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Archives for Youth

Winning the Battle Against Undernutrition and Stunting

Most people have never heard of stunting. It’s one of the least reported, least recognized, least understood issues facing humanity, yet tackling it should be seen as an opportunity both for personal health and national development.

Stunting, caused by chronic undernutrition in children, does not only affect a person’s growth or height. The damage that undernutrition causes to a brain’s cognitive capacity is permanent. It cannot be reversed.

As UNICEF documented in its 2013 report, ‘Improving Child Nutrition: The achievable imperative for global progress’, chronic undernutrition scars the lives of some 165 million children around the world. Undernutrition contributes to half of all child deaths and around one fifth of maternal deaths.

Two children in Zambia. Photo credit: Nazo Kureshy, USAID

Stunting traps people into a lifelong cycle of poor nutrition, illness, poverty and inequity. Children’s poorer school performance results in future income reductions of up to 22 per cent on average. As adults, they are also at increased risk of obesity, diabetes and cardiovascular disease.

Despite the challenges, we can and must win the battle against stunting and other forms of undernutrition – and investing in the first 1,000 days of a child’s life shapes the future of nations.

Experts have consistently confirmed that taking action on undernutrition is the single most important, cost-effective means of advancing human well-being. This would accelerate the achievement of the Millennium Development Goals, would save lives and should be a top global priority.

We know what works and what needs to be done to radically reduce stunting and undernutrition: from micronutrient and vitamin supplements to awareness raising, promoting exclusive breastfeeding and treating severe and acute malnutrition. Efforts should also be linked to improving access to education and safe water, promoting hygiene, preventing and treating diseases, and strengthening social safety nets.

Over the past 20 years alone, the number of stunted children under the age of five in the world has fallen by 88 million – from 40 to 26 per cent, or a one-third reduction.

However, a brand new Lancet series on nutrition from 6 June 2013 shows that progress is not fast enough. What is needed now is strong, global commitment and leadership to accelerate efforts.

UNICEF is a proud partner in the major global initiative called the Scaling Up Nutrition (SUN) movement, which is bringing much needed focus and investment for nutrition in a number of countries. Through the SUN country network, government focal points from each of the 40 countries involved share experiences, seek advice and provide each other with assistance, analyses of progress and lessons learned.

Broader efforts to address child survival are also galvanizing partnerships. Governments including those of Ethiopia, India and the U.S. have thrown their weight behind the A Promise Renewed movement, which –  with supported by UNICEF – is uniting governments, civil society, faith based leaders and private sector around the clear and compelling goal: to end preventable child deaths and give every last child the best possible start in life.

No child, no mother, no country should ever have to suffer the injustice of a lack of nutrition in the 21st century. We cannot stand by and allow a child to be condemned to a life of deprivation – especially when we know how to prevent it.

For updates on what the United States is doing to improve nutrition, follow the hashtags #Nutrition4Growth and #GHmatters on Twitter. 

Building a More Nutritious Future for All

A silent crisis is happening right now. It affects 165 million children globally, robbing them of the future they deserve and leading to more child deaths every year than any other disease. In a world of plentiful, nutritious foods and advanced science, this is unacceptable.

We can do better. And we can do it together.

At a landmark event in London this weekend, global government, business, and civil society leaders will join together to commit to a different future — one in which every child benefits from the nutrition needed to grow and thrive.

Administrator Shah at the Nutrition for Growth event in London. Photo credit: USAID

As the head of USAID – and as a parent of young children – I am privileged to show the United States’ support for global nutrition at the Nutrition for Growth event today. This event’s global reach reflects growing recognition that the challenge of undernutrition is solvable, but requires a new approach.

To proactively address the root causes of hunger and undernutrition and get the most out of every development dollar invested, we cannot treat nutrition, global health, and food security as isolated priorities. We must integrate our approach across sectors, forging high-impact partnerships and driving game-changing innovation from farms to markets to tables.

Feed the Future is doing just that, working with businesses, local communities, farmers’ organizations, and country leaders to not only reduce poverty and hunger but undernutrition too. Last year, we reached 12 million children through nutrition programs that reduced anemia, supported community gardens, and treated malnutrition.                                                                                          

This focus reflects the United States’ long history as the global leader in nutrition, from providing emergency food aid during crises to helping farmers and their families grow and consume more nutritious foods.

