Women & Gender

A community health volunteer explains the use of pregnancy tests to a client.

This World Health Worker Week (April 2-8), we honor the health workers around the world who work every day to improve health in their communities. This photo essay illustrates the important role that community health volunteers play in strengthening Madagascar's health system.

Community health volunteers (CHVs) play a critical role in providing primary health care services in Madagascar, especially for rural populations who live far from health facilities. In many areas of the country, CHVs often collectively offer services to more people than health centers do. CHVs are important extensions of the Malagasy health system, particularly for women and children.

As of 2016, the USAID Mikolo Project, led by MSH and funded by USAID, supported nearly 7,000 CHVs across 506 communes. They fill a critical gap in human resources for health in support of the Ministry of Public Health’s efforts to improve health care in the country.

[A CHV provides reproductive health education.]A CHV provides reproductive health education.

 {Photo credit: Todd Shapera}Community Health Workers during a morning of training on the lawn at Rukumo Health Center, Rwanda.Photo credit: Todd Shapera

(This post originally appeared on the WomenDeliver blog.)

Throughout global societies, women’s roles place them at the epicenter of risk from disease outbreaks and epidemics. This is true everywhere, but especially so in poor countries with health systems unprepared to meet the ever-surging demands of a public health emergency.

The interaction between gender roles, disease transmission, and socio-economic stability reach a perilous tipping point in epidemics; failing to address that interaction will result in deficient strategies for outbreak prevention and control, and in massive setbacks for women’s health, and development gains. Unless global health security measures help us understand the impact of emerging diseases on women, nations and the world will remain vulnerable to pandemics.

{Women in Malawi are increasingly engaging in sustainable ways to grow household income and end poverty, such as village savings and loans groups. (Photo Credit: Feed the Children / Amos Gumulira)}Women in Malawi are increasingly engaging in sustainable ways to grow household income and end poverty, such as village savings and loans groups. (Photo Credit: Feed the Children / Amos Gumulira)

Follow the conversation at the Commission on the Status of Women:

As we prepare to join the Commission on the Status of Women (CSW) next week, where the focus will be on women’s economic empowerment in the changing world of work, I am reminded of my visit to Malawi last month.

{Fatimata Kané, Project Director of the FCI Program of MSH in Mali.} Photo Credit: Catherine LalondeFatimata Kané, Project Director of the FCI Program of MSH in Mali.

(Français)

Putting a child on the earth is a whole different type of work. Not everyone can guide a woman and her baby safely through pregnancy and childbirth.

I know what it means to keep women and babies alive and healthy because I am a midwife.

As a young girl in Mali, I passed the village dispensary on my way to school every day. I felt sorry for the people lined up outside waiting for treatment for their illnesses. I always told myself that one day I would wear the white coat of health workers and help those who are sick. During my health education training, I studied midwifery because I wanted to educate, advise and assist women before, during, and after pregnancy. 

Although I stopped practicing midwifery in maternity wards, I apply my professional passion to my work with MSH. No matter where I am or what project I’m working on, I speak with midwives, visit community health centers, and counsel pregnant women about their health and about that of their children whenever I can. When I visit communities, I encourage women to go to their local clinics for prenatal exams and to breastfeed and vaccinate their babies.

{Photo Credit: Catherine Lalonde}Fatimata Kané, directrice du programme FCI de MSH au Mali.Photo Credit: Catherine Lalonde

(English)

Mettre un enfant au monde est tout un travail différent. Tout le monde peut aider quelqu'un qui est malade, mais tout le monde ne peut pas faire le travail d'une sage-femme--guider une femme et son bébé en toute sécurité pendant la grossesse et l'accouchement. Je sais ce que signifie garder les femmes et les bébés vivants et en bonne santé parce que je suis une sage-femme.

Comme une jeune fille, le chemin de mon école passait à côté du dispensaire de mon village ou je voyais les malades attendre les soins. J'avais vraiment pitié d'eux et je me disais toujours qu'il faille que je porte la blouse blanche tenue portée par les agents de santé au Mali afin de venir au secours des malades. Au niveau de l'école de la santé, j'ai bien voulu faire les études de Sage-Femme qui est un métier noble. Une Sage-Femme éduque, conseille et aide les femmes avant, pendant et après les grossesses. La Sage- Femme surveille et aide les femmes en travail jusqu'à la naissance du bébé. C'est très réconfortant d'aider à donner vie à un bébé.

{Photo Credit: Rebecca Weaver/MSH}Photo Credit: Rebecca Weaver/MSH

This is the last in a series of four stories about how strong health systems improve the health of women and children. It was originally published on Global Health Now's website.

