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Archives for Women

R.E.S.P.E.C.T Find Out What It Means To Us

From November 25th (International End Violence Against Women Day) throughDecember 10th (International Human Rights Day), USAID joins the international community for 16 Days of Activism Against Gender Violence. During this time IMPACT will highlight USAID’s work to combat gender-based violence.

It is no accident that Aretha Franklin’s rendering of “Respect” rapidly became an anthem for marginalized and disenfranchised individuals and groups. The denial of human rights, particularly the most basic rights, such as respect, touches on a universal chord.

In recent years, global attention has been growing surrounding the horrifying issue of disrespect and abuse of women during childbirth.

Indonesia Maternal Health

USAID’s presence in Indonesia has been vital to the success of various health initiatives. The Blue Circle campaign of the 1980s and the Bidan Delima program in 2005 are just two examples of these initiatives that made it possible for women, like those pictured waiting in line, to receive maternal and child health and family planning services at community health centers. Photo credit: USAID/Indonesia

Think about the treatment you, or your wife, sister or daughter, expect from your maternity care provider. He or she is responsible for helping you (or your partner) give birth safely. Can you imagine a doctor scolding you for not using family planning to control your fertility? Or being separated from your newborn because you don’t have enough money to pay the discharge bill? Or giving birth unclothed while visitors walk by?

In both developing and developed countries around the world, pregnant women experience disrespect that ranges from subtle denial of their autonomy to blatant abuse. Numerous studies (PDF) document physical abuse in childbirth, including slapping, restraining, suturing without pain medication, or forcibly pushing on a woman’s abdomen. For women carrying or at high risk for HIV, the fear of stigma and discrimination from providers is often compounded by stigma from partners and families, especially regarding HIV testing or positive status disclosure.

This lack of respectful care also deters many women from seeking hospital care; instead they choose to give birth at home without the care of a skilled health attendant. This increases the change of complications from childbirth, possibly causing death.

While some may blame healthcare providers, many of these providers are working under suboptimal conditions, with many being overworked, underpaid, and burdened with unmanageable caseloads. The lack of empowerment, dignity, and security for midwives and nurses is driven by deep-rooted attitudes derived from gender, class, caste, race and cultural norms towards women. These problems undermine the resilience of midwives and nurses and negatively impact their capacity to provide quality care.

What does respect for women giving birth mean? The Universal Rights of Childbearing Women Charter (PDF) clearly outlines what respect means; certainly it includes the physical safety of pregnant women, but it also includes the respect for women’s basic human rights, including respect for women’s choices, preferences, feelings, and autonomy. It also means addressing the conditions of healthcare providers.

To eliminate the humiliation and abuse of women in childbirth, USAID supports the White Ribbon Alliance to lead global and country level advocacy and the University Research Corporation TRAction Project (PDF) to carry out implementation research to assess the prevalence of disrespect and abuse and test approaches to decrease these behaviors. With USAID funding, the Jhpiego/MCHIP Project has developed a comprehensive Respectful Maternity Toolkit available throughout the world. Furthermore, USAID is partnering with the World Health Organization to review the evidence on the status and working conditions of midwives and address the disrespect and abuse of women in childbirth.

We see the need for increased awareness and support for civil society engagement and advocacy, and the need to work with all involved in the direction, management and provision of care to women giving birth. Global initiatives, such as the Third Global Forum on Human Resources for Health, are key opportunities to realize these basic human rights.

Until recently, this was a problem hidden behind a veil of silence. Now we hear the silence being broken across the globe, but it is just a start.  Women’s voices need to be heard. And all of us need to respond to promote social justice and improve quality of care. Women’s lives depend on it.

Meeting the Needs of Children and Adolescents Who Have Experienced Sexual Violence

From November 25th (International End Violence Against Women Day) through December 10th (International Human Rights Day), USAID joins the international community for 16 Days of Activism Against Gender Violence. The blog below highlights USAID’s work to combat gender-based violence and celebrates ten years of our HIV and AIDS work under PEPFAR in advance of World AIDS Day (December 1).

