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Learning from Past Elections to Improve Current Elections

Rapid Assessment Review cover

Together, PPL and DCHA staff compiled a Rapid Assessment Review of Kenya’s 2013 elections.

International support for elections has emphasized various dimensions during the past several decades.   In an effort to promote free and genuine electoral processes, assistance has included technical support for election commissions, provision of electoral commodities, international and domestic election monitoring, political party capacity building and many other modes. The March 2013 Kenyan elections, whose anniversary we mark this month, brought to the fore a new approach: the international community’s multi-faceted support for an election process combined with a proactive violence prevention campaign. The fact that Kenyan institutions ultimately managed the process in a manner that minimized violence, in stark contrast to the horrific post-elections experience in 2007, and where all parties accepted the results despite a close result and Supreme Court appeal, makes this election worthy of study.

The USAID/Kenya mission, which dedicated considerable time and creative effort to supporting the Kenyan election process over several years, sought to memorialize its efforts in a manner that could be shared with other USAID missions facing similar circumstances.  Hence, the Mission requested that I and two DCHA colleagues conduct a Rapid Assessment Review (RAR) of USAID’s experience, beginning with the period immediately following the 2007 election violence and continuing through the post-election period in 2013.  We chose a RAR rather than a more immediate After Action Review and or the more rigorous evaluation performed in accordance with USAID’s 2011 Evaluation Policy, to quickly, but fully, capture important lessons about election support in dynamic, politically complex settings, where diverse interventions are required to achieve desired outcomes.

The RAR emphasizes that USAID was not the principal actor that contributed to the largely successful outcome. Most important, a wide range of Kenyans –election officials,  party activists and civil society organizers – were the individuals committed to the reform process initiated in response to the previous post-election violence.  USAID’s role in the Kenyan elections was embedded in a broader U.S. government effort, which featured the active involvement of several U.S. Ambassadors, a team from the Department of State’s Bureau of Conflict and Stabilization Operations (CSO) and, in the lead-up to election day, a proactive inter-agency effort, both at post and in Washington.

Among the RAR’s 11 recommendations are the following:  “Promote elections that are peaceful and credible, and avoid operating as if these objectives are inherently in conflict” and “Start early – An election is a process, not an event.”   Having just returned from a visit to Nigeria, I know that these and other lessons included in the RAR will resonate with Nigerian officials as they prepare for February 2015 elections in a country with even more linguistic, ethnic and geographic divisions than Kenya, and which has also had experiences with poorly administered elections leading to increased tensions and violence.

USAID is not alone in seeking to learn from the Kenya experience.  In addition to the RAR, you can learn more about the Kenya elections process through the State Department’s “Final Evaluation on CSO ‘s Kenya Engagement,” the UN Office of Coordination for Humanitarian Affairs’s ”OCHA Lessons Learned of the Kenya Election Process Humanitarian Preparedness Process and the Global Center for the Responsibility to Protect’s “R2P in Practice: Ethnic Violence, Elections and Atrocity Prevention in Kenya.  And just last week, the U.S. Institute for Peace organized a symposium on “Kenya, One Year Later: Lessons Learned for Preventing Mass Violence.”

USAID and INGOs – Traveling a New Path Together

Photo of Tony Pipa

Tony Pipa, Deputy Assistant to the Administrator, Bureau for Policy, Planning, and Learning

The landscape of international development, and the architecture of aid that has traditionally underpinned it, have shifted significantly over the last decade. In 2012, official development assistance (ODA) from members of the Development Assistance Committee (DAC) of the OECD comprised less than 10 percent of the international resource flows into developing countries. Development has become an enterprise dependent not on aid, but a conception of partnership involving a multitude of other actors – civil society, faith-based organizations, private philanthropy, the private sector, emerging economies, and the political leadership and commitment of developing countries themselves – that will be the focus of the forthcoming High-Level Meeting in Mexico City of the Global Partnership for Effective Development Cooperation in April, highlighting progress since commitments made in Busan. The “how” of development is no longer just about aid effectiveness – it encompasses all actors with a stake in its success.

