Health

  • Technology alone is not enough

    In 1879, Thomas Edison unveiled his incandescent light bulb. Within six years, electric power had spread across the nation and ignited an explosion of invention that created new industries and thousands of jobs and transformed every aspect of society. A century later, in 1978, Steve Jobs introduced the Apple personal computer and unleashed another wave of innovation that reaffirmed our faith in the power and potential of technology to drive human progress.

    I was reminded just how high our expectations are for technology at two events in September: the U.S. Agency for International Development’s Frontiers of Development conference and the Clinton Global Initiative’s annual meeting, each of which showcased inventions, tools and concepts to improve public health and raise living standards. A few of the breakthrough innovations highlighted at these events or in recently announced grants include:

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  • Making the connection between vasectomy, family planning goals and development

    Dominick ShattuckWorld Vasectomy Day offers an opportunity to consider how vasectomy can contribute to development. This underused contraceptive method is particularly important as countries work toward achieving the Family Planning 2020 goals, which include providing an additional 120 million women and girls in the world’s 69 poorest countries with access to voluntary family planning information, services and supplies by 2020.

    The number 120 million is a lot of women and girls to reach, and it raises an important question: What role do men play in achieving this target?

    Robust family planning initiatives protect women’s and children’s health, help fight HIV infection, reduce abortion and give women control over when they become pregnant.1 When experts and leaders from 150 countries gathered for the 2012 London Summit on Family Planning, they recognized that providing comprehensive access to contraceptives is both beneficial and achievable. They identified metrics to measure their success.

    Vasectomy programs can make a strong contribution to fulfilling the Family Planning 2020 goals while allowing men to more fully participate in family planning. Vasectomy is safe, effective and one of the least expensive contraceptive methods.2 Vasectomies are provided more quickly — and are safer— than female sterilization.3

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  • The power of political will in the fight against malaria

    Mwensi Halima“A lack of political will” is often cited as an impediment to the delivery of health care in the developing world and a factor that stymies the fight against many of the preventable diseases the world is grappling with, including malaria. It is commonly perceived that countries fail to prioritize health care delivery, depend totally on donor aid and generally do not own the fight.

    My experience working with African leaders proved the opposite. I recently completed a two-year detail with the African Leaders Malaria Alliance (ALMA) Secretariat, an organization that has successfully generated political will to control malaria on the continent. I assisted in establishing the ALMA office in Africa, a job that also involved liaising with member-country ministries of health and representing ALMA’s voice.

    ALMA came to life in 2009 when forward-looking heads of states, led by His Excellency President Jakaya Mrisho Kikwete of Tanzania, demonstrated ground-breaking leadership and political will by taking ownership of the malaria problem. They made a commitment to holding themselves accountable to their citizens and the global community on this important issue.

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  • In Africa, tobacco presents a looming threat to healthy living

    In 2013, The Network of African Science Academies, in collaboration with the United States National Academies, convened a committee of 16 diverse experts, including me, to discuss the current state of tobacco use, prevention and control policies in Africa.

    The committee’s findings, recently published in Preventing a Tobacco Epidemic in Africa, were alarming: Without comprehensive tobacco prevention and control policies, smoking prevalence in Africa will increase by nearly 39 percent by 2030, from 15.8 percent in 2010 to 21.9 percent. While tobacco use and tobacco-attributable mortality rates in Africa are currently among the lowest in the world, data indicate that without intervention, this situation will change dramatically for the worse.

    The committee’s report also revealed some startling findings about tobacco as it relates to Africa’s women and youth. Though fewer African women smoke, they are disproportionately affected by tobacco through not only the direct effects of smoking, but also secondhand smoking and the secondary effect of smoking on pregnant women and their fetuses. African youth, meanwhile, represent the largest potential market for tobacco, and levels of smoking in this highly vulnerable population will continue to rise as aggressive tobacco marketing encourages the uptake of smoking. Both women and youth are also targets of covert messaging from the tobacco industry that is designed to mainstream smoking behavior as an element of evolving social norms and empowerment.

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  • Pioneering the Mobile for Reproductive Health program

    Did you know that 220 million women and girls have unmet needs for family planning? In particular, Tanzania has one of the lowest doctor-patient ratios in the world — 1 doctor for every 50,000 patients. With those limitations, how are individuals supposed to make informed choices about their health when they can’t access information about their options?

    This is a question being asked by the maternal health and global health community. As studies have shown, improved access to comprehensive sexuality education and modern contraception increases opportunities throughout a woman’s life. This includes the ability to pursue education and earn an income leading to a healthier life for a woman, her children and her family.

    With mobile technologies advancing in developing countries, we can now get health information and support to many more women and couples. Text messaging (SMS) in particular, offers benefits:

    • Messages are available to all mobile phone users regardless of phone type.
    • Mobile phone users typically carry them everywhere, making maximum program reach likely.
    • In many cases, text messages are less expensive than voice calls.
    • Text messages can be automated and efficiently delivered, reaching many people.