Ruth was doing “okay,” with the help of her HIV medication and the friends she had made in a local support group for people living with HIV. With a shy smile, Ruth told me that she was getting by, but she missed her two young daughters. Her nine-year-old, Sarah, had been raped a year before and was now at a recovery center with her sister, who stayed with her for company. “She still hasn’t spoken, but she is getting better,” Ruth said with a sad smile.

In Swaziland, just before sunset, a young girl tests out a new seesaw on a playground built by the Elizabeth Glaser Pediatric AIDS Foundation at the Mkhulamini Clinic. Photo credit: Jon Hrusa, Elizabeth Glaser Pediatric AIDS Foundation

In Swaziland, just before sunset, a young girl tests out a new seesaw on a playground built by the Elizabeth Glaser Pediatric AIDS Foundation at the Mkhulamini Clinic. Photo credit: Jon Hrusa, Elizabeth Glaser Pediatric AIDS Foundation

Like many single mothers, Ruth worked during the day doing laundry and chores for other families. A male neighbor took advantage of her daughter when she was home alone. The attack had been so brutal that her daughter had been in the hospital for over a month. With the help of friends, Ruth made sure the man was arrested and prosecuted. It had been hard. The time spent on the case had left little time to earn income. Ruth’s family was struggling, but people were helping. She had hope that things would get better, and that her daughter would recover.

Ruth’s story and her courage epitomize the struggle to achieve an AIDS-free generation. Treatment is a miracle, but the true test of our resolve to end AIDS lies in our commitment to end the inequities of gender, of rich and poor, of powerful and vulnerable.

Girls, often marginalized by age and social status, are at a particularly high risk. Globally, young women aged 15-24 are the most vulnerable to HIV and account for 22 percent (PDF) of all new HIV infections (twice as high as young men). Furthermore, an estimated 150 million girls have experienced some form of gender-based violence before age 18. But this is not just limited to girls. According to the World Report on Violence Against Children (PDF), an estimated 73 million boys globally have also experienced sexual violence before age 18. Such violence has severe consequences for their immediate and long-term health and well-being, including increased risk for sexually transmitted infections such as HIV, reproductive and sexual health complications, alcohol and drug abuse, and psychosocial health issues. In addition, results from the PEPFAR Sexual Gender Based Violence Initiative showed that when sexual assault services were introduced to primary health centers, a large percentage of patients presenting for care were under 18, but services were not tailored to meet their unique needs.

USAID, as a key implementing agency of PEPFAR, has a strong commitment to addressing the unique needs and vulnerabilities of children and adolescents experiencing sexual violence, including addressing the gender-related factors that underlie such violence. The recently launched guide, Clinical Management of Children and Adolescents Who Have Experienced Sexual Violence: Technical Considerations for PEPFAR Programs, offers step-by-step technical advice for clinicians, social workers, pediatricians, child protection workers, HIV specialists and others on appropriate clinical care and management. These technical considerations are meant to serve as a starting point for national level adaptation and development of comprehensive, integrated services for children.

As we travel down the road to an AIDS-free generation, we hope that stories like that of Ruth’s daughter dwindle into extinction. In the meantime, for those children that are afflicted by such unspeakable sexual violence, we pledge to continue serving their unique needs and vulnerabilities.

Achieving Equity Through Women in Leadership

I’ve just returned from the International Conference on Family Planning in Addis Ababa, Ethiopia, where thousands of leaders and experts came together to discuss how to improve access and choice in family planning services across the globe. One of the highlights of the conference for me was speaking on a panel about the role women leaders can play in this arena.

I don’t think you have to be a woman to be committed to achieving equity in access to family planning services.  There are countless men in leadership roles that are deeply committed to expanding equity across the board, including in access to family planning.  That said, I think having women in leadership positions is incredibly important.

Mother and child at a health clinic in Ethiopia. Photo credit: USAID

Mother and child at a health clinic in Ethiopia. Photo credit: USAID

We often talk about women leaders as role models for girls.  Certainly having women in leadership roles lets girls see someone who looks like them doing things they might dream of doing and helps validate those dreams.  But women in leadership positions are role models for boys too—that women belong in leadership positions, that having women in these roles is normative. Having women in leadership roles in government is an especially public acknowledgement of legitimacy.

