• September 20, 2014

    Building momentum for sexual and reproductive health in the post-2015 dialogue

    Written by
    Tricia Petruney, Technical Advisor, FHI 360
    Ward Cates, Distinguished Scientist and President Emeritus, FHI 360

    Sexual and reproductive health, which includes access to family planning and HIV prevention and treatment, is increasingly being linked to progress across all areas of development. As the United Nations Open Working Group (OWG) on Sustainable Development comes closer to finalizing the post-2015 global development goals, a growing crescendo of voices is commenting on where we stand with regard to meeting the sexual and reproductive health needs of the world’s girls, women and couples and is offering ideas on how to move ahead. We are also seeing important shifts in policy.

    There are many examples that illustrate the lively dialogue that is now happening on sexual and reproductive health.

    An article in the journal Contraception acknowledges that although significant, measurable progress on sexual and reproductive health has been made in the two decades since the International Conference on Population and Development (ICPD), momentum on key areas of family planning has slowed in recent years.

    New commentaries in the Bulletin of the World Health Organization and The Lancet summarize the evidence for why universal access to family planning should be a key component of the post-2015 development agenda. Additional commentaries in The Lancet and Global Health: Science and Practice Journal offer actionable recommendations for meeting global demand for family planning. Finally, Womenatthecenter.org, an exciting new website, is sharing “inspiring, interconnected stories of women’s reproductive health and rights, empowerment and environmental sustainability.”

    Continue reading

  • September 19, 2014

    Does 1+1=3? Proving the integration hypothesis

    Written by
    Patrick Fine, Chief Executive Officer, FHI 360

    integrationhypothesisLast month, we began the 500-day countdown to the conclusion of the Millennium Development Goals (MDGs). Policymakers, the private sector, civil society groups and academics worldwide are all taking stock of progress in achieving the eight MDGs and asking, “Where are the gaps? What can we do differently? What would a post-2015 framework look like?”

    While we don’t yet have the answers to these questions, it is clear that there is much more work to be done. We are now living in a world where emerging economic, technological and demographic shifts have created more sophisticated and demanding challenges. From dramatic climate changes and rapid urbanization to a growing youth bulge, these shifts are putting previous investments at risk and forcing us to rethink how to tackle increasingly complex development challenges.

    We need to get smarter about how we approach development.

    On September 23rd in New York, as world leaders gather at the United Nations, an important conversation will be taking place down the street. Moderated by Al Jazeera journalist Femi Oke, a discussion titled “Does 1+1=3? Proving the Integration Hypothesis” will bring together academics, funders and representatives of governments, business and implementing organizations to reignite a discussion on integrated approaches to human development.

    Continue reading

  • September 19, 2014

    Perspectives on how implementation science can improve global health

    Written by
    Theresa Hoke, Director, Health Services Research, FHI 360
    Rose Wilcher, Director, Research Utilization, FHI 360

    What is implementation science, and what can it do for the field of global health?

    Earlier this month, FHI 360 brought together over 150 public health specialists, researchers, scholars and donors in Washington, DC, for a day-long symposium to wrestle with these questions.

    One clear conclusion emerged: There is no single definition for implementation science. Symposium speakers used definitions including: the scientific study of methods to promote the integration of research findings and evidence-based interventions into health care practice and policy (U.S. National Institutes of Health); the application of systematic learning, research and evaluation to improve health practice, policy and programs (U.S. Agency for International Development); and the study of methods to improve the uptake, implementation and translation of research findings into routine practices (U.S. President’s Emergency Plan for AIDS Relief).

    Despite the lack of consensus on definitions, symposium participants agreed that implementation science can make essential contributions to global health. Setting implementation science apart from other research disciplines is its focus on how to implement proven interventions in real-world contexts, delivered at scale. Noting that implementation occurs within complex systems, Greg Aarons of the University of California, San Diego, introduced participants to frameworks that help us consider the interaction of factors that affect the success of the implementation process. (View the symposium’s presentations and webcast.)

    Continue reading

  • September 15, 2014

    Family planning: A look at the past, the present and the future

    Written by
    Ward Cates, Distinguished Scientist and President Emeritus, FHI 360

    In 1971, the world was a different place demographically. Our planet was mostly agrarian, family sizes were large and birth control was unavailable. That year, FHI 360’s heritage organization, the International Fertility Research Program, was created to perform clinical trials of emerging contraceptive technologies, such as oral hormonal contraception and intrauterine devices (IUDs). These studies helped jump-start global family planning programs, creating health services for women where none had previously existed.

