Family Planning

Women waiting for health services outside of Tambura PHCC, South Sudan.

 

Sitting under the lush mango trees in rural Tambura, South Sudan, I realized Mother’s Day was approaching and I needed to send my mom in Chicago a gift. More and more each year, I treasure my mom, who raised four children. But this year, while working on a health project in South Sudan, my appreciation and wonderment is also for mothers worldwide.

Dr. Ronald O'Connor, Founder of MSH, and Marcia Herrera, Director of Talent Management at MSH, co-authored this blog post.

Dr. David Sencer died on Monday, May 2, 2011 in Atlanta, Georgia at age 86. He died at Emory University Hospital, due to complications of heart disease.

Dr. Sencer, one of the major twentieth century public health thought leaders, was also one of the rarest: a warm-hearted, modest man of great accomplishments and lifelong dedication to Management Sciences for Health's mission of closing the gap between what is known and what is done to solve important public health problems around the world.

From 1986 until his retirement in 1993, Dr. Sencer was a valued MSH colleague and advisor; he served in the roles of Chief Operating Officer and Senior Fellow. Dr. Sencer led by empowering others; he believed that more could and would be done when leaders put the action, and often the visibility, in the hands of those most directly on the front lines of practical public health action.

Indeed, Dr. Sencer was doing it long before MSH was conceived, in a career that spanned many personal and professional challenges: Dr. Sencer overcame tuberculosis as a young physician and went on to lead many important health initiatives and institutions.

It’s common sense that a mother who is on treatment for AIDS, pregnant, has a sick child, and is accompanying a sister debilitated by Tuberculosis should not have to visit four separate service delivery points to receive care. Integrated health services not only make the world a healthier place, but also decrease the burden on health systems.

Integration is a comprehensive approach to service delivery. It is the transition from a vertical or horizontal approach to a diagonal, synergistic approach at all levels of a health system. Smart integration means coordinating disease specific programs (such as HIV and AIDS) with other health programs that have operated independently in the past (for example, family planning) to deliver services at the same time or, more importantly, with the same funding. Integration helps organizations maximize the impact of their health investments while allowing people, information, and funding to flow more easily among collaborating groups and stakeholders. Equally important, integration enables providers to treat the health needs of individuals and families more efficiently---regardless of the initial reason a person seeks care.

This is a guest post from Olive Mtema, Policy Advisor, from the Community Based Family Planning and HIV & AIDS Services project in Malawi. Olive is an employee of the Futures Group.

On March 12, 2011, Muslim Leaders gathered in Lilongwe, Malawi for a conference on Reaffirming Muslims' Positions on Family Planning and HIV & AIDS Issues. The conference was hosted by the USAID-funded Community Based Family Planning and HIV & AIDS Services project (CFPHS) in collaboration with the Malawi Ministry of Health, Reproductive Health Unit (RHU); Muslim Association of Malawi (MAM); and Quadria Muslim Association of Malawi (QMAM). CFPHS is led by MSH, with Futures Group and Population Services International as key implementing partners.

This is a guest blog post written by Derek Lee from Pathfinder International.

The donkey cart ambulances were built by local craftsman.

On October 15, 2010, dozens of Kenyan women in bright headscarves gathered beneath the acacia trees scattered outside Balambala sub-district hospital.  The area chief was in attendance, as were members of the local women’s livelihood groups.  Despite the oppressive heat, everyone was in jovial spirits because this sunny day marked a momentous occasion for their “Care for the Mother” project.

Last week, the United Nations Commission on Population and Development (CPD) met in their 44th session to negotiate next steps on a resolution for fertility, reproductive health, and development.  The Commission helps inform the United Nations (UN) on their global efforts and provides crucial recommendations to form UN Resolutions.

MSH, with over 80 partners and advocacy organizations, sent an open letter to the delegates of the 44th session. Together, we called on the Commission on Population and Development to:

Over the course of the past ten days, I have been fortunate to visit the Central, Eastern, and Western Regions of Uganda.  As part of these visits, I have traveled through and spent time in many of the districts in these regions. It is during these drives through the countryside that I have noticed the campaigns for family planning services over and over again. Though it is possible my eye is fine tuned to notice these signs, as I am here supporting STRIDES for Family Health (a MSH-led, USAID funded family planning, reproductive health, and child and maternal health project), it would be hard for anyone to miss the cheerful rainbows that are posted on signs outside many of the health centers and hospitals indicating that family planning services are provided in that facility.

Signs promoting available family planning services in Uganda, March 2011.

 

The Global Health Initiative (GHI) and its approach of integrating health programs with HIV & AIDS, malaria, tuberculosis, maternal, newborn, and child health, nutrition, and family planning and reproductive health is in line with the current approaches and health priorities of the Government of Malawi.

Malawi, with a population of slightly over 13 million people, has 83% of its people living in the rural hard to reach, underserved areas. The biggest health challenge facing the country is access to basic health services by the rural population. The problem of access to health services is multifaceted. For instance, family planning services are mostly facility-based, contributing to a low Contraceptive Prevalence Rate of 28% and high unmet family planning need of 28% (Malawi Demographic and Health Survey, 2004).

However, there is also a critical shortage of trained health service providers and availability of contraceptives is a logistical nightmare in Malawi. Making a routine mix of all contraceptives accessible to women of reproductive age regularly in rural communities can avert unwanted pregnancies and maternal deaths, and reduce high total fertility rate and infant mortality rate. Rural people walk long distances to seek health services, sometimes only to return without a service due to shortage of health personnel and stock-out of supplies.

Halida Akhter receiving the United Nations Population Award in 2006.

Bangladesh, which is situated in a resource poor setting with a population of over 150 million, faces the major health challenge of a high maternal mortality rate. In the 1970s, the maternal mortality rate was 700 deaths per 100,000, and now it is still at 320 per 100,000. Although Bangladesh has made progress in reducing its infant mortality, much progress needs to be made to reach the Millennium Development Goals for maternal mortality. Bangladesh will need more than five years to achieve the goals. The Global Health Initiative (GHI) will help address the major health challenges women face in Bangladesh. Bangladesh has successful models of collaboration and public-private partnerships to share with other countries.

On this World AIDS Day, we reflect yet again on progress made toward global commitments to fight the HIV epidemic. According to UNAIDS, new infections have decreased this past year from 2.7 million to 2.6 million, but, 30 years into the epidemic, only 5.2 million people out of the estimated 15 million who need drugs have access to treatment. Stigma, discrimination and human rights violations against persons living with HIV still exist, even in countries with generalized epidemics.

Integrated HIV programming across the entire health system can minimize many of these barriers to HIV prevention, care and, treatment.

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