Governments have a responsibility to treat their citizens equitably, which means they have a special role to play in addressing disparities, whether that is as a direct provider of health services or by making it attractive for the private sector to serve the underserved or both. When governments prioritize making it possible for poor women, rural families, adolescents, and racial or ethnic minorities to exercise their right to choose the number, timing, and spacing of their children by expanding access to high quality, voluntary family planning information, services, and methods, they send a message about their commitment to equity and rights.

Having women employed in visible roles in government programs, whether they are in formalized leadership positions or not, also sends that message.   And there are great examples all around us:

  • Managing the largest portfolio that USAID has in Asia, female Foreign Service Nationals at USAID’s Bangladesh mission have strengthened the family planning portfolio. Dr. Umme Meena in the mission there—and other men and women like her employed as Foreign Service Nationals by the U.S. government worldwide—demonstrate America’s commitment to equity in family planning every day.
  • In Amhara, Ethiopia, USAID supports activities to prevent child marriage by identifying young female community mentors who can advocate against marriage before the age of 18. These youth leaders are powerful agents of change and gender equity in their communities.
  • Community health workers are some of the most passionate and committed champions for equity in access to family planning and health services. Esther Nyokabi in Kenya is an illiterate woman who overcame significant personal obstacles to become a champion for post-abortion care. She mobilized her community to demand better health infrastructure from the government. She is now a passionate community health worker and part of a government –sponsored training team for post-abortion care. Her efforts have brought life-saving antenatal care, skilled attendance at delivery, and family planning services to a community that did not have health services previously.

It is the commitment, passion, and actions of leaders like these that will achieve full choice in family planning.

Watch a video clip of Ellen Starbird at the International Conference on Family Planning and read news and announcements made by USAID at the conference. 

A Lesson in Holistic Care: What I Learned from Working with Transgender Women and Health Providers in the LAC Region

November 20 is Transgender Day of Remembrance.

I have collaborated closely with transgender women and health providers in Latin America and the Caribbean to learn more about the needs of transgender populations and to train health workers to provide quality services. Working alongside transgender women on needs assessments, trainings for health providers, and in the development of a blueprint (PDF) for comprehensive transgender services, opened my eyes to their experiences, gaps in existing programs that limit access to critical services, and the opportunities we need to pursue. To help you understand my recommendations, I would like to share a story I heard repeatedly from transgender women:

I was 13 years old when my family threw me out of the house because of who I am. I tried to continue my studies, but I dropped out of school because my classmates insulted me every day and sometimes hit me, and I was afraid to use the boys’ bathroom (the only one I was allowed to use) because I was afraid of being assaulted by male students. The teachers looked the other way or called me names. I have developed a thick skin because when I step out of my home, people stare, make comments and give menacing gestures. Going to a clinic is also unpleasant. I get sick like everybody else, but the nurses always assume that I am a sex worker and that I have HIV. Frequently, they give me condoms and an HIV test and send me home. One time I was jumped by four guys in the street, and I ended up in the emergency room. When one of the nurses opened my robe and saw that I am a transgender woman, she gave me a look of disgust and called me a homosexual. She must have told others about me because several nurses came, opened my robe and walked away laughing. I waited for a long time before a doctor saw me. He told me that real men do not dress like women, and that I should cut my hair and stop wearing make-up so I could get a job. I had a cut in my head that needed stitches and the doctor did not even clean the blood in my hair.

