USAID Impact Photo Credit: USAID and Partners

Archives for Youth

Why Women’s Leadership Matters in a Macho World

Gangs are often seen as a problem of boys and men. Historically, communities have focused on men as both perpetrators and victims of gang related crimes, which include assault, kidnapping, extortion, illicit substance and human trafficking, theft, and murder. And to date, the answer has also been a predominantly male approach – police and court systems that focus on penalizing individuals for these crimes.

However, gangs don’t only make boys and men vulnerable; they make communities insecure for girls and women, too. Although the majority of homicide victims and perpetrators are male, there is an alarming trend of girls joining gangs as well as becoming victims of sexual assaults and femicide.

Volunteers of the Youth Movement Against Violence in Guatemala. Photo credit: Creative Associates

Fed up with the violence and driven by a desire for positive change in their communities, women are taking leadership roles to tackle gang violence and crime. Through youth movements, such as Movimiento Jovenes Contra La Violencia (Youth Movement Against Violence)  in Central America, young women are leading efforts and bringing together communities, governments, and youth to form partnerships and find creative solutions.

“I am worried about the alarming situation and of the number of youths that are killed every day, and the impact that the violence has on my family. So I decided to take part in finding a solution,” says Vivien Rueda, one of the founders of Youth Alliance Association in Guatemala City.

The Youth Alliance Association project takes a whole-of-community prevention approach. Through USAID’s outreach centers in high-crime areas, the group helps to provide a safe space for recreational activities and job training for at-risk youth as well as ex-gang members. In order to strengthen a sense of community, the centers are called “Outreach Centers for My Neighborhood,” which is similar to a local, common catch phrase “for my neighbor, for my neighborhood.”

The visibility of youth activism was raised to the national stage in Honduras by Alejandra Hernandez, former head of Movimiento Jovenes Contra La Violencia in Honduras. In addressing the Honduran National Congress, she echoed the frustration of youth, of which 2.3 million are girls: “We are here to say that we are tired of being just observers of the violence in our country, now we want to be actors in the construction of solutions that allow us a safer Honduras.”

Women are unique actors and add value to these crucial conversations. They are instrumental to help achieve peace in their communities by bringing diverse perspectives, mobilize a variety of community actors, and ensure that all citizens have their security concerns heard.

Asking the Right Research Questions to Achieve Global Health Goals

This blog is part of the Global Health Research & Development Blog Series.

Asking the right questions is the first step to generating the ‘downstream’ evidence needed for the implementation of health policies and practices, as my colleague E. Callie Raulfs-Wang described in her March 12 blog. And fostering the right partnerships is crucial to determining the right questions. Partnerships facilitate operations research, or the testing of scalable solutions that overcome barriers to access, demand, and quality in real world settings. Investing in operations research to accelerate results is also a key strategy in the Global Roadmap of the Child Survival Call to Action. This pledge, signed by more than 160 governments, renewed their commitment to child survival and to eliminating all preventable child mortality in two decades, as USAID Administrator Rajiv Shah explained.

A thriving Ethiopian child. Photo credit: Nazo Kureshy

USAID’s Child Survival and Health Grants Program (CSHGP) supports new operations research partnerships among non-governmental organizations (NGOs), academia, and ministries of health to generate evidence about how to solve critical challenges in the implementation and scale-up of high impact maternal, newborn, and child health interventions. By working in partnership with ministries of health, studies are designed to meet the ministries’ expressed needs for evidence that would strengthen their systems. Solutions are tailored to local contexts, with relevance to global implementation challenges, such as how best to: integrate services within and across sectors; improve the continuum of care to maximize access and lower costs; ensure equity in access to health information and appropriate use of services; and strengthen systems’ capacity for accountability to communities.

As USAID’s Jim Shelton commented in Nature magazine this year, promoting health literacy for preventive health behaviors such as handwashing and breastfeeding, and deploying community-based interventions for services and health education, are among the priority public health approaches needed now for universal access to health.

