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Archives for Women

How the Future of Women & Girls is Tied to Water

Almost 800 million people in the world today lack access to clean water.  Africa and the Middle East are the most water scarce regions in the world. Three hundred million people in Sub-Saharan Africa live in water-scarce environments and every year the number of people under water stress grows larger and larger.

Girl travels by camel in Mongolia Photo Credit: James Orlando

Fresh water scarcity affects everyone, but no one is touched more than women and girls. The consequences of constrained water access for them are dramatic. In much of the world, women and children are primarily responsible for water in their households. Some two-thirds of the households that lack easy access rely on women and girls to get the family’s water. Girls under the age of 15 are twice as likely as boys their age to be the family member responsible for fetching water.

This may not seem so important but about 40 billion hours are spent carrying water each year in Africa alone. Those are hours that could be spent in school or earning an income. They also represent time when women’s and children’s health and safety are threatened. In Asia and Africa, it’s common for women to carry 40 pounds of water on their heads while making a trek than can exceed 20 kilometers each way, especially in times of drought. This increases their risk of violence and sexual assault

In 2010, this reality was brought home to me when I served on USAID drought relief task force for the Horn of Africa. I visited a Kenyan community where under-nourished women and girls were spending the vast majority of their time fetching water; their donkeys had died during the previous drought cycle, leaving them to hand carry water back and forth almost daily for their homes. The need for water to survive subsumed their ability to perform other basic tasks, obliterating any hope for an education and further undermining their nutritional well-being by inhibiting their ability to garden and grow food.

The broader implications of water scarcity can be dramatic too. It has been estimated that, 443 million school days are lost and 700 thousand children die each year due to water related disease and poor sanitation. Poor water and sanitation keep children, especially girls, out of school; inadequate sanitation and the lack of separate toilets in schools particularly reduces girls’ attendance, sometimes pushing them to drop out at puberty. According to the United Nations Development Programme: “every $1 invested in water and sanitation generates on average an $8 return in the form of saved time, increased productivity, and reduce health cost.”

 

While women and children are most burdened by the need to obtain drinking water and basic sanitation, they are often excluded from decision making about water. What’s more, if women were more regularly included in water management it could improve deliberations. They know a lot about the reliability of water supplies, where it can be found, and how availability varies by season. Their personal knowledge can improve water-related management. Community-based organizations that successfully involve women in discussions regarding water access, sanitation, and hygiene, are more likely to result in robust economic growth and improvements in the quality of life. Sustainable economic growth and development goals simply cannot be achieved without a focus on water and gender.

Now that USAID has released its new water strategy, we must remember that while easy access to clean water can have profound implications for the ability of societies to thrive, it can have particular importance for women and girls. Their lives and futures are often inextricably tied to whether or not water is available close by to meet families’ and communities’ basic needs.

 

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.

 

More than 30,000 Fistula Repair Surgeries Supported by USAID

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

On Thursday, May 23, the world will be marking the first-ever International Day to End Obstetric Fistula, as recently designated by the United Nations General Assembly. USAID commemorates this day by celebrating a milestone in global maternal health: Over 30,000 fistula repair surgeries have been performed with U.S. support since 2005. Fistula, a devastating childbirth injury believed to affect millions of women in developing countries, can be surgically repaired up to 90% of the time. Unfortunately, most women who suffer from fistula lack access to a skilled surgeon or fully equipped health center, making treatment and prevention too often out of reach.

Fistula clients in Uganda after receiving treatment. Photo credit: Fistula Care/EngenderHealth

Ten years ago, USAID launched a global effort to both treat and prevent fistula and is today one of the largest funder of such activities worldwide. To date, through initiatives such as the EngenderHealth-led Fistula Care project, and in collaboration with local governments, regional health care organizations, faith-based organizations, and other partners, USAID has supported training and equipment for medical teams in 15 countries at 56 health facilities across Africa and Asia for fistula repair surgery. Efforts to support fistula prevention have been supported by Fistula Care at an additional 43 sites.

