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Archives for Women

Healthy Beginnings: New Evidence Cites Breastfeeding’s Health Benefits for Moms, Babies and Economies

A new mother at the Karambo Health Center in Rwanda breastfeeds her newborn baby. Immediate breastfeeding after delivery helps prevent diseases and malnutrition in newborns. / Amy Fowler, USAID

A new mother at the Karambo Health Center in Rwanda breastfeeds her newborn baby. Immediate breastfeeding after delivery helps prevent diseases and malnutrition in newborns. / Amy Fowler, USAID

When it comes to the health of the world’s most vulnerable mothers and children, supporting the practice of a few simple behaviors can be just as beneficial as the most high-tech innovations.

Handwashing with soap helps prevent the spread of communicable diseases. Skin-to-skin contact between mothers and premature babies keeps preemies warm and helps regulate their breathing and heart rate. Having a skilled birth attendant deliver the babies of pregnant women significantly decreases the risk of mortality for both the moms and their babies.

Each of these behaviors has been shown to improve mothers’ and newborns’ health and wellbeing, without requiring new technologies or significant funds.

And new evidence shows one of the most effective of these behaviors is breastfeeding.

In a series published today in The Lancet journal, researchers cite compelling evidence of the benefits afforded by optimal breastfeeding practices, both health-related and economic, for women and children in high- and low-income countries alike.

At USAID, we have already begun to act on the evidence. We concentrate our maternal and child health efforts in 24 priority countries that together account for 70 percent of the world’s maternal and child deaths, and we employ a data-driven approach to maximize our impact through the most effective interventions available.

We’ve identified breastfeeding as one of 10 “Accelerator Behaviors” — the key feature of USAID’s Accelerate project, begun last year to expand the ability of stakeholders in those priority countries to implement high-quality behavioral programming.

And in our Multi-Sectoral Nutrition Strategy, we recommend early initiation of breastfeeding within one hour of birth, exclusive breastfeeding for the first six months, and continued breastfeeding for two years or longer.

This mother in Bakapome, Senegal, a rural village near Thies, knows that breastfeeding doesn’t just benefit infants: it also reduces the risks for breast and ovarian cancers in women. / Jane Silcock, USAID

This mother in Bakapome, Senegal, a rural village near Thies, knows that breastfeeding doesn’t just benefit infants: it also reduces the risks for breast and ovarian cancers in women. / Jane Silcock, USAID

The health benefits are significant. Higher rates of breastfeeding could save more than 820,000 lives — 87 percent of them infants — in low- and middle-income countries each year.

Breastfeeding is also associated with a reduced risk of breast and ovarian cancers for women. At current breastfeeding rates, 20,000 maternal deaths are averted annually. Improved breastfeeding practices could prevent another 20,000 each year.

The new Lancet series also highlights the economic benefits of increasing the number of women who breastfeed. Currently, the cognitive losses associated with not breastfeeding amount to $302 billion globally — including more than $70 billion lost in low- and middle-income countries and $230 billion in high-income countries.

Even a 10 percent increase in breastfeeding rates would translate into hundreds of millions of dollars in healthcare savings through reduced child and maternal mortality and morbidity.

The evidence speaks for itself: Supporting women to practice optimal breastfeeding is a health intervention that we cannot afford to ignore.

USAID is working with national governments, NGOs, the private sector and civil society organizations to generate data and provide insights into the impact that social and behavior change programs can have on saving lives. We work with our partners to then use that data to design and apply effective and innovative behavioral programming.

Throughout the process, we track and measure our programs’ successes and persistent barriers, and provide technical assistance and share lessons across our network of partners — contributing to our goal to reach 38 million women with improved health services by 2020.

When it comes to interventions such as breastfeeding, collecting evidence is a necessary first step. But we must then act on our findings, incorporating the evidence across all levels of our health programs — from the policies of national governments to the daily routines of individual households.

The USAID-funded Suaahara project in Nepal engages young mothers as well as fathers and other men in the family to ensure supportive environments for healthy behaviors, such as breastfeeding, to promote the wellbeing of women and children. / Suaahara Project

The USAID-funded Suaahara project in Nepal engages young mothers as well as fathers and other men in the family to ensure supportive environments for healthy behaviors, such as breastfeeding, to promote the wellbeing of women and children. / Suaahara Project

In Nepal, for instance, USAID began implementing an integrated approach to nutrition in 2012, incorporating community education and personal counseling. Since then, rates of exclusive breastfeeding for the first six months have increased from 46 percent to 69 percent.

The Lancet’s series bolsters our behavior change work and solidifies the evidence base for including breastfeeding as an Accelerator Behavior.

I am encouraged by the successes that USAID has already seen in using these evidence-based approaches to save children’s and mothers’ lives.

Most of all, I am excited about our past, present and future progress towards maternal, newborn, child and adolescent health worldwide, as support for breastfeeding and other lifesaving interventions continues to grow in the global community.

ABOUT THE AUTHOR

Elizabeth Fox is the Director of the Office of Health, Infectious Diseases and Nutrition in USAID’s Bureau for Global Health.

USAID Delivers: Quality Care for Expectant Moms Results in Fewer Stillbirths

Fatima holds her 2-day-old baby, safely and successfully delivered at the USAID-funded Smiling Sun Clinic in Tongi, Bangladesh. / Amy Fowler, USAID

Fatima holds her 2-day-old baby, safely and successfully delivered at the USAID-funded Smiling Sun Clinic in Tongi, Bangladesh. / Amy Fowler, USAID

At the Smiling Sun Clinic in Tongi, Bangladesh, Fatima happily holds her healthy newborn baby, delivered in the facility a short while ago. Fatima chose to deliver in the facility to ensure a healthy outcome, for her first pregnancy had ended in tragedy.

Each year, over 130 million babies are born into the world. For a mother, pregnancy is a time of excitement, and the birth of a baby is a time of joy.

Yet, for millions of others, pregnancy can end in tragedy. Each year, nearly 3 million children die in their first month of life, and an additional 2.6 million women suffer a stillbirth. Fatima was one of them.