Some questions that must be addressed in order to operationalize these approaches include:

  • How can community health workers (CHWs) more effectively reach households with timely information, case management, and referral?
  • What are effective models for partnerships between health care providers and community agents/traditional caregivers to improve the continuum of care and increase demand for services through culturally appropriate and respectful care?
  • How can data collected by communities be used as a communication and planning tool to improve the quality of care and accountability?

The answers to these questions would facilitate the research goals of integrated maternal and newborn health, child health, and nutrition, as outlined in USAID’s Report to Congress: Health-Related Research and Development Strategy. As stated in the research goals for health systems strengthening (HSS), “Ensuring equitable access to high-quality essential health services requires an increase in the evidence base on how to best implement HSS interventions and promote uptake of best practices.” These partnerships have the potential to achieve more than the sum of their parts by bringing together perspectives and skills that yield rigorous, relevant, and practical evidence.

At this year’s Global Maternal Health Conference in Arusha, Tanzania, presenters from CSHGP’s NGO partners in Peru, Liberia, Pakistan and Ecuador shared experiences on bridging the gap between communities and health systems to meet the maternal and newborn health needs of their most vulnerable populations . These research projects are helping ministries of health learn how best to operationalize and improve current policies on providing culturally competent, respectful care, and are testing new systems for overcoming geographic and financial barriers to safe childbirth. These partnerships are meeting the evidence needs of ministries of health that are striving to implement policies that make access to care more equitable.

To learn more about some of these 30 research partnerships in 23 countries check out this brief (PDF).

Read other posts in the Global Health Research & Development Blog Series:

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Photo of the Week: Helping Youth in El Salvador

Assistant Administrator for Latin America and the Caribbean Mark Feierstein with youth in El Salvador. Photo Credit: Juan Quintero, U.S. Embassy Public Affairs 

USAID Assistant Administrator for Latin America and the Caribbean Mark Feierstein joins youth from San Martin in sports activities organized in their municipalities as part of their crime prevention projects. USAID/El Salvador recently launched a $42 million public-private alliance called “SolucionES” (“Solutions”) to help local governments and citizens to prevent crime at the municipal level.

A Time for Action and Working Together to Improve Women’s Lives

This past week I traveled to India and Burma to meet with leaders of the private sector, civil society, and government who are charting their nations’ bright and prosperous futures. In Mumbai, I had the opportunity to sit down with a group of courageous women advocates to discuss gender-based violence. It was especially meaningful to have this conversation leading up to International Women’s Day, particularly because this year’s theme is A Promise is a Promise: Time for Action to End Violence against Women. It was only recently that thousands of young men and women took to the streets in India to protest the tragic death of a 23-year-old physiotherapy intern who was the victim of a brutal gang rape in Delhi.

At our meeting, we discussed the opportunity to shift ingrained social and cultural practices that perpetuate sexual violence among women, girls, and boys and the importance of educating India’s future generations. We also talked about the need for better data, stronger laws, and expanded services to both prevent and respond to gender-based violence.

I was honored to inform them that the young woman known worldwide as “Nirbhaya” (Fearless) would be honored posthumously by First Lady Michelle Obama and Secretary of State John Kerry at the Department of State’s Women of Courage Awards event this year.

In 2012 alone, Dr. Aye Aye Mu, who is part of USAID’s SUN Quality Health clinics in Burma, conducted over 5,000 reproductive health consultations, diagnosed and treated 107 pneumonia cases, diagnosed and treated 243 tuberculosis cases with a treatment success rate of over 80 percent. Photo credit: Richard Nyberg, USAID

A few days later, I had the opportunity to meet Dr. Aye Aye Mu, who has been practicing medicine in Burma since 1977. It quickly became clear that the Doctor and I share the same vision for development—beginning with the community level and drawing on the strengths of both private sector and civil society. Dr. Aye Aye Mu is part of a network of active health providers that is supported by our Agency and covers 217 of Burma’s 324 townships.

