Women & Gender

 {Photo credit: Jafary Liana/MSH}Audensia Batholomew shares her path to accreditation as an drug shop outlet owner and dispenser with Dr. Suleiman Kimatta.Photo credit: Jafary Liana/MSH

In developing countries, a community medicines shop often serves as the first point of contact for health care. Empowering the drug shop owner and dispenser to provide safe, quality medicines, and referrals to a health facility for more complex care, is key to improving maternal and children’s health in rural areas.

MSH’s Jafary H. Liana and Dr. Suleiman Kimatta visited two accredited drug dispensing outlet (ADDO) owners in Mkuranga District, Tanzania. One woman owns two ADDOs, while the other owns one. Both are also trained ADDO dispensers (an estimated 90 percent of ADDO dispensers are women).

Meet Audensia Batholomew

Audensia Batholomew, MBIGI, a 45-year-old single mother, lives in Mkuranga district headquarters with two dependents and an adult son at university. She owns two ADDOs, one located in Chamazi village (20 km from her home) and one in Njopeka village (30 km away). Audensia also holds a one-year nurse assistant certificate.

Why did you become an accredited drug shop owner?

 {Photo credit: Rui Peres}Children in Uganda, one of many LMICs where good governance at all levels of the health system is key.Photo credit: Rui Peres

This post originally appeared on the LMGforHealth.org Blog. USAID's Leadership, Management and Governance (LMG) Project, led by Management Sciences for Health (MSH), hosted the Governance for Health (G4H) in Low- and Middle-Income Countries Roundtable 2013 (G4H2013) at Georgetown University in August.

The overwhelming consensus of G4H2013? Governance matters.

Health sector leaders gathered in Washington, D.C. in August for the second roundtable on enhanced governance for the health sectors of low- and middle-income countries (LMICs). Governance involves decisionmaking by diverse stakeholders that set the strategic direction for public and private organizations; assembling and allocating resources needed to implement the strategic plan; monitoring the progress of champions; and protecting the mission of the organization.

 {Photo by Aurélie Jousset.}Elina Jean-Baptiste and her newborn daughter, Dadeline who was at the Cazale following its reopening.Photo by Aurélie Jousset.

On July 4, 2013, 26-year-old Elina Jean-Baptiste of Cazale, Haiti began experiencing painful contractions as she prepared to deliver her child. Realizing she was going into labor, Elina walked to the Cazale health center and with the help of trained nurses and a doctor, delivered a healthy baby girl named Dadeline. “The labor and delivery were very painful, but as soon as I arrived at Cazale, I knew I was in good hands,” she said.

For the past decade, the town of Cazale has lacked a functioning health center despite high rates of maternal and infant mortality and increasing rates of infectious diseases. Women often delivered at home in the absence of a skilled healthcare provider, thus increasing their risk of injury or death due to pregnancy-related complications. 

MSH Global Technical Lead on HIV & AIDS, Scott Kellerman, MD, MPH, has a new article published today in the PLOS Medicine magazine.

Scott Kellerman and colleagues argue that the scope of the current HIV elimination agenda must be broadened in order to ensure access to care and treatment for all children living with HIV.

In 2011, despite the global initiative to eliminate mother-to-child transmission of HIV, 330,000 new pediatric infections were added worldwide to the existing pool of 3.4 million children living with the virus. Children are more vulnerable to HIV infection and have higher morbidity and mortality. Without treatment, half of those children infected will die before the age of 2 years, yet only one third of those eligible for treatment are currently receiving antiretroviral therapy.

{Photo credit: Genaye Eshetu/MSH}Photo credit: Genaye Eshetu/MSH

Strengthening health systems at all levels is the core of MSH’s response to the HIV epidemic. We build organizational capacity to implement innovative HIV, prevention, care, and treatment interventions in over 35 countries---from Côte d'Ivoire to Ethiopia to Vietnam.

So, how will high-burden, low-resource countries respond to the new World Health Organization (WHO) guidelines that recommend starting HIV treatment earlier? Will the global AIDS movement join forces with those calling for universal health coverage (UHC) targets post-2015? How are civil society organizations working with countries on the HIV & AIDS response---and how can we strengthen their capacity?

The July/August edition of MSH's Global Health Impact Newsletter (subscribe) answers these questions and more, combining thought-provoking editorials and first-hand accounts from MSH countries around the world.