USAID’s Policy Framework, launched in 2011, identified this new “aidscape” as a key global trend shaping the Agency’s future. Our commitment to achieve the President’s mandate from last year’s State of the Union address to end extreme poverty, reflected in our new mission statement, provides added impetus for us to evolve and adapt. The updated model of development we have been pursuing, which emphasizes local policy reforms and private sector engagement in combination with our investments and the reforms of USAID Forward, provides us an excellent template for continued progress.

International nongovernmental organizations (INGOs) have been both catalysts and subjects of this changing aidscape. A recent report by FSG, “Ahead of the Curve: Insights for the International NGO of the Future,” enjoins the evolution of the 50 largest U.S. INGOs in response to these disruptive forces, cataloguing the challenges they pose to the traditional INGO business model and highlighting paths of promise for both adapting and increasing their overall impact.

We have much to learn from each other. As the FSG report suggests, INGOs are well-placed to build upon their project experience and global reach to develop approaches that address large-scale challenges at the systemic level. Mercy Corps, World Vision, Save the Children and other INGOs helped pioneer approaches to building resilience in the face of crisis, integrating humanitarian response and long-term development strategies to help vulnerable communities respond to and recover from shocks and stresses. Their innovations in programming and designing systemic solutions were instructive in the development of USAID’s first-ever policy on resilience, and together we have been working with governments to lessen the effects of persistent drought in the Horn of Africa and the Sahel. USAID’s recent commitment to engage external stakeholders directly and post policies in development for public comment and feedback enables INGOs both to shape future market directions and identify opportunities for innovation.

To achieve transformative impact, USAID is increasingly focused on creating multi-stakeholder platforms for public-private partnerships built upon the political commitments of developing countries to a given cause. The New Alliance for Food Security and Nutrition has attracted $3.7 billion in private sector commitments in its drive to raise 50 million people out of poverty over the next ten years, and Power Africa, which seeks to make electricity available to 20 million people, launched last year with $9 billion in private sector commitments.

Investments are just part of the value of this engagement. Private companies bring strategic thinking, market savvy, distribution channels and value chains that, when leveraged, increase the development impact of our work. INGOs could be a key partner in developing and structuring more of these types of alliances to enable private sector commitments that result in public gain. INGOs are also an increasingly significant source of private resources in their own right, as evidenced by the $1 billion pledge made by InterAction‘s members to improve food security. Their growth as purveyors of private development assistance provides new opportunities to explore how we might leverage our combined resources through new and interesting partnerships.

And the financial support, both philanthropic and public, for international development that is emanating from emerging economies will only continue to grow.  Mercy Corps has been active in supporting the growth of social entrepreneurship in China and recently deepened its collaboration with the China Foundation for Poverty Alleviation – even adding its president to the Mercy Corps board of directors – at the same time as USAID is embarking on the first-ever U.S.-China development dialogue with the Ministry of Commerce. As part of our new five-year strategy in Indonesia, USAID will work with the government to build and strengthen their own aid agency, and our new strategy in India also marks a significant shift away from the traditional donor/recipient relationship of the past to a strategic partnership.  This evolution is not only spurring INGOs to tailor their operations in these countries to a new reality, but also opening them up to opportunities to diversify their resource base through local sources. Given our experience with INGOs and their capabilities, USAID can be an ally as INGOs seek to adapt and take advantage of potential new relationships.

From my perspective, the examples cited by FSG and our own experience suggest that leadership, strategic creativity and the willingness to risk new approaches despite resource constraints are key ingredients to charting a new path for the journey that has just begun – one that we will share.

Learn more at www.futureingo.org

Download the report here.

IWD 2014: An AIDS Vaccine as a Force for Women’s Equality

We’ve come a long way in 104 years of marking International Women’s Day. But far too many women remain left behind in far too many parts of the world.

