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USAID Egypt’s Health and Population Legacy Review
›On May 23 the Middle East Program, ECSP, and the Global Health Initiative of the Woodrow Wilson Center, along with the Global Health Technical Assistance Project, hosted a panel of speakers discussing the past 30 years of the U.S. Agency for International Development’s health and population initiatives in Egypt, as outlined in the new Egypt Health and Population Legacy Review. Geoffrey Dabelko, director of ECSP and coordinator of the Global Health Initiative at the Wilson Center, moderated the event. [Video Below]
Peter McPherson, former administrator of USAID during the Reagan administration, and George Laudato, the administrator’s special assistant for the Middle East, presented on the historical context behind USAID in Egypt and the results of their efforts. McPherson pointed to three lessons that can be drawn from the recent report:- “Big payoffs” require long-term efforts; and
- Economic support for a country can have a dramatic impact; but
- The host country’s commitments and investments are still important.
Motaz Zahran, political counselor for the Embassy of Egypt, noted that USAID efforts were “just one sector of a fruitful partnership” between the United States and Egypt that he hoped would continue. He said the success story outlined by the report was reflective of improvements in coordination and addressing specific goals.
Other panelists outlined the successes of USAID in Egypt as related to their own areas of expertise. Leslie B. Curtin, co-author of the review and an expert in demographics and health outcomes, noted the dramatic improvements in a range of health sectors, in particular the rise in contraceptive prevalence and immunization rates and decrease in both maternal and infant mortality rates.
Nahed Matta, MD, senior maternal and newborn health officer at USAID, focused on improvements to the quality of maternal health, which she said were made possibly through better technology and increased fact-gathering to identify the key factors regarding maternal health trends. Sameh El-Saharty, MD, senior health policy specialist at the World Bank and Health Legacy Review Committee member, credited the increased number of health professionals in Egypt, better information gathering on health systems, and restructured models of health insurance, as successful strategies.
Concluding the session, Amie Batson, deputy assistant administrator for Global Health at USAID, discussed the lessons that other development initiatives can draw from the legacy of USAID efforts in Egypt. She highlighted the importance of country ownership, in which the developing country engages with other institutions and religious and political leaders at both national and local levels, and of policies that fund routine monitoring and evaluation. She also outlined the possibilities of innovation and south-to-south sharing on the local and international scale, referencing inroads made by two recent initiatives: the “MAMA” mobile device program, launched by Secretary Clinton in May 2011 to assist with disseminating maternal health information, and the Saving Lives at Birth initiative, launched by USAID in partnership with several other organizations in March 2011.
Laura Rostad is an intern for the Middle East Program at the Woodrow Wilson Center.
Image Credit: Adapted from cover of the Egypt Health and Population Legacy Review, courtesy of USAID; cover photo courtesy of Leslie Curtin. -
Designing Health and Population Programs to Improve Equity: Moving Beyond the Rhetoric
›“There needs to be ongoing flexibility and creativity in our ways of approaching health equity,” said John Borrazzo of the U.S. Agency for International Development (USAID) at a recent Global Health Initiative event at the Wilson Center. Borrazzo is the chief of the Maternal and Child Health Division in the Bureau for Global Health. He moderated a discussion on practical strategies to improving access to health services for the world’s poor and other marginalized groups, with panelists Mickey Chopra, chief of health and associate director of programmes at UNICEF; Davidson Gwatkin, senior fellow at the Results for Development Institute and senior associate at Johns Hopkins Bloomberg School of Public Health; Cesar Victoria, professor of epidemiology at the Federal University of Pelotas in Brazil; and Jennifer Luna, senior monitoring and evaluation adviser for the Maternal and Child Health Integrated Program (MCHIP). [Video Below]
MDG 4: An Equity Approach
“Massive benefits can be gained by reaching the poorest and most marginalized,” said Chopra. “It’s actually more cost effective to have an equity-based approach; it’s not just right in principle, it’s right in practice.”
While there has been some progress in reducing the rates of mortality for children under five (the UN’s Millennium Development Goal 4), Chopra said “there has to be a change” if they are going to be achieved completely. Most of the 30 percent decline in child mortality so far has been in Asian countries, while Africa as a whole remains stagnant. Further, two-thirds of the 35 countries that have made significant progress to meet MDG 4 show worsening inequalities between the highest and lowest income brackets of the population.
In the majority of countries, the “rich are still capturing most of the benefits of new investments and interventions,” said Chopra. “The challenge at the program and policy levels is to understand why there is this gap between the richest and the poorest in terms of uptake of critical interventions.”
Delivery channels are faced with “bottlenecks” that prevent services from reaching marginalized communities, said Chopra. Clinic-based services often lack adequate human resources, consistency in the quality of service, and can be very expensive. Population-oriented services, which include government and NGO-led outreach and scheduled services at health facilities, are often challenged with low demand and lack of continuity, while availability and cost of health commodities are barriers for community-based interventions delivered through local organizations or social marketing campaigns.
Shifting delivery of services within channels, appropriately shifting delivery to different channels, or improving the performance of an established delivery channel could help increase uptake of treatment and prevention among poor and marginalized communities, concluded Chopra. He stressed that progress need not come at the expense of the poor. According to a UNICEF report, Ghana, Eritrea, Nepal and Malawi have all reduced under-five mortality and inequality by prioritizing providing essential services to the most marginalized communities first.
Designing Equity-Based Health Programs
“Performance variability in terms of equity across countries is very large,” said Gwatkin. “In some places a given technique can work well and in others it can be a complete flop.”
