• Taking a student-based approach to youth development

    How do we best meet the needs of adolescents, recognizing that the world they are entering is rapidly changing?

    Youth programming should focus on the successful transition from adolescence to adulthood, rather than on the reduction of behavioral problems, a past trend. Such programming ensures adolescents’ mental and physical health, as well as provides opportunities to develop positive social values, human and social capital, a sense of well-being and an ability to make sound choices.

    Unfortunately, donor-funded discourse on secondary education reform is still dominated by a dialogue on expanding access and improving quality in education. Youth development and large-scale secondary school reform usually operate on parallel tracks, with youth development approached through afterschool, extracurricular or nonformal programming.

    Continue reading

  • Research points to the power of educational equity in reducing civil conflict

    Unequal educational opportunity often lies at the heart of deep inequities in economic productivity, social well-being and participation in democratic institutions. Key livelihood statistics show that across the globe, individuals with lower levels of education are more likely to earn less, have poorer health outcomes and are less likely to enter leadership positions. For this reason, efforts to improve equity must start with education.

    A soon-to-be released study, completed by the FHI 360 Education Policy and Data Center (EPDC) and commissioned by the United Nations Children’s Fund (UNICEF) Peacebuilding, Education and Advocacy Programme, indicates that ensuring equitable access to educational resources may be more than just a moral right: It may also contribute to reducing the likelihood of civil conflict.

    Using an innovative methodology that captures disparities in educational attainment among ethnic and religious groups, as well as among subnational regions within countries, we found that violent civil conflict is more likely in countries with high levels of disparity among groups. Preliminary results showed that the difference in the odds of conflict between highly unequal and more equal countries was large in magnitude and held true even after accounting for the countries’ differences in economic development, political systems, populations and income inequalities.

    Continue reading

  • A unique partnership develops emerging global health researchers

    WASH_ConferenceAd_10yrbadge_blueAt FHI 360, cultivating partnerships and building capacity are high priorities that lead to lasting impact globally. Capacity development in global health has many facets. In the more than 70 countries where we work, many of our global health, population and nutrition programs and research studies include the training of public health workers and scientists. We also value partnerships in the United States that foster the development of the next generation of public health leaders.

    This year marks the 10th anniversary of the FHI 360 and University of North Carolina (UNC) Gillings School of Global Public Health Research Fellowship Program. This relationship provides graduate students from the Gillings School with the opportunity to work side by side with leading global health researchers. For the last decade, FHI 360 and UNC have built and sustained a local partnership through which yearly at least two students from the Gillings School work at FHI 360 and are mentored by our global health research experts.

    Through this program, FHI 360 has had the privilege of working with some of the brightest young minds in the growing field of global health research. Over the years, 23 fellows have worked on a wide range of topics, generated research protocols, analyzed data, written manuscripts for scientific journals and developed technical skills that are essential to global health research.

    Continue reading

  • Let’s get real in Addis: The high cost of people-centered development

    When heads of state, ministers of finance and leaders of the international development community gather in Addis Ababa this July for the Third Conference on Financing for Development, I hope that the discussion will be grounded in the hard realities facing the least-developed countries struggling to provide basic services to their growing populations.

    I also hope that conference participants rise above the popular but misleading narrative that the private sector is the panacea.

    Looking to the private sector as the primary source of financing for development is particularly seductive for two reasons: Statistical evidence seems to support the argument, and it provides a rationale for reducing official development assistance at a time when donor nations are struggling with debt and budget crises.

    However, placing unrealistic expectations on the private sector to meet basic needs in health, education and public administration clouds a critical debate.

    Part of the problem is definition. “Private sector financing” is one of those catch-all terms. It encompasses business spending (foreign and domestic direct investment), remittances from migration in a globalized world, user fees to private providers of public services, and large-scale private philanthropy that has exploded out of the technology revolution.

    Read the remainder of the blog here.

  • Sayana® Press could mean a breakthrough in family planning

    As elsewhere in Africa, a woman in rural Malawi often must walk for miles to reach the nearest health clinic. When she finally arrives, long queues await and a preferred contraceptive, Depo-Provera®, is often unavailable. Even if the barriers of distance, long waits and stock-outs did not exist, a busy clinic would not be an ideal venue for those who seek contraception in a private setting away from the prying eyes of neighbors and acquaintances. Many women use Depo-Provera because it is effective, requires only a single injection every three months and can be used without the knowledge of a sexual partner.

    In many villages in Malawi, and other countries, an auxiliary nurse sells a wide variety of over-the-counter medicines, as well as condoms and oral contraceptives, in a small drug shop. Women in these villages wish that injectable contraceptives were as easily and discreetly available as the pills and condoms in the drug shop.

    This situation may soon change with the arrival of a new, lower-dose formula of Depo-Provera called Sayana® Press. Sayana Press provides the same three months of safe, effective pregnancy prevention as Depo-Provera but comes in an easy-to-use, pre-filled injection device designed to allow low-level health workers, and even users themselves, to inject the product. To further simplify the injection, the long needle formerly required for deep muscle injections has been replaced by a much shorter needle for a simple injection just beneath the skin.

    Several countries in Africa, such as Senegal and Uganda, are beginning to use Sayana Press in their family planning programs, especially those in which community health workers provide contraceptives. More importantly, a few countries will soon begin stocking Sayana Press in pharmacies and perhaps rural drug shops.

    Continue reading

  • Exploring the potential link between hormonal contraceptive use and HIV acquisition

    morrison_charles_2012_220x200Are women who take hormonal contraceptives at an increased risk of acquiring HIV? If so, do some contraceptives put women at higher risk than others?