Through an innovative approach called “social franchising,” Dr. Aye Aye Mu helps encourage doctors running their own private clinics to improve the scope, quality, and accessibility of their services by joining the franchise called the SUN Quality Health Clinics. Started by our long-standing partner Population Services International in Myanmar, this network provides affordable, quality health care services nationwide.

Today, this network is contributing in remarkable ways to USAID’s ambitious yet achievable goal of ending preventable child death and improving the lives of women and children. In 2012 alone, Dr. Aye Aye Mu conducted over 5,000 reproductive health consultations, diagnosed and treated 107 pneumonia cases, and diagnosed and treated 243 tuberculosis cases with a treatment success rate of over 80 percent. By leveraging the local private sector to deliver health commodities and better quality, affordable health care services, she receives quality birth spacing products and anti-malarial drugs at subsidized prices and passes the savings to those who need it them most.

Our Agency is working hard to save lives, especially among children. Building upon the Child Survival Call to Action, USAID is introducing a global public private partnership, Survive and Thrive, which will be linked to local partnerships to increase coverage of high impact and high quality interventions delivered by midwives to women and newborns wherever births occur.  Working closely with our partners, these efforts will help improve the quality of maternal and newborn health by linking Burmese health care providers at the community level to their peers from American professional associations.

From India to Burma, these efforts advance the aspirations of the first-ever United States Strategy to Prevent and Respond to Gender-Based Violence Globally, which was released this past year. The strategy pledges to improve coordination across U.S. government agencies to improve the quality of our programming and strengthen our impact.  In a world where rates of gender-based violence show no signs of abating, it is increasingly important that we work together to improve women’s lives.

This past week has been an incredible experience. Even as we advance gender equality and women’s empowerment worldwide, it is important to remember on this International Women’s Day that women and girls are not just victims. They are leaders, change-agents, and innovators, courageously improving lives and expanding opportunities around the world for individuals, families, and communities.  As our policies and initiatives gain traction and implementation gains speed, we will work beside them to ensure our aspirations translate into concrete results around the world.

Success in India Paramount to Ending Preventable Child Deaths Globally

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

I just returned from India‘s “Call to Action Summit for Child Survival and Development“, which took place in Mahabalipuram, Tamil Nadu.

India accounts for the largest number of deaths of children under five: nearly 1.5 million per year. This number is staggering, but there is good news. There has been a steady rate of decline in child mortality — even ahead of the global rate of reduction. As I told DevEx during the Summit, “success in India is paramount to see the global success and vision of ending preventable child deaths in this generation.”

Led by India’s Ministry of Health and Family Welfare, the Summit called for an accelerated response to decrease child mortality across the country. This event was a direct outcome of the Call to Action held in Washington, DC last year — where India joined Ethiopia and the United States with UNICEF to launch a global roadmap to end preventable child deaths globally. About 300 policymakers, public health practitioners, private sector, civil society and media representatives attended India’s Summit, including 27 international and 35 national experts. Notably 20 State delegations were present. U.S. Ambassador Nancy Powell, a stalwart advocate for child survival, addressed the opening plenary on behalf of the United States.

The Summit had several main themes related to child survival and development: quality of newborn care, interventions for preventing diarrhea and pneumonia, social determinants of child survival, nutrition, strengthening health systems, improving accountability, communication for child survival, partnerships for improved maternal and child health, and leadership dialogue. The complete agenda and speakers can be found on the Summit’s website.

There was a rich discussion at the Summit along with solid deliverables. The Government of India launched the Reproductive Maternal Neonatal Child Health Adolescent health strategy (RMNCH+A), which serves as a roadmap for the States. Also released were several guidance documents including implementation of newborn care as well as management of pneumonia and diarrhea.  A National Child Survival Scorecard was showcased, and States were encouraged to develop their own scorecards and to monitor progress.

