Women & Gender

Ezekiel Kyasesa, village health team coordinator in western Uganda. {Photo credit: Margaret Hartley/MSH.}Photo credit: Margaret Hartley/MSH.

Ezekiel Kyasesa is a village health team coordinator and supervisor in Kasese District, western Uganda. He supports 11 villages, 90 parishes, and 2 health centers.

Ezekiel has been working in community health for a few years, but only on a small scale. A year ago, he was selected to attend a training provided by STRIDES for Family Health to learn new family planning, child survival, and reproductive health information and the skills to become a village health team member. He was then nominated by his peers to become the coordinator and supervisor.

Now Ezekiel is educated and has the skills to go out to the communities and talk to people about the benefits of going to the health center for a range of services. The village health teams are a crucial link to sharing knowledge and information between the clinics and the communities.

Ezekiel and his village health team visit 10 households two days each week (20 visits per team member each week). He explained that they discuss with the mothers --- the key person to a healthy family --- four topics:

A physician assesses a mother and children for malaria at a health center in Bujumbura, Burundi. {Photo credit: Rima Shretta/MSH.}Photo credit: Rima Shretta/MSH.

Today, April 25th, Management Sciences for Health (MSH) joins the global community marking World Malaria Day. "Sustain Gains, Save Lives: Invest in Malaria" -- the theme of this year's World Malaria Day -- recognizes this crucial juncture in the global fight against malaria.

Significant gains have been made in the last ten years; since 2000, malaria mortality rates have decreased 25 percent globally, and 33 percent in Africa. However, progress could be reversed unless malaria continues to be a priority for global, regional, and national decision-makers and donors.

Burundi, Democratic Republic of the Congo (DR Congo), South Sudan, and Uganda are among several MSH countries commemorating World Malaria Day with malaria awareness activities and events, including health talk sessions at football (soccer) games and drama activities with kids.

Speakers at the Inaugural Conference on Global Health, Gender and Human Rights. {Photo credit: PAHO/WHO.}Photo credit: PAHO/WHO.

Health is a human right and should not be denied based on any factor, including gender, ethnicity, or socioeconomic status.

On March 21 and 22, 2012, law students, global health professionals, and human rights experts gathered at the Inaugural Conference on Global Health, Gender and Human Rights at American University to discuss tackling global health issues from a human rights perspective.

Co-hosted by the American University Washington College of Law, the Pan American Health Organization (PAHO), and the Royal Norwegian Embassy in Guatemala, the two-day conference focused on six crucial topics: disabilities, women's and adolescent girls’ health, gender identities, older persons, access to medicines, and tobacco control.

Speakers and participants articulated the important role gender and human rights play in the promotion of health around the world.

Dr. Sima Samar speaking on 'How to advance women's rights in developing countries.' {Photo from World Bank webcast, March 5, 2012.}Photo from World Bank webcast, March 5, 2012.

On Monday, March 5, 2012, everyone from policymakers to students gathered at the World Bank for a Special Event on the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) and Women’s Rights.

CEDAW is a treaty that has been ratified worldwide by all but six countries --- the United States, Iran, Sudan, Somalia, and two small Pacific Island nations (Palau and Tonga).

The event was hosted by Caroline Anstey, Managing Director of the World Bank, in conjunction with the Nordic Trust Fund, The Leadership Conference Education Fund, and the United Nations Foundation.

Video that highlights the work of thousands of Tanzanians---mostly women---working as accredited community drug sellers operating in rural areas.Video that highlights the work of thousands of Tanzanians---mostly women---working as accredited community drug sellers operating in rural areas.

Today is International Women’s Day, celebrated around the world as an opportunity to look back on women’s accomplishments and look forward to the realization of their full economic, political, and social rights. The United Nations theme for this year, “Empowering Rural Women,” is one that resonates powerfully with MSH’s work.

A midwife in Wau, South Sudan. {Photo credit: MSH.}Photo credit: MSH.

Josephine, a wife and mother of six living in rural Uganda, tried to soothe her 3-year-old daughter. The girl was suffering from diarrhea and a high fever and her crying filled the home. Recognizing that the girl's health was in danger, Josephine summoned the courage to ask her husband for permission to take their second-youngest child to the local health facility unit -- and pleaded for money to cover the travel and treatment expenses.

