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Local Health Support Builds Better Lives for Mothers and Babies

Posted by  on Monday, October 3rd 2011     

As we headed out for a health-focused field trip in Timor-Leste’s central highlands, we were treated to almost all the geographical delights of the country.  Along the coast road, the dry season winds were whipping up the sea into the biggest waves I’d seen since I arrived in Timor-Leste.  As we turned inland, the brown fields among the rising hills attested to the end of the harvest.  Driving ever higher—along narrower and narrower roads—the altitude brought back the green of forests.

We were headed through the district of Ermera to the “sub-village” of Hatugeo, tucked just below the peak of Timor-Leste’s highest mountain.  This district has some of the country’s worst health indictors:

  • Infant mortality is 70 babies per 1,000 births, far higher than the national average of 45/1,000, and higher than in neighboring Indonesia (34/1,000).
  • Only 3 percent of mothers deliver their babies in a health care facility, compared with 22 percent across the country.
  • A higher percentage of children show signs of malnourishment and illness than in the rest of Timor-Leste.

Why is that?  I’ve been told there are four main reasons (and I suppose that there are more).  First, the district is very mountainous; second, there are few roads; third, there is a shortage of professional health staff; and fourth, this district is known for its festivals and parties—people spend what little money they have on these, not on nutrition and health, so says the Deputy Director of the District Health Service Florindo De Araujo.  This is a big problem, and Mr. De Araujo and his staff are wracking their brains to figure out what to do about it.

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From the Field

Posted by  on Monday, September 26th 2011     

In Batticaloa, Sri Lanka we held a friendly cricket tournament between youth from the East and South  to mark International Peace Day.

In Jaffna, Sri Lanka we opened a collection center and distributed “freezer trucks” to farmers as part of USAID’s public-private alliances program.  This hand over of equipment, tools and grants will improve productivity and profitability of fruit and vegetable cultivation in the conflict-affected Northern Province. These partnerships will not only provide employment to young men and women in the conflict-affected districts but also offer training and social integration among members of diverse ethnic groups.

In Vavuniya, Sri Lanka under our Office of Transition Initiatives program, we will hand over a large truck  to recently resettled farmers in the North in a bid to enhance their marketing potential and to foster relations between the North and the South. Farmers will also receive water pumps and sprinklers on a credit basis.

In Iraq, as part of an ongoing effort to improve local governance and build local capacity, we held a competition for the best District Council website.  The websites will evaluated based on their content quality and quantity, layout/ organization, update frequency, and objectivity/reliability.

In Jordan, as part of our water resources management program, we began work at a new wastewater treatment plant.  Jordan is one of the ten most water-deprived countries in the world. The treatment plant will help improve the health and environmental conditions of the surrounding areas.

In the Ukraine, we will hold a 10th Anniversary celebration of Telekritika, a key media watchdog in Ukraine and a long-standing USAID partner. The celebration includes award ceremony to honor TV producers and TV journalists whose activities represent the highest ethical reporting standards to strengthening independent media in Ukraine.

From the Field

Posted by  on Friday, September 16th 2011     

In Serbia, we held a launch event for an environmental joint initiative to reform waste management practices and achieve a sustainable long-term solution for waste management. The initiative is designed to strengthen the work of civil society organizations who are focusing on this issue. The group consists of five core members: the Center of Modern Skills, Young Researchers of Serbia, Yurom Center Nis, Group 484, and the European Movement in Serbia.

In Iraq, to commemorate International Literacy Day, we handed out 1,200 certificates to women who have graduated from the Women’s Awareness and Inclusion Program. The program provides basic literacy courses for women in south Iraq. Over 23,000 women have participated in the program to date.

In Sri Lanka, we opened a garment factory as part of USAID’s Public Private Alliances program that allows USAID to work collaboratively with the private sector to create job opportunities, jump start economic growth in former conflict areas and help build lasting peace. This partnership will not only provide employment to young men and women in the conflict-affected district of Ampara, it will also promote training and on the job interaction among members of diverse ethnic groups in the area.

Stopping the Spread of Polio in Central Asia

Posted by  on Wednesday, September 14th 2011     

When my daughter Caitlin cried getting her polio booster, I was able to staunch the flow of her tears by describing the amazing work USAID/Central Asian Republics did in Tajikistan last spring when USAID’s rapid response and advocacy with the host governments and other donors resulted in more than 7 million children getting vaccinated (that’s more than 95 percent of the under-five population).

Caitlin’s response to me was “I’d be happy to give my vaccine to the kids who need it. But what else can I do to help?”  Her innocent comments reflect the spirit of our team as we rolled up our sleeves and mobilized the Tajik Health Ministry and other donors to respond decisively with a series of national immunization campaigns that effectively stopped the spread of the outbreak in six months.