REDTRANS and Miluska staff conducting a workshop on HIV and human rights. Photo credit: Manuel Contreras

REDTRANS and Miluska staff conducting a workshop on HIV and human rights. Photo credit: Manuel Contreras

This story, and the others that I heard through this work, underscored the need for a new approach to transgender health:

  1. Prevention efforts must engage families and schools to foster supportive environments.  Transgender teens frequently experience rejection from their families and bullying in school. Homelessness, low literacy, and lack of family protection not only increase the likelihood that these teens will experience exploitation, but also severely limit their opportunities to find jobs.
  2. Many people, including health providers, do not clearly understand the spectrum of sexualities, genders, and identities. Their confusion often leads to stigmatizing attitudes and discriminating practices in health care settings, which in turn discourages transgender women from seeking care.
  3. Increasing access to counseling and testing and other HIV services should not be an end in itself. Securing the human rights of transgender communities and creating a safer environment where they can access appropriate services without fear of violence or discrimination should be the focus.
  4. Increasing access to condoms and HIV information are cornerstones of HIV prevention, but national prevention programs need to go beyond these two strategies. Policies and programs should also support employment and education opportunities for transgender persons. The pressure to put food on the table and a roof over their families’ heads can lead to poor decision making, resulting in risk-taking behaviors.
  5. Engaging transgender persons in program activities as facilitators or data collectors strengthens their technical capacities and allows them to engage with health providers and communities as professionals and peers. This can effectively dispel myths and negative beliefs about transgender women, their capacity, and their behavior.

By sharing my observations and the stories I heard, I hope to raise awareness of the issues that come into play and to encourage all of us to reconsider how our programs can better contribute to the well-being of transgender persons and their communities. We can make that commitment today on Transgender Day of Remembrance, an internationally recognized day to memorialize those who suffered or died as a result of anti-transgender hatred or prejudice.

Aysa Saleh-Ramirez, MPH is AIDSTAR-One Senior Technical Advisor at John Snow, Inc. AIDSTAR-One is funded by PEPFAR through USAID.

Empowering Women to Address Climate Change

Today marks the second annual Gender Day at the Conference of the Parties to the United Nations Framework Convention on Climate Change (UNFCC) Conference, which opened (PDF) last week in Warsaw, Poland. Leaders from around the world are focusing on how to achieve their commitments to promote gender balance and improve women’s participation in international and local level decision-making related to climate change.

This year, USAID is proud to announce that we are initiating a new partnership with the International Union for the Conservation of Nature (IUCN) to work together to expand and enhance USAID’s efforts to address gender issues through programming and support to our partner governments.

Members of the Huruma Women’s Group in Kenya. Photo credit: Photo Credit: Fintrac Inc.

A group of women in Kenya who supply maize for sale in local markets. Photo credit: Photo Credit: Fintrac Inc.

This support is critical as climate change will have a serious impact on the livelihoods of poor women in developing countries; the increasing frequency of droughts and stronger storms will affect agriculture and water resources, sectors in which women have an essential management role.

Speaking on a panel this morning, Nancy Sutley, Chair of the White House Council on Environmental Quality emphasized that “globally, women are central to unlocking solutions to the climate change challenges we face.”

IUCN has found that women often lead the way in adapting to climate change impacts, and play a key role in mitigating climate change by optimizing energy efficiency, using low-footprint energy sources and techniques, and influencing a household’s and community’s consumption patterns. Women’s participation in decision making at higher levels has specifically benefited environmental policy, such that countries with a higher number of women in their parliaments are more likely to set aside protected land areas and ratify international environmental treaties. In fact, recent data (PDF) reveals that there is a causal relationship between environment and gender; when gender inequality is high, forest depletion, air pollution and other measures of environmental degradation are also high.

While women can be agents of change, their contributions are seldom fully harnessed. The result is a lost opportunity. This new partnership will be aimed at advancing women’s empowerment and gender quality to achieve greater strides in reducing emissions to mitigate climate change, building resilience to climate change impacts, and promoting better development in general.

While plans are necessary to illuminate the pathway to a goal, they are not sufficient for attaining those goals.  This new agreement with IUCN to implement the Gender Equality for Climate Change Opportunities (GECCO) project will provide USAID and our partner governments with support for our mutual goal of advancing women’s empowerment and gender equality through and for the benefit of climate change and development programs.

We have seen great progress in recent years, with growing attention to gender issues within the UNFCCC and within projects addressing these issues at the country level.  However, there is much work still to be done, so we are excited about the opportunities this new partnership with IUCN brings.

