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Realizing the Health Goals of the Panama Declaration

This blog is part of a series to coincide with A Promise Renewed in the Americas: ”Reducing Inequalities in Reproductive, Maternal and Child Health Summit,“ that was held during September 10-12 in Panama.

The Promise Renewed for the Americas conference, just held in Panama City September 10-12, was attended by over 280 people representing governments, NGOs, faith organizations, multi- and bi-lateral organizations and civil society from throughout Latin America and Caribbean (LAC) region. The conference was a call to action to address persisting inequalities in maternal and child health in the region. The Declaration of Panama signed on the first day expressed the commitment of 26 governments  and many organizations to heed that call. The conference concluded with a provisional framework for reducing health inequities for women, children and youth in the LAC region. Now that I’ve had a week to reflect on the event, I’d like to share some thoughts with the broader global health community and so many others who contribute to furthering health in LAC, focusing on: “why this conference was so important to have in the first place,” “why now?”  and “what’s ahead?”

A Promise RenewedWhy convene this meeting in the first place? In 2015, most LAC countries will meet Millennium Development Goal (MDG) 4 (child health), and many will meet MDG 5 (maternal health.) However, it is certainly too early to declare victory in maternal and child health in LAC. Some countries will not meet either MDG 4 or 5, and Haiti’s indicators will fall considerably short of its goals. Moreover, averaged, national-level statistics mask major inequalities in maternal and child health in almost all countries in the region. And, the groups with much-worse-than-average health outcomes – most notably in maternal and neonatal deaths – are LAC’s most vulnerable and marginalized populations. Often these are also people whose voice is not heard in policy-making. Further, as outlined in an article for the Journal de  Perinatología y Reproduccion Humana, the pace of progress in reducing preventable maternal, child, and newborn deaths has slowed considerably throughout the region. At the same time, the investment of international donors in the health sector in LAC has declined markedly over the last two decades. So, the capacity and resources of the region itself will have to be better focused to reduce its major “equity gaps” in maternal and child health. In this context, the Panama conference was initiated by USAID’s Bureau for Latin America and the Caribbean, and sponsored by a consortium of donor agencies, USAID, PAHO/WHO, UNICEF, UNFPA, UNAIDS, the Inter-American Development Bank, and the World Bank, to catalyze a more concerted regional effort to address those gaps.

So, why now? In addition to the convergence of the region-specific factors just mentioned, the timing of the Panama conference was important in a global context because it forged a link between the Latin America and Caribbean region and the new global movement “A Promise Renewed” (APR). That movement was launched in June 2012 at the Child Survival Call to Action event in Washington, D.C. that was hosted by the governments of Ethiopia, India, and the United States, in collaboration with UNICEF. APR aims to re-energize those working on maternal and child health world-wide, and increase attention and investments toward the goal of ending preventable maternal and child deaths within the next generation – by 2035. Several follow-up conferences in Africa and Asia have helped sub-regions and individual countries to begin development of detailed roadmaps to reach this goal. For the LAC region, reaching the global goal will require a fundamental commitment to bridging equity gaps. Going forward, we expect that LAC’s active participation in the global APR platform will lead to accelerated learning and better metrics for gauging progress.

What’s ahead? A major consensus emerging from the conference was that the true locus of control for closing these equity gaps lies in the countries of the region –their governments, civil society, academies, churches, and other institutions. The appropriate role for donor agencies is supportive, not primary, in setting goals, timelines, the route to reach them, and the metrics to measure them. Many conference participants called for a regional mechanism to help facilitate collaboration, information exchange, south-to-south sharing, and access to technical expertise to accelerate the reduction of inequities.