Obstetric fistula is an injury caused by prolonged or obstructed labor, when the head of the baby cannot pass safely through the woman’s birth canal. The baby often dies as a result, and the woman is left with an abnormal opening in the birth canal and chronic incontinence.

The hopeful part of the story is that in addition to most cases being reparable, fistula is almost entirely preventable. This is why USAID-supported projects work to improve access to routine and emergency obstetric care and cesarean deliveries for women who experience complications during labor and delivery. Together with skilled attendance at all births and access to voluntary family planning, these efforts can make fistula as rare in the developing world as it is in the United States. USAID works to engage all levels of society to raise awareness about fistula and its underlying causes, including early pregnancy, poverty, and a lack of education and empowerment for women and girls.

As the largest USAID-supported effort to both treat and prevent fistula, EngenderHealth’s Fistula Care project is committed to transform the lives of thousands more women and girls around the world.

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

ROADS II Video: Transforming Corridors of Risk into Pathways of Prevention and Hope

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. 

Since 2005, the Regional Outreach Addressing AIDS through Development Strategies (ROADS) Project – Phases I and II - funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Agency for International Development (USAID) East Africa and bilateral missions, has linked communities along transport corridors of east, central and southern Africa with critical HIV and other health services. ROADS is also helping vulnerable men, women and children reduce their vulnerability to HIV by expanding economic opportunities, improving food security, supporting community-based substance abuse counseling and working to protect women and girls from sexual exploitation and abuse. In this video, ROADS II project director Dorothy Muroki describes how the project takes an integrated approach to human development and how it is transforming corridors of risk into pathways of prevention and hope.”

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

Join My Village Lift Women and Girls out of Poverty

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.

In the last 23 years, global mortality rates have decreased by 47 percent. With funding from international governments and non-governmental organizations, developing countries across the globe have received unprecedented aid in the form of education and healthcare support to decrease mortality rates.

Join My Village (JMV), a program of CARE in partnership with General Mills and Merck, is working to resolve this issue by building awareness online and providing on-the-ground programming that includes support groups for men and women as well as community engagements to reduce misconceptions about pregnancy and maternal health. JMV helps to lift women and girls out of poverty through education while also providing sustainable improvement in maternal and newborn health through effective service delivery and women’s empowerment initiatives. The programs are having a remarkable impact on communities in India by changing the behavior and attitude of whole communities around the treatment of women.

Preventing maternal deaths not only saves women’s lives, it can positively impact families and whole communities. Photo credit: PATH/Evelyn Hockstein

Along with working to uplift women, JMV is has also made a point to engage men in these communities. Men have a larger say in decisions that ultimately affect women’s economic, educational and reproductive health. To ensure that the women have a conducive and supportive environment at home, their husbands are invited to participate in the interactive meetings.

Recently, we heard from a young husband and wife participating in the JMV program in Uttar Pradesh, India. After going through a difficult first pregnancy where the mother did not receive prenatal care, the young woman almost lost her life and her baby. Of the second pregnancy, her husband said, “Though that incident taught me the risks involved in home deliveries, today’s meeting taught me how to be better prepared even before the child arrives. My wife stopped taking her iron tablets as she said they made her nauseous. I didn’t bother much about it until I came here today and learned how important they are for both the child and my wife. Now I will ensure she takes them at the appropriate time to avoid uneasiness. Planning for the future is another critical thing I learned, and I will start saving for the child right away.” The couple, happy to have attended the meeting, feel that they are now better equipped for the birth of their second child.

Preventing maternal deaths not only saves women’s lives, it can positively impact families and whole communities. When a mother dies, her family oftentimes breaks apart and her children are less likely to go to school, receive immunizations against diseases and eat nutritionally sound diets. By equipping women and their partners with lifesaving information, women will bear children at the healthiest times so that mother and child are more likely to survive and stay healthy.

Through these outreach programs, JMV encourages communities to be supportive of the health, education and empowerment of women and girls. To learn more about Join My Village and its partners please visit www.joinmyvillage.com.