In sub-Saharan Africa, AIDS is the leading killer of women of reproductive age. Limited education, economic and social dependence on men, and gender-based violence severely restrict women’s power over their own health. Imagine what an AIDS vaccine could change for African women and their children.  Photo Credit: IAVI

In sub-Saharan Africa, AIDS is the leading killer of women of reproductive age. Limited education, economic and social dependence on men, and gender-based violence severely restrict women’s power over their own health. Imagine what an AIDS vaccine could change for African women and their children. Photo Credit: Frederic Courbet

In Africa, a vicious cycle of HIV and AIDS and gender inequity continues to thwart women’s hopes for a healthy and productive life. AIDS is the number-one killer of women of reproductive age in sub-Saharan Africa and the world, and women account for more than half of the people living with HIV in low- and middle-income countries. It’s a human tragedy and an economic one.  Beyond the epidemic’s direct costs, women are a driving force behind Africa’s economy, and their productivity loss takes a toll. Women own nearly one-third of firms in sub-Saharan Africa and grow at least 80 percent of the food.

Inequity in daily life explains much of the disproportional impact of HIV on women. Limited education, economic and social dependence on men, and gender-based violence severely restrict African women’s power over their own lives and health. An effective and widely available AIDS vaccine will help break through many of the related social and cultural barriers.

Women in Africa are disproportionately impacted by HIV/AIDS and play a critical role in the global response, from doctors, nurses and lab scientists to counselors, community organizers and volunteers in clinical trials of vaccines and other new prevention technologies. Photo Credit: IAVI

Women in Africa are disproportionately impacted by HIV/AIDS and play a critical role in the global response, from doctors, nurses and lab scientists to counselors, community organizers and volunteers in clinical trials of vaccines and other new prevention technologies. Photo Credit: Jean-Marc Giboux/Getty Images

Helping to ensure development of an AIDS vaccine is more than a job for those of us at the International AIDS Vaccine Initiative (IAVI) and our many partners. It’s a passion – from the clinician in Entebbe, to the community organizer in Kilifi, to the trial participant rolling up her sleeve in Kigali. At a young age, I learned the power of vaccines when my parents, who had lost a child to measles, took me to get the measles vaccine soon after it was introduced. As a senior executive in the vaccine industry, I have seen firsthand the transformative value that vaccines have brought to the developed and developing worlds. Just imagine what an AIDS vaccine could do for women in Africa. Today, they face heavy odds that they might contract HIV and potentially leave their children orphaned, but tomorrow they could be confident that they are protected from HIV and live healthy and productive lives.

There has been enormous progress in treatment and prevention, but AIDS still kills 1.6 million people every year. I am proud to work daily alongside the thousands of dedicated scientists, advocates, clinicians, counselors, and community organizers – so many supported by the President’s Emergency Plan for AIDS Relief through USAID – who are devoting their lives and passions to achieving this sustainable solution for the women of Africa. As we collectively work to find an effective vaccine and ensure its swift distribution to all those who need it, we are already opening avenues to healthcare, education, and support that equalize and empower women.

Investing in Africa’s Future

Note: this article was adapted from a version originally published in “Ventures Africa.”

With 200 million people aged between 15 and 24, Africa maintains the youngest population in the world. The current trend indicates that this population will double by 2050, according to an African Economic Outlook report, which aggregates data from several multilateral organizations including the African Development Bank and the United Nations Economic Commission for Africa.

Gaining professional skills helps the West African business community engage in more trade and encourages economic growth for the region. (Photo Credit West Africa Trade Hub)

Gaining professional skills helps the West African business community engage in more trade and encourages economic growth for the region. (Photo Credit West Africa Trade Hub)

Sub-Saharan Africa’s workforce is also becoming larger and better educated, indicating that there is an overwhelming potential for economic growth and development. But even with this progress, youth unemployment and underemployment still remains a major constraint.

Youth in Africa are full of innovative ideas that seek to address a variety of societal challenges. With upwards of 10 million young people entering into the job markets each year on the continent, vastly outnumbering the jobs available in both public and private sectors, many of these youth have turned to entrepreneurship. Yet the fact remains that without an established credit history, significant assets, or business experience required by traditional investment models, young entrepreneurs are constrained by access to affordable capital to start or expand a business.

