Women & Gender

The Improving Performance of Nurses (IPN) project in Upper Egypt celebrated the first Arabic publication of Management Sciences for Health's (MSH)'s “Managers Who Lead” handbook with an event last November. A delegation of prominent leaders from Egypt’s health sector---including representatives from the Ministry of Health and Population (MOHP), Egyptian universities and non-governmental organizations (NGOs), MSH, and USAID---attended the event in Cairo.

At the event, there was a feeling of hope for the future of the health sector in Egypt, and that this handbook is a small but important part of that future. Dr. Emad Ezat, director of health and nurses sector at MOHP, praised the book for helping to strengthen the performance of health organizations and improving health services. Dr. Abdo Al Swasy, IPN program manager, spoke of the work that had gone into the handbook and its importance. Dr. Gihan Fathy, IPN field manager, highlighted some of the tangible effects from the use of this book in the field, including building nurse leaders able to make decisions independently for positive changes in the health community.

I was circumcised when I was eighty days old, as is the tradition in Ethiopia. My sister was three. My mother had tried to spare us, but her aunt discovered that we were not circumcised and took it upon herself to have us circumcised.

Years later, I asked my aunt why she did it. Her response was not defensive. On the contrary, she responded very matter-of-fact: My sister and I were circumcised so that we could find a husband, have children, and become women. This is the cultural ideology that most Ethiopian women believed at that time, and unfortunately, that many still adhere to in the 21st century---an ideology and practice that is detrimental to a woman’s health.

Female genital circumcision alters or causes injury to the female genital organs for non-medical reasons. There are no health benefits for girls. On the contrary, the procedure can lead to severe bleeding, infections, and problems urinating, during sexual intercourse, and complications in childbirth, as well as later cysts and increased risk of newborn deaths---not to mention the severe pain and shock of the procedure.

In Moen Kas, one of the villages where the project introduced community-led total sanitation, officials and villagers celebrate Open Defecation Free (ODF) certification. {Photo credit: Noorgha CLTS Supervisor/Afghanistan.}Photo credit: Noorgha CLTS Supervisor/Afghanistan.

A new report from the USAID-funded Afghan Sustainable Water Supply and Sanitation (SWSS) Project, led by Tetra Tech ARD, describes the methodology and results from the Sustainable Health Outcomes component, led by Management Sciences for Health (MSH). The SWSS project worked to improve the health and infrastructure of rural Afghans, with an emphasis on providing water supply and sanitation facilities and improving community hygiene behaviors (read stories).

SWSS was the first project in Afghanistan to implement community-led total sanitation (CLTS) on a broad scale. While challenges for ongoing hygiene and sanitation remain, the project’s success led the Afghan Ministry of Rural Rehabilitation and Development to include CLTS as part of its national water and sanitation policy and strategy.

Jane Briggs of the USAID-funded SIAPS program at MSH gives examples from Rwanda and Kenya during the Improving Access to Essential Maternal Health Medicines session on the first day of the conference. {Photo credit: C. Lander / MSH.}Photo credit: C. Lander / MSH.

Cross-posted from the SIAPS website.

“Respectful maternal care was said to be more than just a means to an end, and can be framed as several issues: human rights, quality of care, equity and public health,” Jocalyn Clark, senior editor of PLoS Medicine, noted about the final day of the 2013 Global Maternal Health Conference (GMHC).

The conference brought together scientists, researchers, practitioners, and policymakers to share knowledge, ideas, innovations, research, programs and policies on maternal health quality and access, among several other topics. Participants also worked on building progress towards reducing and eliminating preventable maternal mortality and morbidity.

Quality of maternal care was a consistent theme throughout the conference.

Shelly with her latest trophy after winning first place at a 2012 regional Emancipation Day race. {Photo credit: V. Hinds/MSH.}Photo credit: V. Hinds/MSH.

Shelly has always been very athletic. She competed in both her high school track events and in community races in her hometown of Essequibo, Guyana. In 2010, she was ecstatic after winning a cash prize for placing first in an annual regional championship. However, her life took a turn one year later.