    This week, the influential health journal, PLOS Medicine, published the results of a large individual-participant data meta-analysis, authored by FHI 360 and collaborators, that seeks to answer these questions.

    While this issue matters to the field of reproductive health, it is especially critical to women in East and Southern Africa. In these regions, women potentially have a double risk factor: high rates of HIV and high use of hormonal contraception, particularly depot-medroxyprogesterone acetate (DMPA), a type of contraceptive that is injected every three months. So far, the evidence on DMPA shows that it is the hormonal contraceptive that has the most potential to increase HIV acquisition; however, the evidence is inconclusive.

    FHI 360’s meta-analysis combines the results of 18 prospective studies, including more than 37,000 women, of whom more than 1,800 became infected with HIV. We found that women who used DMPA had a 50 percent increased risk of HIV acquisition compared with women who did not use hormonal contraceptives. We found no significant increase in HIV risk among women using combined oral contraceptives (COCs) or norethisterone enanthate (Net-En), a contraceptive injected every two months. Women using DMPA also had an increased HIV risk when compared directly with COC or Net-En users.

    Continue reading

  • A warm welcome in Mumbai

    It was 100 degrees outside when we pulled up in front a school in Mumbai last month. We were greeted by the sounds of booming drums, singing voices and ringing tambourines. The children were assembled outside of the school to welcome us. Before arriving, I was curious about how these children would receive us, but all doubts slipped away as they met us with open arms. The memory of that welcome continues to humble and inspire me in my travels to similar schools around the globe. Fifty students from two Mumbai schools were selected to participate in the three-year Johnson & Johnson Bridge to Employment (BTE) program designed to provide academic support, encourage lifelong learning and build awareness of careers in health care. BTE also works with parents, teachers and employees to support and guide students to new opportunities.

    According to 2012 data, only 58 percent of students from municipal areas graduate, leaving 42 out of every 100 young people without a high school diploma. For more than 20 years, BTE has been focusing on impacting communities all around the world with similar statistics.

    We’ve trained over 20 Johnson & Johnson employees, who serve as volunteers to mentor these 50 children, ages 13–16. BTE volunteers here in India and in all programs around the globe talk to their mentees about life and what it took to reach their own career goals and why civic engagement matters. Mentors teach students time management as well as resume writing, interviewing, teamwork and communication skills.

    Continue reading

  • Can women living with HIV and taking antiretroviral therapy use hormonal contraceptive methods?

    Extraordinary gains have been made in the last decade toward increasing access to antiretroviral therapy (ART) for HIV. With an eye toward ending the AIDS epidemic by 2030, UNAIDS recently released bold targets related to HIV diagnosis and treatment. By the year 2020, their aim is to have 90 percent of all people living with HIV aware of their status, 90 percent of people diagnosed with HIV receiving sustained ART and 90 percent of people on ART achieving viral suppression. As we move closer to these laudable public health goals, we must also consider how expansion of ART may affect and be affected by other health issues, such as prevention of unintended pregnancy among women living with HIV.

    An increasingly important issue is whether certain ART regimens are expected to have drug interactions when used with certain hormonal contraceptive methods. In theory, an interaction could affect the efficacy of either medication or cause side effects or toxicity. If contraceptive efficacy decreases, the chances of contraceptive failure, unintended pregnancy and the accompanying consequences increase. A decrease in ART efficacy could lead to treatment failure, viral resistance and greater likelihood of subsequent HIV transmission. Increases in side effects or toxicity can affect quality of life and medication adherence. Yet, despite the importance of this issue, relatively few studies (particularly those with clinical outcomes such as ovulation, pregnancy or treatment failure) have been conducted.

    Continue reading

  • Making strides in college and career readiness in North Dakota

    The goal of Succeed 2020, an education and workforce development project in North Dakota, is to help the state’s students become better prepared for college and 21st century careers.

    Achieving this goal is no small task. North Dakota’s eight Regional Education Associations (REAs), our primary partners, are leading implementation of Succeed 2020. With management and technical assistance from FHI 360, the REAs work with school districts to improve their educational programs and services through professional development, direct services and data analyses. The REAs are bringing together institutions of higher education, community-based organizations, business associations and employers, state and local government agencies, and Native American groups to ensure that all students have access to rigorous curricula, ongoing college and career planning, and the supports they need to succeed in school.

    Our numbers show that Succeed 2020 is making significant progress. In the 2013–2014 school year, 2,000 teachers, 300 administrators, and 150 counselors and careers advisors participated in professional learning opportunities that ranged from workshops on how to improve students’ literacy and numeracy skills to one-on-one guidance to understand classroom data. Professional learning communities bring together teachers from similar grades and content areas to solve common challenges.

    Continue reading

  • Learning from failure in global development

    One of the most promising trends in global development is the rising priority of understanding and investing in “what works.” As the funds available for international assistance have flatlined in post-recession years, everyone from donors to practitioners has become increasingly committed to making decisions that are informed by evidence. Given FHI 360’s commitment to research utilization, we’re encouraged by the attention being paid to evidence-informed development. Yet, the best-kept secret within the growing what works movement is the importance of learning not just from our successes, but also from our failures.

    Based on typical nongovernmental annual reports, scientific conferences and even social media content, one can be forgiven for forming the impression that our development efforts are nearly perfect. Successes are proudly packaged in glossy formats and heavily disseminated, whereas any objectives not achieved are relegated to the obligatory and typically short lessons learned section. Yet, this practice does not accurately represent an important reality: Development efforts do in fact fail.

    Venture capitalists and corporate investors understand that less than 20 percent of new businesses will succeed, and they invest in innovations and new ideas with a transparent acknowledgment of the high risk for failure.

    So why, by comparison, is the global development enterprise so different?

    Read the remainder of the blog here.