Investing in young people requires a unique set of skills, and an appetite for a different kind of portfolio. Some youth may require long term patient capital with a long tenor, as well as mentoring and training to manage risk. Others may require seed funding, or funding to develop a new technology, which requires shorter term financing. With web-based enterprise on the rise, investment in youth has become as easy as a funds transfer or mobile payment, and runs the same risk as any impact or venture capital investment. While many investments can be captured within traditional investment classes (such as debt, equity, venture capital), it’s clear that young people in Africa and other emerging markets present a tremendous market opportunity.

The United States Government recognizes the need to invest in young people on the continent, and the Obama Administration has already undertaken a tremendous effort to invest in Africa’s future. The President’s Young African Leaders Initiative, more commonly known as YALI-, empowers and bolsters young African leaders through academic coursework, leadership training, mentoring, networking, and ongoing support.  Starting in June 2014, the YALI Washington Fellowship will bring 500 young Africans (between the ages of 25 to 35) to the United States to participate in a comprehensive six week “Institute” in one of three areas: public management, civic leadership, or business and entrepreneurship.

All of these sessions will culminate in a YALI Summit, to be hosted in July 2014 in Washington, DC. Not only will the Washington Fellows have the opportunity to interact with President Obama and senior staff, but they will be able to meet with private sector leaders, and interact with one another, allowing for a truly diverse mix of representatives from all countries, regions, and sectors.

Upon completion of the program in the United States, the investment in young leaders will continue upon their return to the continent, where USAID and the State Department in partnership with the private sector, host governments, and civil society, will offer growth opportunities in four key areas: networking, professional development, access to seed capital for entrepreneurs, and opportunities to give back to their communities. This will significantly increase opportunities for employment and accelerate professional development for leaders. The United States African Development Foundation is also supporting this program with a $5 million entrepreneurship grants program that will include competitively awarded grants for the Fellows with innovative business ideas.

For example, Fellows who have completed the business and entrepreneurship institutes will have built technical and leadership capacity in areas such as strategy, supply chain management, business ethics, social entreprenership, microfinance, management, and risk analysis. Though these skills are invaluable, paired with YALI’s provision of small grants, networks, coaching, and mentoring, the Fellows will be well equipped to build a viable enterprise.

The Washington Fellowship received thousands of applications for just 500 slots, demonstrating that young people are all too aware, and appreciate having an opportunity to substantively engage with senior leaders.

Though applications are closed for this year, its not too late to engage! The State Department’s Bureau of International Information Programs  will continue to interact with a growing email list of over 38,000 self-identified young African leaders interested in the United States, known as the Young African Leaders Network (YALN). YALN is open for registration, and will transmit updates on future opportunities available for young Africans to engage the U.S. Government.

For a truly sustainable impact, governments can’t go it alone. As investors across Africa seek to diversify their portfolios, they may increasingly look to young people for high growth opportunities. A commitment to Africa’s future can be best demonstrated by investing in its young people, who will continue to be engaged in shaping their own futures.

Want to empower women in agriculture? Use technology.

It’s very difficult to effectively manage responsibilities if you have neither the authority over nor access to the required skills, networks, resources, or decision-making power needed to complete critical tasks. Yet, that is the situation women in Tanzania’s agricultural sector face.

According to research from the World Bank, women form the majority of Tanzania’s agriculture work force – particularly in rural areas, where 98 percent of economically-active women are involved in agriculture. They prepare, plant, weed, harvest, transport, store, and process their farms’ products. In addition to these time and labor-intensive activities, women also cook meals and perform other household management tasks. These are crucial in a country where 42 percent of children under 5 years old suffer from stunted growth, due to malnutrition, and 16 percent are underweight.

Tanzanian women are keenly aware of their responsibilities and the challenges embedded therein. Limited decision-making power, unfavorable regulations, and biased sociocultural norms reduce their access to finance, land, technical training, labor-saving equipment and other productive resources. As a result, barriers are stifling their potential to be leaders of technological invention, entrepreneurship, and legal and regulatory change throughout the agriculture sector. But these challenges are not insurmountable.

In fact, with a little help from the U.S. Agency for International Development, farmers are developing their own solutions.

The Innovations in Gender Equality (IGE) to Promote Household Food Security program, in close coordination with Feed the Future projects in southern Tanzania, is helping farmers address constraints they face when working in agriculture.