In fact, we have nearly doubled nutrition-specific funding through our global health programs and we have tripled agriculture funding since 2008, targeting our investments where we can deliver meaningful impact. We’ve also been a strong supporter of the Global Agriculture and Food Security Program, which funds country priorities in agricultural development and nutrition.

Today, I was pleased to announce that the U.S. Government is providing more than $1 billion for nutrition-specific interventions and nearly $9 billion on nutrition-sensitive activities over fiscal years 2012-2014.

These investments support and accelerate trends in stunting reduction; ultimately to reduce stunting by 20 percent over five years in the areas where we work through Feed the Future, translating into 2 million fewer stunted children.

Today we also signed on to the global Nutrition for Growth Compact, endorsing high-level goals for improving nutrition.

Integrating and expanding nutrition activities into our agricultural development programs makes good sense and is effective, as many of our civil society partners demonstrate every day in the field. And a growing body of research and knowledge, including the recently released The Lancet Series on Maternal and Child Nutrition, provides strong evidence that improving nutrition is one of the best ways to achieve lasting progress in development.

Ensuring that a child receives adequate nutrition, particularly in the critical 1,000-day window from a woman’s pregnancy to her child’s second birthday, can yield dividends for a lifetime as a well-nourished child will perform better in school, more effectively fight off disease, and even earn more as an adult. Nutrition is central to ending preventable child death.

The evidence is also clear that governments can’t do this alone.

Momentum for improving nutrition is strong, in large part thanks to our civil society partners who have worked tirelessly to mobilize support around the world behind the evidence that nutrition matters. Just today a coalition of U.S. NGOs pledged $750 million over five years in private, nongovernment funds for nutrition.

In a world where private sector investment flows vastly outpace official assistance, nations will only achieve development in partnership with a vibrant and transparent private sector as well. That is the mission behind the New Alliance for Food Security and Nutrition.

In just one year, the New Alliance has grown into a $3.75 billion public-private partnership that builds on country investment plans developed by African countries through the Comprehensive Africa Agriculture Development Program and works to integrate the principles of the Scaling Up Nutrition movement, which recognizes the meaningful impact of nutrition on all aspects of society—from health to agriculture to long-term growth and stability.

During its presidency of the G-8 this year, the United Kingdom has worked hard to carry the New Alliance forward, keeping momentum strong for this groundbreaking partnership.

Ending extreme poverty by advancing nutrition from farms to markets to tables is the vision that brings business, development, and civil society representatives together this weekend.

It’s also what inspires us to work together to ensure that every child has a healthy start and every nation a brighter future.

For updates on the Nutrition for Growth event this weekend and what the United States is doing to improve nutrition, follow the hashtags #Nutrition4Growth and #GHmatters on Twitter. 

Maryan’s Milk Mustache

During the first week of June, IMPACT will be highlighting the key role of nutrition in Global Health

Three-year-old Maryan is wearing a pretty blue headscarf and a milk mustache.

She is drinking one of the 30 cups of milk that Save the Children provides monthly to each of the nearly 11,000 women and children enrolled in its milk voucher program.

Successive droughts in the country have taken their toll on Wajir, in the northeast region of Kenya. As water sources dried up and crops failed, the livestock that the people have always depended on for their livelihoods perished. Milk became increasingly rare and children began to show signs of hunger.

Three-year-old Maryan drinks milk. Her mother Habiba (left) enrolled her in Save the Children’s milk voucher program when she showed signs of malnutrition. Photo credit: Susan Warner. February 2013

A survey taken in October 2012, found one in four children to be malnourished. To address this, Save the Children launched a nutrition project funded by USAID, which gives the local dairy industry a boost by issuing milk vouchers to those who need it the most. The vouchers, coupled with nutritional supplements, are distributed to malnourished pregnant women, breastfeeding mothers and children under the age of five. The vouchers can be traded for milk at the market, which traders and pastoralists can redeem for money. The cash infusion is slowly rehabilitating the pastoral economy as investments in livestock, fodder and veterinary services increase.

Today Maryan’s milk mustache is framed by cheeks that are round and full, but this wasn’t always so. When she first enrolled in the program a few months ago she was weaker and thinner than her peers. Her upper arm circumference, one of the measures used to determine nutritional status, had shown her to be moderately undernourished. After three months in the program her weight increased by 10%, an astonishing gain, when one factors in an illness that set her back slightly in February.