Following are some other key decisions and next steps that came out of the conference:

  • Conferees identified key principles to guide efforts to close equity gaps, among them: use of cross-sectoral approaches for multi-sectoral problems; a focus on marginalized populations (rather than expecting benefits to trickle-down); use of multicultural approaches; and promotion of gender awareness.
  • Conferees supported the establishment of a regional network dedicated to addressing health equity gaps, which would be open to countries, civil society, private sector, and international agencies.
  • Representatives from several countries indicated that they would initiate national, and potentially sub-national, meetings to address maternal, child and adolescent health inequities in their own countries.
  • The donor consortium agreed to continue support for the A Promise Renewed for the Americas website, to serve as a platform for virtual discussion and planning, an information repository, and mechanism for technical interchange.
  • Conferees provided ideas orally and in writing for a regional framework aimed at supporting country progress on reducing inequities. This framework, along with a limited organizational structure, will continue to be developed in the coming months, with modest funding from the seven-agency donor consortium.
  • Setting of region-wide goals for reduction of health inequities was deferred, given the diversity of circumstances and the lack of standardized data across the region that could help inform policies and decision making. There was also general agreement that imposing regional, uniform, health equity reporting requirements on countries would not be feasible or desirable at this point. However, it was widely agreed that gauging progress in reducing health inequities is essential for accountability. That will require countries to disaggregate their health data to allow analysis by geographic, economic, ethnic, and gender variables, over time.
  • Conferees also stressed the importance of LAC participation in shaping the post-MDG 2015 health development agenda.

For the LAC region, some of the most difficult challenges in maternal, child, and adolescent health still lie ahead, because they require reaching those who are hardest to reach, but the Panama conference showed that solidarity and commitment in the region are strong. The LAC region has a history of success in maternal and child health and can draw from the extensive knowledge and expertise already in the region. The Panama conference catalyzed an ambitious process that will be ongoing until, as one speaker observed, “we meet to celebrate ‘A Promise Fulfilled.’”

Related blog posts:

Vocational Courses Give Economic Empowerment to Women of Georgia

From our Mission of the Month: Georgia, learn how a USAID-supported project empowers women to acquire training that allows them to contribute to their family incomes. 

Christina Blurtsian is a 22-year old ethnic Armenian student passionate about the arts. She paints, sings, plays guitar and even makes costumes for one of the local theaters in Tbilisi.

“When I was a kid, I would spend nights painting. It was my true passion. I would draw on a piece of paper, cardboard, asphalt, even on a wall-paper. Soon sewing became my passion. It first started when my mom gave me a doll and I decided to make her a dress.”

Christina Blurtsian. Photo credit: USAID/Georgia

Christina Blurtsian. Photo credit: USAID/Georgia

Since then Christina has made several dresses for her friends and actors as well.  She will turn this passion into a profession soon. After completing a USAID-supported vocational training course in sewing machine skills, Christina will start working at an apparel factory.

In partnership with the apparel industry, the USAID Economic Prosperity Initiative (EPI) developed a short-term training program that connects vocational colleges and the apparel industry.  The partnership allows the apparel sector access to a qualified workforce that will increase the industry’s productivity while women like Christina gain skills, empowerment, and employment.

Sewing machine operator training students in Georgia. Photo credit: USAID/Georgia

Sewing machine operator training students in Georgia. Photo credit: USAID/Georgia

“I prefer to start working at an apparel plant. After I gain enough experience, I am going to teach others. I’m trying to find a permanent job not just because I need to earn money, although I have to support my parents. I’m striving to achieve my goals.”

Christina is very clear about her plans and goals. In a large family of seven, she is now the only one living with her parents. Christina’s mother works at a grocery store, her father is a pensioner, and their income barely covers utility bills. Christina knows her earnings will be an important contribution to the family income. Still, Christina believes hard work, a sense of purpose and diligence are qualities that matter just as much as a better living of her family. “Realizing my interests and aptitude in life is a key drive for me. Everything I do, I do for this reason.”

Iveta Tskhovrebashvili. Photo credit: USAID/Georgia

Iveta Tskhovrebashvili. Photo credit: USAID/Georgia

Iveta Tskhovrebashvili is a dedicated mother who completed the same course. At 40 years old Iveta saw the course as a second chance to finally have a real profession. She’s always had a knack for sewing. “I would often make myself a dress. It was during the particularly difficult times when not many people could afford fancy clothes, especially my acquaintances. My dresses did draw attention; none of them would miss a compliment. People really liked them,” Iveta recalls.

The sewing courses showed Iveta new techniques and helped her improve. “Speed, meticulousness, the ability to work with complex garments – these are the skills I’ve acquired through the courses,” Iveta says.

Iveta believes the courses will help her find a job and support her family. “My husband is without work and there are so many things my daughter needs that we cannot afford. Once I start working in an apparel factory the situation will become better,” she says.

