed at identifying, showcasing, and accelerating innovative approaches to specific global challenges. LAUNCH searches for visionaries whose world-class ideas, technologies, or programs show great promise for making tangible impacts on society.

Since the beginning of LAUNCH in 2010, we have completed four program cycles (Water, Health, Energy, and Beyond Waste) and have just kicked off a fifth focused on transforming the system of textiles and apparel manufacturing.   For each challenge, LAUNCH convenes a group of thought leaders for an expert consultation called the “Big Think” to help identify the areas ripe for innovation within that sector and guide us in sharpening our challenge statement. A two-day Summit follows, where global stakeholders from across that cycle’s system build a collective understanding of the systems problems outlined in the LAUNCH challenge.  The challenge is publically released at the Summit, beginning an open innovation process that will identify hundreds of innovations related to the challenge. Ten promising innovations are chosen through a rigorous evaluation process and invited to the three-day LAUNCH Forum, the centerpiece of the LAUNCH process. At the Forum, the ten innovators meet with the LAUNCH Council, a selected multidisciplinary group of leaders whose expertise, networks and resources align with the particular challenge.   During the Forum, the LAUNCH Council helps the innovators chart a course of action that will accelerate their innovations forward.  Innovators then receive six months of support through the LAUNCH Accelerator, a program custom designed for each innovator to harvest and act on the most promising connections, ideas and opportunities surfaced during the LAUNCH Forum.

What kinds of innovations has LAUNCH supported?

Over the past three years, LAUNCH has supported dozens of innovations with game-changing potential. The Carbon for Water project, for example, has distributed nearly 900,000 easy-to-use water filters in western Kenya, obviating the need to boil water to make it safe for drinking. This reduces wood consumption and carbon emissions by an estimated two million tons annually. The company that manufactures the filters is subsequently able to sell carbon credits on the global carbon credit market. That’s real financial sustainability alongside cost-effective service delivery.

Or LUCAS, (now produced by spin-off company Holomic) a lens-free microscope that attaches to a camera-equipped cell phone and is able to remotely detect bacteria and parasites in blood or drinking water. The LUCAS technology came out of Professor Aydogan Ozcan’s UCLA lab and has subsequently garnered significant private investment.

What makes LAUNCH different from other types of programming models?

For one thing, LAUNCH is fundamentally about sustainability—we pick apart sustainability problems and find the innovators we think stand the best chance of radically impacting those problems. We’re sourcing and supporting new technologies and innovations, yes, but we don’t want these to be one-off innovations that get “stuck in the garage.” We want to promote innovations that are sustainable, scalable, and contribute to human development in a way that minimizes the strain on resources. And we want to do it in a way that is ultimately financially sustainable. LAUNCH is as much about systems thinking as it is about new technology.

Secondly, LAUNCH is collaborative and open. We’re partnering with NASA, NIKE Inc., and the State Department precisely because we believe that each partner brings its own unique perspectives, capabilities, and audiences to the table, and each plays a major role in shaping the program. A powerful network built by the partners and our collaborators that is poised to help LAUNCH innovators with their greatest business or program needs is critical to our success. The principle of openness also applies to the selection of our LAUNCH innovators (the winners of each LAUNCH Challenge), many of whom are organizations that have never worked with USAID before.

What should we know about the new phase of LAUNCH that began with the LAUNCH 2020 Summit?

We held a LAUNCH 2020 Summit at NIKE headquarters to kick off a new LAUNCH focus on systems innovation. After a few program cycles, we realized that the problems we are addressing are fundamentally systems problems and that the program should both explain and attack them as such.  We began by gathering a broad selection of members of the system we’re addressing in one room for a few days. We used the Summit to build a collective understanding of that system’s challenges and the possibilities for collaboration in solving them. We decided to focus on the textiles and apparel system because of its complex global supply chains, common interest for all four partners, and immense scope for change in the system. This industry has a disproportionate impact on the livelihoods and the environmental and social well-being of the world’s poor. As a result, it provides fertile ground for the LAUNCH program model and its new focus on tackling systems innovation problems to drive transformative progress in the industry. For the LAUNCH 2013 Systems Challenge, we’ve chosen to focus on the materials of which fabrics are made and the manufacturing systems that make those fabrics. Elements of the challenge statement focused on putting workers at the center of innovation in the industry and on building inclusive business models should be of very significant interest to the development community.