Shelly became pregnant and, during an antenatal care appointment, tested positive for HIV. The news devastated her, as she believed that an HIV diagnosis meant her athletic career was over. Shelly was unaware of how to remain healthy while living with HIV, and so she soon became ill, weak, and lost a significant amount of weight. To add to this, she was unemployed and lacked the means to provide for her newborn son.

Attendees of the Global Maternal Health Conference 2013. {Photo credit: MSH.}Photo credit: MSH.

Management Sciences for Health (MSH) staff presenting at the Global Maternal Health Conference in Arusha, Tanzania, January 15-17, 2013. (Photo credits: C. Lander & J. Briggs / MSH)

Dr. Agnes Binagwaho is a pediatrician and serves as the Minister of Health of Rwanda. {Photo credit: dr-agnes.blogspot.com/}Photo credit: dr-agnes.blogspot.com/

The second Global Maternal Health Conference began yesterday in Arusha, Tanzania, as an intentional dialogue between scientists, researchers, implementers, advocates, policymakers, and media. More than 700 people (from about 2000 abstracts) were selected to attend and share knowledge on how to improve the quality of care and eliminate maternal deaths.

This is my first global maternal health conference --- but not my first maternal health conference. I keep wondering: how will this one be different?

As I went through the first day of sessions and informal exchanges, I couldn't help feeling like one person "stole the show". At lunch and dinner, the conversations kept coming back to the dynamic Dr. Agnes Binagwaho, the Minister of Health from Rwanda. She served as the keynote speaker in the opening plenary and a panelist for another session.

When you hear Dr. Agnes speak, you know she is smart and accomplished. And, talking with other attendees, it is clear that, regardless if participants agreed with her specific recommendations, Dr. Agnes' commitment, knowledge, logic, and candor are appreciated and needed in the conference conversation.

Women visit the SDSH-supported Marmont clinic in Haiti’s Central Plateau. {Photo credit: C. Gilmartin/MSH.}Photo credit: C. Gilmartin/MSH.

Late one April night in 2012, 19-year-old Ilionelle was struggling to give birth at her home in rural northwest Haiti. After several hours, she began having seizures, a clear indication of eclampsia, a severe medical disorder that can lead to the death of the mother and/or baby.

Ilionelle’s situation is not uncommon in Haiti, which has the highest maternal mortality rate in the Western hemisphere with 630 deaths per 100,000 live births. Fortunately, Tilma, the traditional birth attendant helping Ilionelle, quickly identified these life-threatening symptoms and arranged for her transport to Beraca Hospital for emergency obstetric care. After being carried on a stretcher for four hours along a steep and treacherous road, Ilionelle arrived at Beraca Hospital where she safely delivered a healthy baby boy. “If it wasn’t for Tilma, both my son and I could have died,” Ilionelle said.

Tilma is among thousands of Haitians working to improve their nation’s health after recent years of misfortune.

When I worked in Smallpox eradication in the mid-1970s, I traveled all over northern India and Bangladesh. I never took malaria prophylaxis, because malaria had been cleared from those areas. Likewise, I did not take malaria prophylaxis when I worked in the Brazilian Amazon in the late-1970s. At that time, malaria was found only in gold miners in isolated tributaries of the Amazon. Now, due to our financial inability to continue high levels of malaria eradication activities worldwide in that time period, emergence of both anti-malarial and insecticide resistance, and spread of the mosquito vectors, all of these are heavily malaria endemic areas with a high mortality rate for pregnant women and children.

The World Health Organization (WHO) recently released the World Malaria Report 2012, summarizing 2011 data from 104 malaria-endemic countries and citing progress and challenges toward the eradication of malaria.

Tanzanian woman (Photo credit: MSH)Tanzanian woman (Photo credit: MSH)

Management Sciences for Health (MSH) invites you to attend the following sessions and poster presentations at the Global Maternal Health Conference in Arusha, Tanzania --- whether in person at the Arusha International Conference Center, or watching via archived videos online. (All times are listed in Eastern Africa Time: UTC/GMT +3 hours. Sessions will be recorded and available within 24 hours.)

Sessions: Tuesday, January 15

Improving access to essential maternal health medicines (Track 3): 13:30–15:00 · Simba

Moderator: Deborah Armbruster, USAID

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