FEATURED POST

Focusing on key populations affected by HIV: A smart investment for greater impact

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GenderHealth

Research on key populations leads Botswana to smarter HIV prevention

By Mike Merrigan, Regional Technical Advisor and Kerry Aradhya, Science Writer, FHI 360

At approximately 18 percent, the prevalence of HIV in Botswana’s general population is one of the highest in the world. As a result, national HIV prevention efforts have focused more intensively on the general population than on other populations. Little is known about key populations, such as female sex workers and men who have sex with men, whose behaviors are both stigmatized and illegal in Botswana.

In 2012, the Botswana Ministry of Health used an integrated behavioral and biological surveillance survey to estimate population sizes and prevalence of HIV and sexually transmitted infections (STIs) among female sex workers and men who have sex with men. The study was historic. For the first time, it showed the HIV and STI burden among these two key populations and raised awareness about how they might have contributed to the generalized HIV epidemic.

The survey, carried out with technical assistance from FHI 360 through the Preventive Technologies Agreement (funded by the U.S. Agency for International Development), uncovered a population of more than 4,000 female sex workers in the three districts where the survey was conducted. Among these female sex workers, HIV prevalence was 61.9 percent, and the prevalence of gonorrhea and chlamydia were both higher than 10 percent. The female sex workers had a mean of more than seven partners per week, and condom failure, which includes condom breakage and being paid or forced not to use condoms, was common. (more…)

Health

Improving HIV testing in targeted populations in India

By Bitra George, FHI 360 Country Director, India

At the 20th International AIDS Conference (AIDS 2014) in Melbourne, Australia, staff from FHI 360’s India office will present a poster on a study that shows improved HIV testing among clients of female sex workers. The study contributes to evidence about what works to strengthen HIV prevention.

Why focus research on the clients of female sex workers?
Recent studies from India suggest that the purchase of sex from female sex workers is most predominant in higher HIV-prevalence states, such as Andhra Pradesh, Maharashtra and Tamil Nadu. In India, there is a growing recognition of the importance of considering clients when looking to stop HIV transmission, and a number of prevention efforts under the national program have targeted these clients, most of whom are men.

Conducting surveys among clients of sex workers is challenging, because clients do not like to be identified. There is also little evidence that establishes clients’ risk of contracting HIV in India. To bridge this gap and to provide invaluable information on HIV trends and risk behavior, FHI 360 designed and managed the largest integrated biological and behavioral assessment (IBBA) for most-at-risk populations in India.

Collecting evidence to inform HIV programming
Conducted in 2006 and 2009, this cross-sectional survey interviewed approximately 10,000 clients of sex workers as part of Avahan (the India AIDS initiative). This program, funded by the Bill & Melinda Gates Foundation, gathered evidence to inform future HIV prevention programs in India. The IBBA survey was implemented by the institutes of the Indian Council of Medical Research, and technical support was provided by FHI 360. (more…)

Health

Focusing on key populations affected by HIV: A smart investment for greater impact

By Ward Cates, FHI 360 Distinguished Scientist and President Emeritus and Kimberly Green, FHI 360 Chief of Party, Ghana

A version of this blog originally appeared on The Lancet Global Health blog. We are reprinting with permission. You can view the original post here.

In an era of limited resources, HIV prevention, care and treatment efforts need to focus on the smartest investments. This means investing in programs that can have the greatest impact in halting HIV transmission and turning back the epidemic. From a public health perspective, the effective use of resources requires focusing on key populations who have the highest level of HIV infection and tackling the barriers that discourage and prevent them from accessing health systems and services. These populations are broadly defined as sex workers, men who have sex with men, transgender persons and persons who inject drugs.

As the world gathers at the 20th International AIDS Conference (AIDS 2014) in Melbourne, Australia, July 20–25, 2014, we have an excellent opportunity to share how investing in evidence-based strategies can change the trajectory of the epidemic once and for all. (more…)

EducationGenderYouth

Too young to wed: The high price of early marriage

By Carina Omoeva and Rachel Hatch, FHI 360 Education Policy and Data Center

Photo: Jessica Scranton/FHI 360

Today, we celebrate Malala Day, a commemoration of girls’ empowerment and gender equality across all areas of human development. Like Malala Yousafzai, thousands of girls around the globe are dedicated to pursuing their education and choosing their life path yet are prevented from realizing their full potential. For the vast majority of these girls, the greatest barrier to schooling is not the bullets of terrorists — it is the day-to-day economic pressures and the unequal social expectations they face as they enter adolescence and young adulthood. It is a sad reality that in the 21st century, many girls are forced into marriage and starting a family as early as age 14, which brings their educational aspirations to a halt.

