USAID Impact Photo Credit: USAID and Partners

Archives for Global Health

Repairing Obstetric Fistula in Nigeria

Posted by  on Thursday, September 30th 2010     

USAID-supported fistula services in Nigeria began in 2007. USAID’s Fistula Care project works with six hospitals to prevent and repair fistula and/or to train health professionals about fistula case management.

Obstetric fistula is the result of prolonged labor without prompt medical intervention, causing a hole in a woman’s birth canal which leaves her with chronic incontinence and in many cases, the loss of the baby.

Thirty-two-year-old Joy Emmanuel lived with fistula for half of her life. Long after giving up hope of a remedy, she heard on the radio that women could receive fistula surgery at the Faridat Yakubu Fistula Center, in Gusau, Nigeria. Emmanuel’s baby survived, but she was left with the serious medical condition. Women with fistula are stigmatized among their peers and by society in general.

USAID is supporting increased access to quality family planning and reproductive health services. Maternal and child health efforts focus on birth preparedness, maternity services, and obstetric fistula repairs.

The Nigerian National Strategic Framework for fistula prevention and control estimates that between 400,000 and 800,000 women are affected. Nearly half of worldwide fistula cases occur in Nigeria, with between 50,000 to 100,000 new cases each year. USAID is working to address the challenge of obstetric fistula in five states in northwestern Nigeria. During the project’s first three years 2,822 women received fistula repair surgery.

Increasing the Involvement of Men in Family Health

Posted by  on Thursday, September 30th 2010     

Reducing maternal deaths by 75 percent throughout the world by 2015 will take the involvement of men in countries where it matters most. Many of the countries where USAID works are male dominated cultures. To improve maternal health outcomes for women in developing countries, men must be equal partners since they are the decision makers about health care in the family. These decisions include determining family size, timings of pregnancies, and whether women have access to health care.

In programs around the world, USAID works to integrate men into maternal health activities at the community level. One example is through USAID’s Maternal and Child Health Integrated Program (MCHIP). Special efforts are made to emphasize men’s shared responsibility and promote their active involvement in responsible parenthood, sexual and reproductive health. This means reaching out to community elders, leaders, and religious groups – entreaties that could be rejected because of traditional cultural values and perceptions that maternal health is the responsibility of women only.

In some areas of Nigeria— where a woman can’t leave the home without her husband’s permission— USAID sends in male motivators, community volunteers trained in communications, to help local men achieve their vision for a healthy family.

“In many of the countries where we work, these are male dominated cultures,” said Lily Kak, senior maternal and neonatal health advisor in USAID’s Bureau for Global Health for a feature in Frontlines. “We need to involve men in our programs since they are the decision makers about health care in the family.” These decisions include determining family size, timing of pregnancies, and whether women have access to health care.

To improve maternal health outcomes for women in developing countries—one of the targets of the United Nation’s Millennium Development Goals—men must be equal partners. “Men need to see the advantages for themselves,” Kak said.

Evidence Shows Historic Breakthrough Can Save Lives

Posted by  on Tuesday, July 20th 2010     

Carol is in her mid-20s and raising her young daughter on her own.  With very few economic options available to her she turned to commercial sex work when she was 21 years old. Every day she puts herself at risk of HIV, other STIs, and unintended pregnancy. Because of a USAID-funded campaign, Carol knows she needs to use condoms to protect herself but as a commercial sex worker she does not always have the negotiating power to do so.

Often at USAID we support the ABC approach- abstain, be faithful, and correct and consistent condom use. While these methods can be effective in preventing HIV transmission, often it can be difficult for women to negotiate prevention interventions. With women representing nearly 60 percent of those living with HIV in sub-Saharan Africa, it is imperative to find a method of prevention that can be initiated by women.

Women participating in the CAPRISA 004 trial in the CAPRISA Vulindlela Clinic in KwaZulu-Natal Midlands, South Africa

Women participating in the CAPRISA 004 trial in the CAPRISA Vulindlela Clinic in KwaZulu-Natal Midlands, South Africa

For almost 25 years, USAID has been on the frontlines of the HIV/AIDS epidemic. Our development programs have been cutting-edge, and have long put women at the center of programming. Gender, prevention of mother-to-child transmission, male circumcision, counseling and testing, nutrition, and HIV vaccine research are just some of the comprehensive array of HIV/AIDS prevention, care, and treatment programs administered through USAID.

Progressive programs continue today with the USAID-funded clinical trial, CAPRISA 004. The trial, which took place in South Africa, provided the first evidence that use of a vaginal gel, or microbicide, containing an antiretroviral drug (ARV) known as tenofovir can prevent HIV infection in women.

Tenofovir gel is a clear, colorless, and odorless viscous gel in single-dose plastic applicators

Tenofovir gel is a clear, colorless, and odorless viscous gel in single-dose plastic applicators

In the trial, tenofovir gel administered topically before and after sexual activity provided moderate protection in women at high risk of HIV infection. At the end of the study, researchers found that the use of 1% tenofovir gel by 889 women at high risk of HIV infection in Durban, South Africa proved the method to be 39 percent effective in reducing a woman’s risk of becoming HIV infected. The gel could be a unique HIV prevention tool for women who are not able to negotiate HIV prevention methods.

The successes of CAPRISA 004 ties in with the core principles of the U.S. Government’s Global Health Initiative (GHI). USAID is committed to a women- and girl- centered approach, creating a strong partnership with countries to sustain country ownership, and focusing on learning and accountability.

Once the results are confirmed through ongoing and future studies, USAID will work at every level to ensure women are able to access this unique form of prevention. This means Carol, and other women in developing nations, will have a form of protection against HIV that they can control and initiate. This new discovery puts the power of protection against HIV transmission in the hands of the woman and can ultimately save lives.

Why Family Planning Matters

Posted by  on Friday, June 18th 2010     

USAID is a global leader in the effort to provide voluntary family planning services and programs that allow couples to choose how many children to have, and when to have them. When men and women are given the knowledge and the right tools to plan their family, most couples choose to have fewer children.  In countries where families have fewer children, women are more likely to be educated, there is a higher paid female population, and women are increasingly involved in activities outside the home because they are not tied to the traditional household role.

USAID currently supports programs in more than 60 developing countries that work to ensure both men and women have access to these life changing services.  Our programs focus on educating people about pregnancy, how to plan it, and how to ensure the health of both the child and mother.  Increasing access to these services will also reduce the rates of abortion since more pregnancies will be planned.

Since the inception of USAID’s family planning programs in 1965, the use of modern family planning methods in the developing world has nearly quadrupled—from less than 10 percent to more than 39 percent today.  In the 39 countries with the largest USAID-supported programs, the average number of children per family has dropped – by choice – from more than 6 to fewer than 4.1.

USAID’s Dr. Jeff Spieler Talks Implementing Best Practices at Global Health Council Conference in Washington D.C.

Posted by  on Tuesday, June 15th 2010     

Dr. Jeff Spieler, USAID’s Senior Technical Advisor on Science and Technology for Family Planning will highlight how the Implementing Best Practice (IBP) Consortium has contributed to improving reproductive health outcomes worldwide. Speakers from WHO, USAID, UNFPA, and IBP partners in the field, will celebrate the 10-year anniversary of the IBP Initiative.

IBP is an initiative begun in 1999 to enhance the ability of countries to identify and apply evidence-based and other demonstrated practices that improve the quality and delivery of reproductive health services. Initiated by the World Health Organization’s Department of Reproductive Health, USAID and other partner organizations and agencies quickly signed on, including the United Nations Population Fund, the International Planned Parenthood Federation, and 14 other organizations.

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