    1994: Setting a new agenda

    Fast forward to 1994, the year of the International Conference on Population and Development (ICPD). This pivotal global event caused a seismic shift in family planning, from concern about population growth to a commitment to reproductive rights and justice. Women’s empowerment took center stage. Issues related to sexually transmitted infections, especially HIV, were folded into the sexual and reproductive health agenda.

    The ICPD also strengthened voluntary family planning as a fundamental human right. This enabled women and couples to determine the timing and spacing of their pregnancies. With control over their fertility, women improved both their personal health and their career aspirations. Family size preferences decreased, and the demand for more effective, longer-acting contraception increased.

    Family planning drives development

    Today, the shift from larger to smaller families represents one of the most important transformations in developing regions. This shift was made possible in large part by the increased availability of modern contraception. Demographers have traditionally defined “modern” as any method other than “traditional” (for example, natural family planning and withdrawal). During the past two decades, evidence has demonstrated the contributions that family planning can make to global health and development, including progress toward the Millennium Development Goals.

    Continue reading

  • September 11, 2014

    Anticipating the impact of cutting-edge technology on democracy and development

    Written by
    Wayan Vota, Senior Mobile Advisor, FHI 360
    Matthew Pietz, Director, Civil Society, FHI 360

    What might nongovernmental organizations, governments and world leaders have done differently if, fifteen years ago, they could have predicted the transformative effect that mobile phones and Internet access would have on the world’s poorest countries? What can we do now, if we look far enough down the road, to anticipate the next waves of revolutionary technology?

    Technology has brought us to the doorstep of a world once only imaginable. Google cars now drive themselves across California. An autonomously piloted drone can be purchased on Amazon.com. Computers are acting more and more like people. This year, one passed the Turing test, a measurement of a machine’s ability to mimic human behavior. There are working prototypes of spray-on skin and mind-controlled prosthetic limbs. A thousand robots can work together to complete a common task. Things are changing fast.

    These technologies will shape the future of the world and change development as we know it.

    Funders, governments, practitioners and technology leaders need to anticipate the impact of emerging innovations on democracy and human rights and plan accordingly. Technology can empower activists and dictators alike. To be prepared, we should start asking questions, such as: How will development and civic engagement change when citizens in the most remote parts of the world have access to the Internet? How might drone journalism provide safe, reliable access to conflict-affected parts of the world? How can wearable technology innovations like Google Glass make citizens freer or, conversely, be misused by governments to monitor and control citizens?

    Continue reading

  • September 9, 2014

    Advancing economic development: Meeting systems challenges in a complex world

    Written by
    Paul Bundick, PhD, Director, FIELD-Support Leader with Associates Program, FHI 360

    PaulBundick_2014_200x220The term “results oriented” has become a new buzzword in international development. Its near-universal usage among funders and practitioners suggests our industry has failed to give sufficient attention to measuring meaningful outcomes along with associated costs.

    The drive to do more with less has given rise to the measurement imperative — the use of rigorous quantitative methods to establish fundamental relationships between a few variables with the aim of identifying simple causal pathways to pre-established indicators of success. As a corollary, we find an increasing emphasis on accountability to better control the production of intended results as cost-effectively as possible.

    Who can argue with the need for doing more with less? As serious practitioners of social and economic change, we accept this moral imperative of being held accountable — to our fellow citizens, to our funders, to our clients and to ourselves. Yet, there is something missing. It is as if we have reduced our understanding of reality and all of its complexity to fit the limitations of our methods. This view feels incomplete and needs some major re-envisioning.

    Anyone who has ever implemented a project will agree that many results are neither intended nor direct. The causal pathways that underlie our work are usually far from simple. Reality often diverges significantly from the results framework to which we are held accountable. Effects are often subtle, indirect, mediated or delayed. It is difficult to know what will actually happen in a system unless the parameters are highly constrained and the all-important context is artificially removed. How do we reconcile the need for achieving results and accountability within a more complex, interrelated yet unpredictable understanding of reality?

    Continue reading

  • September 8, 2014

    Tapping the potential of literacy for conflict mitigation

    Written by
    Emily Koester, Literacy Technical Officer, FHI 360

    Development organizations are increasingly being asked to provide education in places that have been torn apart by wars and other conflicts. Reading and writing instruction is often pushed to the forefront of education-in-conflict interventions, because literacy is a foundational skill for future education and success in the workforce. The U.S. Agency for International Development (USAID) goal of improving the reading skills of 100 million children by 2015 emphasizes the value of literacy.

    Importantly, literacy also offers the potential to mitigate conflict. Instructional materials to develop literacy can include stories that model peaceful problem solving, value diversity (through characters who identify with various ethnic groups, for example) and communicate important information about safety and emergency measures.