Both Christina and Iveta are interns at a local apparel manufacturing company and, if successful, will secure a job.

Learn more about our Mission of the Month: Georgia. For ongoing updates in the region, like USAID Georgia on Facebook and follow them on Twitter (@USAIDGeorgia)!

Empowering Women with the Female Condom

September 16 is Global Female Condom Day. 

Believe it or not, the female condom is a controversial tool in the arsenal against HIV transmission. Donors argue that it’s expensive and not widely used. Women complain that it’s too big and hard to insert. What no one can argue is that it works.

Female condoms are the only woman-initiated method available that offers dual protection from unintended pregnancy and sexually transmitted infections (STIs), including HIV. Studies have shown that the female condom is at least as effective as the male condom in reducing the risk of contracting STIs and can reduce the per-act probability of HIV infection by 97 percent. Studies from Madagascar, Brazil, Kenya, India and the United States demonstrate that female condom promotion and use increases the total number of protected sex acts.

RH Councillor Jonathan Kabanda in a councilling session with client Pauline Phiri at SFH Obote Site, Livingstone, Zambia. Photo credit: PSI

RH Councillor Jonathan Kabanda with a female condom in a counselling session with client Pauline Phiri at SFH Obote Site, Livingstone, Zambia. Photo credit: PSI

But to provide the dual protection it was designed for, female condoms must be used. And while gaining acceptability and uptake among women is not an easy task, it can be done.

Patience Kunaka first heard about female condoms in Zimbabwe in the early 1990s. “I first thought it might be a good prevention tool. In those days, HIV was taking its toll and antiretroviral therapy was not yet known and available.”

Patience worked then as a midwife trainer for the National Health Ministry. While her training provided her with knowledge of reproductive anatomy, she was still shocked when she saw the female condom. “I wondered how it would remain inside me with the movement of the penis. I thought it would be sliding in and out and become a really messy act!”

Despite her concerns, she attended a female condom training and decided to try one during her menstrual cycle. “It takes a lot of practice to get used to it. But it’s worth it in the end.”

Patience joined Population Services International (PSI) Zimbabwe in 2006 as the training manager and has become an outspoken advocate for female condoms. “It takes time to get used to female condoms but mainly it takes a positive attitude toward trying it. I am a regular user and talk to a lot of women about trying it.”

In the nearly 20 years since it started programming for female condoms, PSI has learned valuable lessons in supporting their uptake. Relying solely on traditional commercial marketing strategies is not effective. PSI targets female gathering places such as hair salons, which allow for prolonged interaction between potential users and promoters to encourage trial and repeat use. Promoters receive intensive training to demonstrate female condom use with interpersonal communication to their female peers. Non-traditional channels also include barber shops and gathering places for men, which can help programs achieve male partner buy-in.

As the international community gathers to celebrate Global Female Condom Day on September 16, it is important to remember that the female condom provides another option for women whose partners refuse to wear a male condom or women who want to take charge of their own reproductive health. As additional female condoms become commercially available, the prices will hopefully reduce, providing access to an even greater number of women. And while programming for female condoms can be complex—just as any behavior change can be—women like Patience Kunaka demand it.

Through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), USAID supports PSI and other implementing partners’ female condom programming in a number of sub-Saharan African countries.

Educating A First-Time Mother

It was the height of the Indian monsoon season and I sat cross-legged on a concrete floor in the slums of outer Delhi. An excited chatter filled the air from the 25 new and expectant mothers packed into the small room. There, I met a young Bengali woman, Manali. Manali is a recently married 18-year-old who, less than a year ago, traveled a very far distance from her family’s village to join her now-husband in India’s second largest city. She sat shyly in the corner of the room.

Mother and child. Photo credit: MAMA

Mother and child. Photo credit: MAMA

I soon learned that she was expecting her first child. While she had the same joy in her expression and excitement in her voice as other expectant mothers I’ve met around the world, I realized there was something different: her knowledge level.

