• Integrated development approaches are challenging but resonate with clients

    Tamimah grew up in Nakuru, a community in Kenya’s Rift Valley where the rate of HIV infection is high and where many young people don’t graduate high school. Tamimah’s early home life was precarious: Her mother left her and her three younger siblings, and her father provided limited support. The children were raised primarily by their grandmother.

    Before Tamimah turned 13, her grandmother died, leaving the children without primary support. Tamimah and her two sisters and brother struggled to take care of themselves, stay in school and be healthy. It was “very hard to grow up in this place,” Tamimah said.

    Things began to shift, however, when they were recruited to take part in APHIAplus, an FHI 360 project focused on improving health care delivery and multisector services to vulnerable populations in the Rift Valley. Through APHIAplus, which is funded by the U.S. Agency for International Development, Tamimah gained access to health education and services. She also received support to cover the costs of her school fees and supplies.

    From these multipronged activities, there was a ripple effect: She was able to stay in school. Upon graduation, Tamimah studied tailoring through a vocational program also offered through APHIAplus and was able to provide for her siblings. After a year, she saved enough to open Al Hamis Café, named after her brother.

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  • Women and girls deserve better

    How can an adolescent girl succeed in school if she is not protected from sexual violence inside the classroom? How does a child thrive when his mother must choose between buying medication or nutritious food? We know that poverty, lack of access to education, poor health and violence are intimately linked, and how we tackle these problems is a global issue with important implications for the way the United States funds international development programs for women and girls. At the moment, we tend to compartmentalize our efforts in top-down, single-issue solutions, not because that is the most effective way to meet the needs of women and girls, but because it meets the needs of funders and their implementing partners. As we enter the new era of the Sustainable Development Goals (SDGs), we need to do better.

    There is an obvious starting point.

    We need to be a lot more deliberate and get a lot better at integrating efforts to improve the well-being of women and girls. Given the siloed nature of how we organize development work, especially in terms of funding and specialized expertise, we tend to think and act with narrowly predetermined notions of cause and effect. As a result, we miss vital connections and opportunities for action and impact. For example, I recently asked an African Minister of Health what was the biggest obstacle to women’s and girls’ health, and he immediately responded, “access to transport” to get to health facilities and obtain medicines. And yet, how often does transport come up as a priority when funders and development agencies plan health programs?

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  • Creating healthier Nigerian communities through laboratory strengthening

    Laboratory strengthening is a component of Strengthening Integrated Delivery of HIV/AIDS Services (SIDHAS), a five-year project to build local capacity for the delivery of sustainable, high-quality and comprehensive HIV/AIDS prevention, treatment, care and support services. FHI 360 implements SIDHAS in 13 states in Nigeria.

    What is laboratory strengthening and how is SIDHAS meeting this need?

    Lab strengthening is a form of support to improve the capacity of a lab for quality service delivery, helping to achieve optimal performance, increase productivity and efficiency, deliver accurate and replicable diagnostics services, achieve customer satisfaction and promote safety. Lab strengthening also provides infrastructural development, equipment maintenance and quality control services to allow timely delivery and accurate results.

    FHI 360 has supported the improvement of labs through training and mentoring to facilitate good quality management systems and record keeping. This work in lab improvement aligns with the World Health Organization Africa Regional Office (WHO-AFRO) initiative known as Strengthening Laboratory Management Towards Accreditation (SLMTA). Working within SLMTA parameters with our Nigerian government counterparts provides regular collaboration and deepens the leadership, stewardship and sustainability of the country’s labs.

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  • A conversation on ending extreme poverty

    What will it take to eradicate extreme poverty?

    I sat down with Carla Koppell, Vice President for the Center for Applied Conflict Transformation at the United States Institute of Peace to discuss the U.S. Agency for International Development’s (USAID) ambitious Vision to End Extreme Poverty. A former Chief Strategy Officer at USAID, Koppell shares her insight on how the international development community can turn vision into reality.