India’s Call to Action is the beginning of a national movement. Attendees demonstrated a passionate commitment to mobilize on behalf of India’s children — and to hold each other to account. India’s leadership and programmatic success will help galvanize the global response. USAID will continue to be a steadfast partner of “A Promise Renewed”, the sustained effort led by UNICEF to reach our global goal. Working together, ending preventable child deaths will be one of the greatest moral victories of our time.

India’s Leadership Furthers Global Child Survival Movement

At the forefront of the fight against child mortality and morbidity, India is leading the global community in placing a renewed emphasis on this important mission. India’s Call to Action demonstrates leadership and commitment to both the global community and the children of India.  India has an opportunity to make great gains on child survival with increased commitment and funding for the most effective life-saving practices. Moreover, India’s unique culture of social entrepreneurship, innovation, and technological advances present a historic opportunity to accelerate progress in reducing childhood illness and death.

William Hammink speaks at opening press conference for India’s Call to Action on February 3, 2013. Photo credit: U.S. Embassy

India is a regional leader and can guide and support other countries in several ways.  We commend the progress India is making in tackling child survival and strengthening India’s health sector.  India is one of the countries to have significantly reduced the incidence of HIV – from 0.41 percent in 2002 to 0.27 percent in 2011.  India has reduced its maternal mortality by more than 50 percent – from 570 in 1990 to 212 in 2009 per hundred thousand live births – and child mortality by 45 percent from 119 in 1992 to 59 per thousand live births in 2012.

The United States has been a longstanding partner of the Government of India, and our relationship dates back more than six decades. The U.S. Government through its agencies including the United States Agency for International Development, and the Centers for Disease Control and Prevention has been actively engaged in working alongside the Government of India as it endeavors towards ending preventable child deaths within a generation. In recent years, USAID has made significant investments in the area of reproductive, maternal, newborn, and child health, nationally and in key Empowered Action Group States.

USAID is currently developing its five-year Country Development Cooperation Strategy, while continuing to provide targeted assistance to support flagship national health programs, it will increasingly adopt methods focused on innovation and partnerships: more directly engaging local partners; leveraging co-financing instead of fully funding agreements; and developing platforms and alliances to generate development outcomes that encompass multiple organizations.

The U.S. Government is proud to be a part of this initiative and to give our unwavering support to India’s Call to Action. In the coming months, USAID will look at opportunities for newer partnerships with multi-stakeholder engagement including the government, private sector, entrepreneurs, and civil society to identify, and scale up solutions to address the challenges in accelerating child survival efforts.

As USAID Administrator Raj Shah said in his welcome letter to Summit participants: “An investment in India’s children is an investment in India’s future.” We stand ready to be part of India’s tomorrow.

Photo of the Week: Saving Children in India

Did you know that almost 7 million children under five died in 2011 from largely preventable diseases? In India, 1.7 million children under five died in 2011. February 7 marks the start of the the National Summit on “Call to Action for Child Survival and Development“, to be held in Mahabalipuram, Tamil Nadu.

Organized in partnership with UNICEF and USAID, the Summit is a critical platform that will strategically engage over 200 delegates including 27 international and 35 national experts, key policy makers, planners and implementers from the health sector representing all states of India, representatives and heads of UN and development agencies, global health experts and practitioners, civil society members and private sector, to discuss and debate on child survival and development in India. The Summit will be an opportunity for sharing experiences and challenges; celebrate successes in maternal, newborn, child survival & development programmes; and pledge to meet India’s child survival and development goals. Photo is from UNICEF.

 

A United Africa Under a Child Survival Revolution

Peter Salama, Unicef Representative to Ethiopia, makes closing remarks at “African Leadership for Child Survival” held in Addis Ababa, Ethiopia on January 18,  2013. Photo credit: UNICEF

Last Friday, it was a real honor for me to take part in the closing ceremony of the African Leadership on Child Survival – A Promise Renewed (ALCS/APR), together with H. E. Kesetebirhan Admasu, Minister of Health in Ethiopia, my esteemed colleague Dennis Weller, USAID mission director to Ethiopia, and my African colleagues in health and development.