Teenage, Married, and Out of School, a new study by the FHI 360 Education Policy and Data Center, highlights the heavy toll early marriage inflicts on school participation among adolescent girls in nine countries of east and southern Africa. While the universally ratified 1990 African Charter on the Rights and Welfare of the Child (ACRWC), as well as national legislation in all nine countries, protect children against marriage before age 18, early marriage is still visibly present across the region. Some countries, such as Rwanda, have managed to bring this disturbing phenomenon down to a minimum, while marriage at age 14 through age 17 appears to be fairly commonplace in others (Figure 1). (more…)

GenderHealthYouth

The role of youth sexual and reproductive health in individual and national development

By Kate Plourde, Technical Officer and Robyn Dayton, Senior Technical Officer, FHI 360

A version of this blog originally appeared on the Interagency Youth Working Group’s Half the World blog. We are reprinting with permission. You can view the original post here.

In honor of this year’s World Population Day, the theme of which is youth engagement and the sustainable development agenda, we are reflecting on youth — our future leaders, parents, entrepreneurs and citizens. Today’s generation of young people is the largest in history: there are 1.8 billion people between the ages of 10 and 24 on the planet. In many countries, more than half of the population is under age 25, creating opportunities for national economic growth but also underscoring the need for greater investment in their health — with consequences that will affect the world’s social, environmental and economic well-being for generations.

Investment in young people’s sexual and reproductive health in particular ensures that young people are not only protected from HIV and other STIs, but also that they have the number of children they desire, when and if they wish to have them. The ability to control one’s fertility increases individuals’ productive capacity and can lead to a decline in a country’s dependency ratio (number of working citizens compared to nonworking citizens). When the dependency ratio declines in conjunction with adequate investments in youth education and economic opportunity, per capita income can increase — a phenomenon known as the demographic dividend.

Unfortunately, many young people do not have access to the critical sexual and reproductive health information and services required to stay healthy and avoid unintended pregnancy. Many young women report not wanting to become pregnant, but the level of unmet need for contraception among adolescents is more than twice that of adults. In some regions of the world, the unmet need for contraception among adolescents is as high as 68 percent. Fulfilling the unmet need for contraceptives among adolescents alone could prevent an estimated 7.4 million unintended pregnancies annually. (more…)

Health

A bold plan for ending HIV and AIDS in New York State

By Dr. Timothy Mastro, FHI 360 Director, Global Health, Population and Nutrition

Dr. Timothy MastroFor more than thirty years, health care providers, program implementers, policymakers and academic researchers have strived to meet a goal that once seemed impossible: a world without AIDS.

The fourth decade has brought hope, based on extraordinary progress in learning how to combine HIV treatment and prevention. However, much work remains to be done, including in the United States where, according to the U.S. Centers for Disease Control and Prevention, the groups most seriously affected are gay, bisexual and other men who have sex with men, and, in particular, young African-American men who have sex with men.

On June 29, 2014, Governor Andrew Cuomo of New York announced an initiative designed to achieve an AIDS-free generation in his state by 2020. Governor Cuomo’s three-pronged plan focuses on improved testing, preventing the spread of the virus and providing better treatment for those living with HIV.

At FHI 360, we applaud Governor Cuomo’s bold plan to end the HIV epidemic in New York State. We currently have the scientifically proven prevention and treatment tools to stop HIV transmission. Now, we need to commit to using these tools for all populations in order to end the epidemic in New York, the United States and globally.

We are encouraged to see Governor Cuomo take a brave stand against HIV and hope that others will join him. Together, we believe we can make a world without AIDS a reality.

HealthNutrition

Don’t forget about dad: Six strategies for getting fathers more involved in child feeding

By Ann Jimerson, Senior Specialist in Behavior Change, Alive & Thrive, FHI 360

Organizations around the world have committed to Every Woman Every Child, a multi-stakeholder movement to inspire action toward the United Nations’ Global Strategy for Women’s and Children’s Health. FHI 360, through the Alive & Thrive project funded by the Bill & Melinda Gates Foundation, commits to improving infant and young child feeding and maternal nutrition in several countries in Asia and Africa. This commitment is one way that FHI 360 is helping to meet the aim of Every Women Every Child — to save the lives of 16 million women and children by 2015.

Whether he’s aware of his influence or not, almost every father in every culture influences his family’s choices about how to feed the children. His everyday decisions about how many of the eggs the family’s chickens lay will be sold at market and how many will be kept at home for the family to eat can make the difference between a stunted child and one who reaches his or her full growth potential.

