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5thBDay badge in white background.5thBDay badge in white background.

Every child deserves a fifth birthday. It seems simple enough. But for many children in the world — especially in countries with the highest burden of child mortality, such as India, Nigeria, Democratic Republic of the Congo (DRC), Pakistan and Ethiopia — preventable deaths will claim their lives, before they reach the age of five.

Today, USAID launched an ongoing child survival awareness campaign, called, “Every Child Deserves a 5th Birthday.”

The “5th Birthday” campaign kicked off with a briefing event at Kaiser Family Foundation, featuring USAID Administrator Dr. Rajiv Shah and other experts. Dr. Shah and colleagues stressed that reducing the burden of child mortality is critical to our future as a global community.

While the global community has made great strides reducing child mortality, inequality in child mortality remains: several regions and countries continue to shoulder the greatest burden and loss of life.

A woman and baby rest at St. Josephs' Health Center -- the only health institution in Abricots, Haiti. {Photo credit: MSH.}Photo credit: MSH.

Suzanna Ile, a 26-year-old woman from South Sudan, lost her first two babies in childbirth. Suzanna did not have a nurse or midwife to tell her that her pelvis was dangerously small for childbirth; nor was there a safe place for a caesarian section even if she had known the risk.

Suzanna’s experience is typical of what women have faced in South Sudan, the newest country in the world. South Sudan is home to 10 million people, spread across an area about the size of France. The people have experienced civil war off and on for five decades --- hardly anyone remembers a time without conflict. In places like the capital city of Juba, the infrastructure has been seriously damaged. The conflicts have devastated the economy and disrupted the education system.

South Sudan has some of the worst health indicators in the world. Health facilities are grossly understaffed as health workers fled the country: only ten percent of staff positions are appropriately filled. There are less than two doctors for every 100,000 people. A woman in South Sudan is five-hundred-times more likely to lose her life giving birth than a woman in Europe. Forty-five percent of children suffer from physical stunting due to malnutrition.

Women and child in Tambura, South Sudan. {Photo credit: MSH.}Photo credit: MSH.

Nearly 50 countries, including Afghanistan, Democratic Republic of the Congo, Haiti, Liberia and South Sudan, are considered a fragile or conflict-affected state -- a state that is in conflict, recovering from conflict or crisis, or a state that has collapsed or has a strong and repressive government. Over nearly 40 years of working in fragile states, Management Sciences for Health (MSH) has identified best practices, lessons learned, and appropriate interventions for a myriad of situations in fragile states.

MSH takes an integrated approach to building high-impact sustainable public health programs that address critical challenges in leadership, health systems management, health service delivery, human resources, and medicines. Wherever our partnerships succeed, the positive impact of good health has a ripple effect, contributing to the building of healthy nations.

MSH works collaboratively with health care policymakers, managers, providers, and the private sector to increase the efficacy, efficiency, and sustainability of health services by improving management systems, promoting access to services, and influencing public policy.

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.

Women, men and children stand in line at the St. Joseph's Health Center in Abricots, Haiti. {Photo credit: Gumy Dorvilmar/MSH.}Photo credit: Gumy Dorvilmar/MSH.

It was 11 o’clock one February morning when the Santé pour le Développement et la Stabilité d’Haiti (SDSH) project technical team arrived on site at St. Joseph Health Center.

The center’s activities were well underway. Dozens of people sat on benches or stood in line, waiting for their turn. One person comes to care for her child who has had a high fever. Another comes for contraception. Another just gave birth to a healthy infant.

St. Joseph Health Center is located in Abricots, a remote community in the department of Grande’Anse, Haiti, far from Port-au-Prince. Abricots is nearly inaccessible because of rough terrain and hazardous mountain trails.

Since 2007, with support from the USAID-funded SDSH project, led by Management Sciences for Health (MSH), St. Joseph Health Center has provided a basic package of health services: pediatrics, maternal health, reproductive health, detection and treatment of sexually-transmitted infections, HIV/AIDS, tuberculosis (TB) and family planning.

This free clinic is the only health institution in this hard-to-reach area, serving an estimated 32,000 people.

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.