My colleague Daphne asked Manali how she will know when she is in labor, where she plans to deliver, and what to give her baby if he is sick. Second- and third-time moms will usually jump in to supply the information. Manali, on the other hand, smiled shyly and shrugged her shoulders. Surprisingly, the majority of women in the room had a mobile phone in their hand–basic “candy bar” phones, many with broken screens–but all had used their device to receive calls. When this is the case, these phones can be used to deliver vital health information and knowledge to mothers, especially first-time moms like Manali who need this information the most.

In two weeks, Johnson & Johnson will head to New York City, where the world’s global leaders will come together for the United Nations General Assembly to tackle some of the biggest issues facing the world, including meeting the Millennium Development Goals. With fewer than 850 days to 2015, we are far short of our goal to reduce child mortality and improve maternal health.

Progress has been made: 13 commodities have been identified by the UN Commission on Life-Saving Commodities to address preventable deaths in women and children. Countries such as Nigeria and Tanzania have put together plans and begun to implement these recommendations, saving millions of lives. However, less action has been taken to inform the women themselves of these life-saving commodities.

For example, if a mother knew about oral rehydration salts solution (ORS), which would help manage her baby’s dehydration from diarrhea (and that ORS solution costs just a few cents), she could seek out this simple treatment. If she knew about the warning signs for pre-eclampsia, she could recognize them and get to the clinic early for treatment with magnesium sulfate.

The World Health Organization recognizes that a lack of information is a contributing factor to women not getting the care they need. A first-time mother is especially vulnerable. She is younger, less experienced, and often feels isolated and less empowered amid her husband’s family. Mobile messages delivered via voice or text are a simple way to inform, support, and educate her with accurate health information.

The model to address this opportunity is an intriguing example of the power of public-private partnerships. MAMA founded by USAID, Johnson & Johnson, UN Foundation, Baby Center and mHealth Alliance, is getting this vital health information out to mothers through partnerships around the world. These stage-based messages—developed by BabyCenter, a Johnson & Johnson company, in partnership with global health experts—are timed to coincide with the stage at which the mother needs them. The messaging is adaptable, i.e., easily translated into other languages and dialects.

In its first two years, the model is showing promise. A growing alliance of partners–235 organizations across 59 countries–is reaching 530,000 new and expectant mothers. New MAMA child messages are now also available, developed in partnership with MDG Health Alliance, GBC Health, and UNICEF.

For first-time moms like Manali, the information delivered increases their knowledge, helps to develop their confidence, and connects them to life-saving commodities. While phones cannot and should not replace doctors, nurses, or community health workers, the ubiquity of these devices offers new mothers the opportunity to have a healthy pregnancy and give her baby the best start to life.

This blog first appeared on the Huffington Post’s Global Motherhood page, as part of a month-long series in partnership with Johnson & Johnson to highlight the successes and remaining opportunities in the Every Woman Every Child movement. With the aim of improving the lives of women and child around the world, EWEC was launched by UN Secretary General Ban Ki-moon in 2010 to accelerate progress against the Millennium Development Goals (MDGs). To learn more, click here.

Neonatal Alliance Locks in on Largest Contributor to Under-5 Death in Latin America and the Caribbean

This blog is part of a series to coincide with A Promise Renewed in the Americas: ”Reducing Inequalities in Reproductive, Maternal and Child Health Summit“ during September 10-12 in Panama.

Each year, over 121,000 babies in Latin America and the Caribbean (LAC) will die during their first month of life. Nearly a quarter of these neonatal deaths are due to prematurity and low birth weight; and these deaths are more likely to happen if the baby is born to a mother who is poor, uneducated, or lives in a rural area.

To prevent neonatal deaths and advance neonatal health in general, many of the LAC region’s ministries of health, the United States Agency for International Development (USAID), several United Nations (UN) agencies, non-governmental organizations, and professional associations (pediatric, obstetrics-gynecology, midwifery, and nursing), have formed a partnership in 2005 called the LAC Neonatal Alliance.

Mother and child. Photo credit: MCHIP

Mother and child. Photo credit: MCHIP

This regional Alliance provides an ongoing platform for active engagement in neonatal issues at the regional and national levels. It champions key initiatives such as the promotion of the Neonatal Integrated Management for Childhood Illness (IMCI) strategy, development of “Trainer of Trainers” workshops for neonatal resuscitation using the Helping Babies Breathe (HBB) protocol, implementation of Kangaroo Mother Care, and creation of communities of practice for  the exchange of experience and dissemination of evidence-based practices. The Alliance model allows for quick action to address priority issues because of its organizational character: transparent and trusting collaboration, plus tightly defined and monitored goals that are supported by a shared annual work plan and budget. This structure has allowed the Alliance to make a significant impact on neonatal health in the LAC region.