The Alive & Thrive project reviewed programs from around the world that were designed to engage fathers in child feeding, identifying the strategies that seem to make these programs work. Not surprisingly, the six strategies we identified in the most innovative “dads” programs echo sound principles from behavior change and social marketing. Our review indicated that, especially when program planners apply these six strategies, fathers’ actions can lead to real improvements in nutrition. (more…)

HealthNutrition

Bringing global attention to the need for reducing micronutrient malnutrition

By Rebecca Egan, FANTA Technical Advisor, Nutrition and Infectious Diseases, FHI 360

Today and tomorrow (June 20–21, 2014), the U.S. Agency for International Development (USAID) is calling attention to the critical role that nutrition plays in ending preventable child and maternal deaths. The emphasis on nutrition is part of a larger social media campaign, 20 Days of Action for #MomAndBaby, in anticipation of a June 25 high-level forum, Acting on the Call: Ending Preventable Child and Maternal Deaths.

Photo: Jessica Scranton / FHI 360

Good nutrition is critical in preventing child and maternal deaths. Deficiencies in micronutrients, such as iodine, iron, vitamin A and zinc, can lead to impaired physical and cognitive development, poor pregnancy outcomes (for example, a low birth weight baby), a weakened immune system, anemia, night blindness and even death. It is estimated that micronutrient malnutrition affects more than 2 billion people worldwide.

For more than a decade, the Food and Nutritional Technical Assistance (FANTA) project, funded by USAID, has been a key contributor to the global effort to reduce micronutrient deficiencies. Our work has focused on the development of new methods to identify dietary gaps, through research on the impact of lipid-based nutrient supplements on the health status of vulnerable populations and dissemination of the most up-to-date, relevant information to a wide range of nutrition stakeholders.

Recently, FANTA contributed to the development of software called Optifood, which can be used to identify local food combinations that can fill (or come as close as possible to filling) micronutrient gaps based on local foods and diet. Optifood results contribute to the development of cost-effective, context-specific approaches. (more…)

Gender

A call to prioritize gender in development

By Patrick Fine, Chief Executive Officer, FHI 360

A version of this post originally appeared here on The Huffington Post. Reposted with permission.

Patrick FineThe most effective 21st century international development organizations will be those that ask — and come up with workable answers to — the right questions about gender. The right answers are ones that boldly empower women and girls, engage men and boys as partners and don’t shy away from approaches that disrupt business as usual. The organizations that get gender right will be the ones that truly transform lives.

On June 16, 2014, more than 200 gender experts, funders, policymakers and development organizations will convene for the inaugural Gender 360 Summit in Washington, DC, to explore approaches for empowering women and girls and prioritize gender equality in our work. It is an opportunity for the international development community to examine the roadblocks, reflect on what we are doing well and where we are failing, and push ourselves to do better.

What have we learned about gender inequalities in different social, cultural and geographic settings? Beyond investing resources, what role can funders and their implementing partners play in elevating the importance of integrating gender considerations into all their work? What are the indicators of success and how do we measure them? These are just a few of the questions that need actionable responses.

Gender is not just about women and girls. Understanding gender means understanding the differences, in particular the economic, social, political and cultural attributes, constraints and opportunities that are associated with being female and male, and in some places, a third (or other) gender. It also means understanding how the social and economic forces unleashed by modernization (and abetted by development programs) affect women, men, boys and girls and the interactive relationship among them. (more…)

Economic DevelopmentGenderYouth

A youth leader speaks out on the importance of girls’ education in Nigeria

NaomiNaomi, 17, is a peer educator in FHI 360’s Four Pillars PLUS project in Nigeria. The Four Pillars PLUS project, funded by the GE Foundation, uses the model of scholarships, teacher professional development, mentoring of girls and community participation to improve the quality and relevance of education for orphans and other children, especially girls, in secondary school. An additional key component of the project is addressing the challenges of youth employment by helping young women successfully transition from school to the workforce.

Naomi is one of four youth delegates to this week’s 2014 InterAction Forum in Washington, DC. In this Q&A, she discusses her experience with the Four Pillars PLUS project and her views on girls’ education.

Q: What prevents girls in Nigeria from receiving a quality education?
A:
Girls in Nigeria face many obstacles. These include high school fees, gender inequality and other social pressures that cause them to drop out. Security is a big risk for many girls, especially since the recent kidnappings. Some girls are just too afraid to go to class. The conditions at school can also be a challenge. My class has 50 students and no fan. Some classrooms have no ceiling, no fan and even more students. At certain times of the day, like when the sun is directly overhead, it is too hot for students to even sit in the classroom and impossible for them to concentrate and learn.

Some policies also limit girls. If a girl is pregnant, she cannot return to school after she has her baby. One mistake should not be the end of a girl’s education. (more…)