More From the Blog

  • September 13, 2012

    Sex, Money and Girls: Reflections from Day 2 of the Global Youth Economic Opportunities Conference

    Written by
    Joy Cunningham, Senior Technical Officer, FHI 360

    Many of us who spend our time in the youth sexual and reproductive health (YSRH) world don’t often cross paths with those in the business of economic empowerment and livelihoods programs for young people. Although both worlds are aware of the converging paths, funding streams generally keep us operating on parallel roads. Therefore, I was pleased to facilitate a panel session this morning at the conference: “Exploring the Intersection of Adolescent Girls’ Reproductive Health and Economic Empowerment.” During a lively session, panelists shared their experiences with both issues for girls. Some of the themes were:

    • Even though we are aware of the problem, the data on SRH and economic empowerment for girls, taken together for developing countries, is shocking. The rates of HIV, maternal mortality and morbidity, poverty and isolation paint a dismal picture for girls.
    • Programs that target girls and adults in the community, with messages on both SRH and economic empowerment, are showing some successes. There’s more to learn, but results are encouraging.
    • Models that incorporate peer education and work with girls on SRH and economic empowerment show positive results: the Tesfa program led by the International Center for Research on Women, the Siyakha Nentsha program in South Africa led by Population Council, and a program by Restless Development in Northern Uganda all included a peer education component.
    • Reducing social isolation seems key for increasing both SRH and economic outcomes for girls. Girls need access to other girls for many reasons, but importantly, to give them an outlet to talk about themselves: their ideas, dreams and goals.
    • It’s important to work with the adults, not just the girls. Teachers, parents and faith leaders all play roles in girls’ lives, and we need to get them on board with difficult topics. Sex and money are not easy to discuss with young people, and the adults need to build their skills to do it.

    Today’s session initiated some vital discussion about next steps. It’s my hope that the two worlds of SRH and economic empowerment for young people will start to cross more often and begin to operate more closely together. This year’s conference is an encouraging step toward that. Look for more information on this topic, including a research brief and e-forum, by visiting the Interagency Youth Working Group website.

  • September 12, 2012

    How do you target young people effectively? Start by knowing how they spend their time.

    Written by
    Diana Rutherford, Research and Evaluation Specialist, Economic Development and Livelihoods, FHI 360

    A version of this post originally appeared on Making Cents’ Blog. Reposted with permission.

    Understanding how children and youth spend their time is crucial for designing effective development interventions that improve their well-being. Child time-use studies provide a tested way of shedding light on this essential topic. Perception of time varies by culture, gender, and age; youth perceive time differently than adults. The value attributed to how youth spend their time often differs among cultures. For example, in many societies girls tend to engage in home-based, non-economic chores, while boys engage in economic labor away from home. Economic labor is often more highly valued than the home-based labor, profoundly affecting how girls and boys perceive themselves and their value and place within the household. The interdependence of people within the household and the value placed on their work (at home, away from home, economic or not) influences well-being. Young people often value work in the same way they perceive that their parents do.

    Knowing where youth are and when

    When designing youth-focused programming, one key step is to understand where the target beneficiaries are throughout the day, so as to know when and where to engage them. Some labor youth engage in is designed to limit their autonomy (“keep them busy and out of trouble”).Other activities, despite being labeled as labor, provide outlets for young people to interact with people their own age with limited or no supervision. Fetching water or going to the market are two common examples. How the target beneficiaries value their time and perceive their freedom to make choices (personal agency) will affect their interest, willingness and ability to partake of project activities designed to benefit them.

    The best source of information about time-use is the youth themselves. Children as young as eight can work together in groups to describe how they spend their time. With youth groups, a facilitator can provide a framework and instructions before stepping away to provide the youth space for private discussion.

    Tools for measuring time-use

    While there are several time-use tools, a quick, efficient tool for measuring how youth spend their time is through participatory rapid appraisals, which use mapping and day/time grids and photos or drawings of places and activities. The STRIVE program has employed this tool successfully in the Philippines with children from households engaged in seaweed farming and weaving. In about one hour, you can understand:

    • Where youth are and when
    • The routes and means of transportation between locations/activities
    • Where and when you might locate your intervention
    • Where safety might be an issue
    • How your target beneficiaries perceive time and value their current activities

    For more information on the importance of child time-use studies, see Ben-Arieh, A. & A. Ofir (2002) Time for (More) Time-Use Studies: Studying the Daily Activities of Children. Childhood, 9(2), 225-248.

