Fragile States

Fragile States (including Afghanistan, Democratic Republic of Congo, Haiti, Liberia and South Sudan)

A common challenge in advancing family planning is overcoming the misconceptions religious leaders have about the use of contraceptives.

Concerns from religious leaders are often based on misconceptions about family planning methods rather than their religious beliefs. The fear that hormonal methods will cause infertility or are dangerous, are commonly expressed as concerns from religious leaders.

These methods are 300 times safer than becoming pregnant in Afghanistan and about 100 times safer than pregnancy in Yemen, Malawi, and Tanzania is an appropriate way to look at the risks versus benefits.  My experience in these four countries has been that this message was well received by both Muslims and Christians, along with the sound evidence for improved child and maternal health outcomes with healthy timing and spacing of pregnancy (HTSP). 

Pick up any American newspaper these days, and all of the stories coming out of Haiti are negative: earthquake relief work is going slow, displaced people are still living in tented camps, men and women are still struggling to find work.  And while these facts can’t be disputed, there are many other stories that are being left untold.  Working in Haiti earlier this month, I encountered six women who are on the front lines of the battle against Haiti’s HIV & AIDS epidemic, who shared their stories with me.

Women in Haiti

Originally posted on Global Health TV's website.

Watch Video Coverage of Dispelling Myths About Haiti

The Global Health Council and its partners held a press conference at the International AIDS Conference in Vienna, to bring the attention of the media back to Haiti six months after it was devastated by earthquake.

Experts such as Dr. Paul Farmer, Dr. Jonathan Quick from Management Sciences for Health, Jeff Sturchio from the Global Health Council, and Dr. Jean William Pape from GHESKIO discuss the struggles and successes being made in the troubled nation - and try to dispel a few myths too.

As we have heard, Haiti is the poorest country in Western Hemisphere and has some of the worst health statistics. Many things did not work well before the earthquake and the recovery effort has not progressed as many had hoped.

There is a perception among some, though, that nothing was working before the January 12th earthquake and that nothing has happened since.

Certainly in the health sector, and specifically in AIDS, this perception is simply wrong. The earthquake has been devastating for Haiti and its people, but in the health sector there were many good things going on before the earthquake and some real strengths to build upon. The government of Haiti, at both the national and department level, has been playing a strong leadership role.

MSH first began working in Haiti over 30 years ago. Over the last decade our nearly all-Haitian staff has worked intensively to develop leadership, management, planning, and service delivery skills within the Ministry of Health and Population, nationally and at the departmental and local levels. We also work to strengthen over two dozen service delivery NGOs.

In fragile states, constraints on governments often prevent them from simultaneously building their stewardship role and immediately expanding service delivery. National and local governments must ultimately lead the process and work together with NGOs and the private sector to successfully strengthen their own health systems.

In Haiti, a two-pronged approach was successfully developed and implemented prior to the earthquake by a four-way partnership between the Government of Haiti, the United States Government, a network of Haitian and international NGOs  (Santé pour le Développement et la Stabilité d’Haíïti) (SDSH), and Management Sciences for Health.

The two-pronged approach included:

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