Through the support of USAID, she was able to access the care and services she needed to ensure that her next pregnancy had a happier ending: a safe pregnancy, a successful delivery and a healthy baby.

At USAID, we are committed to saving the lives of mothers and children. Our vision is to end preventable child and maternal deaths within one generation. Our efforts to achieve this vision are also helping address the tragedy of preventable stillbirths.

In a new Lancet series of papers on stillbirths published today, more than 200 researchers, investigators and advisors — including myself and my USAID colleague Donna Vivio — have collaborated to report on the problem of stillbirths worldwide.

Skilled birth attendants, like these nurse-midwives at a midwifery education center in Afghanistan’s Bamyan province, are vital for ensuring safe and healthy deliveries for mothers and their babies. USAID has helped train more than half of all midwives currently working in Afghanistan. / USAID Afghanistan

Skilled birth attendants, like these nurse-midwives at a midwifery education center in Afghanistan’s Bamyan province, are vital for ensuring safe and healthy deliveries for mothers and their babies. USAID has helped train more than half of all midwives currently working in Afghanistan. / USAID Afghanistan

Unavoidable stillbirths, which are caused by congenital abnormalities, account for only 7.4 percent of all stillbirths in the world. The rest are largely preventable. In fact, nearly half of all stillbirths — 1.3 million each year — occur during labor and delivery.

The hours and days surrounding childbirth are the times when women and babies are most vulnerable, and high-quality care at these times has the greatest potential to reduce maternal and newborn mortality and stillbirths.

Another way to reduce these unnecessary deaths is through family planning. Empowering and educating women and girls helps families choose the number, timing and spacing of their pregnancies, translating into improved birth outcomes for both mothers and their babies.

In fact, quality care for pregnant women before and during childbirth — coupled with optimally-timed pregnancies — would prevent most stillbirths, as well as most preventable maternal and newborn deaths.

During pregnancy, adequate nutrition and quality prenatal care, including treatment for maternal infections, keep women healthy and increase the likelihood of a healthy newborn. These measures have also been shown to improve child development outcomes, thereby yielding a quadruple return on investment.

A network of 300 Smiling Sun clinics throughout Bangladesh, supported by USAID, provides essential services to individuals and communities across the country. / Amy Fowler, USAID

A network of 300 Smiling Sun clinics throughout Bangladesh, supported by USAID, provides essential services to individuals and communities across the country. / Amy Fowler, USAID

In Bangladesh, USAID works to provide these vital services to the most vulnerable populations of women and children. We support a network of Smiling Sun Clinics that are active throughout the country.

The Smiling Sun Clinic in Tongi serves a population of some 94,000 individuals, providing prenatal and postnatal care, immunizations, and family planning services. Now in its 19th year of operation, the clinic provides services free of charge to the poorest of the poor through funds paid by other clients, ensuring the clinic’s sustainability. And it was this clinic in Tongi that changed Fatima’s life.

After losing her first child, Fatima resolved to seek care from the Smiling Sun Clinic during her next pregnancy. She delivered in the facility, open 24 hours a day for delivery services, in the presence of skilled birth attendants.

Gift Usami Ava, pregnant with her third child, receives prenatal care at the Ugep General Hospital in Nigeria’s Cross River State. Quality prenatal care during pregnancy helps reduce stillbirths and improves maternal and newborn health. / Amy Fowler, USAID

Gift Usami Ava, pregnant with her third child, receives prenatal care at the Ugep General Hospital in Nigeria’s Cross River State. Quality prenatal care during pregnancy helps reduce stillbirths and improves maternal and newborn health. / Amy Fowler, USAID

Fatima’s story had a happy ending, and her baby was delivered safe and healthy. We believe all women should have that chance.

Pregnancy and motherhood ought to be a time for celebration rather than for mourning. We have set ambitious targets to save the lives of babies, children and mothers worldwide, and we are confident that, with the support of strong global and local communities, we will be able to achieve them.

ABOUT THE AUTHOR

Katie Taylor is the deputy child and maternal survival coordinator at USAID and the deputy assistant administrator for the Bureau for Global Health.

All in Good Faith: Partnering with Malawian Ministries for Maternal Health

In USAID’s—and the world’s—goal of ending preventable child and maternal deaths, the faith sector is a powerful partner.

Close to 90 percent of the world’s people adhere to some religious belief, and in rural areas in many of the developing countries in which we work, health care is provided by religious organizations. Faith-based organizations like the Christian Health Association of Malawi (CHAM) reach deep into the community, and bring a unique set of skills, experience and contributions to the development arena.

They play a pivotal role in improving the quality, accessibility and respectfulness of maternal and child health services—and in promoting the demand for these services. Many faith-inspired groups are enthusiastic supporters and invaluable allies in our efforts to save the lives of mothers and children.

Memory Mponda (right), Priscilla Ziyaye and Pacharo Kumwenda, USAID-supported students training to become nurse-midwives, stand outside the Kangaroo Mother Care ward at the Chonde Health Center. / Grace Soko, Christian Health Association of Malawi

Memory Mponda (right), Priscilla Ziyaye and Pacharo Kumwenda, USAID-supported students training to become nurse-midwives, stand outside the Kangaroo Mother Care ward at the Chonde Health Center. / Grace Soko, Christian Health Association of Malawi

Take the Ndirande Health Center in the city of Blantyre, Malawi, where 15 students from St. Joseph’s College of Nursing and Midwifery work alongside clinical staff to check the vital signs and collect the histories of women who have come to give birth. They assist during the deliveries, and administer necessary care when emergency situations arise.

Recent visitors to the hospital have been pleased that their waiting time has been reduced, as the students, organized into teams, quickly and efficiently check people in and get them the care that they need. As the only public health facility in a district of more than 300,000 people, there is never a dull moment at Ndirande.

On the other side of Blantyre, at the Chilomoni Health Center, 19 of their classmates perform similar duties. Both facilities see upwards of 300 deliveries a month; at Ndirande, that number sometimes approaches 450. On average, 10 or more women come to each facility to give birth each and every day.