I was reminded of this victory last week when the European Regional Certification Commission for Poliomyelitis Eradication (RCC) announced that Europe will keep its polio-free status.  Last week, in Copenhagen, the RCC said that wild poliovirus transmission had been interrupted.  “No new cases of polio had been reported since September 2010 because countries took effective action.”  That statement is referencing Central Asian countries—for example, Tajikistan—which in 2010 saw its largest polio outbreak in decades.  There were 898 reported cases of acute flaccid paralysis in Central Asia in 2010.  Acute flaccid paralysis is the most common symptom of polio and is one indicator for polio surveillance during an outbreak.

A Tajik mother holds her son while he gets his polio vaccination. Photo Credit: USAID

The RCC acknowledged the contribution and technical support of the World Health Organization Regional Office for Europe, the Global Polio Eradication Initiative partners and the Russian Federation, India, and USAID.  Not only did our work halt this devastating disease, but it also built the foundations of new U.S.-Russia bilateral cooperation on joint efforts to assist with strengthening health systems and surveillance in the region.

Polio has no cure, and only vaccination can prevent it.  But additional funding, coupled with technical assistance and strong advocacy, increases the ability to mount high-quality campaigns and sustain a population’s immunity, which is the best we can do until global eradication is achieved.  The Central Asian Republics have eradicated polio successfully in the past, and serve as an important lesson to stay vigilant and maintain a strong immunization program.

From the Field

Posted by  on Monday, August 15th 2011     

In Liberia, we held a signing ceremony for the signing of the new Education Reform Act,  an historic moment for Liberia’s education sector. The signing of this act has a number of implications, chief among  them are that by law all basic education (up to grade 9) in Liberia will be free and compulsory, as well as the formation of county school boards that will promote community ownership of, and responsibility for schools and their effectiveness.

In Sri Lanka, the first thirty fish farmers have signed agreements under USAID’s public private alliance to create a new sea bass cage farming initiative.  The sea bass cage farming initiative is part of a public-private alliance between Aqua N’ Green and USAID called the Integrated Aquaculture project (IAP). The IAP will help approximately 1,300 small farmers in the Northern and Eastern provinces, over 50% of whom are women, raise and sell sea bass, mussels and oysters on a guaranteed price basis to Aqua N’ Green. Once fully underway, 200 jobs are expected to open up in a fish hatchery, fish cage farming, feed mill and a fish processing plant to be built soon.

In the West Bank, three school bag distribution events were held in the northern, central and southern West Bank.  These events provide school bags and other school equipment to needy Palestinian children in advance of the new school year.  It is also serves as a goodwill gesture during the Muslim holiday Ramadan.

From the Field

Posted by  on Tuesday, August 2nd 2011     

Our weekly feature highlighting upcoming events at USAID Missions around the globe.

In Sierra Leone this week, we will launch the “We Pikin Network”.  In commemoration of this year’s World Breastfeeding Week celebration, the Ministry of Health and Sanitation in collaboration with its partners will embark on public sensitization, advocacy, and the national launching of the “We Pikin Network” (Krio language for ‘Our Children’) of support groups. The group’s role is to protect, promote and support other mothers in the community to initiate early and exclusively breastfeed their infants and thereafter continue to support introduction of appropriate complementary foods. The membership of We Pikin groups varies from 10-15 volunteers who are all mothers, and each group supports 50 households on infant and young child feeding practices. Currently, a total of 1,233 support groups have been established nationwide.

In Madagascar this week, we will launch a partnership with the Peace Corps to fight Malaria.  Four Peace Corps volunteers will work in Antananarivo and in the field to utilize their Malagasy language skills and knowledge of the field to better coordinate between partners and the field and also share best practices.

Saving Lives Across Nepal: Female Community Health Volunteers

Posted by  on Friday, July 29th 2011     

Taking a health sector initiative “to scale” and making it sustainable is a challenging development goal. Ambitious, but achievable. In Nepal, the Ministry of Health and Population has succeeded in bringing maternal and child health information and health services to every community in the country. This, in spite of the fact that the majority of Nepal’s 29 million people live in rural and often remote areas, far from any health service facility.

The Female Community Health Volunteer program, with the support of USAID and other partners, has built upon existing country resources to organize, train and supply a powerful “workforce” of approximately 50,000 women—each elected by her community, who contributes her time and effort to care for those in her village.

Doctors at the central/federal level drive a cascading series of trainings which pass vital knowledge to ever larger groups of health services workers at the various organizational and geographical levels of the Department of Health Services. At the final tiers, Health Post and Sub-Health Post staff train the volunteers from the surrounding areas. It is sort of like what would happen if a snowball was rolled off the summit of Nepal’s Mt. Everest… it would grow in size as it rolled downward, resulting in something extraordinarily large by the time it reached the base.

At “Ama Samuha” mothers’ group meetings which volunteers hold each month, they act as health promoters covering topics such as the benefits of proper diet during pregnancy and how certain traditional beliefs can result in life-threatening situations during and after delivery. They also serve as health providers who, at their home or during house-calls, treat among other things the primary causes of childhood mortality (diarrhea and pneumonia) and administer vitamin A, which by itself saves the lives of an average of 15,000 children annually.