The Democratic Republic of the Congo has a chance to save millions of children with an inexpensive grassroots community effort.

In the Democratic Republic of the Congo (DRC), a country beleaguered by years of civil war, official corruption and mismanagement, and civil apathy, the path to building a strong health system is challenging. One initiative, focused on building up community-level care, has shown success—but without more support from the Congolese government, it might not continue.

 The USAID-funded Integrated Health Project (IHP) aims to increase the availability of health services for the most vulnerable people in the country, which has one of the world’s highest rates of child mortality (the top killers include malaria, diarrhea, and pneumonia). IHP has focused on interventions ranging from simple—handwashing, breastfeeding—to more complex, such as tuberculosis care, financial management, medication distribution, etc.

{Photo Credit: Francies Hajong/MSH}Photo Credit: Francies Hajong/MSH

This is the third in a series of four stories about how strong health systems improve the health of women and children. 

Every day, approximately 830 women die from preventable causes related to pregnancy and childbirth, and 99 percent of them live in developing countries, according to the World Health Organization. Many of these women – and their babies – could be saved with medicines. However, access to these medicines is often limited in the countries where they are most needed. Sheena Patel, a technical advisor for the MSH-led, USAID-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) project, talks about the program's work in helping to improve access to essential medicines. This story was originally published on the SIAPS website February 23. 

MSH: The health of women and children is critical to the overall health and prosperity of a country—and the world. Can you talk a bit about why?

MSH representatives at the launch meeting of the Quality of Care Network (L-R): Zipporah Kpamor, MSH Nigeria Country Representative; Erik Schouten, Country Lead, MSH Malawi; Grace Mlava, Technical Clinical Director, ONSE Health in Malawi; Rudi Thetard, Project Director of ONSE Health in Malawi; Catharine Taylor, Vice President of the Health Programs Group, and Antoine Ndiaye, Country Lead, Cote D’Ivoire.

This is the second in a series of four stories about how strong health systems improve the health of women and children.

Nine countries, with support from the World Health Organization (WHO), the United Nations International Children’s Fund (UNICEF), and other partners, launched the Network for Improving Quality of Care for Maternal, Newborn and Child Health last week.

The new Network aims to improve the quality of care that mothers and babies receive in health facilities while supporting countries in achieving their targets agreed under the Sustainable Development Goals to end preventable maternal and newborn deaths. 

Despite remarkable progress in improving access to health services proven to reduce maternal and newborn deaths, every year worldwide, 303,000 women die during pregnancy and childbirth, 2.7 million babies die during the first 28 days of life, and 2.6 million babies are stillborn. Most of these deaths could be prevented with quality care during pregnancy and childbirth.

However, the provision of care is uneven within and between countries, and often fails to respect the rights and dignity of those who seek it.

Nurses at health clinic Virgen del Lourdes in Lima, Peru (Photo Credit: Leslie Alsheimer)

This is the first in a series of four stories about how strong health systems improve the health of women and children.

Last year, we shared with you stories of the people we work alongside all over the world. We introduced you to Aster Amanuel Desalegn, a 70 year-old woman from Ethiopia who relies on her town's public hospital for her diabetes medication. You met Linvell Nkhoma, a midwife manager in Malawi who lives on the hospital premises so she can be on call 24 hours per day. And you heard from Animata Bassama, a representative from a community in Mali that worked with MSH to open a center providing a safe space for gender-based violence survivors to seek medical and psychosocial care.

 {Photo Credit: Warren Zelman}A hospital in Mwene Ditu, DRCPhoto Credit: Warren Zelman

Before the civil war in the late 1990s, the Democratic Republic of Congo (DRC) had a large network of clinics and health facilities. But decades of conflict weakened a fragile health system and robbed this resource-rich country of its potential to become one of sub-Saharan Africa’s wealthiest nations. By 2010, 70 to 80 percent of Congolese people had little or no access to healthcare, and the country suffered from a lack of basic security, communication systems, power, clean water, and transportation. Exacerbated by a dearth of health providers, essential medicines and nutritious foods, the country’s maternal, infant, and child mortality rates rose to some of the highest in the world.

I’m in the U.S. this week to share my experiences working side-by-side with the Congolese government and partners on the Integrated Health Project (IHP), funded by USAID and implemented by Management Sciences for Health (MSH) and its partners, International Rescue Committee and Overseas Strategic Consulting, Inc. . The aim of IHP was to rebuild and strengthen the health system and improve health across 78 health zones in the country. In five years, IHP improved health services for more than 13 million people – 17 percent of the Congolese population.

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