An important example of the Alliance’s work involves the implementation of a low-technology, cost-efficient technique to save premature babies. Kangaroo Mother Care (KMC), which involves constant skin-to-skin contact between the newborn and his or her mother (or father), was developed in 1982 in Colombia in response to a lack of incubators. This simple intervention helps newborns regulate their temperature and other physiological processes – but its benefits have not been well understood until recently.  The intervention has been shown to reduce newborn mortality and morbidity in premature and low birth weight infants by approximately 50 percent more than traditional care. A recent USAID-funded study in Nicaragua found that use of KMC reduced hospital stays for newborns by four days, which results in less potential for hospital-acquired infections and allows the family to resume their normal life, including infant-related responsibilities, sooner, while saving an average of almost $400 per infant.

The Alliance has brought teams from 10 LAC countries to Colombia for training in KMC, and eight of these teams instituted training programs in their home countries to further disseminate KMC. Through this work, the Alliance is potentially reaching over 20,000 mothers and their infants per year.

With neonatal deaths remaining a major challenge in Latin America and the Caribbean, especially among disadvantaged groups, the Alliance will keep this issue in the forefront and continue to push for universal adoption of life-saving interventions in the region.

For detailed information on the LAC Newborn Alliance and Kangaroo Mother Care visit the following websites: Kangaroo Foundation, Maternal and Child Health Integrated Program, and the Newborn Alliance.

Follow @USAID and @USAIDGH from September 10-12 for live tweets and Facebook content from the conference. Follow the hashtag: #PromiseRenewed or #PromesaRenovada.

Video of the Week: Yaajeende Conservation Agriculture in Senegal

BioReclam is a major activity being conducted with vulnerable women to provide them with access to land for producing food and earning income during the rainy season. The project works with Communities to allocate abandoned lands to vulnerable people, This land is being reclaimed using a package of innovative techniques and is used to produce lucrative, low maintenance crops rich in micronutrients such as Okra and Hibiscus (leaves and flowers). These crops/varieties are selected to be particularly rich in Iron and Zinc. Learn more about we are doing in Senegal.

What Do Walmart and USAID Have In Common?

This originally appeared on the U.S. Global Leadership Coalition Blog.

So what do Walmart and USAID have in common? That was a question we at Walmart asked ourselves several years ago.

Well, for starters we both can be found all over the globe, but what else? We both work with farmers and business owners—USAID through sustainable development efforts and Walmart through our supply chain. We both have demonstrated a commitment to community-oriented solutions that solve big problems. And perhaps most importantly, like USAID, Walmart believes that businesses have an important role to play in advancing the economic development of the communities we serve around the world.

(from L-TO-R) Mike Duke, President & CEO, Walmart; Dan Bartlett, Executive VP of Corporate Affairs, Walmart; Rajiv Shah, Administrator, USAID. Photo credit: USGLC

(from L-TO-R) Mike Duke, President & CEO, Walmart; Dan Bartlett, Executive VP of Corporate Affairs, Walmart; Rajiv Shah, Administrator, USAID. Photo credit: USGLC

That’s why today Walmart, the Walmart Foundation, and USAID signed a new global Memorandum of Understanding (MOU) to work even closer together on our common goals. You see, Walmart and USAID share the same approach to doing business, believing in the power of partnerships, leveraging assets, and maximizing resources.

Walmart’s global initiatives often have a development goal, and we are excited to work alongside USAID on Women’s Economic Empowerment, Farmer Training and Sustainable Agriculture, and Vocational and Youth Skill Training. Whether it’s our initiative to train one million farmers or to double our sourcing from women-owned businesses, the goal is to help farmers and women access modern supply chains, increase their income, and in turn, contribute to the economic development of their communities.