    With this in mind, I developed Mobile for Reproductive Health or m4RH, in 2010 with FHI 360, Text to Change, and ministries of health and NGO partners in Tanzania and Kenya.

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  • Preparing students for health careers in Kenya

    Dominic-220x415If you were to ask 100 students in Kenya what their career ambitions are, there is a significant chance that at least 50 of them would say doctor or pharmacist. However, few understand what is really involved in achieving a health care career.

    Even if students gain admission to university, they are often unable to afford it. And, should they overcome those challenges, they often make ill-informed decisions about what to study, because they are not given adequate guidance and exposure to their desired profession. The few who successfully complete appropriate coursework may still struggle to get hired. In Kenya, there are far more college graduates than can be absorbed into the job market. Without meaningful work experience, recent graduates lack any competitive advantage.

    As co-founder and country director for the Kenya Education Fund, a scholarship organization that helps students living in poverty attend high school, I have learned firsthand the value of mentorship programs. Mentorships expose students to real-world professionals who provide the support necessary to help students realize their educational and professional aspirations.

    Today, the Kenya Education Fund coordinates with Johnson & Johnson’s Bridge to Employment (BTE) program to provide a mentoring program and regional workshops focused on problem solving and life skills. This program brings together Phillips Healthcare Services, a distribution partner of Johnson & Johnson, FHI 360, three institutions of higher education and two secondary schools. Fifty young men and women participate in BTE, and it has been an overwhelming success.

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  • An interconnected approach to improving handwashing behaviors

    Each year on Global Handwashing Day, hundreds of millions of people around the world gather to celebrate the power of handwashing with soap to save lives. This day also provides an opportunity to consider the current status of the hygiene sector and catalyze further action. As we look toward the future of hygiene behavior change, we need to ensure that we are maximizing the broader topic of integrated development and fully considering its relationship to hygiene.

    Integrated development, which can be defined in many different ways, is increasingly being discussed within the international development community, and FHI 360 plays an active role in convening this conversation. I recently had the opportunity, on behalf of the Global Public–Private Partnership for Handwashing (PPPHW), to attend an event hosted by FHI 360 titled Does 1+1=3? Proving the Integration Hypothesis, which brought together expert panelists from academia, government, donors and nongovernmental organizations.

    I took away many key learnings from this event, but the one that stuck with me most is this: If we hope to move the needle on the most entrenched development challenges, we need to consider the benefits that could be offered by combining services or sectors.

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  • What challenges do girls in Kenya face in receiving a quality education?

    First, there is the barrier of poverty. The high cost of school fees often does not allow girls to enroll in school, because they cannot afford the books, supplies and uniforms. Even if they can pay their fees, they often cannot afford menstrual hygiene products, and without them, their learning is interrupted due to school absence. Next, discrimination in society and school makes it difficult for girls. Girls are only seen as future mothers, wives and caretakers. They are not seen as capable of tackling difficult subjects such as math and science. Because of this, girls often have low self-esteem and lose interest in school. They also fear sexual harassment and violence, which can make traveling to and from school dangerous. Finally, girls are expected to take on many more household duties than boys and often cannot devote adequate time to their studies, causing them to fall behind.

    How has the Four Pillars PLUS project made a difference to you?

    Four Pillars PLUS paid for my school fees at a boarding school, where I was able to get a quality of education that many girls could not. At boarding school, I had more time to study because I no longer had to do chores until late in the evening. I did not have to fear for my safety as I did when I walked long distances between school and my home each day. As a result, I studied hard and finished secondary school with a B+ average.

    Receiving mentoring helped me to deal with discrimination. It allowed me to see myself as a person with the same opportunities as boys.

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  • Pushing for progress on maternal, newborn and child health

    The numbers are shocking. Each year, 2.8 million babies die during their first 28 days of life, while almost 800 women die every day in pregnancy or childbirth.

    A vast majority of these deaths are preventable through simple interventions: providing mothers and their children with access to basic, quality health care, especially during pregnancy and childbirth; encouraging mothers to breastfeed; and treating diarrhea and pneumonia, two of the leading killers of children under 5 years of age.

    Despite the impressive progress that has been made in recent years, achieving the Millennium Development Goals (MDGs) on reproductive, maternal, newborn and child health (MDGs 4, 5 and 6) by 2015 will require an all-out global push.

    In June, the U.S. Agency for International Development (USAID) announced a major realignment of US$2.9 billion of its resources to “save up to half of a million children from preventable deaths by the end of 2015.” In addition, USAID introduced an ambitious strategy, Acting on the Call: Ending Preventable Child and Maternal Deaths, to dramatically increase progress in 24 countries that account for 70 percent of child and maternal deaths.

    This is an important policy shift — one that has the potential to have great impact on development by saving the lives of 15 million children and nearly 600,000 women by 2020. FHI 360, a member of the Advisory Group for Acting on the Call, supports USAID’s commitment. We have seen how evidence-based interventions in maternal, newborn and child health are making a difference in communities around the world.

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

    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.”

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