Women & Gender

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.”

All key indicators for SHTP II improve from FY10 to FY11: Diphtheria, Pertussis, Tetanus, third dose (DPT3); Intermittent Preventive Therapy, second dose (IPT2); first and fourth antenatal care visits (ANC1, ANC4); skilled birth attendant (SBA) deliveries; and family planning (FP) visits.

 

All project health indicators for the second phase of the USAID-funded Sudan Health Transformation Project (SHTP II), led by Management Sciences for Health (MSH) in partnership with the International Rescue Committee, have shown improved performance over the past two years.

On the ground, this means that more people are being immunized against diseases, communities are receiving education on HIV, and lives are being improved.

Over 2,300 delegates, many colorfully dressed, gathered in Dakar, Senegal  at the jam-packed amphitheatre and two exterior tents of Le Meridien President for the start of this week’s 2nd International Family Planning Conference, sponsored by the Bill and Melinda Gates Institute for Population and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health. Monica Kerrigan, of the Bill and Melinda Gates Foundation, said that one third of Africans live in francophone Africa, and yet it has been the most neglected area for family planning services. She praised Senegal for hosting the first family planning conference in French-speaking Africa and urged Senegal to use this opportunity to act boldly and make family planning an urgent priority.

Jessica Poni is a midwife in Panthou Primary Health Care Center -- the only primary health care center in Aweil South County in Northern Bahr al Ghazal, South Sudan. Panthou Primary Health Care Center is managed locally by the International Rescue Committee (IRC), the implementing partner of the USAID-funded Sudan Health Transformation Project (SHTP II), led by MSH.

Leafing through Malawi’s Nation newspaper, the headline, 'wild men in society escalating rape cases' jumps off the page. I pause and stare at the accompanying photo and caption.

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