The 2013 Systems Challenge went live on April 24th and will close on July 15th.  We will also soon be opening our first LAUNCH “nano-challenge,” a call for solutions specifically aimed at university students.

Please visit www.launch.org for more information about the program. You can view the current challenge statement and submit an application. Please distribute the challenge statement far and wide across your own networks (downloadable file here)—it’s a critical part of finding the very best innovators!

Free Press: The Cornerstone of Democracy

Today marks two decades since the United Nations General Assembly designated May 3 as World Press Freedom Day to celebrate press freedom and raise awareness about threats to media independence around the world.  A free press plays a vital role in democratic societies, enabling the open exchange of information and opinions among ordinary citizens, businesses, citizen associations, political parties, and governments. Free and open media systems give voice to citizens, truth test candidates and political parties during elections, inform policy debates in legislatures, investigate corruption, hold public officials accountable, enable democratic governance and facilitate more effective development.

Yet the global struggle for press freedoms remains a work in progress. According to the latest Freedom House reports, the sobering reality is that more than one-third of all global citizens live under highly state-controlled media and information environments classified as “not free”.

In Mozambique, USAID supports the five-year, $10 million Media Strengthening Program to promote a free, open, diverse, and self-sustaining media sector. Photo Credit: IREX

In nearly 35 countries, USAID provides media development assistance, tailoring initiatives to local conditions and prevalent challenges. Using a multi-pronged strategy, USAID aims to strengthen journalists’ skills, build economic self-sustainability of media outlets, and legally protect press independence.

Since 2002, USAID has been instrumental in building a freer, more professional media in Afghanistan. Once very isolated, the Afghan people now enjoy unprecedented access to quality local newscasts (such as the national radio news program Salam Watandar) and international education and entertainment media. With USAID support, a national network of nearly 50 Afghan-owned and operated radio stations has emerged, reaching virtually all corners of the country. USAID also provided the initial seed capital for the highly successful independent television network Tolo TV, which now reaches over two-thirds of the population.

In Burma, USAID has worked for over a decade with more than 1,000 Burmese journalists, starting with support on the Thai-Burmese border in 2001 and extending inside Burma since 2003. Journalists trained in the program’s early years have now gone on to become leaders of the media industry, as part of both the local print media and the media in exile. USAID’s media program responded to almost every major development in the country: it equipped Burmese journalists with training and key support to cover the Saffron Revolution in 2007, Cyclone Nargis in 2008, the constitutional referendum in 2008, and the elections of 2010-2012.

In Eastern Europe, the USAID-funded Regional Investigative Journalism Network helps connect practicing investigative journalists across borders who seek to uncover corruption, organized crime, and others engaged in the criminal services industry.

In eight countries throughout the Middle East and North Africa, the “Building a Digital Gateway to Better Lives” program empowers professional and citizen journalists, giving them hands-on experience with digital tools to design and implement multimedia projects that report on public service issues affecting citizens’ everyday lives. Almost 300 journalists have participated in the program so far, with results felt throughout the region. Gripping stories of the abuse of children with disabilities in Jordan, human rights violations in Lebanese prisons, corruption in the West Bank/Gaza, polluted drinking water in Iraq, and detecting unexploded landmines in Morocco have attracted significant public interest and response.

Today and every day, USAID applauds the brave work of journalists, editors, and the increasing millions of “citizen reporters” throughout the world in their common pursuit to freely gather, report, analyze, and share news. We also commend the media activists who advocate for media development and freedom despite challenging and sometimes dangerous conditions. We salute you.

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