In June 2012, during the first Call to Action – Promise Renewed meeting in Washington D.C., Dr. Tedros had committed that Ethiopia would host an African Leadership for Child Survival Conference that was linked to the AU summit. That promise is now fulfilled and I wish to thank Dr. Tedros and Dr. Kesete and all of the colleagues at the Ministry of Health for making this all African meeting a reality and a success.

The pledge signed by the African countries present and the consensus reached by the conference are both significant and historic. The event has marked a new era for the African continent in which it is no longer acceptable for any child to die an untimely and preventable death.

As we have seen at this meeting, in many ways the progress made in the health sector in Ethiopia, as well as many other African countries, has become a  powerful global symbol of what can be achieved in resource-constrained environments and has given many international partners renewed faith in the development enterprise.

To accelerate progress we need to do some things differently. Dramatic reductions in preventable child deaths can be achieved through concerted action in five critical areas, outlined in the global roadmap: geographical focus, high burden populations, high impact solutions, gender equality, and mutual accountability and financing.

The theme of equity, in all its dimensions, has come out very strongly through the conference conclusions on geography, gender equality and high burden populations. We know that as much as we have made global progress on child survival in recent decades so too have we seen an increasing concentration of child deaths in Africa which now accounts for around half of all the world’s child mortality.

During the three days, we have also seen that the highest rates of death are now overwhelming in fragile states and conflict-affected countries and regions. This demands that our attention also be placed on governance issues and on human security. There is a major role here, not only for the United Nations but also for regional institutions, and is why the role of the AU will be even more paramount as we move forward on this initiative. Indeed we are very hopeful that with the Ethiopia government taking over the chair of the AU in 2013, maternal and child survival will be seen as not only a health and development issue but as a peace and security issue. It seems auspicious that the African Leadership on Child Survival has taken place right before the AU heads of state meeting next week. I sincerely hope that the recommendations of this conference are shared with the AU leadership and head of states for their endorsement.

We have seen the strong leadership of African governments in this process. This is not an initiative led by UNICEF or USAID or any other partner, and it is very refreshing to see that this initiative and the commitments being made are home-grown. All countries have existing strategies and plans for improving maternal, newborn and child health. Integration of the ALSC/APR initiative with local processes, rather than setting up vertical mechanisms, will be important. Government should also coordinate efforts of various partners and the different initiatives and synthesize them into a coherent whole at the country level.

One of the most exciting aspects of the meeting and the overall process for me is to have seen the peer to peer dynamic in action. I know the lesson learning and sharing of good practices from country to country will continue over the coming months and that many countries are planning study visits to other African countries. We should nurture this dynamic at all costs. I believe the seeds of success and of sustainability for us in African have been planted by all at this meeting. By working hand in hand, we can and we will end all preventable maternal, newborn and child deaths, and thus complete the work begun under the child survival revolution.

Under Five Child Survival Under Microscope at Summit

This post originally appeared on Mom Bloggers for Social Good.

This week child survival is under critical review in Addis Ababa, Ethiopia during the African Leadership for Child Survival – A Promise Renewed summit. This meeting, held at the African Union headquarters and convened by the Ethiopian government along with UNICEF and USAID brought together African Ministers of Health to enter into discussions about markedly improving child survival rates. The summit ends Friday.

Between 1990-2011 child mortality has decreased 39% in sub-Saharan Africa. Photo credit: Mom Bloggers for Social Good

Between 1990-2011 child mortality has decreased 39% in sub-Saharan AfricaAccording to UNICEF, 1 in 8 children in sub-Saharan Africa die before their fifth birthday from five leading causes: pneumonia, pre-term birth complications, diarrhea, intrapartum-related complications, newborn infection and malaria…continued

Read more to learn which key tweets and infographics are emerging from the summit at the#promise4children hashtag.

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