For the nursing students at St. Joseph’s, the challenges and experiences that they face at the health facilities are an invaluable learning tool. And for the clinical staff, the extra hands on deck provide much-needed assistance throughout the busy days. At Chilomoni, the hospital’s staff is more than doubled by the addition of the students.

St. Joseph’s is one of 12 constituent training colleges funded in part by USAID and operated by CHAM. Established in 1966, CHAM is an ecumenical organization overseen by the Episcopal Conference of Malawi and the Malawi Council of Churches, and provides administrative and technical support to the health care services of member units across the country.

With 175 member health facilities, CHAM reaches more than 4 million Malawians with health services—37 percent of all care provided in Malawi, and second only to the Ministry of Health. Through training programs like those at St. Joseph’s, students are able to become nurse midwife technicians, medical clinicians, laboratory technicians and psychiatric nurses.

This training helps students bring knowledge and experience to Malawian communities—and is an important step towards ending preventable newborn, child and maternal deaths.

Chimwemwe (“Joy” in the local Chichewa language), a community health worker in Malawi, meets with an HIV-positive pregnant woman at her home in Lilongwe through the USAID-funded Tingathe program, which works closely with the Ministry of Health. / Chris Cox, Baylor College of Medicine Children’s Foundation.

Chimwemwe (“Joy” in the local Chichewa language), a community health worker in Malawi, meets with an HIV-positive pregnant woman at her home in Lilongwe through the USAID-funded Tingathe program, which works closely with the Ministry of Health. / Chris Cox, Baylor College of Medicine Children’s Foundation.

In the 2014 Acting on the Call report, USAID laid out a framework for using proven, high-impact interventions and data-driven investments to improve health outcomes in 24 priority countries for maternal and child health, saving the lives of 15 million children and 600,000 thousand mothers through 2020.

In Malawi, a scale-up of key interventions could save more than 25,000 newborns and 5,000 mothers—lives that we know how to save, but that will likely be lost if we do not act.

Already, our efforts are yielding results and translating into lives saved. The 2015 report shows that Malawi is on track or has exceeded the year’s target for improving key interventions, such as the percentage of live births occurring in a health facility or being overseen by a skilled birth attendant, or the percentage of households with at least two insecticide-treated bed nets. But more rapid progress is needed in pregnant women receiving antenatal care and in women and children having access to clean water.

Our collaboration in Malawi with CHAM is one of many ways we are leveraging strategic partnerships, promoting country ownership and building the capacity of local communities. The holiday season reminds us how vital these partnerships are—now, and all throughout the year.

As the students at St. Joseph’s graduate next year, we will be there applauding them for their hard work, wishing them future success, and welcoming in the next class of students to begin their training.

ABOUT THE AUTHOR

Katie Taylor is the deputy Child and Maternal Survival Coordinator and a deputy assistant administrator for the Bureau for Global Health at USAID.

16 Days: Making Schools Safe Everywhere For Students Anywhere

In 2013, this 11-year-old girl from the Democratic Republic of Congo was raped by a family friend. In the aftermath she faced social stigma, isolation and teasing in school. USAID-supported interventions like counseling and medical care helped her regain her voice and her dignity. / Morgana Wingard, USAID.

In 2013, this 11-year-old girl from the Democratic Republic of Congo was raped by a family friend. In the aftermath she faced social stigma, isolation and teasing in school. USAID-supported interventions like counseling and medical care helped her regain her voice and her dignity. / Morgana Wingard, USAID.

“He told me I couldn’t tell anyone.”

Angelina was only 14 years old when she was sexually abused by her teacher. Born into a poor family in rural Mozambique, she sold eggs on the side of the road to help cover the cost of her education and dreamed of becoming a nurse.

Teachers wield incredible power to positively influence young lives. However, they are also able to abuse that power. In this case, Angelina’s teacher promised financial support in exchange for her silence.

Scared and struggling to afford school fees, Angelina continued to suffer abuse for an entire year. It wasn’t until she participated in a school health program run by USAID partner ANDA that Angelina realized what was happening to her was wrong.

Worldwide, 246 million children experience gender-based violence at or on their way to school every year. A report released by the United Nations Human Rights Council noted that attacks on schools occurred in at least 70 countries between 2009 and 2014, and that about 3,600 attacks against schools, teachers and students were recorded in 2012 alone.

A student at the Saffa Girls School in the West Bank raises her hand in class. The school is one of 57 in the area that USAID provided teacher training to. The school now also has 28 rehabilitated classrooms, a computer and science lab, a library, resource center, and a protected playground. / Bobby Neptune for USAID.

A student at the Saffa Girls School in the West Bank raises her hand in class. The school is one of 57 in the area that USAID provided teacher training to. The school now also has 28 rehabilitated classrooms, a computer and science lab, a library, resource center, and a protected playground. / Bobby Neptune for USAID.

And those are the numbers we know. The truth is that gender-based violence in schools is happening in every country around the world right now. It is a global phenomenon depriving children, especially girls, of their right to a safe, quality education.

From kidnappings to shootings, from acid attacks to poisoning, and from discrimination to intimidation, girls are being threatened, harassed, attacked and killed while trying to learn.

With the help of her school health program, Angelina was finally able to recognize her abuse, prosecute her abuser, and pursue an education free from fear and harassment.

In Mozambique and around the world, going from the classroom to the courtroom can be incredibly challenging. It requires survivors, communities, teachers, law enforcement and governments to work together for justice. But Angelina’s counselor hopes other girls will have the courage to say no and speak out.

We at USAID believe that schools free from abuse and violence are possible. It is exhausting and difficult work. Changing mindsets, fighting stigma, and speaking up for those who’ve been silenced can sometimes feel futile.

But behind every statistic and every story is a hero like Angelina and the brave men and women who worked tirelessly to support her. We must continue to fight alongside them until schools everywhere are safe so students anywhere can reach their potential.

The 16 Days of Activism Against Gender Violence campaign begins today. The 2015 global theme is From Peace in the Home to Peace in the World: Make Education Safe for All. This year, USAID will spotlight 16 teachers, students, leaders and activists worldwide who have triumphed over gender-based violence and/or are helping students learn and thrive.