 

Access to Water Empowers Women in Morocco’s Middle Atlas

I recently returned from Outerbate, a village high in the Atlas Mountains in central Morocco, where USAID broke ground on a new water supply system. In this Amazigh, or Berber village, the water supply system is more than 80 years old and serves only a handful of the village’s 300 homes.

I met Fatima Mazrou, a woman in her late 70s, who shared, “When we look for water, we sometimes get frozen and sick because the weather can go to below 10 degrees. It takes me at least one hour lining up to get water. Water and bread are critical to our survival.”

Increased access to water changes women and girls' lives in Morocco. Photo credit: USAID

Increased access to water changes women and girls’ lives in Morocco. Photo credit: USAID

I was surprised to see that women do most of the hard work of filling buckets to provide their families with water. The challenge is that the village’s 1,200 inhabitants must fill buckets and water containers at a common tap, and the task disproportionately falls to the village’s women and girls.

During the summer months, the tap frequently runs dry. Water-related health problems are common. In the winter, this arduous trek up the mountain in freezing weather and back to the village carrying heavy pails of water leads to health problems for women, including miscarriages.

The time and work involved collecting water also means reduced primary school attendance by the village’s girls. Kuba Hamou, a sheep herder, told me that “having better access to water would eventually free women to pursue income-generating activities and help keep our daughters enrolled in school.”

Financed by USAID’s Development Grants Program, the Outerbate water system is being installed to address some of these challenges. Implemented by a local NGO, Al Kheir, the program will provide clean drinking water to every home in the village, ending the current practice of women and girls filling water containers at a common tap. With the introduction of the new system, girls’ attendance in schools should also increase and hundreds of families will have access to water and improved sanitation conditions in their homes, schools and public areas.

In addition, we have been able to work with Al Kheir in other life-improving ways. We helped the village set up a thriving artisan business selling locally produced honey and apple juice. And within Al Kheir, two young women are now on the association’s board of directors – the first time a woman or a youth has served in this capacity. Since this project began, Al Kheir has begun working with European and Japanese donors on other projects.

“None of this would have been possible without the engagement of USAID. We appreciate their support and its effects on our village,” said Haddou Maadid, Al Kheir’s president.

At the heart of USAID Forward is a belief that our results are always better when we partner directly with local institutions since they are empowered to take control of their future. In Outerbate, we are helping a village access safe water. By working directly with local partners, our assistance is amplified far beyond the water tap.

Why the Arts and Youth Matter for LGBT Global Development

Last month, I had the opportunity to join Urooj Arshad of Advocates for Youth in a conversation following a performance of The Laramie Project, Moises Kaufman’s play about Matthew Shepard at the Ford’s Theatre in Washington, DC. As I watched characters like the Muslim Bangladeshi-American university student and a skeptical university student slowly learning about lesbian, gay, bisexual and transgender (LGBT) people, I was reminded of the importance of the arts and youth in international development.

USAID Administrator Rajiv Shah dances with a Family Ayara Youth Foundation dancer in a trip to Bogota, Colombia in April 2013. Photo credit: USAID

USAID Administrator Rajiv Shah dances with a Family Ayara Youth Foundation dancer in a trip to Bogota, Colombia in April 2013. Photo credit: USAID

The power of images and storytelling moves people and societies. USAID has been at the forefront of using the arts as a tool for social change in countries where we work:

  • In Lebanon, USAID supported youth in photography, painting, writing, and drama as a way to express fear about “the other” and find a way to understand those different from themselves.

  • Most recently, in Colombia, the Canal Capital television network broadcast a one-hour documentary on LGBT issues and the diversity of families in Colombia. Local television networks throughout the country are re-broadcasting this documentary, contributing to increased awareness of LGBT families in Colombia. Promoting LGBT issues is a core part of USAID’s efforts to help civil society build a culture of human rights in Colombia.

USAID’s efforts to protect and promote the rights of LGBT persons in Colombia is not unique. We take hate crimes and the vulnerability of LGBT persons seriously by focusing on the resilience and power of LGBT persons as change agents.

