Women & Gender

{Photo credit: MSH/Democratic Republic of the Congo.}Photo credit: MSH/Democratic Republic of the Congo.

On this historic World Population Day --- the first with the world’s population at seven billion and growing --- we call your attention to a crucial summit in London happening today, and to the ongoing importance of supporting access to family planning and sexual and reproductive health.

The London Summit

Over one hundred high-level decision-makers are convening at The London Summit on Family Planning in hopes of securing a better future for women and girls globally. Hosted by the UK government and The Bill & Melinda Gates Foundation, with UNFPA and others, the summit seeks to provide an additional 120 million women in resource-poor countries with lifesaving contraceptives, information and family planning services by 2020.

Anna outside Kaginima Hospital, eastern Uganda. {Photo credit: M. Hartley/MSH.}Photo credit: M. Hartley/MSH.

“I knew I wanted to be a nurse since I was 10. A woman used to come home to my village in her nurse uniform on the weekends and she was so smart and nice. It was my goal,” said Anna.

Anna finished nursing school and her formal training in 1998 and started working in 1999. In 2000, she began working at Kaginima Hospital in eastern Uganda, where she still works today.

Kaginima Hospital is an expanding facility and uniquely has a lot of space for patients and services. The facility has a surgical theater with two beds and is well stocked with medical supplies. As a private, nonprofit hospital, Kaginima does not receive any support from the Ugandan government. The hospital relies on support from USAID, international organizations, faith-based organizations, and local nongovernmental organizations. They also charge nominal fees for the services directly to patients.

Rabi giving a public awareness lecture on HIV in her locality. {Photo credit: MSH, Nigeria.}Photo credit: MSH, Nigeria.

Rabi gives a public awareness lecture on HIV. (Photo credit: MSH, Nigeria)

Forty-year old Rabi Suleiman lives in Koko Besse area in Kebbi state, Nigeria. She is married without children. Rabi, who now lives with her third husband, recalls that her ordeal with illness and social ostracism began in 2009. Rabi’s three marriages were the result of her inability to conceive, and a continuous search for a partner with whom she could successfully bear children. In the course of her marriages she contracted HIV.

Weakened by continuous infections and emaciated beyond recognition, Rabi recalls that she was abandoned, equated to animal status and locked up in a hut meant for cattle in her family home. Her meals were pushed to her through a door opening by relations who refused to look her in the face.

Today, Rabi has a new story to tell. With the assistance of the Prevention Organizational Systems AIDS Care and Treatment (ProACT) project outreach team, Rabi was enrolled with the USAID-supported ProACT antiretroviral therapy (ART) program in the General Hospital, Koko, late in 2009.

Ramatu Fullah now ekes out a decent living selling acheke; her two children stand by her side. {Photo credit: ACEPT staff/MSH.}Photo credit: ACEPT staff/MSH.

Ramatu Fullah is a 27-year-old woman in the Pujehun district of Sierra Leone.  She comes from a poor family and, for years, had to earn her living as a sex worker to take care of her two children. Recently, Ramatu learned skills that enabled her to change her trade through an awareness-raising campaign supported by the USAID West Africa Regional Health Office's Action for West Africa Region II (AWARE II) project, managed by Management Sciences for Health (MSH). Today, Ramatu sells acheke, a local delicacy, on the streets of Sierra Leone.

Women and HIV & AIDS in Sierra Leone

{Photo credit: MSH.}Photo credit: MSH.

Over 100 conference delegates came together at the United Nations Conference on Sustainable Development last week in Rio de Janeiro, Brazil, to strategize smart solutions to global development and poverty reduction while promoting environmental concerns such as clean energy, sustainability, and equitable use of resources.  Popularly known as “Rio+20” --- for occurring twenty years after the 1992 Earth Summit  --- the three days of high-level meetings attended by heads of state and government and high level representatives resulted in “The Future We Want,” a 53-page document that outlines and renews global commitments to sustainable, earth-friendly development.

Three Afghan children. {Photo credit: MSH.}Photo credit: MSH.

