STRIDES for Family Health

{Photo credit: Katy Doyle/MSH, Lesotho}Photo credit: Katy Doyle/MSH, Lesotho

For more than three years, TOMS Giving (TOMS), and Management Sciences for Health (MSH) have partnered to address critical health and social issues facing mothers and children in rural sub-Saharan Africa.

Together, MSH and TOMS have helped nearly 1,000,000 moms and kids in Uganda and Lesotho stay healthy.  

How are MSH and TOMS ensuring a successful partnership? Utilizing complementary innovation and expertise toward aligned social impact goals. TOMS is known for their innovative One for One® philanthropy model—for each pair of shoes that is purchased in higher-income countries, TOMS provides a pair of shoes for a child or caregiver in need—one for one. But often times, the logistics of providing these shoes in rural areas in Africa can be daunting. That’s where MSH comes in: For over 40 years, MSH has helped build locally-led, locally-run health systems in over 130 countries, including among the poorest and most vulnerable populations in some of the hardest-to-reach regions of the world.

{Photo credit: Warren Zelman.}Photo credit: Warren Zelman.

MSH spoke with Fabio Castaño, MD, MPH, global technical lead of family planning and reproductive health about MSH’s approach to family planning and what will define the future of family planning and global health. Below is part one of the conversation. 

What is MSH’s approach to family planning and reproductive health?

[Dr. Fabio Castaño.]Dr. Fabio Castaño.Fabio:

First of all, I have to tell you that MSH has been working on family planning [FP] for over 40 years. Our first-ever international program was working with Korea! We supported their successful story of making FP an essential part of public health activities. At that time, we worked on FP from a standpoint of population control. Then, to help improve the health situation, and also contributing to reducing poverty. So, that is an interesting piece of history for MSH.

Celia Tusiime Kakande. {Photo: Tadeo Atuhura/MSH.}Photo: Tadeo Atuhura/MSH.

For most of my life, women in Uganda---as in most countries---were treated as inferior to men. Girls were less likely to be educated than their brothers, and had little control over the direction of their lives. Many girls grew up being told how to act, eat, and talk; many women were regarded as little more than domestic caregivers. However, in 1986 the ruling government radically changed the dynamics of Ugandan women in global development and their participation in decision-making at all levels of government. This International Women’s Day we, in Uganda, are celebrating this transformation with a theme of “connecting girls, inspiring futures,” and wishing women around the world similar progress and success.

Women Lead: Government

Women in Uganda now hold more leadership positions than ever before—35 percent of the seats in Parliament are now occupied by women, and our Speaker of Parliament and Minister of Health are women. The introduction of universal primary education has allowed more girls to begin their schooling, and affirmative action at the university level has provided more women the opportunity to realize their dreams for fulfilling professional careers.

Celia Tusiime Kakande. {Photo: Tadeo Atuhura/MSH.}Photo: Tadeo Atuhura/MSH.

For most of my life, women in Uganda---as in most countries---were treated as inferior to men. Girls were less likely to be educated than their brothers, and had little control over the direction of their lives. Many girls grew up being told how to act, eat, and talk; many women were regarded as little more than domestic caregivers. However, in 1986 the ruling government radically changed the dynamics of Ugandan women in global development and their participation in decision-making at all levels of government. This International Women’s Day we, in Uganda, are celebrating this transformation with a theme of “connecting girls, inspiring futures,” and wishing women around the world similar progress and success.

Women Lead: Government

Women in Uganda now hold more leadership positions than ever before—35 percent of the seats in Parliament are now occupied by women, and our Speaker of Parliament and Minister of Health are women. The introduction of universal primary education has allowed more girls to begin their schooling, and affirmative action at the university level has provided more women the opportunity to realize their dreams for fulfilling professional careers.

Doreen Nalweyiso happily holding her twins. {Photo credit: T. Athura/MSH.}Photo credit: T. Athura/MSH.

In July 2011, Doreen Nalweyiso, a 27-year-old woman living in Mpigi Town Council, Uganda attended her second antenatal visit at Mpigi Health Centre IV. She was surprised to be examined with an ultrasound machine--and even more shocked to be told that she was expecting twins!

“I was thrilled when the nurse showed me images of twins through the ultrasound TV scan. I had never experienced it in my lifetime,” she explained.

This was her first pregnancy and there was no history of twins in her family. Because carrying multiple fetuses can cause complications for both the mother and babies, Doreen received support from the health center throughout her pregnancy.

Since she knew her delivery could be complicated, Doreen traveled to Mpigi health facility to deliver by caesarian section.

If she hadn’t known she was carrying twins, Doreen might not have known to seek out specialized medical care during labor and delivery.

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.

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:

Meet Okata and his grandmother, watch the video.Meet Okata and his grandmother, watch the video.

On this World Health Day, we invite you to meet Okata, a 3-year-old orphan living with HIV, and his grandmother, his caretaker.

World Health Day, celebrated April 7th, marks the founding of the World Health Organization. This year's theme, "Good health adds life to years," encourages the global community to rethink what it means to be "old".

Watch the video, Building a Stronger Health System in Uganda, and share Okata's story with your network of family and friends.

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.

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