“The program has helped my child. She is more playful and happier and even though she is not fat, she is quite strong.” says Habiba Osman, Maryan’s mother.

Though Maryan remains somewhat slender, “she has shown great progress in terms of her weight gain,” says Saadia Ibrahim Musa, the community health worker who first treated Maryan at the local health clinic, where Habiba brought her for a screening in October last year.

Habiba and Maryan see Saadia regularly now, since they walk to the health clinic, where the supplements and vouchers are distributed, twice weekly. There, Habiba also attends nutrition classes with other Wajir mothers. “We discuss the dangers of malnutrition to a child’s development, the importance of feeding a child a balanced diet, and the importance of handling food in a hygienic manner,” says Saadia.

“Saadia has taught me a lot of things,” says Habina, “I now know to take Maryan to the hospital as soon as I notice something is wrong and how important it is not to share Maryan’s [nutritional] supplements with anyone else in the household as this makes her recovery more difficult.

The changes are visible throughout the community. “The children are happier and more playful now. The mothers are happy as their children now get the milk they couldn’t afford before the project. The traders involved in the project have increased their incomes and their lives are better. Everyone is happy,” says Habiba. “And Maryan loves the milk!”

Learn more about USAID’s efforts to improve nutrition.

Follow USAID (@USAID) on Twitter and use #GHMatters to join in the conversation about global health issues including nutrition.

What I Saw and Learned in Southeast Asia and Why I Left Inspired

This originally appeared on the Clinton Foundation Blog

Over last week, I traveled across Southeast Asia, delivering clean water as part of Procter & Gamble’s Clinton Global Initiative (CGI) commitment in Myanmar, attending the Women Deliver conference in Kuala Lumpur and ending my trip in Cambodia, where I saw how the Clinton Health Access Initiative (CHAI) is working with the government to fight HIV/AIDS and improve health care delivery at the national level through better supply chain management and at the local level in different hospital and clinic settings.

Chelsea Clinton visits a Clinton Health Access Initiative project. Photo credit: Thu Van Dinh

In Myanmar, I helped Naw Phaw Si Hser and her family turn dirty, unsafe water into clean, drinkable water. Procter & Gamble (P&G) first came to the village a couple of months ago and the families, particularly the mothers, all said their children no longer get sick from the water – and that the water tastes better now too! The liter of water that Naw Phaw Si Hser and her family received marked the six billionth liter of clean water from P&G’s CGI commitment. Through their CGI commitment, P&G aims to save one life every hour, every day, every week, every year by delivering more than two billion liters of clean drinking water every year by 2020, preventing cholera, diarrhea and other water-borne illnesses that still too often bring disease and death around the world.

While I was in Myanmar, P&G announced a new partnership with USAID to improve maternal and child health in Myanmar and provide 200 million more liters of clean drinking water over the next two years, furthering its CGI commitment. It is these types of innovations and partnerships that will continue to save millions of lives and fundamentally change health care in developing countries.

Mission Director for USAID Burma, Chris Milligan, greets children in Burma. Photo credit: Thu Van Dinh

After Myanmar, and a trip to Kuala Lumpur for the Women Deliver conference, where I joined leaders and experts to discuss the health of women and girls, my last stop was in Cambodia – a remarkable country and a model in the fight against HIV/AIDS. CHAI began working in the country in 2005, at a time when only 6,000 patients – including 400 children – were receiving the treatment and care they needed. Today, there is close to universal access for antiretroviral (ARV) treatments for adults and children with HIV/AIDS and I am proud that CHAI has been part of drastically changing the treatment equation in Cambodia. CHAI works in part by helping countries like Cambodia access ARVs at affordable prices, because CHAI and its partners have worked with the pharmaceutical industry to increase supply, and with governments to guarantee demand, which has led to a more than 90 percent drop in ARV prices in the developing world since 2002 when CHAI began. Cambodia is one of the first countries in the world to achieve universal access to ARV treatment for both adults and children and one of the first to meet its Millennium Development Goal (MDGs) targets for maternal and child health – truly a leader.