    Why focus on extreme poverty? How do strategies for addressing extreme poverty differ in states with weak institutions? How do we balance getting rapid results with strengthening local capacity? These are just a few of the topics we dive into as we search for ways to turn ideas into action.

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  • Keeping up the momentum to control TB

    Dr. Timothy Mastro

    Dr. Timothy Mastro
    Photo: Leanne Gray/FHI 360

    World TB Day 2016 comes at a watershed time in the history of the tuberculosis (TB) epidemic and the broader global response to health and development. In recent years, we have expanded access to more sensitive TB diagnostic services, increased awareness about the important role of infection control within health care settings and have new treatment options for individuals with multidrug-resistant (MDR) TB. But, there is much work still to be done.

    TB now rivals HIV as the top global infectious disease, yet we have not applied the same vigor to controlling TB as we have to controlling the HIV epidemic. That time is no longer. We have the opportunity to mirror the advances gained toward ending the HIV epidemic, largely based on evidence, driven by ambitious targets and linked to well-designed guidance.

    In many parts of the world, HIV poses a particular challenge to TB control, which we cannot ignore. We have developed HIV prevention and treatment tools that will allow us to end the HIV epidemic, and we must add urgency to align these with TB control efforts. Doing so will assure successful outcomes in the fight against HIV and TB coinfection. The urgency comes from World Health Organization reporting that indicates mortality from TB eclipses mortality from HIV. The tremendous research and program advances from unprecedented investments in the HIV response must be leveraged to take control of TB morbidity and mortality.

    Dr. Carol Dukes Hamilton

    Dr. Carol Dukes Hamilton
    Photo: Leanne Gray/FHI 360

    This moment in time is particularly important as we transition to the Sustainable Development Goals (SDGs) that will guide policy and funding over the next 15 years and are linked to a pledge to end poverty, everywhere, permanently. While health is now only one of 17 goals, the shift in focus may bode well for control of TB, which is a disease of poverty exacerbated by malnutrition, overcrowding and poor hygiene.

    FHI 360’s TB initiatives strategically align with the SDGs. Our projects provide technical assistance to governments to yield evidence-based solutions to their local TB situations. We assist governments with improved disease surveillance so they can invest in ways that will yield the greatest impact by providing curative treatment and limiting new infections. We promote an approach that focuses on those most vulnerable in society because TB concentrates in the most marginalized populations of any given society. A human rights-based approach that engages affected communities is the basis for a sound, effective response.

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  • Social marketing for public health systems change

    Can social marketing efforts to promote individual behavior change inhibit progress instead of advancing it? On one topic at least, the answer appears to be yes.

    A couple months ago I had the pleasure of attending the Robert Wood Johnson Foundation’s Childhood Obesity Program Leaders’ Advance, which brings together leaders in the fight against childhood obesity to discuss strategies and approaches for reversing the increases we’ve seen in the past 30 years. The meeting was held in Oakland, California, and included a visit with the Alameda County Public Health Department to learn about their efforts. An official from the department posed a question to the group, “What do we think is the biggest barrier to the success of community efforts to reduce obesity?” What he didn’t say was: funding, poverty, racism, education, or the food and beverage industries. His answer might surprise you — individualism.

    Individual-focused messaging has led Americans to believe obesity is caused by personal choices. Click To Tweet

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  • Using technology to help farmers adapt to climate change

    Hellen Mary Akiror’s livelihood relies on the right amount of rainfall coming at the right time.

    A farmer in Uganda’s Soroti district, Hellen lives with her husband and seven children. Growing millet, groundnuts, sorghum, cassava and potatoes on her four acres, she is dependent on rain-fed agriculture for her survival. Yet, she said, “Rainfall comes at the wrong time, in huge quantities, and stops when we need it most.”