  • July 20, 2012

    A Smart Approach to Human Development

    On July 14, 2012, U.S. Ambassador at Large for Global Women’s Issues, Melanne Verveer, made a special visit to the SMARTgirl project in Cambodia, a USAID PRASIT project initiative, led by FHI 360. SMARTgirl aims to prevent and mitigate the impact of HIV and improve the sexual and reproductive health of entertainment workers, many of whom are sex workers. There are an estimated 35,000 entertainment workers in Cambodia, working at night clubs, bars, massage parlors, karaoke clubs (KTV), restaurants, beer gardens, as well as on the street. Prevalence of HIV is as high as 14 percent, among some groups of entertainment workers.

    SMARTgirl stands apart from other programming among entertainment workers in Cambodia because of its positive, non-stigmatizing approach. It combines evidence-based interventions with the strong SMARTgirl brand, which empowers women to protect their health and well-being. SMARTgirl reaches nearly half of all EWs in Cambodia in their workplace, because it treats them respectfully, recognizes what is important to them and improves health-seeking behavior by raising self-esteem.

    SMARTgirl is one of a number of projects that validates what the international community and national leaders have been emphasizing for more than a decade— that empowering women and girls are vital components of human development. Since coming into office, U.S. Secretary of State, Hillary Clinton, as well as Ambassador Verveer, have continually underscored the importance of integrating these issues into Department of State foreign policy objectives.

    During Secretary Clinton’s recent ASEAN development meeting in Phnom Penh, she was influential in integrating gender equality and women’s empowerment into the Lower Mekong Initiative agenda. In a statement, she emphasized the importance of reproductive rights for achieving gender equality; an area that the innovative FHI 360 SMARTgirl program has been integrating into its HIV mitigation program:

    “Reproductive rights are among the most basic of human rights. … Millions of women and young people in developing countries don’t have access to information to plan their family. They don’t have health services and modern methods of contraception. This is not only a violation of their right…it’s also a question of equity as women everywhere should have the same ability to determine this fundamental part of their lives.”

    As this short video on SMARTgirl reveals, the women in the program feel inspired, often for the first time. They see themselves as “smart girls”– women who are empowered to change their lives, and educate others about health issues and rights.

    Says Kheng, “Before I became a SMARTgirl leader, I used to face issues on my own, … but we have the right to help each other and we have to participate in the community where we live.”

    Read more stories from participants in FHI 360’s SMARTgirl program.

  • July 10, 2012

    London Summit on Family Planning

    On Wednesday, July 11, 2012, the U.K. Government and the Bill & Melinda Gates Foundation are hosting the groundbreaking London Summit on Family Planning. According to the Summit’s website, the meeting plans to, “mobilize global policy, financing, commodity, and service delivery commitments to support the rights of an additional 120 million women and girls in the world’s poorest countries to use contraceptive information, services and supplies, without coercion or discrimination, by 2020.”

    FHI 360 believes that family planning is a key aspect of human development. The following posts are perspectives from FHI 360 staff on family planning’s importance around the world.

  • June 28, 2012

    Improving Health System Performance Starts from the Ground Up

    Written by
    FHI 360 Health Systems Strengthening Unit

    Imagine: a district health official sits at her desk with the results of a country-wide assessment that details 20 pages of vague recommendations to improve the health system. Suggestions range from “increasing use of financing mechanisms” to “providing adequate benefit packages for health workers” to “utilizing budget-neutral retention schemes to improve rural retention of health workforce.”

    She realizes that these issues are potentially important to her work, but she faces more immediate challenges on a day-to-day basis. Just this morning, a local hospital director was in her office discussing the low number of women who attend their antenatal care appointments. Everyday issues such as this seem disconnected from the greater health system — but are they?