{Photo credit: LMS Haiti/MSH}Photo credit: LMS Haiti/MSH

Today, as we celebrate International Youth Day and the theme of “Youth Migration: Moving Development Forward,” we are reminded of difficult situations millions of young people experience every day—and of the power young people have to create change in their lives when they connect with their peers.

Adolescents and young men and women need access to quality, affordable reproductive health services. In the developing world, 52 million never-married women, aged 15-24, are sexually active and in need of reproductive health and HIV prevention services and information. Yet, adolescent girls often face greater barriers than adult women in accessing them. In the sub-Saharan Africa region, only 21 percent of married adolescents are using a modern contraceptive method; and the adolescent birth rate in the region is four times the rate in Europe and Central Asia. In the Latin America region, teenagers have doubled their proportion of the fertility rate from 8.5 percent in 1955 to 14.3 percent in 2005, despite a steady decline in overall fertility numbers.

International breastfeeding symbol

This week the global health community celebrates World Breastfeeding Week (August 1-7). Breast milk is nutritious, clean, available, natural, and does not require special preparation or handling. Let’s take a moment to consider some of the numerous benefits of breastfeeding to baby and mom:

  1. Breastfeeding is the world's most effective solution to reducing child deaths
  2. Breastfeeding could save the lives of nearly 1 million children per year
  3. Breastfeeding reduces deaths to pneumonia and diarrhea
  4. Breastfeeding and nursing promote closeness for baby and mom
  5. Nursing reduces mom’s risk of breast and ovarian cancer later in life
  6. Nursing contributes to reduction in maternal mortality by helping moms space their births and prevent unintended pregnancy
  7. Nursing helps lower rates of obesity among women

In addition to the individual benefits to baby and mom, breastfeeding can help the global community achieve Millennium Development Goals 4 (reduce child mortality), 5 (reduce maternal mortality), and 1 (reduce poverty and hunger).

{Photo credit: Reavis/MSH, Malawi}Photo credit: Reavis/MSH, Malawi

The World Health Organization (WHO) made waves at the International AIDS Society conference in Kuala Lumpur when it issued revised guidelines for HIV treatment. The new guidelines—WHO’s first major update since 2010—recommend an earlier start to treatment, from a CD4 threshold of 350 cells/mm3 to 500 cells/mm3. While most patients don’t show symptoms of disease at these higher CD4 counts (a measure of immune system strength), the new guidelines responded to evidence that an earlier start improves long-term clinical outcomes and that ARV treatment dramatically reduces patients’ likelihood of transmitting the virus to sexual partners.

{Photo credit: Warren Zelman}Photo credit: Warren Zelman

My family’s story exemplifies how access to reproductive health and family planning in a low-income country can have tremendous economic and life-transforming impact for young people and a whole generation—beyond the reduction in fertility and improvements in health.

My parents got married in the 60s, at a time when Profamilia, The International Planned Parenthood Federation (IPPF) affiliate in Colombia, was pioneering the country’s path through successful demographic transition. My father, the youngest child of a family of nine, and my mother, the oldest of seven, never went to college. Instead, they worked through their teen years, struggling to help their families.

My mother (influenced by distant women relatives who were educated) had made up her mind to give her children the education she never had. She convinced my father (in spite of the macho, progenitive culture) that the only way to pursue their dreams was to secure a way out of poverty through hard work—and a small family. Sure enough, I, their oldest child, was the first one in the 70-plus extended family to graduate from college and medical school. My two sisters continue to benefit from the education they received.

{Photo credit: MSH}Photo credit: MSH

Management Sciences for Health (MSH) joined African civil society organizations (CSOs) at a side event  on July 2 of the Abuja +12 meeting of African heads of governments. The groups agreed that universal health coverage should be included in the post-2015 development agenda.

In April 2001, the Heads of State and Government of the African Union signed the Abuja Declaration after undertaking a critical review of the rapid spread of HIV and AIDS on the continent. The Declaration cited practical strategies to deal with the menace. It also urged governments of member states to increase funding for health to at least 15% of the national budget. 

The Nigerian government and the African Union (AU) will co-host the Abuja +12 Special Summit of the AU Heads of government from July 15 to July 19 to review the 2001 Abuja declaration. The Summit intends to focus on the unfinished work of the health-related Millennium Development Goals. It will serve as an avenue to review the progress made on the implementation of the Abuja Declaration on HIV/AIDS, Tuberculosis and Other Communicable Diseases. It will also propose a framework for post-2015 development agenda for Africa. 


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