Africa

Cynthia Isioma, Nigeria

In the village of Owa Ofie, Nigeria, Cynthia Isioma, a young girl who has survived enormous odds reclaimed her dream of secondary education.

Cynthia lost both parents at the age of two and was left in the care of her grandmother who died three years later. Cynthia’s situation grew more challenging when she was then moved to her blind grandfather’s home at the age of five.

Rather than receive care, Cynthia had to take on the responsibility of caring for her grandfather who could not afford to send her to school.  Cynthia became a child caregiver, providing for herself and her grandpa. Her daily duties included going to the forest to collect cocoyam, palm nuts, snails, and waterleaves to sell and for household use.

Cynthia’s situation changed when she was 13 years old and Rural Linkage Network (RULIN), a community-based organization based in Boji Boji, visited Owa Ofie to identify orphans in need of support. RULIN is supported by the USAID-funded, MSH-led Community Support for OVC Project (CUBS).

This blog post originally appeared on the US Agency for International Development's IMPACT blog.

Yodit Assefa (center) and procurement colleagues from PEPFAR’s Supply Chain Management System (SCMS). Photo credit: SCMS

As a procurement specialist with PEPFAR’s SCMS (the Supply Chain Management System) project, I am one of a growing number of women working in supply chain management in Ethiopia. I manage procurements of HIV/AIDS commodities---including the complex procurement of specialized medical equipment used to treat HIV/AIDS---as well as the vehicles that distribute those commodities.

Well planned, strategic procurement is a smart investment. Our team helps save money by minimizing costly unplanned and emergency procurements and buying low-value and bulky products locally.

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.

 

For 40 years, MSH has promoted equal access to health care for women by strengthening health systems and building the capacity of women as leaders and managers, technical experts, clinicians, and community health workers. Management Sciences for Health celebrates International Women's Day, March 8, 2011. Meet the women who inspire us.

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.

There have been a collection of high-profile and well attended mobile health (mHealth) “summits” held around the world in the past few years, including last month’s second annual mHealth Summit in Washington, D.C. (headlined by Bill Gates and Ted Turner), but the really interesting conversations are happening on the African continent. While large providers in the “developed world” are talking about the need for business plans and analysis, the debate in Kenya and Nigeria and Ghana is on how country-based leadership can scale up proven programs, develop sustainability, and provide practical and integrated models for cooperation between the government, mobile service providers, the medical community and the private sector.

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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