    It is widely recognized that failure to reach health care goals can be attributed to constraints on the system, but the relationship between these constraints and specific health issues is not well understood. FHI 360’s Health Systems Strengthening unit has developed a tool to examine the links between the concrete problems in performance experienced at a subnational level and overarching health system issues.

    FHI 360’s Health System Rapid Diagnostic Tool guides identification of bottlenecks and sets the scene for addressing those hurdles. The Rapid Diagnostic Tool provides a step-by-step framework, operational guide and metrics for an in-country team to process to identify and measure the strength of priority health system functions.

    Other health system assessment tools exist, but their results are aggregated into lengthy reports — such as the report on our imaginary district health officer’s desk — full of recommendations that are difficult to act on and not linked to daily work. These other tools focus on assessing what health system problems exist at a high level. In Kenya, for instance, a dozen assessments have been performed in the past decade, and Kenyan health officials are very aware of the issues they face. What is not clear, however, is how to address those issues and how to achieve better outcomes.

    The Rapid Diagnostic Tool dives deep with focused data collection and analysis to identify root issues that lead to poor health-system performance. Its level of detail makes it ideal for assessment at the regional, district or subdistrict level, as opposed to the health sector as a whole. The final diagnostic report serves as a basis for designing health systems strengthening interventions.

    Delving into the root causes of many health system problems is like pulling a thread on a sweater. It quickly becomes clear that one problem is interrelated with many other issues and can be overwhelming for a project or individual to deal with alone. With the Rapid Diagnostic Tool, stakeholders work together to prioritize systems issues and find the root cause of more proximate problems. With this understanding in hand, they are equipped to design initiatives that will improve health system efficiency and effectiveness by addressing the underlying causes of poor performance. For more information on the Rapid Diagnostic Tool, contact the FHI 360 Health Systems Strengthening Unit at HSSD[at]fhi360.org.

  • June 27, 2012

    The Co-founder of National HIV Testing Day asks, “Why do we need a special day for HIV testing?"

    Written by
    A. Cornelius Baker, Technical Advisor and Co-project Director, Be the Generation Bridge, FHI 360

    Today, June 27, is National HIV Testing Day in the United States. It is an observance that is now recognized in many countries around the globe. Why set aside a special day for something that should be a routine part of medical care for people at risk of getting HIV? Because ending the stigma of HIV and creating multiple opportunities for testing is an urgent need in our effort to create an AIDS-free generation.

    In the late 1980s, many of my friends had died of AIDS or were very sick. The decision to get an HIV test was not an easy one. But in 1986, I went for an HIV test at Whitman-Walker Clinic in Washington, DC, because it was important for me to know my HIV status. This was at a time when there were few treatment options, and the testing process involved a long and scary wait for your results. In 1995, I worked with my colleagues at the National Association of People with AIDS (NAPWA) and we created National HIV Testing Day. This effort was designed to help reduce the stigma of HIV testing and to normalize it as a component of regular health screening. At that time, there was a lot of fear about testing. Because there were few treatments, many thought it unnecessary. People who were known to be HIV positive were subjected to being fired from their jobs or becoming victims of violence. At NAPWA, we believed it was important to confront this situation by encouraging people to “Take the Test, Take Control.” We also believed that the more of us who stood up, the less the world would be able to ignore the epidemic.

    Last week, members of parliament in Zimbabwe provided the type of leadership needed in the United States and worldwide to end the stigma of HIV testing. Over 47 legislators, and 60 of their staff, underwent voluntary counseling and public testing for HIV in an effort to encourage other citizens to follow suit. As a result, Blessing Chebundo, chairman of the Zimbabwe Parliamentarians Against AIDS, told SW Radio Africa that, “181 people went through the doors for testing, and 23 men underwent circumcision (proven to reduce the risk of HIV infection).”

    Today, there are dozens of treatments available to keep people with HIV healthy. There is excitement also about the progress we are making in biomedical prevention interventions such as circumcision, PrEP (pre-exposure prophylaxis) and treatment as prevention. HIV testing itself is easier and quicker with results available in 20 minutes. The promise of these new opportunities begins with everyone knowing their HIV status without fear of discrimination, stigma or violence.

    To learn more about National HIV Testing Day, visit the website here.