By working hand-in-hand with the USAID Forward initiative, Walmart will be able to leverage and scale existing programs while allowing us to maximize one another’s expertise. In Central America, while USAID helps train farmers on agricultural standards and how to produce more in their harvests, Walmart can determine the right assortment and timing for farm products we need in our stores. It’s a win-win as farmers have a sustainable income from their work, Walmart has access to locally grown fruits and vegetables, and consumers in the region have the products they want.

Last year alone, Walmart purchased $75 million in produce from 3,400 small and medium-sized farmers and their families, accounting for 35 percent of fruit, grain, and vegetables sold in our stores across Central America.

We look forward to strengthening our partnerships with U.S. development programs as we continue to invest in emerging markets. We believe there will be new opportunities to leverage the Feed the Future initiative to assist more African farmers in providing for their families, serving as another effective example of just how much a difference public-private partnerships can make.

This is truly doing good by doing well, and it’s important for building our economy here at home, providing opportunity in struggling communities around the world, and in creating a better, safer world.

Sarah Thorn serves as Senior Director of Federal Government Relations for Walmart and as Vice President of the Board of Directors for the U.S. Global Leadership Coalition.

Learn more about the partnership between USAID and Walmart.

The LAC Effect: Addressing Inequalities to Save Lives

Ariel Pablos-Mendez, PhD, is the Assistant Administrator for Global Health

Ariel Pablos-Mendez, MD, MPH, is the Assistant Administrator for Global HealthThis blog is part of a series to coincide with A Promise Renewed in the Americas: “Reducing Inequalities in Reproductive, Maternal and Child Health Summit” during September 10-12 in Panama.

This blog is part of a series to coincide with A Promise Renewed in the Americas: “Reducing Inequalities in Reproductive, Maternal and Child Health Summit” during September 10-12 in Panama.

I’m in Panama City, Panama for the A Promise Renewed in the Americas: “Reducing Inequalities in Reproductive, Maternal and Child Health Summit“, where 19 ministers and vice ministers of health from 17 countries throughout the Latin America and Caribbean (LAC) region are gathering together to figure out a game plan on how to further progress in ending preventable child and maternal deaths.

But before I launch in to what I think would be one significant contribution from USAID and others in the donor community, I’d like to brag a bit. Being from Mexico, I’m immensely proud of what the region has been able to accomplish in a relatively short period of time. Almost all LAC countries have reached or are close to reaching their Millennium Development Goals (MDGs) 4 and 5, which address child and maternal health respectively.

The LAC region has led the way with innovative solutions. The concept of Kangaroo Care originated in Colombia in 1982, and is a simple, no-cost intervention that involves skin-to-skin contact between parent and newborn, is responsible for saving newborns by keeping them warm and encourages exclusive breastfeeding. Latin America’s storied success in immunization and polio eradication inspired the rest of the world. Starting in the late 1990’s, Brazil and Mexico began experimenting with conditional cash transfer programs, which has reduced poverty and improved health and other outcomes through the provision of incentive payments for certain behaviors. The approach has since spread throughout the region and now 18 countries have a CCT program with nearly 130 million beneficiaries. The LAC region was also one of the first to adopt the Integrated Management of Childhood Illness (IMCI) approach, which builds on existing efforts to integrate child survival programs at the community level.

Then there is my favorite topic…Universal Health Coverage, which is defined as access for all to appropriate health services without incurring financial hardship. The region has made tremendous strides in UHC with significant health reforms that include the Unified Health System in Brazil, The Social Health Insurance program in Chile, and coverage for 50 million Mexicans under the Popular Health Insurance Program. This fall, Brazil will host the Global Forum on Human Resources for Health dedicated to sharing experiences with the world on how to move towards UHC.

The LAC region should feel deep pride in its health accomplishments, country graduations from assistance and many, many other success stories. But if it were all good news, all these ministers, global health leaders and donors would not be coming together for a summit.  We still have work to do.

In Latin America and the Caribbean, more than 180,000 children under 5 years old and nearly 9,000 mothers still die annually, most of them poor, indigenous and marginalized groups.  Despite two decades of development gains and recent economic growth in LAC countries, a large health disparity remains among and within countries with regard to access and quality of health services. This is especially true for voluntary family planning services which we know dramatically improves maternal and child health and can more broadly contribute to economic and social development and stability.  And on average, countries in the region only spend 3.5 percent of their GDPs on health, and out of pocket expenditures remain high at nearly half of national health expenditure overall.  This is a recipe guaranteed to drive a low- to middle- class family back into poverty with one catastrophic health episode.