Requesting permission from her husband to travel to the facility was not her only choice, however: choosing to take her daughter for treatment also meant leaving her other children -- including her youngest -- unattended at home. Once at the health center, she continued to navigate the challenging road to treatment for her daughter, communicating her situation to the health providers and negotiating the financial and provider aspects of the health center system, without assistance. Relieved and exhausted, Josephine returned home safely with her daughter, oral rehydration salts, and knowledge.

Recognizing women leaders

What makes a person in the health system a good leader? Who determines that he or she is a leader? How do we empower leaders to improve the health of those around them?

Mbambu, a midwife at a western Ugandan health center. {Photo credit: MSH.}Photo credit: MSH.

Mbambu is a midwife who works at Isole Health Center III in rural Western Uganda. When I had the opportunity to visit with her, she was the only health care provider at the center. Trained as a midwife nine years ago, her passion for her job pours out of her. Since primary school, becoming a midwife "was always my mission,” she said.

A little over a year ago, Mbambu was trained in family planning and reproductive health skills by STRIDES for Family Health, a USAID-funded program in Uganda led by MSH. Prior to the training, the health center could only offer education and basic family planning services.

Now Mbambu educates women who are waiting to have their children immunized or receive antenatal treatment about family planning, healthy spacing and timing of pregnancies, and the benefits of delivering at a health center. Her new skills also empower her to administer basic and long-term family planning services.

Mbambu shared a compelling story that I promised I would share with others:

Women learning about family planning at Bikone Health Center II, Western Uganda. {Photo credit: MSH.}Photo credit: MSH.

This was my first trip to Africa working with a development agency. While I had visited the African continent for personal trips previously, arriving in this context felt different. I was immediately aware of the challenges Uganda is facing. From the crumbling road infrastructure and high incidence of traffic accidents in Kampala, to the mobile phone networks that are pretty reliable while internet access is often spotty, to the prevalence of street children --- I can for the first time see what my local colleagues are up against.

I felt a bit overwhelmed in the first few days. Is there any way we can address all these challenges? Can we make a difference?

Visiting communities and health centers in Kampala, Eastern and Western Uganda -- and seeing first-hand the impact MSH is having across the country -- quickly re-inspired me.

I had the pleasure of meeting a particularly passionate and committed Clinical Officer, Rodger Rwehandika, at Bikone Health Center II in Western Uganda. As a health center II, Bikone is an outpatient facility, but the staff of the facility can also conduct outreach programs to educate and serve the community.

Rodger and his two staff facilitate health education programs at the local schools and also host youth-friendly programs on using condoms.

Norah Nakato (right) receiving care from Fausta Nalukwago, midwife at Mpigi Health Center IV in Uganda. {Photo credit: MSH}Photo credit: MSH

Norah, a 21-year-old teacher at a private school in Nansana, Uganda, did not know she was pregnant. Pain in her lower abdomen prompted her to go for a consultation at a private clinic in Nansana, where a urine test revealed the pregnancy. “I was shocked because I had last had my period on the 15th of that month,” Norah said.

At the clinic, Norah was given an antibiotic and a pain killer to relieve abdominal pain. Norah left the clinic excited about her pregnancy. But, two weeks later, the pain persisted and Norah began bleeding. Her mother advised her to go to Mpigi Health Center IV for an ultrasound.

At the health center, Norah saw a problem on the ultrasound screen. “The doctor showed me what was in my uterus and there was no baby," Norah said. "It was swollen with liquid and unclear substances. He said the substance had to be removed. I was very scared."

After counseling from the doctor, Norah was admitted and given medication to induce labor. When the contractions began, she was taken into surgery.

The doctor advised her to wait at least one and a half years before conceiving another child to allow time for her uterus to heal and the abnormal hormone levels to normalize.

Mildred Akinyi sitting by a family planning unit in Masafu sub-county, Uganda. Photo: MSH.

 

Post updated February 2, 2012.

Mildred Akinyi had abdominal pain for some time before she attended a reproductive health workshop for HIV positive couples at Masafu Hospital in Uganda in July 2011.

“I always felt pain in my abdomen, and would take a lot of panadols to ease the pain. I did not know what was wrong with me," Akinyi said. "When I heard from the case manager at Masafu hospital that STAR-E had organized for women living with HIV and their partners to be screened for cervical cancer and sexually transmitted infections (STIs), I could not wait to use that chance to get checked.”

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