  • June 25, 2012

    U.S. Education Blog Series: Prepared to Succeed

  • June 20, 2012

    The Domino Effect of Family Planning

    Written by
    Megan Averill
    Tricia Petruney
    Ward Cates

    Imagine a line of dominos stretched out as far as the eye can see, with additional lines branching off into the distance. This web of dominos represents the multiple connections between family planning and every dimension of sustainable development. What many still don’t comprehend is how large and far reaching this web truly is.

    We’ll begin with a simple and intuitive causal relationship: voluntary use of contraception prevents unintended pregnancies. Unintended pregnancies result in thousands of deaths globally and many more disabilities each year. Many unplanned pregnancies end in abortion. Almost half of the 40 million abortions performed each year are unsafe, placing nearly 20 million women at risk for infection, hemorrhage, disability, and death. Thus, contraception prevents unintended pregnancies and saves women’s lives.

    Dr. Ward Cates, President Emeritus at FHI 360, visits health workers that are involved with the Bill & Melinda Gates Foundation-funded Urban Health Initiative (UHI) in India.

    And the benefits of family planning don’t end with women. Families using contraception have fewer, healthier children and reduced economic burden. Children born to mothers who have used modern contraception in planning their families are not only more likely to have a mother, and one who is healthy, they also are more likely to have been breast fed for longer and received more parental attention, support and resources than children born in to families that were not planned. All of these factors increase the chances that they will survive infancy into childhood. Therefore, family planning also saves children’s lives. Moreover, if after childhood girls and women are given control over their fertility, they are more likely to stay in school and to get jobs. Educated, employed women are in turn more likely to use contraception, thus re-initiating the virtuous cycle of benefits that family planning brings to women and their families.

    The benefits still don’t end there. Ensuring that we can feed our growing population while protecting the planet has quickly become one of the most pressing challenges in sustainable development. Regions of the world with the highest unmet need for family planning are already forced to bear the burden of climate change effects to which they have contributed the least. These effects include drought and famine. Turning an extra acre of forest into tilled land is not a choice for a woman without access to reproductive health resources. It is a matter of survival. And it is a preventable scenario. Right now more than 200 million women worldwide want to plan and time their pregnancies but are unable to do so for lack of information and access to contraceptive resources. If the percentage of women with unmet family planning needs remains constant, developing country populations are expected hit 9.7 billion by 2050, and 25.8 billion by 2100. By filling this need, we could greatly relieve some of the combined pressures being placed on resources and communities, including a growing demand for food.

    The right and ability of women and couples to plan their families is not peripheral to the aims and objectives of Rio+20. Indeed, the call for greater attention to women’s rights and issues at Rio+20 is growing into a crescendo. Women’s Major Group is mobilizing women across the world to share their stories and ensure that women’s rights are front and center on the agenda. Over 100 of the world’s leading scientific academies have called upon world leaders to enact rational, evidence-based responses to sustainable development challenges, including global access to comprehensive reproductive health resources.

    Until now, too few people have been aware and too few leaders willing to acknowledge the essential role that family planning plays in achieving sustainable development. Rio+20 is our chance to tip this pivotal domino piece forward, and witness the measurable cascade of progress it evokes.

  • June 15, 2012

    Las Manos de Apá: The Hands of My Father

    An Interview with
    Judith Sikora, Senior Early Childhood Education Advisor, FHI 360
    What is Las Manos de Apá?

    Las Manos de Apá was a program FHI 360’s early childhood experts created and piloted with a grant from the Office of Head Start. We created a curriculum and materials that childcare workers and administrators in Head Start and Early Head Start programs could use to help the Latino fathers in their schools improve their parenting skills and better understand the early literacy needs of their children. The materials were used in Migrant and Seasonal Head Start programs in Michigan and New York.

    Why did this program target fathers specifically?

    We wanted to reach out to fathers because research shows that fathers are generally less involved in the Early Head Start and Head Start programs than other family members. In the migrant and seasonal programs, a lot of the dads are farm workers, and many are illiterate. We found that many dads who participated in Las Manos de Apa had very negative memories of their school experiences and didn’t understand the different stages of child development or how to engage with their children in early learning activities.