About 7.6 million children under age five die each year of preventable causers; 3 million — 40 percent — are newborns (under 28 days old). Ninety-nine percent of these occur in developing countries; three-quarters are mainly due to preventable causes such as neonatal conditions, pneumonia, diarrhea, malaria, and measles. Many of these under-five deaths could be averted by known, affordable, low-technology interventions.

Any preventable child death is one too many.

Here are 10 important interventions for child survival --- a list that is by no means exhaustive:

  1. Exclusive breastfeeding

    Could keep 1.3 million infants from dying (including by preventing pneumonia)

  2. Long-lasting, insecticide-treated bednets

    Would save more than 500,000 children by preventing malaria

  3. Vaccines, such as PCV, Hib, and rotavirus

    Would help prevent common childhood illnesses, such as measles, and save children’s lives

  4. Micronutrient supplements, such as vitamin A and zinc

    Would fight malnutrition. (While not a direct cause of death, malnutrition contributes indirectly to more than one-third of these deaths.)

Sophia is now the go-to person for family planning and reproductive health services at Rwesande health center IV in western Uganda. {Photo credit: M. Hartley/MSH.}Photo credit: M. Hartley/MSH.

Sophia is a humble woman. She has been working as a nurse for 10 years, and is currently one of five nurses posted at Rwesande health center IV in the hills of western Uganda.

When I arrived I was impressed by the number of services the health center offers, and the general appreciation felt around the compound. Rwesande health center IV has a maternity ward to safely deliver babies; counseling areas for family planning, reproductive health, and HIV; a general ward, a surgery theater, and health education space.

Family planning counseling and services now available

As Sophia shows me her meticulously-kept record books I can see the pride she takes in her work. She explained how women are now coming and asking for family planning services.

Not too long ago clients were not coming, and the nurses didn’t have proper training on methods to offer clients.

While global health and policy efforts to protect young girls from early or forced marriage are increasing, millions of girls are forced into early marriage every year. Pictured: four Senegalese girls. {Photo credit: S. Galdos/MSH.}Photo credit: S. Galdos/MSH.

If you think that child marriage is not an issue in the twenty-first century, think again.  In developing countries, 82 million girls who are now ages 10 to 17 will be married before their 18th birthday. Over the past decade, 58 million girls in developing countries -- one in three -- have been married under the age of 18; 15 million -- one in nine -- were married by age 15.

These girls are often married against their will, despite national laws that prohibit marriage until the age of 18, and numerous international declarations, conventions, and global conferences that “guarantee” the rights of girls, like the Universal Declaration of Human Rights.

Senate Passes Preventing Child Marriage Act

Child marriage is increasingly becoming a hot topic within the realm of global health -- and influencing U.S. domestic and global policy.

The International Protecting Girls by Preventing Child Marriage Act (S. 414) -- reintroduced in the U.S. Congress in February 2011 --- passed on the Senate floor by way of voice vote on May 24, 2012. (The bill also passed the Senate unanimously in December 2010.)

Scott Kellerman, around age 5. {Photo courtesy of S. Kellerman.}Photo courtesy of S. Kellerman.

The prevention of mother-to-child transmission (PMTCT) of HIV is taking center stage this week during USAID’s 5th Birthday campaign -- and rightly so.  Preventing mother to child transmission of HIV is one of the most critical, effective tools to helping kids reach their fifth birthdays.

Arifa leads a computer class at FACT in Guyana. {Photo credit: MSH.}Photo credit: MSH.

When Arifa arrived in August 2010 at Family Awareness Consciousness Togetherness (FACT), a USAID-funded non-governmental organization (NGO) that receives technical support from the MSH-led GHARP II Project, it was immediately evident that she had major communication challenges. At age 17, Arifa found it difficult to have even brief conversations with anyone.

The Berbice Technical Institute had sent Arifa to FACT as a work-study student for a two-month term. At the time, she was studying for a Certificate in Information Technology (IT).

FACT assigned Arifa to be an assistant teacher in their computer program with 40 orphans and vulnerable children (OVC), ages twelve to fifteen. Most of the time, Arifa could be found sitting in a corner all alone. When she did speak, the children made fun of her.

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