This project is a partnership between Land O’ Lakes International Development , the Massachusetts Institute of Technology’s Development Lab (MIT D-Lab), and USAID.

It offers community-centered technology design training to smallholder farmer groups in the Southern Agricultural Corridor of Tanzania. Trainees, the majority of whom are women, develop prototypes in group settings and receive in-depth coaching from MIT D-Lab trainers.

What do the results of these technology design trainings look like?

  • Time and labor burdens are reduced. These technologies – developed by farmers, for farmers – save time and reduce drudgery, freeing up women’s availability to engage in alternative income-generating opportunities.
  • What’s impossible alone becomes possible together. When we ask IGE farmer-inventors why they never developed the technology design prototypes before that they are designing now, one answer is constant: they couldn’t do it alone. D-Lab’s community-centered design philosophy fosters teamwork from the start, which farmers credit for bringing to life the culture of innovation and invention in their villages.
  • Men and women are working together. Women’s empowerment is a community-wide endeavor, with men’s active involvement and support being a critical factor. The technologies farmers are developing are transforming women’s-only agricultural tasks into tasks in which husbands and wives work together, producing a greater overall benefit for themselves and their families.

What technologies are farmers developing?

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Photo Credit: Giselle Aris

Mwanahamisi Goha’s palm oil technology design group, called Jitegeme group, consists of two women and three men. They collectively developed the palm oil extracting machine prototype pictured above, which can extract 20 liters of palm oil in 30 minutes. This is a major improvement, because standard models typically take four hours to extract the same amount of palm oil (a popular product on local markets) and require two people to operate instead of one. This new prototype also allows operators to sit instead of stand.

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Photo Credit: Giselle Aris

Arafa Mwingiliera and Habiba Njaa’s peanut sheller group, Ukombozi, in Morogoro, grinds nuts using a prototype they developed with three other group members. This technology can shell up to 20 kilograms of peanuts in just five minutes – an amount of work that used to take an entire day when shelled peanuts using their bare hands. Women in southern Tanzania often sell peanuts as snacks along the roadside to passers-by and use them in place of cooking oil to season vegetables. Peanuts are high in protein and calories, making them a good source of nutrition and energy, especially for young children.

Photo Credit: Giselle Aris

Photo Credit: Giselle Aris

Amina Hussein, Veronica Hogo and other members of the rice thresher technology design group, Lupiro, test their prototype, which they designed using locally available and affordable materials. This technology can thresh 15 to 20 100 kilogram bags of rice per day without crop loss due to spillage (which occurs when farmers thresh rice by hand). The productivity levels achieved by this prototype are a massive improvement compared to traditional hand threshing, from which farmers yield only two to three 100 kilogram bags of rice per day with up to 5 percent of crops lost to spillage. Rice is one of the main staple crops of Tanzania, and, along with maize and horticulture, is one of the Feed the Future target value chains. These value chains are essential to Tanzania’s food security, which has motivated many farmer technology design groups to develop prototypes that bolster their productivity.

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Photo Credit: Giselle Aris

Stella Malangu, a member of the rice winnower technology design group, Jitambue, in Morogoro, smiles after using the prototype she helped design and build. It generates wind to separate rice from chaff and other unwanted particles and pests before storage. When farmers in this group winnowed rice using traditional methods, which required them to stand and be in constant motion, they were able to clean one 100 kilogram bag of rice per day. With their new prototype, these farmers can now winnow six 100 kilogram bags of rice in just three hours. This technology has dramatically reduced time and labor burdens! And it has even led male community members to become involved in what was previously only women’s work.

What’s next?

Every technology needs investors. Even in cases where inventors have designed functional prototypes, they still require:

  • Resources and skills to transform prototypes into successful commercial products
  • Media attention to accelerate the time it takes for locally popular products to become nationally and regionally renowned and adopted
  • Policy change to address major constraints for women working in Tanzania’s agriculture sector

IGE is working in each of these areas to ensure technology continues to help transform the lives of smallholder farmers in Tanzania. For more information on how you can get involved, visit our website.