But there are things we can do as a global health community, even as we evolve our role as partners in the LAC region.

Here’s the good news. Due to the years of rapid growth, the World Bank estimates that 70 million people in the region have risen out of poverty and 50 million have joined the middle class during the past 10 years. With this transition of economic growth, most low-income countries are reaching middle-income status and it makes sense that international donors would reduce bilateral grants for program implementation and shift toward providing more technical assistance to support government priorities and country ownership. And the LAC region has shown that social inequalities can be generated by economic growth but also tackled with political will.

Governments have led or are currently leading the effort to sharpen and refine their national action plans with costed strategies for maternal, newborn and child survival, and by setting and monitoring five-year milestones. Development partners, in turn, can support national targets by pledging to align their support with government-led action plans and priorities. Private sector partners can spur innovation and help identify new resources for child survival. And through action and advocacy, civil society and faith leaders can support the communities and families whose decisions profoundly influence prospects for maternal and child survival.

Regional solidarity can also play a key role. Region-wide collaboration and exchanges of ideas and knowledge will be a magic ingredient that contributes markedly to the reduction of inequalities. Several countries, including Brazil and Mexico, have already been reaching out with their own know-how and funding, and have begun to forge their own approach to development assistance. This meeting in Panama, like the global Call to Action last June, is but another step in this important effort.

Although USAID LAC will have only two bilateral health programs in Haiti and Guatemala as of 2014, we will continue to provide technical assistance through regional programs aimed at building country capacity on key health issues: health systems, TB control, family planning, and maternal, newborn and child health.  We will continue to coordinate with other U.S. government agencies in-country to maximize the full breadth of our resources and collaborate with country Ministries of Health and other partners “on the ground” to integrate programs and build health systems that support quality care. And we will work to improve information for accountability, and encourage expanded participation in decision-making for better problem solving.

Zero child deaths are hard to attain even in rich countries, but the world as a whole can indeed reach the low mortality levels enjoyed in those countries. And this milestone for our civilization can be attained by our generation. No one government, donor, organization, or campaign will end preventable child and maternal deaths, but together, this IS an attainable goal. I’m looking forward to the outcomes of this Summit over the next few days and look to continue USAID’s deep and successful relationship with the LAC region, understanding full well that success means our eventual departure. As stated in USAID charter by President Kennedy, “We intend during this coming decade of development to achieve a decisive turn-around in the fate of the less-developed world, looking toward the ultimate day when all nations can be self-reliant and when foreign aid will no longer be needed.”  LAC is leading the way.

Resources:

Follow @USAID and @USAIDGH from September 10-12 for live tweets and Facebook content from the conference. Follow the hashtag: #PromiseRenewed or #PromesaRenovada.

Why Strong Land Rights Advance Food Security

This originally appeared on Devex Impact

Under U.S. President Barack Obama’s Feed the Future initiative, we have made incredible strides in increasing crop yields, agricultural surpluses and farmers’ incomes.

We have supported training, the implementation of new technologies and climate-smart management techniques to facilitate economic growth, increase security for the world’s most vulnerable populations, and improve child nutrition and life expectancy. We have targeted assistance to women smallholder farmers, who contribute the great majority of smallholder agricultural labor, resulting in greater investments in children’s health and education.

A woman on a cassava farm at Cauca, Colombia. Clear and defined property rights empower farmers to make better economic decisions with their land, avoid land conflicts or illegal land grabs, and enable them to look into long-term resource management and sustainability practices. Photo credit: Neil Palmer/CIAT/CC BY-SA

A woman on a cassava farm at Cauca, Colombia. Clear and defined property rights empower farmers to make better economic decisions with their land, avoid land conflicts or illegal land grabs, and enable them to look into long-term resource management and sustainability practices. Photo credit: Neil Palmer/CIAT/CC BY-SA

In order to continue this momentum and make hunger, undernutrition and extreme poverty permanently a thing of our past, we must do more. This includes working with governments around the world to help them develop secure property rights for farmers — both large and small-scale.