Whether it’s creating safe spaces for students to grow and play, strengthening laws to protect the most vulnerable, or training teachers to give support when it’s needed, these individuals are working to ensure that girls and boys, and women and men, can realize their universal human right to education. Starting today and throughout the campaign, follow their stories on Instagram and Medium.

ABOUT THE AUTHOR

Susan Markham is USAID’s Senior Coordinator for Gender Equality and Women’s Empowerment. Follow her @msmarkham.

Back in the Classroom: Displaced Students in Nigeria Find Education & Hope

Ikilima Shuib Chiroma teaches a class of adolescent girls on Sept. 21 in a non-formal education facility in Yola, capital of the state of Adamawa in Nigeria. Creative is implementing USAID’s Education Crisis Response program here through partner agency International Rescue Committee to assist youth displaced by Boko Haram. / David Snyder for USAID

Ikilima Shuib Chiroma teaches a class of adolescent girls on Sept. 21 in a non-formal education facility in Yola, capital of the state of Adamawa in Nigeria. Creative is implementing USAID’s Education Crisis Response program here through partner agency International Rescue Committee to assist youth displaced by Boko Haram. / David Snyder for USAID

Like most 10-year-old students, Dinah solves her math problems in the old-fashioned way—with her fingers. She counts to six and jots down the number.

For Dinah’s extended family, they are counting something entirely different—the months since the girl lost her mother during a raid by Boko Haram insurgents on her village in northern Nigeria.

After the vicious attack, the young girl eventually made it to a center for internally displaced persons. Dinah’s uncle drove from the city of Bauchi to bring her to his home.

Today, some seven months after the incident, Dinah is adjusting to a new school and a new future.

An insurgency has wreaked havoc on parts of Nigeria, forcing some 2.2 million people from their homes—one of the largest concentrations of internally displaced persons in Africa. Hundreds of thousands of school-aged children have been set adrift inside the country, ripped from their communities and their schools.

With the magnitude of the situation, USAID, state officials and NGOs stepped in with the Education Crisis Response program.

Launched in 2014, the goal of the program is to expand access to quality and protective non-formal education and alternative education opportunities for out-of-school children, ages 6 to 17, in three Nigerian states and reduce the burden on local schools already stretched thin by limited resources. It is implemented by Creative Associates International and the International Rescue Committee, along with local NGOs.

The project has established 294 non-formal learning centers that provide education, in-class meals and psycho-social services to the displaced children, says Ayo Oladini, director of the Education Crisis Response program.

Local facilitators identified and trained by the program use a government-approved curriculum to teach basic literacy, numeracy and life skills. The learning centers are housed in existing structures like schools or meeting houses that are made available by the local community.

The students attend class three days a week for at least two hours each day and are provided basic school materials.

Adolescent girls in a non-formal education class on Sept. 21 at a school in Yola, capital of the state of Adamawa in Nigeria. Creative is implementing USAID’s Education Crisis Response program here through partner agency International Rescue Committee to assist youth displaced by Boko Haram. / David Snyder for USAID

Adolescent girls in a non-formal education class on Sept. 21 at a school in Yola, capital of the state of Adamawa in Nigeria. Creative is implementing USAID’s Education Crisis Response program here through partner agency International Rescue Committee to assist youth displaced by Boko Haram. / David Snyder for USAID

Paving the way for mainstream education

State officials evaluating the non-formal learning centers say they are working.

“The type of education they do receive is a good one,” says Halilu Usman Rishi of Bauchi’s State Education Secretariat. “That is going to [pave the] way for them to mainstream to a formal system of education.”

The opportunity to return to class is life changing, especially for the many who have been displaced and out of school for years.

“For the kids who had forgotten most of what they have learned [and are] now coming back to a classroom — to say it is therapeutic is an understatement,” Oladini said. “It’s a thing of joy.”

Youth displaced by Boko Haram take part in a non-formal learning class in Gombe, Nigeria on Sept. 26 as part of USAID’s Education Crisis Response program. / David Snyder for USAID

Youth displaced by Boko Haram take part in a non-formal learning class in Gombe, Nigeria on Sept. 26 as part of USAID’s Education Crisis Response program. / David Snyder for USAID

Addressing psychosocial needs

And while education is the foundation of the program, children traumatized by conflict and upheaval can only learn when their fears are also addressed.

USAID responded to the psychological needs of the displaced children by incorporating a psychosocial approach to teaching. Facilitators are trained to teach in a student-friendly manner by incorporating group exercises and encouraging positive, interactive student-teacher relations. Working through local partner agencies, the program also encourages the local community to spread messages of peace.

“We make sure that we don’t create any more trauma, either for these children or within the community where they live,” Oladini explained. “We tell them ‘Look, the future is still there for you. You [may] have lost this, you [may] have lost that…but there is still hope for you.’”

Officials in Bauchi are embracing this strategy to help students deal with what has happened to them and their families.

“The program is, in fact, doing as much as possible to ensure that the children are associating with their friends in the learning centers,” says Bauchi’s Rishi. “Some of them used to tell us as we go around to discuss with them, that initially, they found it very difficult to associate with the other children. But as they interact so much with their friends in the learning centers, they forget thinking about such ugly happenings.”

Preparing for sustained success

Scheduled to phase out in 2017, the Education Crisis Response program is supported by Nigeria’s state and federal governments, which, Oladini said, will help ensure the long-term sustainability of the program.

From the outset, government education officials have been involved in every detail of program planning and worked with the program to identify communities, develop a teacher training manual and sit in on classes.

For every learning center, Education Crisis Response has also trained two local government education officials to serve as mentor teachers whose job is to work with the facilitators and provide feedback to teachers.

“From day one, we made sure [the government understood] that this is your program, it’s not our program,” Oladini said. “So from year one before the end of year two, they’ll be able to plan within their budget to see how they can scale up all these programs.”

And while government’s support of the Education Crisis Response program is essential, it is one part of an overall effort that also depends largely on the communities themselves.

