Discussion of climate change typically involves natural phenomena: raging wildfires, record flooding, ruinous drought. Less frequently examined, but equally important, is the effect of our warming planet on a child’s right to education.
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August 5, 2013
Promoting a culture of compliance
An Interview with
Sean Temeemi, Chief Compliance Officer, Office of Compliance and Internal Audit, FHI 360
What is meant by global compliance? Why is it so important?
Global compliance covers global operations. Like a lot of large, international organizations, FHI 360 works in a complex regulatory world. Complying with rules and regulations is challenging but vital to our credibility and effectiveness. This is an issue that is important to our funders, our Board of Directors and our senior management.
Why is this topic so timely?
We are responding to the needs of funders, who have increased their scrutiny of organizations. A lot of organizations are now developing compliance programs. Just about every day, you read about issues involving fraud and embezzlement. Ten years ago, you would have heard less about it. Today, there is a push to put resources into compliance. It is definitely a trend in the industry and is a priority at FHI 360.
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A version of this post originally appeared on Global Partnership for Education’s Blog, “Education for All”. Reposted with permission.
As part of the ambitious Millennium Development Goals set in the year 2000, the international community pledged to achieve universal primary education. With the target year of 2015 fast approaching, this goal is still far from being reached, and much remains to be done to remove barriers to schooling, particularly for children who are out of school. As the FHI 360 Education Policy and Data Center (EPDC) suggests in its recent report, data availability and reliability on this issue have lagged, making estimates of out-of-school children difficult. The regular revisions of numbers issued by international agencies illustrate this challenge.
A review of available UNESCO Institute for Statistics (UIS) data shows a considerable amount of missing information, particularly for countries where the number of out-of-school children could potentially be quite high given their recent history (for instance, Haiti, Sierra Leone, South Sudan and Sudan). For some countries, including Bangladesh and the Democratic Republic of the Congo, the figures factored into the global estimate are not published, and the most recent figures available from UIS are more than a decade old (1990–1995). This situation could be amended with greater inclusion of household survey data, which are currently used sporadically, if at all. The Global Initiative on Out-of-School Children has already started a review of all available sources of information for several countries, as well as for the Latin America and the Caribbean region, although data have yet to be integrated into the UIS Data Centre or the UIS e-Atlas on Out-of-School Children.
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Degrees recently featured a post “Family planning and text messages: How mobile phones can save lives” from Kelly L’Engle, an FHI 360 scientist, that highlighted Mobile for Reproductive Health (m4RH), a text-message-based health communication program that provides lifesaving information about family planning methods to anyone with access to a mobile phone.
The m4RH team is now very excited to be considered as a finalist for funding through Saving Lives at Birth: A Grand Challenge for Development (Round III). A DevelopmentXChange event taking place in Washington, DC, July 29–31 represents the final stage of the funding competition, and the public showcase will feature displays of the projects for each finalist. The showcase will also feature live and online voting for a People’s Choice Award, which will be considered in final funding decisions.
m4RH needs your votes!
To vote for m4RH for the People’s Choice Award in person, attend the showcase from 9:30 a.m. to 11:30 a.m. on Wednesday, July 31st at the Ronald Reagan Building (1300 Pennsylvania Ave. NW, Washington, DC 20004).
To vote for m4RH for the People’s Choice Award online, please visit http://savinglivesatbirth.net/summaries/248 (you must register to vote).
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Whether on foot, camel, dhow, containership, tanker, or truck—traders have likely criss-crossed Djibouti and its waters for as long as there has been trade. Today, the Port of Djibouti, one of Africa’s busiest, lies at the nexus of major shipping routes between Asia, Africa, and Europe.
From Djibouti, most goods travel inland by trailer-truck: some 800 Ethiopian truckers arrive every day. After offloading coffee, cotton, beans and other commodities from Ethiopia, truckers wait 4 to 6 days to reload with imported electronics, spare parts, construction materials, food aid and much else.
This range of activity makes a small community, virtually unknown outside Djibouti, both important and vulnerable. It’s called PK-12 for “Point Kilometre 12″ in French, the official language. Meaning that it’s 12 km from Djibouti town, the capital and site of the port. PK-12 looks like the mother of all truckstops. Colorful vehicles lie like flattened dominoes as far as the eye can see — thousands of them.
Understandably, drivers with several days on their hands also ferry back and forth another invisible item. About 25 percent are thought to be HIV-positive. The number of HIV-positive young women and men from the community is not known, and the stigma is too strong for even the boldest to disclose their status.
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Albertine,* a 34-year-old mother of five, was determined to get a long-acting family planning method. Because she lives in a remote part of Benin, a country of around 9 million in West Africa, she needed to travel many kilometers in the hot sun with her youngest child on her back to reach a health facility that provides contraceptives. Although she lives in an area where less than 1 percent of women use a modern family planning method, a community health worker had counseled and referred her to the health facility using a mobile phone-based tool (a service provided through the PRISE-C project, which is supported by University Research Co., LLC’s Center for Human Services and funded by the U.S. Agency for International Development).
Once she reached the health facility, Albertine insisted on getting what she called “the five-year method,” the two-rod Jadelle implant that is effective for five years of continuous use. She waited until the late afternoon — when the day’s immunization services were complete — before the midwife could see her. In a scene not uncommon in rural settings, Albertine lay across a small exam table and nursed her son on her right side while the midwife swabbed her left arm, injected the anesthesia, positioned the trocar and inserted the rods one by one. When the insertion was complete, Albertine smiled, took her implant card, and said she would be back in five years for another one!