Now, Cambodia is uniquely placed to be one of the first countries to eliminate new pediatric HIV infections, and through collaborative partnerships, I have no doubt Cambodia will be able to reach its goal. Last Thursday, I joined the National Center for HIV/AIDS, Dermatology and STDs (NCHADS) where they announced, in partnership with CHAI and the government of Cambodia, the Cambodia Strategy 3.0, which aims to reduce HIV transmission between mothers and children to less than five percent by 2015 and less than two percent by 2020, while simultaneously reducing HIV-related mortality among children. The three ultimate goals of Cambodia Strategy 3.0 are no HIV/AIDS deaths, no new infections, and no stigma. Goals we all can and should get behind.

In Phnom Penh, I met with women and children who have benefited from the country’s Prevention of Mother to Child Transmission (PMTCT) programs, and saw first-hand how their country’s health system has transformed their lives. I saw the technologies, treatment, and direct impact that CHAI is having in this community and communities across the country. Outside Phnom Penh, I met Basil, a little boy my father first met in 2006 when he was a baby and his body was ravaged by AIDS and tuberculosis. Today, he is healthy, in school and as rambunctious as any child should be. I am grateful and proud that CHAI can play a part in the Cambodian government’s efforts to ensure there will be more children with stories like Basil’s in Cambodia’s future.

From reducing the prevalence of HIV/AIDS to providing clean drinking water to rural communities, these programs are examples of how, when corporations, NGOs, governments, and people work together, incredible strides can be made to challenges that were once thought intractable. These achievements give me hope that other countries will be able to replicate these models and provide similar health care access to individuals – and that, in my lifetime, we’ll achieve an AIDS-free generation and eliminate mortality caused by unclean water.

Facing History: Education’s Role in Transitional Justice

Karen Murphy is International Director for Facing History and Ourselves, an international educational and professional development NGO. Photo credit: Facing History and Ourselves

In April, I presented alongside USAID education experts as part of the Agency’s Transitional Justice speaker series about the role of education in transitional justice. Transitional justice initiatives aim to address the legacies of widespread, systematic human rights violations, crimes committed by government or officially-backed entities or in the context of armed conflict. Unlike the more commonly discussed traditional transitional justice processes–prosecutions, truth commissions, reparations and other economic and institutional reforms–education is too often neglected. In authoritarian and divided societies with identity-based conflicts, education has quite often been used as an instrument of inequality and division and as a medium for spreading myths and misinformation, as occurred in Rwanda. Yet, we are slow to apply the same kind of rigorous reforms to this sector that we would do for the judiciary, military and police.

There are many interventions that can be made from the level of laws and policies that guide departments of education, to those which inform schools, to interventions in classrooms themselves. For example, USAID supports an education project in Bosnia and Herzegovina to build trust and partnership among students from different ethnic groups, and improve the capacity of teachers, school management and policy makers in implementing intercultural education. One of USAID’s goals in its Education Strategy (PDF) is improving equitable access to education for 15 million learners by 2015 in crisis and conflict environments, focusing on the most vulnerable such as displaced populations, ethnic minorities and war-affected youth.

History curriculum is crucially important within these contexts and is often left untackled because it is so potentially divisive and challenging. But not talking about the violent past and its legacies or addressing the transition and its effects in the classroom does not make them go away–silence can increase the tensions around the conflict and deepen the misunderstandings and misperceptions that groups have about each other (and themselves).

One of the most significant features of education within this context is that it offers a multigenerational opportunity, possibly the only sector with this kind of reach. Adult teachers and department of education representatives are themselves citizens who may have been actors during the conflict as well as witnesses and victims. They often need to wrestle with the violent past and its legacies, and the myths and misinformation in which they are perhaps invested, before they teach and discuss these things with students.

Students represent a new generation of citizens. Northern Ireland’s adolescents were all born after “the troubles.” South Africa’s adolescents are the “born free” generation. While these young people escaped the mass violence of their conflicts, they also missed the critical interventions that marked the transition to peace. Young people are inheriting not just societies that have experienced war and mass violence but the transitions themselves, their legacies and the legacies of the remedies. School is a critical place where new generations can and should learn about their societies, the conflicts and the human behavior that animated them, as well as the people who inspired peace.

Transition is multi-generational if we truly want security, stability, peaceful coexistence, and democracy. South Africa’s “born free” generation, for instance, need to feel deeply committed to the strength of transition, to seeing it through, to protecting the rule of law, a commitment to human rights and a vision of the future that is inclusive.