“We’re letting them know that with or without parents, there is what we call ‘your own mindset’ – your own ability to move forward and persevere in a state of difficulty,” Oladini said. “This is what we are teaching them.”


Produced for USAID by Creative Associates International, with reporting by Michael J. Zamba and Ernest Akoma in Nigeria.

ABOUT THE AUTHOR

Michael J. Zamba is senior director of communications at Creative Associates International and David Snyder is a photographer and writer. Creative Associates International is implementing USAID’s Education Crisis Response program in northern Nigeria. Follow Creative @1977Creative.

Advocating for Sign Language Education as a Human Right

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Georgine Auma in Washington, D.C. for the Young African Leaders Initiative. / Georgine Auma

As children growing up in Kenya, Georgine Auma and Natha Yare were excluded from their right to education.

Why? Because they are deaf. Access to education in sign language is still denied to millions of deaf and hard of hearing children, and even those who are lucky to receive an education — like Georgine and Natha — often lack teachers or specialists adequately trained in sign language, causing children to miss early language acquisition milestones that assistive devices like cochlear implants or hearing aids cannot provide.

For Natha, being deaf meant she couldn’t go to a local school, and instead attended a school for the deaf 15 hours away by bus. Even there, though, Natha was denied her right to a quality education.

“The government decided to introduce new teachers that knew no Kenyan Sign Language; these teachers filled blackboards with words and gestured for us to copy,” Natha said. “When we finished, we felt like we accomplished something. Afterwards, we went outside to run and play, not understanding what was copied.”

In many countries like Kenya, social stigma causes parents and community members alike to perceive deaf and hard of hearing children as impaired or altogether unable to learn.

NathaYare

Natha Yare (far right) with the deaf football team she helped organize at the Dadaab Refugee Camp in Kenya. / UNHCR

When Georgine became deaf at the age of 9, her parents didn’t know what to do with her. Although she already had a strong language foundation, her parents kept her from school for a full year before deciding to re-enroll her equipped with what they believed was a solution: hearing aids.

“I returned to the same school I was in before — needless to say, I never understood a thing taught in class,” Georgine said. “As a coping mechanism, I developed a love for books and literally read everything I could. Reading helped me stay within the top three of my class.”

Georgine recounted struggling with isolation and an identity crisis while growing up. “I thought I was the only deaf person in the world until I discovered Kenyan Sign Language at Maseno School for the Deaf,” she said. “There, I finally found my identity and felt a sense of belonging.”

USAID’s Commitment to Access and Inclusion

When I hear stories like Georgine and Natha’s, it takes me back to Kenya, where I worked at two schools for the deaf as a Peace Corps volunteer. The challenges faced by deaf and hard of hearing people are still prevalent, though; I recently attended the quadrennial World Federation of the Deaf conference, where over 100 deaf youth representatives echoed the same themes of barriers to sign language and education.

USAID is working to change this, providing access to education and sign language around the world. Education projects promoting sign language have been implemented in countries including Ecuador, Georgia and Morocco.

USAID partnered to produce Ecuador’s first-ever sign language dictionary, and with the current All Children Reading Grand Challenge initiative, the Agency is developing revolutionary software to support bilingual education in Morocco and Georgia. In Morocco, with early grade reading software using both Moroccan Sign Language and Arabic, deaf students have been shown to develop better literacy skills, learn better, and thinking more outside of the box than they did before.

Inclusive education is becoming an important theme on the global stage. It is important to ensure that students like Georgine or Natha aren’t left behind. Quality education for deaf and hard of hearing students means equipping teachers with fluency in sign language, thus creating truly inclusive spaces for all learners — because every child has a right to be educated.

ABOUT THE AUTHOR

Josh Josa is a Program Analyst working in USAID’s Office of Education. Follow him @JoshJosa.

To Fight Extremism, The World Needs To Learn How To Talk To Women

This blog is a condensed version of an article published in Foreign Policy. Read the full article here.


When I was in Pakistan about three years ago, a prominent female civil society activist told me how some women in northwest Pakistan were supporting militants by donating their most precious gold and jewelry and endorsing their sons’ radicalization.

We had been talking about engaging Pakistani women to de-radicalize youth, and she warned me that extremists were speaking more effectively than moderates to women, leveraging their influence in the home, family and the community. Women could help combat violent extremism, but it would require a concerted effort to reach out to, counter-message, and actively engage them.

Her message was clear: As violent extremist movements have strengthened, the international community needs to engage more intentionally with women in countering violent extremism.

Members of the Bring Back Our Girls group campaigning for the release of the Chibok schoolgirls kidnapped by Boko Haram Islamists march to meet with the Nigerian president in Abuja, on July 8. / Philip Ojisua, AFP

Members of the Bring Back Our Girls group campaigning for the release of the Chibok schoolgirls kidnapped by Boko Haram Islamists march to meet with the Nigerian president in Abuja, on July 8. / Philip Ojisua, AFP

Tools are already in place. The international community has passed several United Nations Security Council resolutions providing a foundation to better engage women in promoting peace and conflict resolution. U.S. policy has emphasized that women’s empowerment, protection and participation are vital to any effort to fight violent extremism.

Today, women and girls are facing unimaginable brutality at the hands of extremists. Since 2014, Amnesty International estimates 2,000 women and girls have been kidnapped, raped or forced into marriage by Boko Haram in Nigeria. And, according to the United Nations, approximately 2,500 women and children are being held captive in Syria and northern Iraq by the Islamic State; some 1,500 civilians may have been forced into sexual slavery.

During a panel discussion at the U.S. Institute of Peace in July, Zainab Bangura, special representative of the U.N. secretary-general on sexual violence in conflict, eloquently described the interconnections in the work of the Islamic State. She spoke of a “battle that is being waged on the bodies of women and girls” in which sexual violence has become a “tool of terror.”

Women and girls also suffer when violent extremism results in displaced communities. Since the onset of violence in Syria, early marriage has risen dramatically. The U.N. estimates that while about 13 percent of Syrians under 18 were married before the war, rates skyrocketed to 32 percent by early 2014.