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In recent weeks, global health policymakers, implementers, advocates and others have been celebrating the 10th anniversary of the President’s Emergency Plan for AIDS Relief (PEPFAR). At the heart of these celebrations has been attention to the incredible gains that have been made in preventing mother-to-child transmission of HIV (PMTCT). Secretary of State John Kerry marked the anniversary by noting, “Thanks to the support of PEPFAR, we have saved the one millionth baby from becoming infected with HIV.”
One million HIV-free babies. What a remarkable achievement, and one that symbolizes how far we have come in advancing HIV prevention science and practice over the past decade. The development of Anti-Retroviral (ARV)-based interventions to interrupt transmission from a pregnant woman with HIV to her baby — and PEPFAR’s success in expanding access to perinatal ARVs — has prevented new infections, saved lives, and given hope to women and men affected by HIV who wish to become parents. Indeed, this progress has generated worldwide momentum and political commitment for achieving an AIDS-free generation and led to the development of a Blueprint for getting there.
But this isn’t the full story. As we applaud the milestones associated with greater access to ARV prophylaxis for PMTCT, we should also take stock of how meeting the contraceptive needs of women living with HIV also contributes to fewer infections among children and better outcomes for mothers. In a previous publication, we estimated that current levels of contraceptive use by women and couples in the 15 PEPFAR focus countries prevented over 730,000 unintended pregnancies to women living with HIV and averted over 220,000 new infant infections annually. That’s on top of the roughly 230,000 infections averted annually through ARV prophylaxis to HIV-positive pregnant women in PEPFAR-supported programs at that time. Thanks to continued access to voluntary contraception for many women, we can safely assume that the number of infant infections averted over the past decade exceeds one million.
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Now that the U.S. Food and Drug Administration has approved the use of the antiretroviral drug combination of tenofovir disoproxil fumarate and emtricitabine (Truvada®) for HIV prevention, its success will depend on user adherence to the daily drug regimen.
Several trials of Truvada as pre-exposure prophylaxis (PrEP) showed it is most effective when adherence is high. Two trials, VOICE and FEM-PrEP, were unable to determine whether Truvada worked, likely because most participants did not take the study pills daily as directed.
One explanation for low adherence to PrEP is that study participants might have thought they were not at risk of HIV infection.
A study from FHI 360’s Preventive Technologies Agreement (PTA) explored this possibility. Our analysis of data from a randomly assigned cohort of 150 participants who received Truvada in the FEM-PrEP trial yielded some intriguing results, presented in a late-breaker poster this week at the International AIDS Society conference (IAS 2013) in Kuala Lumpur, Malaysia.
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For more than 40 years, FHI 360 has played a pioneering role in increasing the availability, acceptance, safety, effectiveness and use of high-quality contraceptive methods throughout the world. Through the U.S. Agency for International Development’s PROGRESS project, FHI 360 works to improve access to family planning methods and services among underserved populations in selected countries. PROGRESS builds capacity in research and research utilization by strengthening both the supply of and the demand for program research results, as well as by refining contraceptive technologies and services. In this video, Project Director Dr. Baker Ndugga Maggwa describes how PROGRESS has empowered women in countries around the world.
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FHI 360 celebrates World Oceans Day
Written by
From the indigenous communities on the Miskito Coast of Honduras to the communities of northern Mozambique, FHI 360 programs are making an impact on the health of our oceans and the humans who depend on them. FHI 360 joins in the celebration of this year’s World Oceans Day on June 8 — an event first recognized by the United Nations General Assembly in 2008. On this day, oceans are celebrated as vital lifelines of communities around the world. Oceans are essential to food, security and other economic activities totaling nearly US$215 billion. The planet’s oceans affect the health of people worldwide, our ecosystems and the air we breathe. FHI 360 is a part of this complex but thriving environment by managing a sustainable fisheries program on three continents, known as the Global FISH Alliance (G-FISH).
“World Oceans Day recognizes that the ocean is the living link between humankind and the Earth,” says Jimmy Andino, Spiny Lobster Initiative Chief of Party, G-FISH in Honduras. “The ocean provides the perfect conditions so life on Earth can be possible. The ocean provides livelihoods for millions, shelter and breeding grounds for vast marine biodiversity and is responsible for regulating global atmospheric conditions on the planet. As dwellers of a living planet, we deserve a living ocean. It is our responsibility to protect and use it sustainably.”
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The numbers on maternal and child mortality around the world are staggering. Every day, approximately 800 women die from preventable causes related to pregnancy and childbirth. A notable 99 percent of these maternal deaths occur in developing countries, where over 220 million women lack access to effective contraception and family planning services. Statistics indicate that if even half that number, or 120 million of those women, had adequate access to family planning information, the lives of 3 million children would be saved.
In recent years, many people have dedicated themselves to bridging the gap between this sizeable problem and a workable solution. And, as it turns out, answers have come in the form of something as common as a mobile phone. With more than three-quarters of the world’s inhabitants having mobile connectivity, millions of women can benefit from information delivered through what has become a standard 21st century way of communicating: text messages.
It was the growing use of mobile phones and text messaging in developing countries that prompted FHI 360 to develop innovative ways to use technology to improve family planning services. In 2008, with funding from the U.S. Agency for International Development, FHI 360’s Program Research for Strengthening Services (PROGRESS) project started developing Mobile for Reproductive Health (m4RH), an opt-in text message-based health communication program that provides information about family planning methods to anyone who wants it who has access to a mobile phone.