Photo of the Week: Nutrient-Rich Crops for Kenyan Children

During the first week of June, IMPACT will be highlighting the role of nutrition in Global Health

In Kenya, the U.S. Government, through Feed the Future, is working with whole families to improve food security and childhood nutrition by helping farmers introduce nutrient-rich crops to their farms and teaching families new recipes full of vitamins and minerals needed to ensure healthy growth. Photo Credit: Fintrac Inc.

Learn more about USAID’s efforts to improve nutrition.

Follow USAID (@USAID) on Twitter and use #GHMatters to join in the conversation about global health issues including nutrition.

How Rap Music is Saving Lives in the Caribbean

Hurricane Preparedness Week is May 26 through June 1, following the release of the official forecast for the 2013 Atlantic hurricane season. This week, USAID is highlighting the work we do to help disaster-prone countries prepare for and recover from hurricanes.

The Caribbean is one of the most hurricane-prone regions in the world, killing people every year and making communities more vulnerable with each and every storm that hits. But it wasn’t a hurricane that put Yen Carlos Reyes at risk.

Reyes’s father dealt drugs in one of the poorest neighborhoods in the Dominican Republic and rival gang members routinely raided his home. His mother abandoned Reyes, leaving him to bounce around from one relative’s house to another. At age 17, he was a street fighter in the Dominican Republic, headed for jail—or worse.

Members of the St. Patrick’s Rangers, a voluntary youth club in Jamaica, engage in a map reading session through a disaster preparedness program led by USAID’s partner, Catholic Relief Services. Photo credit: Catholic Relief Services

Reyes’ story is one that resonates with many youth across the islands, where a lack of opportunities leads teens to partake in the crime and violence that plagues their communities. But now, in some of the toughest neighborhoods across the Caribbean, the energy and creativity of at-risk youth are being channeled to help them make the leap from neighborhood trouble-maker to community life saver.

The Youth Emergency Action Committees (YEAC) program led by Catholic Relief Services (CRS) with support from USAID’s Office of U.S. Foreign Disaster Assistance (USAID/OFDA) is one that transforms teens like Reyes into disaster-preparedness leaders. It teaches young people how to plan for and respond to hurricanes, administer first aid, map out evacuation routes and set up emergency shelters. In dedicating himself to the program, Reyes just may have saved his own life.

Started in September 2009 in four of the most hazard-prone and marginalized neighborhoods of inner-city Kingston, Jamaica, CRS began engaging youth through an ‘edutainment’ approach—education plus entertainment. Teens write music, create skits, and perform them to raise community awareness about disaster preparedness while simultaneously learning life-saving skills. Rap music, in particular, has been a big hit, with the group  coming up with lyrics such as, “Send in the broom and the shovel. Don’t bring the violence, please leave the trouble.” Because the program was so successful, CRS expanded it to the Dominican Republic, St. Lucia and Grenada.

Reyes says his priorities shifted and his life changed when he joined YEAC. With his teammates, Reyes helped build new homes and rehabilitate old ones for families whose houses were not able to withstand natural disasters. When Hurricane Sandy hit Puerto Plata, Reyes and the others on his committee—named El Esquadron, or the Squadron—were ready, helping to relocate 80 families to emergency shelter and implementing a disaster response plan for their community. Reyes says he has a whole new set of goals including going back to school, thanks to the confidence YEAC has given him.

“Little by little, I started to see that I had value and that the other kids weren’t judging me. The work we did within the communities made me feel like I had something to offer and I started to see that my neighbors were looking at me different too,” said Reyes.

Watch this video for an in-depth look on how the program made a positive impact in Jamaica.

 

Primary Education in Kenya: A Focus on Quality and Learning

If you close your eyes and listen to children playing in the schoolyard, it could be any elementary school in the world, but this is Ithange Primary School two hours east of Nairobi, Kenya, off the main highway down a red dirt road partly washed away by recent rains.  With the help of trained teachers and quality textbooks paid for by USAID, many of the second graders here are able to read their older siblings’ textbooks, say the parents who make up the local school board.

: Ithange Primary School and others that are participating in the Kenya Primary Math and Reading (PRIMR) Initiative are doing so well that the federal government would like to expand the initiative to all Kenya’s primary schools. The PRIMR Initiative is an agreement between USAID and the Government of Kenya. Photo Credit: Katie Donohoe, USAID

We have come to observe teacher Ann’s classroom where she is commanding the attention of 40-plus students and introducing them to new words in a story they are about to read.  “How many of you can read the word ‘skirt’?” she asks.  The children put their thumbs up if they know.  “Who can tell the others what a skirt is?”  She calls on several children.  She pulls a skirt from her bag and holds it up.  “Who can make a sentence using the word skirt?”