    It was very important to us that we engaged the fathers where they felt most comfortable. Many of the fathers fondly remembered the oral storytelling traditions in their culture, and many were exposed to these traditions in their early childhood years. So we used oral storytelling in the lessons to gain the fathers’ trust, build their confidence and engage with them in a way that would be comfortable and familiar. We were simultaneously building their parenting skills and teaching them how to relate to a three- or four-year-old child.

    What kinds of activities did the fathers do in the program?

    In one activity, the fathers learned how to make a book with their children. Even if the father could not read, he could encourage his child to draw pictures and teach his child to look at the book from the left to the right. Another activity the fathers did together was make bookshelves for their children. Some of the dads went all out and engraved their children’s names in the bookcases or added intricate details. That was a culminating activity for them. We also had speakers come to the fathers’ groups to talk about different issues. In another activity, the fathers gave presentations to the mothers.

    There was an opportunity over the three-year period for the program to have different mix of families. There were always new families added to the mix. Migrant and seasonal programs open and close according to the growing season of the area. But we tried to engage them all in social activities as well as the lessons. Things like soccer games and cookouts fostered the community the participants built.

    What did the fathers see as some of the outcomes of their participation in the program?

    Many fathers told us that initially they weren’t sure how to engage with their children, and they lacked confidence about how to interact with their young children. They said that because of the skills they learned in the program, they now talk with their children more and participate in more activities with their pre-schoolers. Overall, they said that they are spending much more quality time with their families. Many of them didn’t have father figures in their households growing up, so they didn’t have role models to follow. Now, they want to be role models for their children. They told us that this project gave them a lot of the tools to do that.

    For more information about the education work FHI 360 does in the United States visit our website.

  • June 13, 2012

    Increasing transparency and participation in the 2012 Senegalese Presidential Election

    Written by
    Jean-Michel Dufils, Chief of Party, Senegal Country Office, FHI 360

    International media coverage paints a bleak picture of how fair, open and representative many recent presidential elections have been. Thanks to Programme Gouvernance et Paix (PGP), an FHI 360-led program funded by USAID, the 2012 presidential election in Senegal saw increased transparency and also increased participation from women and youth.

    Senegal is an island of stability in a tumultuous region. Peace and democracy in Senegal have helped it become a hub for regional and international organizations that work in West Africa. And though the country has a long democratic history, there had been a regression in democratic indicators over the last ten years. FHI 360 teamed with the International Foundation for Electoral Systems (IFES) to support the electoral process in Senegal.

    Before the election occurred, PGP launched a civic awareness campaign that increased voter registration by 120% in Grand Yoff, a working-class suburb of 200,000 in Dakar. This initiative worked with women’s groups and youth organizations to boost voter registration in two underrepresented demographics. The project’s daily dialogue radio campaign was so successful that AFIA FM, one of the 17 implementing stations, incorporated it as a permanent fixture.

    Beyond simply helping the public monitor the election, PGP took proactive steps to increase transparency in the pre-election period. PGP experts worked with leaders of both opposition and ruling parties to amend the election code. Negotiations reached consensus on more than 85% of issues. As a result of these negotiations, a single ballot was approved and a gender parity article was inserted. The next legislative election will, for the first time, provide gender and religious parity in the country’s General Assembly.

    Working closely with print media, PGP trained journalists to monitor elections and provide objective coverage. As a result, those reporters published more than 30 election-related articles in prominent newspapers. Youth and female journalists trained through PGP interviewed presidential candidates about issues important to their respective demographics. Subsequent monitoring by journalists and interested constituencies has confirmed that Macky Sall, the current president, is adhering to the promises he made during these interviews.

    PGP also coordinated a “situation room,” which connected election observers to a centralized technical center. This initiative, funded by USAID and implemented by local CSOs, deployed more than 1,500 election observers for each round of elections. Utilizing the mapping technology of partner OneWorldUK, the program facilitated the first real-time monitoring of a Senegalese election.

    This program exemplifies the FHI 360 tagline, The Science of Improving Lives. We know the context in which we operate — the key actors, stakeholders and issues. We used an evidence-based approach to deliver an integrated solution with measurable impacts.