Voices of TB participants (from left): David Rochkind (moderator); Rachel Urduno (Mexico/Texas); Andre Gariseb (Namibia); Pham Thu Hoa (Vietnam); Francis Apina (Kenya); Rosalie and Faith Stephson (Philippines/Texas); Endalkachew Fekadu Demmisse (Ethiopia). {Photo credit: Claire Moodie/MSH.}Photo credit: Claire Moodie/MSH.

Cross-posted on TB-CARE I.

World TB Day, March 24th, was commemorated in many countries around the world last week to acknowledge the accomplishments made in the fight against tuberculosis (TB), and to call attention to the work that still needs to be done.

Voices of TB, a unique event organized by USAID, featured former TB patients speaking about their personal fight against TB. Survivors of TB from Ethiopia, Kenya, Namibia and Vietnam --- four TB CARE I-supported countries --- and from the United States, spoke at the event on March 22 in Washington, D.C.

(Left to right) Aaron Musiimenta, assistant regional behavior change communication officer; Tadeo Atuhura, STRIDES for Family Health communications specialist; Dr. Baseka Yusuf, district health officer; and Kevin Kisembo, principal nursing officer and STRIDES focal person. Kasese, Uganda. {Photo credit: Margaret Hartley/MSH.}Photo credit: Margaret Hartley/MSH.

The Kasese district in western Uganda is nestled between two national parks. Located hours from the capital city, Kampala, the region attracts tourists to view gorillas and mountain birds.

During my recent trip to Uganda, I met with Dr. Yusuf Baseka, the district health officer of Kasese, who described the health challenges his district faces, and his hopes for the future.

Although the national parks are beautiful and bring a much needed economic boost to the area, they also offer a challenge, Dr. Baseka explained.  The population growth and fertility rate of the district are very high. With the two national parks, there is no land for expansion. The town of Kasese is rapidly becoming a slum with unsanitary conditions that are difficult to address.

Another challenge in his district is that children are not going to or staying in school. They are leaving secondary school early and engaging in risky sexual behaviors. He explains, “We’ve seen a dramatic increase in young mothers, under 18 years, some as young as 12.” Their pregnancies offer unique challenges for the health system to address.

Godgift and his caregiver receiving educational supplies from the Executive Director of Synergycare Initiative. {Photo credit: Anayo Chike Charles/MSH.}Photo credit: Anayo Chike Charles/MSH.

Early one morning Mrs. Fred woke up and found a boy outside her house. Alarmed and curious, she asked him why he was there. Godgift, as he identified himself, told her that the continuous appearance of a snake where he lived forced him to abandon the place he called home, after numerous futile attempts to frighten it off with pepper. Highly disturbed, she arranged for him to eat in a nearby restaurant whenever he showed up by her house.

The boy, Godgift Henshaw, is 13 years old. Godgift's mother took him along when she left her husband and eloped with another man. When the burden of care got too heavy, she left Godgift with her mother in Agbia community, Bayelsa State, Nigeria. Godgift’s grandmother beat and neglected him. Most of the time he went without food and often slept outside the house. Finally, she labeled him a wizard and abandoned him, fleeing from their home.

The landlord evicted Godgift when there was no one to pay the rent. He took refuge in an uncompleted building in a nearby bush, completely at the mercy of the elements. Abandoned and stigmatized (following his identification as a wizard), he fed himself by doing odd jobs.

Originally known as SITE-TB, Sistema TMBR is the official platform for drug resistant TB monitoring and treatment in Brazil.Originally known as SITE-TB, Sistema TMBR is the official platform for drug resistant TB monitoring and treatment in Brazil.

In the 1990s many Brazilian patients infected with tuberculosis (TB) were not being cured, despite starting treatment. Some patients stopped taking their medication, which led to the reemergence of TB. In 1993, the World Health Organization declared that TB was a global emergency. Eventually, a multi-resistant strain of TB surfaced, making it even more difficult to fight the disease.

These occurrences --- referred to as “chronic cases” --- became apparent in some Brazilian states, but health units lacked standardized management systems to treat these cases of TB.

Centro de Referência Professor Hélio Fraga (CRPHF), which is Brazil's National Tuberculosis Reference Laboratory, took control of TB surveillance in 1994. CRPHF defined a more effective treatment scheme and a national network to register and monitor the chronic cases in 1999. CRPHF builds human capacity through training and carries out operational and epidemiological studies. They also evaluate TB and other lung disease control activities and function as a Macro Regional Reference Lab.

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