Brian, who is sitting in front of me at the back of the room wants to answer every question.   The teacher has been taught to call on children randomly to make sure that each child is involved.  “The teacher wears a skirt,” says Anna.   Teacher Ann nods in affirmation and points to her own red skirt.  Then she teaches the word “wear” and calls on Brian to come to the front of the room.  He removes his green school uniform sweater and puts it on again.   “Brian wears a sweater,” the teacher instructs.  He is pleased to be in front of the class, a teacher in the making, perhaps. After they read the short passages about the clothes children wear, she asks them questions to be sure they have understood what they read.  Then she asks a question that can’t be answered from the story.  She is teaching them the difference between a factual question and an inference, says Dr. Ben Piper who runs this USAID-funded program implemented by RTI International. Beside Ben sits the head teacher, who is evaluating teacher Ann’s performance.

Christie Vilsack meets and presents certificates to teachers at Ithange Primary school who are receiving training in how to encourage active learning and participation by both girls and boys in the classroom. Photo Credit: Katie Donohoe, USAID

She works hard for 45 minutes, with a piece of chalk, a few props she brought from home and most importantly, the confidence gained from effective training.  She knows that what she’s doing works.  The schools that are participating in this Kenya Primary Math and Reading (PRIMR) Initiative are doing so well that the federal government would like to expand the initiative to all Kenya’s primary schools with help from global donors, especially USAID.  This “scaling up” is an attempt to move from a focus on providing access to a primary education for all children, to a focus on providing a quality education and learning for all primary children.

Currently, one third of children in second grade in Kenya cannot read a single word, and just three percent can read with proficiency. PRIMR is laying the foundation to measurably improve the language and mathematics skills of 3 million Kenyan children by the end of Grade Two by 2015. Photo Credit: Katie Donohoe, USAID

The parents I spoke with in the schoolyard after the lesson are convinced it works.  They have the anecdotal evidence, but they’ve also seen the data being gathered to assess reading and math programs in schools like Ithange Primary. Now parents are turning their attention to creating a community learning center where teachers and the children can access supplemental books, and one parent mentions the necessity of preparing Kenya’s pre-school teachers in the same way teacher Ann has been prepared.

Youth Win in Central America

“Miss Stefanie.” I turned around to see who had just called my name.  “Can I practice my English with you?” asked Eddie, one of the two Honduran youth moderators who would be leading the following day’s event to officially launch the USAID “A Ganar” (To Win) program in Central America.

Since 2005, the A Ganar program has reached over 11,000 youth between the ages of 16-24, 7,000 of which have graduated from the program. Photo Credit: USAID

Since 2005, the A Ganar program has reached over 11,000 youth between the ages of 16-24, 7,000 of which have graduated from the program. Photo Credit: USAID

Eddie explained that he had been practicing his English skills while participating in the A Ganar program, a youth workforce development program which teaches life and employability skills to at-risk youth through sports.  He was proud of his progress and motivated by the chance to speak in front of Honduran President Porfirio Lobo and United States Ambassador to Honduras Lisa Kubiske (not to mention a few hundred of his fellow A Ganar participants).

I listened to him intently, impressed by his thoughtful and well-written remarks in English.  The next day, I watched him stand on stage, exuding confidence, as he addressed his country’s President and the U.S. Ambassador.

Eddie is from San Pedro Sula, Honduras, the most dangerous city in the most dangerous country in the world.  Those odds put him at-risk of falling victim to a life of crime, drugs, or gang violence.  The program provided Eddie with an alternate path; one that has helped lead him toward a positive and productive future.

A growing number of young people throughout Latin America and the Caribbean continue to leave school without basic literacy and life skills, contributing to alarming youth unemployment rates and rising gang violence. Oftentimes a lack of basic skills, combined with challenging and dangerous circumstances, makes it difficult for young people to break from this cycle of violence in their communities.

Through the A Ganar program, USAID targets at-risk youth like Eddie in fifteen countries across Latin America and the Caribbean, using soccer as a powerful motivator and tool to teach young people important values like respect and responsibility, as well as other vital skills that will help them achieve success as they enter the workforce, pursue their education further, or start their own business.