    Hellen’s story is all too common. In 2014, I met Mukasa, an elderly Ugandan farmer grappling with the fact that his village was facing unpredictable rainfall and temperatures higher than any in living memory. At the same focus group discussion where I met Mukasa, I also met Father Philippe, the pastor of Mukasa’s parish. Father Philippe said, “We have sinned and the lack of rain and excess heat are the wrath of God.” Another parish member said, “We destroyed the trees and we are facing the consequences.”

    While the villagers’ explanations vary, all agree on one point — rainfall in the country is becoming scarce and unpredictable, and extreme heat is increasing in intensity and frequency. During the 80 years between 1911 and 1990, only eight droughts occurred, while in the 10 years between 1991 and 2000, the country experienced seven droughts. As in other sub-Saharan countries, higher temperatures and more frequent and severe droughts and floods in Uganda diminish food security, decrease the quantity and quality of water, and deteriorate natural resources.

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  • How do we promote equity in education? A new research initiative

    Rising inequality is one of the greatest challenges facing the global community today – and equity is rightly at the heart of the new development agenda, reflected in the Sustainable Development Goals and the Education 2030 Incheon Declaration. Nowhere is the challenge of equity more salient than in education, with its potential to positively shape life outcomes – or further exacerbate societal disparities.

    How prepared are we in the education community to address this challenge? Do we have the right tools, metrics, and interventions to track our progress in educational equity? While we have gathered gender-disaggregated data for decades, our collective practice in tracking equity across other dimensions has been far from deliberate. Just as quality proved a blind spot in the early years of the previous goals period, there is a risk that inequality in education outcomes and resources will go unmeasured, unreported, and unaddressed. Without attention to equity now, we may soon find ourselves scrambling to address the equity gap, just as we scrambled to address the learning gap that emerged under the focus on access.

    Read the full blog here.

  • Accelerating progress on Zika through better family planning

    In a statement declaring the clusters of birth defects that appear to be linked to Zika virus infection in Brazil “a public health emergency of international concern,” the World Health Organization recommends important measures for tackling this emerging infectious disease threat: improving surveillance, developing better diagnostic tests, intensifying vector control efforts and carrying out other prevention and treatment measures.

    More remarkable were calls from public health officials in Colombia, Ecuador, El Salvador and Jamaica for women to postpone pregnancy until more is known about the association between the Zika virus and microcephaly, a severe birth defect affecting the brains of newborns. Salvadoran health officials have even advised women to delay pregnancy until 2018, when the risk of being infected with Zika may be lower.

    The spread of Zika in the Americas adds urgency to the need to help all women — and their male partners — avoid unintended pregnancies. But, women and couples in countries affected by Zika face formidable barriers to achieving their fertility intentions, including lack of access to contraceptives and other reproductive health services, some of the world’s most restrictive abortion laws and high rates of sexual violence.

    Placing the burden of protecting unborn children from the virus’ effects solely on women who have limited reproductive rights and contraceptive options is discriminatory and unsustainable. Expanding access to reproductive health services must be part of a comprehensive response to the Zika virus, and these services should be supported in ways that protect and strengthen the reproductive rights of women and girls.

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  • No pipeline, no promise: The role of contraceptive R&D at the International Conference on Family Planning

    This week, nearly 3,000 health professionals and researchers gathered in Nusa Dua, Indonesia, for the 4th International Conference on Family Planning (ICFP), the world’s largest conference focused on family planning. At this and similar events, we often hear about the barriers that prevent women and men around the world from having reliable access to safe, affordable contraceptive services. “No product, no program!” “No provider, no program!” These are common refrains in the family planning community, and they speak to the importance of having both sufficient contraceptive commodities and adequately trained health care providers to ensure high-quality services for individuals who need them.

    This week at ICFP, Dr. Laneta Dorflinger, director of Contraceptive Technology Innovation at FHI 360, offered an additional perspective. “No pipeline, no promise!” she asserted during the Family Planning+Social Good event to highlight the importance of continued investment in contraceptive research and development.

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