The Power of Household Consumption and Expenditure Surveys (HCES) to Inform Evidence-Based Nutrition Interventions and Policies

Understanding food consumption patterns and nutrient intakes is essential for informing evidence-based food and nutrition policies. The international food and nutrition community, however, faces a lack of accurate and reliable data.

Conducting Household Consumption and Expenditure Surveys (HCES)

Though individual dietary surveys, such as 24‐hour recall and observed-weighed food records, are typically viewed as the gold standards for measuring food consumption, they carry prohibitive costs and their methods are complex. For example, during a 24-hour recall, interviewers must exhaustively ask respondents to report the amounts of all foods and beverages consumed by each household member in the previous 24 hours and provide detailed information on the ingredients and preparation methods of mixed dishes. Few of these surveys have been conducted in developing countries and most at only a small scale, calling into question their validity in formulating national nutrition policies.

Household Consumption and Expenditure Surveys (HCES)—a collective term for multipurpose household surveys—are being increasingly recognized as an inexpensive and more readily available alternative for tracking food consumption patterns. More than 700 surveys have been conducted, covering over one million households in 116 low- and middle-income countries. HCES generally collect food consumption information using the recall method and a predetermined list of food items (potentially leaving out important foods). Interviewers ask respondents whether each food item was consumed during a given recall period (typically the last 7 or 14 days) and if so, how much was consumed. While HCES may be less precise than individual diet surveys by design, their relative costs and benefits make them a practical tool for enacting national policies and identifying communities where nutritional interventions are highly needed.

Among their strengths, HCES are:

  1. Routine: HCES are typically conducted every three to five years
  2. Low-cost: HCES are processed and paid for by institutions outside the health/nutrition sector, and thus relatively inexpensive to use for secondary analysis
  3. Representative: HCES are statistically representative at the national, and usually subnational, level
  4. Comprehensive: HCES contain detailed household food consumption and acquisition information and allow direct observation of the agriculture and nutrition nexus, through markets, value chains, and other such pathways

Since 2012, USAID’s Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) project has focused efforts on improving HCES as a source of more relevant and precise food and nutrition data. Recently, SPRING provided technical guidance in using HCES for designing and monitoring food fortification programs—the process of adding micronutrients to food. SPRING presented the economic feasibility of maize flour fortification in Kenya, Uganda, and Zambia using HCES data at a meeting with the World Health Organization. SPRING has guided discussions on introducing a fortification monitoring module and identifying standard indicators to use in current or planned HCES at a workshop with the East, Central, and Southern Africa Health Community Technical Working Group on Monitoring and Evaluation. SPRING is also sponsoring a symposium on HCES at this year’s Micronutrient Forum Global Conference in Addis Ababa, Ethiopia. The conference is expected to draw hundreds of policymakers, program managers, and scientists from around the world.

The use of HCES data constitutes an exciting and unexploited opportunity to address food consumption information gaps. SPRING will continue to work with USAID and partner organizations to repurpose HCES to make them more attuned to countries’ nutrition policy needs and strategies. Country programs and funders are eager to adapt these tools and use the information they provide to improve policies, programs, resource allocation, and ultimately, nutrition outcomes.

SPRING is funded by USAID under a five-year cooperative agreement. SPRING’s experienced implementation team consists of experts from JSI Research and Training Institute, Inc., Helen Keller International, The International Food Policy Research Institute, Save the Children, and The Manoff Group. For more information about SPRING’s work in HCES, visit http://www.spring-nutrition.org/.

Human-Centered Design and the Last Mile

This is an excerpt from a blog post that originally appeared on Stanford Social Innovation Review.

Community health workers demonstrate a storage and inventory management system for commodities, diagnostic tools, and medicines. (Image courtesy of frog design</em>

Community health workers demonstrate a storage and inventory management system for commodities, diagnostic tools, and medicines.
Image courtesy of frog design

Despite many challenges, Uganda’s village health teams deliver care to some of the nearly 85 percent of Ugandans who live in remote, hard-to-reach corners of the country, or the “last mile.” During some months, these committed volunteers know that they will have the medicines necessary to treat children dying of pneumonia, malaria, and diarrhea. But during others, the teams are less sure. They’ve also come to expect inconsistent supervision and training.