Save the Children and Amnesty International have both pointed to economic drivers of increased early and forced marriage; desperate families receive a dowry for marrying off a girl while also reducing the number of mouths they have to feed. Reports of domestic violence have also risen.

Victimization only tells one piece of the story. Women have long been members of extremist groups. Media attention often focuses on female fighters and suicide bombers, though relatively few perpetrate attacks. That said, Syria experts estimate over 20 percent of the Islamic State’s recruits are female, and some 550 of the 3,000 foreign fighters from Western countries are thought to be women.

A Kurdish female fighter of the Women’s Protection Units looks on at a training camp in al-Qahtaniyah, near the Syrian-Turkish border on Feb. 13. Syrian Kurdish forces have been fighting advances by the Islamic State jihadist group. / Delil Souleiman, AFP

A Kurdish female fighter of the Women’s Protection Units looks on at a training camp in al-Qahtaniyah, near the Syrian-Turkish border on Feb. 13. Syrian Kurdish forces have been fighting advances by the Islamic State jihadist group. / Delil Souleiman, AFP

The group has developed messaging that romanticizes the need for devout women to help create a new society. As Islamic State members, these women are recruiting, teaching and building communities, and they are married to male recruits as an incentive for men to join and remain with the movement. They are also encouraged to reproduce to advance the creation of a state committed to the cause.

Perhaps most under-appreciated is the role of women as partners to counter violent extremism. Around the world, women often have influence within the family, giving them enormous potential to stem recruitment and radicalization. As community members frequently left behind in conflict zones to maintain the home and care for children, women and girls often have information that can provide early warning of conflict or the potential for violence.

Examples from around the world illustrate how women can stem violence and extremism. In Sudan, Hakamat singers — women whose songs can foster conflict by belittling other ethnic groups, decrying cowardice, and urging retribution — are promoting tolerance, coexistence and peace. In Somalia, the cross-clan linkages women gain through marriage are used to help mediate. In Central America, women can be key voices in discouraging young people from joining criminal gangs and committing crime.

Along the Tajik and Afghan border, Sisters Against Violent Extremism is establishing schools to teach mothers about preventing the radicalization of their sons. Over 150 mothers have reported reconnecting with distant sons and daughters, persuading them not to attend illegal meetings or read radical material. Two groups of mothers have organized meetings with local police to increase understanding of the role women can play.

Building on this knowledge, USAID is engaging women and girls to counter the rise of violent extremism. In Kenya, USAID is  teaching women about peacebuilding and de-escalating conflict. In Niger, Chad and Burkina Faso, USAID funds the use of radio, social media and civic education to elevate voices of non-extremist women and men. And in many parts of the world, we seek to strengthen the role of women and youth in political and peace processes.

But, we know the international community needs to do more to effectively engage women in countering violent extremism. A critical first step is incorporating gender equality and women’s rights in every facet of society. But that is just a starting point.

In July, experts came together to identify how international development stakeholders could elevate the role of women in countering extremism at a forum organized by the U.S. Institute of Peace, USAID and the State Department. Among their conclusions was the need for the United States to broaden its support for networks of women and youth in communities challenged by violent extremists.

For the international community, the remainder of 2015 is full of opportunities to strengthen these efforts. It is a moment that the world can’t afford to miss.

ABOUT THE AUTHOR

Carla Koppell is USAID’s chief strategy officer. Follow her @CarlaKoppell.

Overcoming the Stigma of Disability Across the Globe

USAID Senior International Education Advisor Christie Vilsack greets young women in an English class at the Lao Disabled Women’s Development Centre in July 2015. / David Lienemann, Official White House Photographer

USAID Senior International Education Advisor Christie Vilsack greets young women in an English class at the Lao Disabled Women’s Development Centre in July 2015. / David Lienemann, Official White House Photographer

Growing up in Laos, Chanhpheng Sivila contracted polio at the age of 3, which affected her leg and spine and made walking difficult. When it came time to go to school, her parents wouldn’t let her attend, telling her they couldn’t afford a school uniform for all 12 of their children.

But Chanhpheng was determined to get an education. Defying her family’s reservations, Chanhpheng decided one day to steal her big sister’s old school uniform and then secretly followed her to school. Her boldness paid off. The teachers at school saw Chanhpheng’s determination and convinced her parents to let her attend.

The 4-foot-7 Chanhpheng battled her way through school and eventually went on to earn a bachelor’s degree from the National Academy of Politics and Public Administration in Vietnam and a bachelor’s degree in business administration from Rattana College in Laos. She refused to let the stigma of having a disability get in her way.

In 1990, Madam Chanhpheng founded an organization that became the Lao Disabled Women’s Development Centre. She is now a tireless and inspiring advocate for the rights of women and girls with disabilities.

25 Years of Empowerment

As Madam Chanhpheng’s center celebrates 25 years of empowering women and girls with disabilities in Laos, the United States is celebrating the 25th anniversary of the Americans with Disabilities Act. This landmark legislation guarantees rights of individuals with disabilities in the United States.

It also serves as model legislation informing disability rights internationally, including in many of the countries where USAID works today. The law’s principles of access, inclusion and non-discrimination are woven into USAID’s own Disability Policy, which promotes the inclusion of persons with disabilities across all of our programs.

Dr. Jill Biden and USAID Senior International Education Advisor Christie Vilsack pose with students from Hanoi College of Information Technology in July 2015. / David Lienemann, Official White House Photographer

Dr. Jill Biden and USAID Senior International Education Advisor Christie Vilsack pose with students from Hanoi College of Information Technology in July 2015. / David Lienemann, Official White House Photographer

I recently accompanied Second Lady of the United States Dr. Jill Biden on a trip to Laos and Vietnam. On the trip we saw some of USAID’s efforts to give children and youth with disabilities access to education as well as workforce development training.

Dr. Biden recognized the Lao Disabled Women’s Development Centre for its work educating and empowering young women in Laos over the last two and a half decades. Each year, the center provides basic education, life skills and job-related training for 35 young women. Since 2002, over 500 young women with disabilities have graduated from the center.