These efforts are part of USAID’s overall focus on inclusive development. We believe that men, boys, girls and women, persons with disabilities and the LGBT community, internally displaced persons, indigenous peoples, ethnic and religious minorities, and youth, are an integral part of the development process. USAID’s suite of policies include the first ever Agency-wide Youth in Development Policy, as well as Gender Equality and Female Empowerment Policy (PDF), U.S. Strategy to Prevent and Respond to Gender-Based Violence Globally (PDF), and U.S. Government Action Plan on Children in Adversity. Our Youth in Development policy highlights many of the challenges and opportunities facing youth as a specific population group and simultaneously emphasizes the fact that youth are not a homogeneous group.

Based on data in the U.S. and anecdotal evidence in my travels worldwide, we know that LGBT youth are at increased risk for being abandoned by their families and rejected, barred, or deterred from accessing schools, all of which undermine their ability to learn and develop the skills that are necessary for a productive life. In an online survey sponsored by Vietnam’s Center for Creative Initiatives in Health and Population showed that 77% of LGBT youth experienced verbal abuse and 44% experienced physical assault in school. 42% of these youth lost interest in school, 33% skipped school, and 6% abandoned school.

The Laramie Project and data on LGBT youth underscore the importance of ensuring marginalized youth have a voice and are able to engage in policy-making processes in their communities. Focusing on LGBT youth is critical to global development.

The data may be daunting; however, based on a track record ranging from the arts to inclusive development to human rights programming and our expertise on NGO organizational development, USAID is leading in addressing the challenge of integrating vulnerable populations, particularly youth and LGBT persons in our programming.

Expanding Access and Choice for Family Planning

Next week more than 3,000 political leaders, scientists, health care professionals, advocates and young leaders from around the globe will gather in Addis Ababa, Ethiopia, for the third International Conference on Family Planning or ICFP2013. A year ago, the global community came together to launch Family Planning 2020, which has generated unprecedented political will and financial support to reduce global unmet need for family planning by giving 120 million more women access to modern contraceptives, information and services by 2020.  Conference participants in Addis will share the latest data, research and program findings to help achieve Family Planning 2020’s goal.

Organized around the theme “Full Access, Full Choice,” ICFP 2013 will call attention to the wide range of health, social, and economic benefits of helping couples plan and space their pregnancies. Holding the conference in Ethiopia is an opportunity to celebrate and showcase the success Ethiopia has had in greatly increasing access to family planning in a few short years. In 2005, 15% of married women used a form of modern contraception, and today nearly 29% are modern family planning users. However, there is still more to be done to ensure women’s needs are met.

Women gather at a health post in Ethiopia. USAID trains and supports health extension workers across Ethiopia's health system in the most populous regions of the country. Photo credit: Nena Terrell, USAID Ethiopia

Women gather at a health post in Ethiopia. USAID trains and supports health extension workers across Ethiopia’s health system in the most populous regions of the country. Photo credit: Nena Terrell, USAID Ethiopia

Women know what they want and when they demand it, we must listen: The ability to make important decisions about childbearing is one of the most basic human rights. Women deserve family planning options that are effective, affordable, available, and accessible and they need to be able to make their reproductive decisions freely and with full information. USAID is committed to developing new, affordable contraceptives and to supporting countries as they strengthen their health systems as part of an effort to fulfill full access and full choice for family planning. We’ve made great progress, but we must do more to ensure that everyone has true access to voluntary family planning information, services and methods that meet their needs.

USAID is proud to co-sponsor the International Conference on Family Planning, which is jointly organized by the Ministry of Health of Ethiopia and the Bill and Melinda Gates Institute for Population and Reproductive Health at Johns Hopkins Bloomberg School of Public Health. A number of USAID’s technical experts will present at the conference on the latest progress and challenges around increasing access to family planning.

Visit USAID’s ICFP webpage to access a calendar of USAID-sponsored events, the latest news and updates from the conference, and useful technical resources for participants.

Follow USAID for Global Health on Twitter for live updates and use the hashtag #ICFP2013 to join the conversation.