We hear from smallholder farmers around the world that they want to increase their productivity and earn greater income to feed their families, send their children to school, and pay for medicine and other life necessities — in short, they want a better life. But in many parts of the world, farmers lack the tools, technology and rights to achieve these aspirations.

To take advantage of new tools and technologies, farmers in all countries need strong property rights to be certain that they will have their land long enough to realize the benefits of their investments. They need to have confidence that their land and crops will not be seized by more powerful interests — particularly if they make productivity-enhancing investments, for example in soil and water conservation — without due process and compensation. Strengthening property rights is even more important for women, who often have fewer and weaker property rights than men, yet play a larger role in agriculture in many countries where we work.

When property rights are clear and secure, all farmers are empowered to make better economic decisions, including whether to sell or lease their land, expand their production, recruit non-family labor, and plant long-term crops for local consumption and for the market. With clear rights to land, farmers are more likely to make investments that increase crop yields, practice sustainable farming methods that improve soil quality, and better manage their resources. At the same time, transparent land rights provide those interested with the option to move out of agriculture — and encourage responsible investment for those who choose to stay…

Read the rest of the article.

Learn more about USAID’s work in securing land tenure and resource rights

From the Field in Vietnam: Small Loans Mean Big Changes for People Living with HIV

Vietnam’s mountainous Dien Bien Province, 500 km (about 310 miles) west of Hanoi, is home to the well-known battleground of Dien Bien Phu, where Vietnamese soldiers fought and won a decisive 55-day battle in 1954 against the French Union that brought an end to that war. Today, Vietnam is now engaged in another battle — against HIV/AIDS. And Dien Bien is one of Vietnam’s two provinces with the highest HIV prevalence.

Ms. Ca Thi Hinh, 32, a member of the Thai ethnic minority group in northern Vietnam, grew up in the province’s Tuan Giao district, an HIV hotspot. Born into a poor family, Hinh married in her early twenties. Her husband was also poor, and all they had was a temporary shelter. They both worked hard as hired laborers, saving as much as they could and looking forward to the moment when they could afford a decent house.

In her traditional costume typical of the Thai ethnic minority group in northern Vietnam, Hinh tells her story to a reporter from Vietnam Television with confidence, shining eyes and a radiant smile. Photo Credit: Richard Nyberg/USAID

In her traditional costume typical of the Thai ethnic minority group in northern Vietnam, Hinh tells her story to a reporter from Vietnam Television with confidence, shining eyes and a radiant smile. Photo Credit: Richard Nyberg/USAID

In 2007, Hinh’s husband was diagnosed with HIV when he was treated for a high fever, and died shortly after. Hinh then found out that she had contracted HIV from her husband, and the sky seemed to fall down on her. She could only gather her courage when she thought about her two small children. “I must live,” she thought. “My children need me to take care of them.”

As stigma and discrimination against people living with HIV/AIDS are still problems in Vietnam, people like Hinh have difficulty finding jobs, face unfair treatment in accessing social services and experience discrimination in healthcare and other settings.

Hinh looked to animal breeding as one option to earn an income, but she was turned down for a loan from a state-owned bank. Then she learned about M7/CFRC, a microfinance service provider supported by the USAID HIV Workplace Project. M7/CFRC staff trained her in financial management and gave her a microloan of $150. Adding $50 from her own savings, she bought two goats, one of which was pregnant. Three months later, her herd had grown to eight and she sold two goats for $215. With this money, she is able to support her children and her sister.

“I am very grateful for the support and care from the project. My children are now well-fed and educated, and I, myself, am more confident,” Hinh said. She hopes to have more goats soon, so that she can sustain her income.

Since 2008, the project, funded under the U.S. President’s Emergency Plan for AIDS relief (PEPFAR), has helped 1,400 people living with or affected by HIV in Vietnam. With microloans from the project, people like Hinh have found jobs and realized their dreams of running their own businesses. The success of the microfinance model for people living with HIV has encouraged local microloan providers to commit $1 million in loans to this target group.

The Government of Vietnam has also adopted the project’s microfinance models and is developing a new policy to provide loans to populations at highest risk of HIV in Vietnam.

Learn more about USAID’s work in Vietnam.

Like USAID Vietnam on Facebook and follow @USAIDVietnam on Twitter  for ongoing updates in the region. 

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