Our delegation visited a reading class and a papermaking demonstration, and then we bought scarves woven by the women in the program. The center benefitted from a USAID grant given to World Education Laos through the Senator Patrick Leahy War Victims Fund; the fund primarily helps individuals with disabilities in conflict-affected countries.

While in Asia, Dr. Biden and I also visited students from the Hanoi College of Information Technology in Vietnam, where USAID has collaborated with Catholic Relief Services since 2007 to provide advanced computer skills training to over 700 youth with disabilities. About 70 percent of the program’s graduates have found jobs; a few have even found their life partners in the class and have plans to marry.

The U.S. Government has supported inclusive development programs in Vietnam for the last 25 years, even before normalization of diplomatic relations in 1995.

The Road Ahead

Madam Chanhpheng Sivila shows off a scarf made by young women at the Lao Disabled Women’s Development Centre. / David Lienemann, Official White House Photographer

Madam Chanhpheng Sivila shows off a scarf made by young women at the Lao Disabled Women’s Development Centre. / David Lienemann, Official White House Photographer

According to UNESCO, most children with disabilities in developing countries are out of school. The problem isn’t that they don’t want to be in school or that they can’t afford it. The reason is often negative and discriminatory attitudes, like those faced by Madam Chanhpheng, combined with physical barriers.

USAID is committed to finding new strategies to reach people with disabilities. Earlier this year, our All Children Reading Grand Challenge for Development awarded funding to five organizations for their low-cost, technology-based solutions to promote literacy for children with disabilities. They are developing and implementing these reading technologies over the next two years in Georgia, India, Lesotho, Morocco and the Philippines.

Another major obstacle to addressing the out-of-school issue is the lack of data on children and youth with disabilities. A great first step would be to gather data on the numbers of children with disabilities in and out of school, disaggregated by type of disability. This would help us to know who is being left out of the education system and allow us to study the barriers in order to plan effective interventions.

The data would undoubtedly be telling, but we will also need to open our minds to what is happening behind the numbers. By learning from people like Madam Chanhpheng, we will be better positioned to steer the agenda for educating children and youth with disabilities.

ABOUT THE AUTHOR

Christie Vilsack is the Senior International Education Advisor at USAID. Follow her @ChristieVilsack.

Around the World in Videos: How USAID is Helping Curb Child and Maternal Deaths

Mom and baby are doing fine because mom was taught how to perform Kangaroo Mother Care to keep her premature newborn warm. / Molly Ronan, Embrace Global

Mom and baby are doing fine because mom was taught how to perform Kangaroo Mother Care to keep her premature newborn warm. / Molly Ronan, Embrace Global

In 1990, more than 12 million children under the age of 5 died every year because of preventable conditions and diseases. Today, we face a situation considerably less bleak.

But still, far too many children today are being robbed of the chance to lead full, healthy lives. They are being robbed by illnesses we can prevent and treat. And far too many mothers won’t get to hold their newborn in their arms. These women won’t have the chance to raise their families or contribute to their communities.

Over the past six years, the Obama administration has strategically focused our maternal and child health programs in the 24 countries that account for more than 70 percent of child and maternal deaths globally.

By providing expectant mothers with high-quality and respectful care during delivery, resuscitation for newborns, vaccinations, diarrhea treatment and education about the importance of breastfeeding and handwashing, it is estimated we have helped save the lives of nearly 2.5 million children and nearly 200,000 mothers since 2008.

Acting USAID Administrator Alfonso Lenhardt joins Indian Prime Minister Shri Narendra Modi and heads of delegations from around the world at the Call to Action Summit on Aug. 27 in New Delhi, India. / Clay Doherty, USAID

Acting USAID Administrator Alfonso Lenhardt joins Indian Prime Minister Shri Narendra Modi and heads of delegations from around the world at the Call to Action Summit on Aug. 27 in New Delhi, India. / Clay Doherty, USAID

This week in New Delhi, I join health ministers from those priority countries and experts from across the globe for The Call to Action Summit to take stock of progress, share best practices and forge alliances.

Here are snapshots of some of USAID’s efforts around the world.

India

Like all mothers, Satyawati wants the best for her children, including for her newborn son. In a world where motherhood is still a risky endeavour, her story reflects the Indian Government’s new approach to maternal and child survival. With help from her local health worker, Satyawati knows how to best care for her children. She has had them vaccinated, and she practices proper hygiene at home.

Millions more have benefited from India’s recent efforts to reduce maternal and child deaths. In fact, under-5 mortality has dropped from 126 per thousand live births in 1990 to 53 per thousand live births in 2013. The government is using a scorecard to track its progress, providing transparency and accountability.

Malawi

“It’s heartbreaking to not have the equipment you can use on a baby to survive,” said Indira Chikomoni, a nurse at Zomba Central Hospital in Malawi. But with USAID’s support, 27 hospitals throughout Malawi now have access to a device called the Pumani bCPAP, which helps newborn babies breathe until their lungs have fully developed. The device has tripled the survival rate for babies treated for respiratory distress syndrome.

Gloria Mtawila’s son Joshua, who was struggling to breathe at birth, stayed on the machine for a month until eventually he could breathe on his own, and now he is a healthy baby boy.

Ethiopia

Adanech Belay is a proud mother of three, one of millions of rural families that used to live beyond the reach of the health system in Ethiopia. With USAID’s help, the Ethiopian Government has trained more than 38,000 health workers and deployed them around the country. Now, Belay can give birth in a clinic. She knows about vaccines, hygiene and family planning. Health extension workers now form the backbone of Ethiopia’s health care system, empowering families like hers to take charge of their own health. And the efforts are working.

In September 2013, Ethiopia announced it had achieved Millennium Development Goal 4—reducing child mortality by two-thirds by 2015—a full two years ahead of schedule. In 1990, Ethiopia’s under-5 mortality rate was one of the highest in the world at 204 for every 1,000 live births; by 2013, this rate had been slashed to 64 for every 1,000 live births.

Nepal

Until recently, three in 100 Nepali babies died before they were 1 month old, often from infections introduced into the body through the umbilical cord stump. In Nepal, where home delivery is common, a newborn’s umbilical cord has traditionally been cut with dirty household tools, and substances like oil, turmeric or even cow dung were rubbed on the stump to encourage “healing.”