The situation in Uganda is not unique—community health worker (CHW) programs throughout the world struggle from limited resources and sub-optimal design, often devolving from a national strategy into a patchwork of nonprofit programs and activity.

Why is this? The global health community understands that these same programs are important for reaching Millennium Development Goal 4 (MDG 4)—to reduce mortality among children under five from the current level of 6.6 million deaths per year to 4.3 million by the end of 2015. Yet many perceive CHWs as inadequate replacements for trained health professionals such as doctors and nurses.

We can flip this logic on its head and take a new approach by placing these workers at the center of our design strategies, recognizing that they provide a vital link between communities and the health system. We need a holistic framework that motivates and empowers them.

At the core of this framework, we would need integrated community case management (iCCM), which offers a systematic approach to delivering and expanding access to life-saving medicines. CHWs form the backbone of this approach; they can ensure that sick and vulnerable populations are correctly diagnosed and treated. If fully funded and implemented, it is estimated that iCCM delivered through CHWs could save up to 250,000 lives by the end of 2015. Accomplishing this would require a few important tools:

  1. Increased access to commodities, diagnostic tools, and medicines. Specifically, this would need to include malaria rapid diagnostic tests and respiratory timers for pneumonia, artemisinin-based combination therapies to treat malaria, antibiotics such as amoxicillin dispersible tablets for pneumonia, and ORS/Zinc to treat diarrhea.
  2. A solid community-based service delivery platform. The platform would have front-line CHWs at the center, with the necessary systems support for them to function effectively and efficiently. Support would include training and deployment (including retention and incentives), an effective supply chain that reaches the most peripheral levels, supportive supervision, and monitoring to maintain quality and skills.

With this in mind, in 2012, UNICEF, MDG Health Alliance, and Save the Children reached out to several other partner organizations, including USAID, with the goal of developing a holistic CHW system that could:

  • Serve as an assessment tool for existing country-level CHW programs
  • Outline a menu of best practices and innovations from across the globe while encouraging idea-sharing
  • Empower, recognize, and motivate CHW programs to serve as platforms for programs beyond iCCM—including newborn and maternal health programs

The team partnered with the innovation consulting firm frog design, which engaged more than 60 organizations—including global health experts, private sector corporations, and program implementers across Africa and Asia—and led the team through sessions and immersion exercises in Uganda and Senegal over 12 weeks…

To continue, please see the full blog post at Stanford Social Innovation Review.

FrontLines: Energy/Infrastructure

FrontLines January/February 2014: Energy / Infrastructure

Read the latest edition of USAID’s FrontLines to see how the Agency invests in energy and infrastructure projects around the world. Some highlights:

An Ethiopian-born entrepreneur from Canada was hoping to operate a mining facility in his homeland, but his plans were thwarted by one thing — a lack of energy to power the mine. Read how Nejib Abba Biya and the Ethiopian Government, with support from the United States, are working to use the country’s natural geothermal energy as a reliable, renewable power source.

Electricity 24 hours a day, seven days a week is the new — and welcome — normal for residents living in Haiti’s Caracol Village.

Waiting and waiting and waiting for a web page to load — that is so 1990s. Just ask the residents and aid workers at the refugee camp in Dadaab, Kenya, where high-speed Internet access is only a click away.

It’s Sri Lanka’s version of “Back to the Future” as some of its citizens embrace rainwater harvesting, a practice dating back to the 5th century that today has a 21st century, enviro-friendly appeal.

If you want an e-mail reminder in your inbox when the latest issue of FrontLines has been posted online, subscribe here.

New Report Highlights the Hardships and Hard-Won Victories for LGBT People in the Europe and Eurasia Region

 

A demonstrator holds a rainbow flag in Bratislava

A demonstrator holds a rainbow flag in Bratislava on September 21,2013, during the Rainbow Pride Parade, a march for the human rights of non-heterosexual people and the celebration of LGBT (lesbian, gay, bisexual, transgender) pride in Slovakia. AFP PHOTO/SAM

As the recent winter Olympics in Sochi illustrated all too well, lesbian, gay, bisexual and transgender (LGBT) people in Russia face tremendous hurdles in their everyday lives, including openly hostile laws and an extremely difficult working environment for the grassroots organizations that advocate for social change in the face of grave personal risks. The situation in Russia is unfortunately not unique, with LGBT people facing increasing hostility, discriminatory laws, and escalating threats of violence in many countries around the world, whether in Uganda, Nigeria, or Eurasia.