Photo of the Week: Women Sing in West Africa

Women sing

Community members sing at the opening of a border information center in West Africa. In the continuing effort to facilitate West Africa inter-regional trade, USAID has supported the opening of several Border Information Centers. The Centers, located at the borders of Ghana and Togo; Ghana and Burkina Faso; and now Benin and Nigeria, bring transport information and assistance to traders, and truck drivers, and allows them to more easily transport goods and needed commodities across borders.

Learn more about our Mission of the Month: Nigeria and USAID’s work in the region.

Read some stories about how we’ve transformed lives in Nigeria.

Follow @USAID and @USAIDAfrica on Twitter and join the conversation with #MissionofMonth! 

 

What Does It Take to Get Contraceptives to Clients in Rural Nigeria?

Many of our clients learn about family planning from routine visits to rural health facilities. The health workers in this facility help patients and their families choose appropriate contraception methods and teach new clients how to use these methods correctly. The same health workers who are responsible for treating patients are often also responsible for monitoring the supply of contraception methods in the facility. When torn between caring for a waiting room full of patients and filling out paperwork to order new supplies, health workers discovered that they were stocking out of essential contraception supplies. This meant that they had to turn away patients—many of whom had traveled considerable distances to get these family planning services. The discouraged clients lost confidence in the health system and were less inclined to seek out family planning services if products they wanted were not available when they needed them.

DDIC truck delivering commodities at a rural health facility in Nigeria. Photo credit: USAID | DELIVER PROJECT

DDIC truck delivering commodities at a rural health facility in Nigeria. Photo credit: USAID | DELIVER PROJECT

To rectify the stock-out situation and improve access and availability to family planning commodities in Nigeria, the USAID|DELIVER PROJECT is piloting a system called Direct Delivery and Information Capture (DDIC) in Ebonyi and Bauchi states. Through DDIC, the project currently delivers 24 public health commodities, including contraceptives, antimalarial medications, and maternal, newborn and child health products to 365 selected service delivery points in the selected states.

The DDIC system utilizes a vendor-managed inventory model, whereby products are delivered from state warehouses directly to the health facilities on trucks that serve as mobile warehouses. The trucks arrive, carrying predetermined quantities of health commodities, based on the facilities’ past consumption data. By investing in reliable transportation, DDIC ensures that truck drivers and team leaders are available to deliver commodities to health facilities according to an established delivery schedule. A team leader traveling with the truck inspects the facilities’ storage space, counts stock-on-hand for the different health commodities, and enters this inventory data into a specifically-designed inventory management database. The database calculates the quantity of products to be issued to the facility to bring the quantity of stock of contraceptives back to the pre-determined levels. Data obtained from each facility are synchronized with a sister software to generate logistics reports that help monitor system performance and prepare for the next resupply period.

Commodities are supplied to the health facilities every two months. After just four consecutive supply trips, the availability of commodities at participating facilities has drastically improved. Stock-out rates of contraceptives and other common health products have been reduced from above 70% before DDIC was implemented to below 5%. Additionally, 100% of the targeted health facilities have received a bi-monthly visit with the team leader. Furthermore, essential logistics data are now readily available for public health supply chain experts to use in future decision making about future health commodity needs.

Though still in the pilot phase, DDIC has improved the availability of contraceptives and other commodities in rural health facilities in supported states. It has also relieved many of the health facility staff of paperwork duties, so they can focus more on providing better quality care to patients. Consequently, clients’ confidence in the health facility’s ability to provide health services is increasing.

So, what does it take to get contraceptives to clients in rural Nigeria?

Through DDIC, USAID is improving availability of contraceptives at rural health facilities on a regular bimonthly delivery schedule, thereby increasing families’ patronage and uptake of family planning services. DDIC has come to the rescue ensuring commodities availability at facilities and data for planning in Nigeria!

Learn more about how USAID is working towards ensuring safe motherhood and healthy families around the world.

Learn more about our Mission of the Month: USAID Nigeria. Follow @USAID for ongoing updates in the region and join the conversation with the hashtag #MissionofMonth!

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