All that is changing now with the support of USAID. With our partner JSI, we’ve helped develop a low-cost antiseptic gel we’re providing to pregnant women free of charge. A network of 50,000 female volunteer health workers are teaching communities how this little tube and new healthy practices can save their babies’ lives.


When a child dies, and when a mother dies giving birth, it is a tragedy for all of us. Because we miss out on everything they might have offered, and because it continues the cycle of extreme poverty that holds the entire world back. Together, we can break that cycle.

The goal of ending preventable child and maternal deaths is within our reach. We will continue Acting on the Call until every mother and child has the chance to lead a full, healthy life.

Subsistence to Surplus: How Gifty Went from Barely Making Ends Meet to Meeting President Obama


Gifty Jemal Hussein met President Obama this week during his visit to Ethiopia. Read on to find out how she transformed her life from a subsistence existence to extraordinary success that’s benefiting her entire community—with a little help from the United States.

Gifty Jemal Hussein was a typical smallholder farmer in Ethiopia. She grew Ethiopian banana, corn and a few coffee plants in her backyard to feed her family and earn a meager income to make ends meet.

Harvests were low and unpredictable. Land was limited. This was life.

But 2013 was different.

In 2013, Gifty planted her small patch of land with new corn seeds, using techniques she’d learned from a development program in her community. She used just the right amount of fertilizer and checked on the corn stalks as they grew. When it came time to harvest them, she exclaimed to herself: Thank God! Her crops had yielded three times as much corn in a single season as before.

It seemed almost too good to be true. She touched every ear of corn she’d harvested. The results were real.

Gifty was so surprised, happy and proud of her harvest that she laid the ears of corn out in front of her house for all to see. She went door-to-door telling others and inviting them to see it with their own eyes. She took a quarter of the harvest to her four adult children in the capital city.

Her neighbors, impressed and happy for her, wanted to know how she’d managed to turn a sparse backyard garden into an abundant farm.

Gifty Jemal Hussein, a smallholder farmer in Ethiopia, spoke with President Obama today. Through a USAID-DuPont partnership, she began using high-yield corn that allowed her to increase her household income. / Daniella Maor, USAID

Gifty Jemal Hussein, a smallholder farmer in Ethiopia, spoke with President Obama today. Through a USAID-DuPont partnership, she began using high-yield corn that allowed her to increase her household income. / Daniella Maor, USAID

Unlocking Agriculture’s Potential

Gifty had been a leader in her community before 2012, but it took on new meaning now. People were paying more attention. She had newfound confidence that life could change—and she would be the one to make it happen.

Gifty went to the local government and asked to lease one hectare of land – for free – for her women’s group to farm. She rented a tractor with her own money to plow the land. She gathered other women in her community to help her sow the corn seeds that had given her a bumper harvest last season and then apply fertilizer, which she bought on her own.

As the corn grew, she brought the 20 women in her group to show them how tall the plants were getting. Then she asked each to invest in this farming venture – to become stakeholders in their shared success. Each woman paid a portion to compensate her for the cost of the tractor and fertilizer. The following season, they also helped buy the seeds.

“It isn’t reasonable to invest in something that doesn’t give you a return,” Gifty said. “So I don’t invest in the [old seed], instead I invest in the new hybrid seed.”

Gifty and her group opened a savings account for the income they were earning from better corn harvests. With it, they’re making investment plans for the future and have a safety net for tough times.

Women representatives visited from other districts to see the group’s bountiful corn crop. They were so impressed that they gifted Gifty a set of farm tools to honor her for her initiative and entrepreneurship.

Taller plants and larger ears of corn translated into more income for Gifty. She’s invested the returns into her farming enterprise, buying a cow, which she’s leveraged into an additional revenue stream by selling the milk and calves. With this money, she’s purchased extra seeds to grow more nutritious and lucrative crops like teff, cabbage, carrots and potatoes. She’s expanded the number of coffee plants she grows too.

Gifty is also using her income to improve her family’s standard of living. She built a new home—her proudest undertaking. She’s paid for her husband’s medical treatment for a disability he has and for her son’s final years of high school. She even had enough to contribute to one of her daughters’ weddings.

From Individual Success to Global Impact  

Fortunately, Gifty’s story is less and less unique these days. Rural communities across countries like Ethiopia are establishing a new normal: One with less poverty and hunger and with more prosperity and opportunity.

Smallholder farmers, with help from the United States, are moving from barely surviving off their farms to running profitable farming businesses—ones that give them enough income to pay for things like school, health care and new homes.

In Ethiopia last year, the U.S. Government’s Feed the Future initiative helped more than 218,000 producers like Gifty use new technologies and management practices to increase their yields. And through nutrition programs, the U.S. Government reached more than 1.3 million young children in Ethiopia with help—including training more than 20,000 adults in child health and nutrition.

Results like these add up to impact, in the lives of individual farmers like Gifty and – increasingly – nationwide. Between 2011 and 2014, stunting – a measure of malnutrition often associated with undernourishment – among young children dropped in Ethiopia by 9 percent. This impact reflects the leadership and efforts of the Government of Ethiopia as well as U.S. Government.

The United States has led the world in taking hold of the tremendous opportunity to unlock the transformative potential of agriculture to connect more people to the global economy and pave a path out of poverty through initiatives like Feed the Future and partnerships like the New Alliance for Food Security and Nutrition.

In fact, as President Obama was meeting with Gifty today, we announced that the program that helped Gifty jumpstart her success with new seeds – a public-private partnership between Ethiopia, the United States and DuPont Pioneer – is expanding to reach 100,000 more farmers and help them flourish, much like Gifty has.

The work is far from finished, but the results and impact are promising. The future looks bright for rural families like Gifty’s.

ABOUT THE AUTHOR

Tjada McKenna is the Assistant to the Administrator for USAID’s Bureau for Food Security. She also serves as the Deputy Coordinator for Development for the U.S. Government’s Feed the Future initiative.
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