    Despite the possible benefits, building literacy in conflict situations is complex. Common challenges, such as limited materials and infrastructure, militarized populations and psychosocial trauma, require substantial creativity and innovation in literacy programming. FHI 360 is addressing these challenges in three key ways:

    First, we are gaining knowledge to inform practice. Education in conflict is an understudied field, and very little is known about best practices for literacy instruction in conflict contexts. In 2014, JBS International commissioned an important research report by Lesley Bartlett and Zeena Zakharia, which provided “the first steps in developing a framework for literacy education in conflict- and crisis-affected contexts.”

    Continue reading

  • September 6, 2014

    Strengthening health systems: What the Ebola outbreak is teaching us

    Written by
    Patrick Fine, Chief Executive Officer, FHI 360

    I am deeply concerned for the wellbeing of people in West Africa confronting the rapid spread of the Ebola virus. We wish to pay our respect to the courageous health workers battling the disease, and who have paid a disproportionate price for their heroism, as well as to the faith-based organizations that have remained on the front lines. We are now faced with a crisis of historic proportions that threatens not just the health of tens of thousands of people, but the economic and social stability of the region. On behalf of FHI 360, I want to express our deepest sympathy for all those affected by this scourge and our solidarity with our staff, counterparts, and colleagues in the affected countries.

    This crisis will undoubtedly have broad consequences not only for West Africa, but for the wider world. If World Health Organization (WHO) officials are correct, the epidemic will take thousands more lives and we can expect an even deeper toll on already overwhelmed health systems. This is a crisis that requires the collective efforts of the international community.

    The Ebola virus outbreak has exposed the fragility of health systems in poor countries—and shown how vulnerable nations are when basic social systems are unable to respond to critical needs. The world is now witnessing the terrible consequences of the failure to equip health systems, connect patients to direct medical care in rural areas, educate medical staff and the general population to risk factors and prevention methods, provide laboratory testing, and track disease surveillance data to monitor the spread of the virus.

    By working to support WHO’s six building blocks of health systems, we can improve availability, use, and quality of health services delivered through both public and private facilities. We need to continue to develop and apply workable strategies to improve the quality of care and the performance of health systems, particularly in resource-constrained environments.

    Continue reading

  • August 22, 2014

    The future of Myanmar is online

    Written by
    Wayan Vota, Senior Mobile Advisor, FHI 360

    Today, Myanmar has similar mobile phone usage rates to North Korea, Eritrea and Cuba – less than 10 percent of the population. At the same time, technology restrictions in the country are easing. Three mobile operators are racing to roll out services, which will rapidly bring the 60 million people who live in Myanmar into a digital reality, practically overnight.

    On August 6, 2014, FHI 360 convened a workshop in Yangon to explore the role of information and communications technology and development in Myanmar, attended by leading technologists and development experts from Myanmar and across the Asia Pacific region. The workshop centered on three questions that address technology’s impact on government, civil society, business and most importantly, people’s lives:

    1. What are the social and cultural impacts when a country goes online virtually overnight?
    2. What will the people of Myanmar find on the Internet of today? Or tomorrow?
    3. Who will benefit when all of the citizens of Myanmar have a digital voice?

    While attendees touched on many points throughout the discussion, and did not always agree on the answers to our questions, we did find general consensus that by 2018, Myanmar will have a very different technology landscape.

    Continue reading

  • August 12, 2014

    Celebrating youth: Revisiting voices from the Interagency Youth Working Group

    Today, as we observe International Youth Day, we look back on the past eight years of FHI 360’s involvement with the U.S. Agency for International Development (USAID)’s Interagency Youth Working Group (IYWG), the only source of global information about preventing both unintended pregnancy and HIV among youth. Our work managing the technical content for the IYWG was conducted under USAID’s Preventive Technologies Agreement, which ends this month.

    During this time, we have made many contributions. The IYWG tools and resources have been used by thousands — more than 30,000 people from 199 countries have visited our website, over 6,000 have participated in our e-forum discussions, and more than 1,000 have attended our annual technical meetings. Since 2007, we have distributed InfoNet twice monthly to approximately 5,000 individuals and developed 21 issues of YouthLens; 1,219 users follow us on Twitter; and 2,444 people like our IYWG and Answer the Call Facebook pages.

    We are grateful to the many dedicated individuals who helped us produce, synthesize and disseminate evidence on youth sexual and reproductive health, and to our partners for sharing their work and supporting ours. To all who have helped us provide practical, evidence-based resources and tools in the service of improving the lives of young people around the world, thank you!

    To mark the end of the IYWG, we are featuring a few of our favorites from the IYWG blog, Half the World. Though we will not be providing any new content, the website and blog will continue to exist as a rich resource for information on youth reproductive health and HIV/AIDS.