Women & Gender

{Photo by Warren Zelman.}Photo by Warren Zelman.

This post also appeared on Gates Foundation's Impatient Optimists Blog and on Frontline Health Workers Coalition's website.

In a week and a half, as a team of our colleagues arrive in Ethiopia for this year’s International Conference on Family Planning, others will already be in Brazil for the Third Global Forum on Human Resources for Health. This year’s HRH Forum addresses universal health coverage (UHC), a concept which continues to gain momentum as the focus of global health efforts from institutions like the World Bank and World Health Organization (WHO).

It’s symbolic that these two meetings are happening half a world apart: as movements around family planning, health workforce and UHC have advanced, there has been too little dialogue and collaboration across these communities.

{Photo credit: Rui Pires.}Photo credit: Rui Pires.

We call on you to celebrate the girl child, read and support the Girl Declaration—a call to action for the post-2015 development agenda to prioritize girls and stop poverty before it begins—and help educate and empower the girl child in all of us. Many of us are shaped by what we experience as children. For those in high-income countries, the world of the girl child is often full of possibilities and options. However, for many in low- and middle-income countries, the girl child lives in a world fraught with harsh realities and limited choices. To understand the journey of women, we must look at the girl child not only as a period in one’s life but as one which continues to live in all of us as we reach adulthood and beyond. "I was not put on this earth to be invisible."

 {Photo credit: MSH}The manager of a community health center dispenses family planning commodities in Mali.Photo credit: MSH

Earlier this month, NASA confirmed that Voyager 1 reached the border of the solar system. This momentous occasion is a major milestone in space exploration. As we close World Contraception Day (WCD2013), September 26, there are many lessons we can learn from Voyager on our journey beyond WCD2013 toward access for voluntary family planning for all.

For those who are too young to remember or have little interest in space exploration, suffice it to say that so far no human attempt to learn about our solar system has given us so much knowledge about  planets, rings, and satellites, as Voyager 1, NASA's biggest planetary expedition, launched 36 years ago.

What can the international public health community learn from Voyager 1 this WCD2013?

Lesson 1: How to make a dream possible by understanding the facts and setting goals.

Voyager 1 started with a dream of reaching our solar system’s big planets and confirming  the few facts we knew about Jupiter and Saturn. NASA set the course for a meticulous scientific goal that resulted in four planets explored and 22 fascinating moons discovered.

 {Photo credit: Jafary Liana/MSH}Germana (right), ADDO owner and dispenser in Kipara Mpakani Village with full-time accredited dispenser (left).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 Germana Firmini Mroso

Germana Firmini Mroso, 31 years old, owns an ADDO named ROSALA DUKA LA DAWA MUHIMU, which is located at Kipara Mpakani Village, Vikindu ward, in Mkuranga District. Germana is both an owner and dispenser in her outlet. Germana holds a one year nurse assistant certificate. She manages a second small business making medicine-packaging envelopes which she uses in her outlet and sells to other outlets.

Why did you become an accredited drug shop owner?

 {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.

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