The U.S. government and USAID are strong supporters of LGBT rights. The Agency’s new mission statement places a premium on the inclusion and the empowerment of marginalized people through our work across the globe. Our missions in the Europe and Eurasia (E&E) region have stepped up their efforts to ensure that LGBT issues are addressed through development projects and that LGBT people are able to participate fully and effectively in all that we do. Testing the Waters: LGBT People in the Europe and Eurasia Region, a new report that was just released by USAID today, was designed to support these efforts by comprehensively documenting the status of LGBT people across the region and describing in detail the challenges they face in seeking to claim their human rights and role as full participants in their communities and societies.

The challenges that the report reveals are daunting. Across the region, attitudes towards LGBT people are very negative, with openly derogatory remarks and homophobic sentiments commonly expressed in public and in private. LGBT people are not legally protected from discrimination in the region, and they frequently suffer physical attacks and intimidation.  Gathering places and offices of grassroots LGBT advocacy groups have been ransacked and destroyed. Harassment at home, in school, and at the workplace is a common feature of everyday life. Not surprisingly, many LGBT people in the region choose not to reveal their sexual orientation or gender identity, even to families and friends.

Despite all of these challenges, the report also makes it clear that LGBT people across the region are speaking up and making a difference. Grassroots organizations advocate for LGBT rights in every E&E country, provide safe spaces for LGBT people, and offer support and much-needed social services. Many people take on great personal and professional risks in their efforts to ensure that the societies they live in are accepting of all people, regardless of who they love or how they express their gender identity.

I hope you will take the time to read this report  and to think about what you too can do to ensure that no-one is left out of our joint efforts to create a world in which everyone is treated fairly and equally.

No Birth Should Be Left Up To Chance

Giving birth ranks among the scariest moments for any mother. It certainly was for me. I was living in Hong Kong at the time when my second child was born. And he was born in a hurry. He came so fast that I actually thought I’d give birth in our car on the way to the hospital! Fortunately, that didn’t happen and I safely delivered my son Patrick surrounded by a team of well-trained doctors and nurses, not to mention my loving (and relieved!) husband by my side.

Mozambican mother holds her newborn. Photo credit: MCHIP

Mozambican mother holds her newborn. Photo credit: MCHIP

But I’m one of the lucky ones.

As new research released today by Save the Children reveals, 40 million women give birth without any trained help whatsoever. What’s more, two million women give birth entirely alone.

I met one of those women in Nepal about five years ago. I was there visiting our programs in the south of the country and stopped in to see a mom who had given birth a month prior. She sat with us and talked quite matter-of-factly about how when she went into labor with her third child, she didn’t panic. She merely laid down in a clean part of her house, caught the baby when she came out, cut the umbilical cord and wrapped her to keep her warm.

When she had finished telling her story, and I had stopped shaking my head in amazement, I couldn’t help but compare her experience to mine. After all, both of our children came into the world faster than we had anticipated. However, while my husband was there to drive me—fast—to a first-class hospital, this woman had no one. Her husband was away in India on business and her two daughters were in the next village. Even if she could manage to get herself to the nearest clinic, which was 2 kilometers away, she would have had to travel on foot. So she did the next best thing; she left it up to chance.

Fortunately for this mom both she and her newborn survived. But for too many women in the same situation, the outcome is much more tragic.

So many things can go wrong when a mother gives birth without a skilled birth attendant (SBA). Things such as prolonged labor, pre-eclampsia and infection—which are perfectly manageable when an SBA is present—can mean a death sentence in the absence of one.

For this reason, Save the Children is partnering with world leaders, philanthropists and the private sector to commit to ensuring that by 2025 every birth is attended by trained and equipped health workers who can deliver essential health interventions for both the mother and the newborn.

Because no birth should be left up to chance.

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