During the filming of the video embedded in this post, Director of International Communications Margy Bailey, Chief of Party of the Nepal Family Health Program Ashoke Shrestha, Health Program Officer Deepak Paudel, USAID Nepal Development Outreach and Communications Specialist Stuti Basnyet and I met truly selfless heroes like Laxmi Sharma from Damachaur village and Amrica KC from Marke ward in Salyan district. In no small part due to their commitment and that of the rest of the cadre of Female Community Health Volunteers, Nepal’s maternal and child mortality rates have dropped significantly. Under President Obama’s Global Health Initiative (GHI)—the next chapter in the way the U.S. Government conducts global health activities—Nepal, which is one of eight GHI focus countries, is expected to achieve its national 2015 health indicator targets.

From the Field

Posted by  on Monday, July 18th 2011     

Our weekly feature highlighting upcoming events at USAID Missions around the globe.

In East Africa, The East African Community (EAC) will hold a regional consultative forum on Electronic Single Window Systems in East Africa.  EAC is a regional intergovernmental organization of the Republics of Kenya, Uganda, the United Republic of Tanzania, Republic of Rwanda and Republic of Burundi EAC.  A Single Window System is a trade system that improves cross-border trade efficiency by streamlining customs information flows.  You can read more about Single Window Systems (pdf, 331 KB) from the United Nations.

In Iraq, we will hold a Youth Employability Skills Training for beneficiaries of USAID’s Iraqi Youth Initiative.  The Iraqi Youth Initiative provides training in basic English, computer operation, interview skills, and business etiquette to prepare participants for interviews with local sponsors who offer three-month apprenticeship positions.

From the Field

Posted by  on Monday, June 20th 2011     

In Benin, we will hold a workshop on the Ambassadors Girls’ Scholarship Program (AGSP). USAID/Africa is undertaking a best practices review of the Ambassadors Girls’ Scholarship Program (AGSP), which has provided scholarships to more than 550,000 primary and secondary school students, predominately girls, since 2002 under the African Education Initiative (AEI).

In the Ukraine, we are holding a National Conference on Court Performance Evaluation. The US Ambassador to the Ukraine will be addressing an audience comprised of members of the Ukrainian Parliament and representatives of the President of Ukraine. This conference is a part of USAID’s larger effort to improve rule of law in Ukraine.

In the Philippines, we will support the opening session of the Asia Clean Energy Forum (ACEF). The event provides an excellent opportunity to highlight U.S. government support towards regional cooperation on clean energy and climate change mitigation both in the Philippines and in Asia as a whole. Since 2006, USAID and the Asian Development Bank have jointly organized the Asia Clean Energy Forum (ACEF), with the aim of sharing best practices in policy, technology, and finance to meet the region’s climate and energy security challenges. In the years since ACEF has come to be seen as Asia’s premier event for policymakers, project developers, technical experts and representatives of the private sector to come together to share knowledge and discuss up-to-date climate and clean energy developments in the region.

Notes from the Field: We Can Feed the Future

Posted by  on Friday, June 10th 2011     

Julie A. Howard is the U.S. Government Deputy Coordinator for Development for Feed the Future

My job as the Deputy Coordinator for Development for Feed the Future is to champion the cause for global food security. It’s good for health, it supports economic growth, and it promotes global stability. For as much as I value the work I do in Washington, it is opportunities to visit our programs in the field that really reinforce for me what a difference investments in food security can make.

I am in Zambia this week for the tenth annual African Growth and Opportunity Act (AGOA) forum. Earlier today, I was with United States Trade Representative (USTR) Ron Kirk when he announced a U.S. commitment of up to $30 million per year for four years to support trade expansion in Africa. This will facilitate U.S.-Africa trade and intra-regional trade. It will also leverage private sector resources and investments by other donors.

Following the day’s events at AGOA, I saw firsthand how this can work. USTR Kirk and I joined U.S. Ambassador Mark Storella for a visit to the Freshpikt canning factory – the only one of its kind in Zambia. Over the past several years, investments from the U.S. Agency for International Development (USAID) have helped the factory to source produce from smallholder farmers, which raises their incomes. In turn, this has provided consumers throughout the region the option to purchase high-quality, locally canned goods that are competing favorably against imported products. They are also being exported, which helps the Zambian economy.

During our visit, Freshpikt and PS International – a U.S.-based company specializing in international trade of bulk agricultural commodities – signed a letter signifying PS International’s intent to invest up to $30 million to increase Freshpikt’s capacity to can tomatoes for regional markets.

A main objective of Feed the Future, the U.S. global hunger and food security initiative, is to sustainably increase agricultural productivity and rural incomes through diversification and private sector development. Today’s visit was inspiring. I’m looking forward to spending the next few days in Zambia!

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