Sports-based activities, such as playing soccer while holding hands with a teammate, are used to facilitate lessons about teamwork and communication.  The field-based A Ganar curriculum is reinforced in the classroom where youth strengthen their basic reading, writing, math and technical skills, and gain the self-confidence and motivation they need to help them succeed.

Since 2005, the A Ganar program has reached over 11,000 youth between the ages of 16-24, 7,000 of which have graduated from the program.  Over 70% of graduates have gone on to find formal employment, start their own business, or return to school.

 

 

Living Positively: The Importance of Pediatric HIV Disclosure

During the month of May, IMPACT will be highlighting USAID’s work in Global Health. From May 18-27 we will be focusing on an AIDS-Free Generation. 

As a public health practitioner and as a physician, I have seen the challenges that pediatric HIV brings to communities and to families. But I have also seen first-hand the positive, transformative effect that disclosing an HIV status can have. One case from my medical practice stands out as an example:

A grandmother brought in her seven-year-old grandchild, who had been orphaned by AIDS, for emergent care. At the clinic, we discovered that the child was HIV-positive, and we provided the grandmother with medication and dosing instructions. Not long after, the grandmother and her grandchild returned to the clinic. Because she did not know she was HIV-positive, the child was beginning to rebel against taking her medication and was getting very sick again. After careful consideration, it became clear to me, as her physician, and to her grandmother, that it was time to disclose her HIV status to her to help this child become adherent to her medications. Through a collaborative process, the child’s grandmother and I were able to help her understand that she had an illness and that it was very important to take medication so that she would continue to feel good. It was through this process of disclosure that the child was able to begin living positively.                         

Statistics from the World Health Organization show that across the world there are approximately 1.3 million children under the age of 15 living with HIV. These children will need anti-retroviral therapy and medical care for their entire lives to stay healthy. There’s a conflicting factor, though—many of these kids don’t even know they have HIV.

Children and adolescents knowing their HIV status is important for the global goal of “getting to zero.” Some studies show that pediatric HIV disclosure at a younger age decreases mortality due to HIV by half among adolescents. Other studies show that disclosure can increase medication adherence by 20 percent. These positive results highlight the importance of pediatric disclosure for living longer, healthier lives.

Disclosure can also play an important role in the psycho-social development of children living with HIV. Early disclosure may decrease anxiety and depression in kids, and make them feel more normal. Overall, disclosure holds great benefits for a child’s ability to engage and maintain medical treatment.

Although the process of pediatric disclosure is important for a child’s health, it is also complex. Many children who are HIV-positive live with other family members who are also positive. This makes disclosure very sensitive and personal. Disclosure also makes a child’s role in his or her own treatment important, and not all children are ready for this kind of responsibility. For these reasons, disclosure must be tailored to children’s own understanding of their illness and its impact on their life.

The AIDSTAR-One Pediatric and Youth Disclosure Materials (examples below) are designed to help tailor the disclosure process to a child’s specific needs. They are intended to be interactive and to encourage discussion among the child, his or her caregivers, and health professionals. The color booklets and accompanying cue cards are easy-to-read, and suited for children of varying ages. They will be printed in French, Portuguese, and Xhosa.

HIV programs can also use these materials as guidelines for establishing HIV disclosure interventions for their own populations. The materials can be used by health care workers, parents, caregivers and children together, throughout the disclosure process to ensure disclosure is completed appropriately and supportively. Just like the seven-year-old grandchild and her grandmother, all children and their caregivers deserve an appropriate disclosure experience; these materials will help other children with disclosure and encourage them to live longer, healthier lives.

Illustration explaining the importance of medication for children ages 2-6 from AIDSTAR-One’s “Booklet 1: How to Keep Healthy." Photo credit: AIDSTAR-One

Explaining HIV transmission to children 6-12 years of age in AIDSTAR-One’s “Booklet 2: Knowing about Myself.” Photo credit: AIDSTAR-One

“Booklet 3: Living a Life of Health” is AIDSTAR-One’s disclosure materials geared towards children over the age of 9. Photo credit: AIDSTAR-One

AIDSTAR-One is funded by PEPFAR through USAID’s Office of HIV/AIDS. The project provides technical assistance to USAID and U.S. Government country teams to build effective, well-managed, and sustainable HIV and AIDS programs.

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

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