Akanksha Nigam is a Media Officer for Join My Village, a program of CARE.

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.

 

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.

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.

Technologies to Keep Mothers Safe

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.

This Sunday—Mother’s Day in the United States—will be a day of light hearts and laughter for many. At PATH, we’re dedicated to developing simple, affordable technology to make sure becoming a mother is a time of joy the world over.

Elizabeth Abu-Haydar, right, with a mother in a prenatal clinic in Rajasthan, India. Photo Credit: PATH/Noah Perin

In some parts of the world—notably sub-Saharan Africa—childbirth remains an extremely dangerous time in a woman’s life. Some 300,000 women worldwide die each year just before or after delivery. Excessive obstetric bleeding— postpartum hemorrhage—causes 1 in 4 of these deaths. And mothers who survive aren’t out of danger. Those who live through severe postpartum hemorrhage are significantly more likely than other mothers to die within a year’s time, leaving their babies and families alone.

Elizabeth Abu-Haydar, public health specialist with our Technology Solutions program, looks for ways technology can make childbirth safer. On May 28, she’ll be presenting her work at Women Deliver, an international conference focused on improving the health and well-being of girls and women. To celebrate Mother’s Day, we asked Elizabeth about some of the technologies that hold promise for making childbirth safer.

What will you talk about at Women Deliver?

I’m going to highlight some of the technologies we’re working on to fill a gap that occurs when women experience severe postpartum hemorrhage. There’s a clear protocol that’s followed when a woman starts bleeding after delivery: She’s given medication and her abdomen is massaged, and in 62 percent of the cases, that works to stop the bleeding. But in those other roughly 40 percent of cases, the woman could potentially continue bleeding, and if she’s bleeding severely, even a healthy woman can die within two hours. Most of these women are not as healthy as they could be, and the biggest problem is that many of them are anemic.

Why does anemia make the problem worse?

These women have low iron stores, and the body during pregnancy requires more iron. If a woman starts bleeding and she doesn’t have iron stores, she’s likely to go into heart failure and shock much more rapidly than a woman who is healthy. In sub-Saharan Africa, where 40 to 50 percent of the women are anemic, that’s a huge problem.

What can we do about it?

We’ve been testing a device that makes it very easy to assess whether a woman is iron deficient or not. We call it a noninvasive anemia screening device. The device measures iron levels using a clip that attaches to the woman’s finger. Ideally, you would use it every time she comes in for her prenatal visit. If there’s a problem, you can start treatment and monitoring. The screening doesn’t require blood, it gives a reading in less than a minute, it doesn’t hurt, and it’s visual, so that it becomes a way to talk about iron with the woman. Plus, there are no sharps and no waste and no resupply issues either, which is a big, big deal.

What do you do to stop the bleeding once it starts?

One option is the balloon tamponade. It’s basically tubing attached to a vessel, such as a condom, that is inflated by pumping water into it. It’s inserted into the uterus and filled until it stops the bleeding. It is very effective and it’s very affordable.

Another option is the antishock garment, which looks a bit like a tight wetsuit. Its main purpose is to reverse shock. If a woman has bled profusely and her organs are shutting down, she starts going into shock. That’s when the antishock garment gets wrapped around her in a sequential manner starting from her legs up so that the blood is pushed to her vital organs. You can combine the antishock garment with the balloon tamponade. It’s a beautiful combination!

You sound very motivated—even though developing technologies is a long haul. What keeps you going?

You know, I was in Kenya in August, visiting 13 clinics that were run by midwives—not fancy, these were serving the slums of Nairobi. We talked about the balloon tamponade, and a couple of midwives had used it. They talk about the woman who came in to give birth, and they really thought she was going to die, and there was no way she was going to make it to the hospital, and somebody said, “Why don’t we use this balloon thing they were telling us about?” And they try it. And the woman survives. And she comes back a week later with her baby. That inspires me. That’s very exciting, I think.

Additional Resources

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.

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