To pick the right technique for the right place, Gwatkin advocated for an iterative approach to program design and implementation, beginning with setting targets in terms of the poor population group of concern. After fully assessing country-specific conditions, a set of potential pro-poor interventions can be selected, based on an analysis of current interventions and suggested alternatives as well successful interventions in other countries. Each of these interventions should be delivered to a large, representative area, he said.
“The next step is to find out how well you have done,” said Gwatkin, stressing the importance of assessing and monitoring interventions with a specific focus on the marginalized target group. Successful approaches should be expanded, while those that are not having the intended benefits of helping the poorest communities should be modified or abandoned.
In sum, said Gwatkin, “It’s more promising to focus on designing a process to fit techniques to individual country settings than to focus on the techniques themselves.” Doing this helps effectively integrate equity concerns into the design and implementation of programs, and as a result, he said, can have a major impact on improving the lives of the poorest people in developing countries.
Analyzing Equity to Maximize Impact
“It’s always possible and useful to include equity in monitoring and evaluation, however, it has to be planned ahead of time,” said Victoria.
The Countdown to 2015 Initiative is an effort to monitor progress made towards the health-related Millennium Development Goals globally. The Countdown’s efforts not only aim to promote access to health services at the aggregate level but also specifically to ensure the equitable distribution and uptake of health services among disadvantage populations, said Victoria.
Generally, in countries with high coverage of preventative and treatment services, like Brazil, there is “bottom inequity,” said Victoria, in which the poor are much worse off than everyone else. Targeting the poor specifically in such countries is therefore essential to improving equity.
Alternately, Victoria continued, countries with low coverage at all levels, like Cambodia or Haiti, suffer from “top inequity,” in which the rich are typically much better off the rest of the population. These countries should work towards increasing coverage for all people and focus on the poor after there are some universal gains, he said.
“Analyzing the shapes of inequity curves can help drive decisions about delivery channels and targeting…and can lead to practical strategies for maximizing the impact of interventions,” concluded Victoria.
Health Equity: From Evidence to Practice
“Projects often state that they are really interested in equity, but when you read the project descriptions, you don’t see exactly what they mean by equity or how they plan on addressing it,” said Luna, speaking of her work at MCHIP.
Luna presented the Health Equity Guidance Document that outlines a systematic, six-step process for professionals who design and implement community-oriented projects to ensure equity is effectively integrated into their programs:1) Understand the equity issues in the project area
Luna stressed that there is no “one size fits all” strategy: “This approach is not a prescriptive one; it presents a series of concepts and approaches to take into consideration and then make decisions.” But for program implementers on the ground, she said, these guidelines and tools “should help lead to a coherent health equity strategy and can serve as a basis for dialogue among stakeholders.”
2) Identify the disadvantaged group on which to focus
3) Decide what is in the project’s manageable interest to change
4) Define equity goals, objectives, and a project-specific definition of equity
5) Determine equity strategies and activities
6) Develop equity-focused monitoring and evaluation
Sources: UNICEF, United Nations Development Programme, World Health Organization.
Image Credit: “Malaria prevention, Kenya,” courtesy of flickr user DFID. -
Accessing Maternal Health Care Services in Urban Slums: What Do We Know?
›“Addressing the needs of urban areas is critical for achievement of maternal health goals,” said John Townsend, vice president of the Reproductive Health Program at the Population Council. “Just because there is a greater density of health services does not mean that there is greater access.”
Townsend moderated a discussion on the challenges to improving access to quality maternal health care in urban slums as part of the 2011 Maternal Health Dialogue Series with speakers Anthony Kolb, urban health advisor at USAID; Catherine Kyobutungi, director of health systems and challenges at the African Population Health Research Center; and Luc de Bernis, senior advisor on maternal health at the United Nations Population Fund (UNFPA). [Video Below]
Mapping Urban Poverty
“Poverty is becoming more of an urban phenomenon every day,” said Kolb. With over 75 percent of the poor in Central Asia and almost half of the poor in Africa and Asia residing in cities and towns by 2020, “urban populations are very important to improving maternal health,” he added.
Collecting accurate data in informal settings such as slums can be very challenging, and there is often a “systematic undercounting of the urban poor,” said Kolb. Data often fails to capture wealth inequality in urban settings, and there is often a lack of attention to the significant variability of conditions between slums.
Kolb also warned about the risk of generalization: “Slums and poverty are not the same.” In practice, there is not a standardized definition of what constitutes a slum across countries, he said. “It is important to look at different countries and cities individually and understand how inequality is different between them.” Slum mapping can help to scope out challenges, allocate resources appropriately, and identify vulnerability patterns that can inform intervention design and approach, he said.
Maternal Health in Nairobi Slums
Addressing the maternal health needs of the nearly 60 percent of urban residents who live in slums or slum-like conditions will be a critical step to improving maternal health indicators of a rapidly urbanizing Kenya, said Kyobtungi.
Only 7.5 percent of women in Kenyan slums had their first antenatal care visit during their first trimester of pregnancy and only 54 percent had more than three antenatal care visits in all – rates significantly lower than those among urban women in non-slum settings.
“In some respects, [the urban poor] are doing better than rural communities, but in other ways they are behind,” said Kyobtungi. But, she said, there are many unique opportunities to improve maternal health in slums: “With these very high densities, you do have advantages; with very small investments, you can reach many more people”
Output-based voucher schemes – in which women pay a small fee for a voucher that entitles them to free, high-quality antenatal care, delivery services, and family planning – have been implemented to help poor, urban women access otherwise expensive services. But poor attitudes towards health care workers, transportation barriers, and high rates of crime still prevent some women from taking advantage of these vouchers, said Kyobtungi.
The majority of maternal health services in slums are provided by the private facilities, though size and quality vary widely. “There is a very high use of skilled attendants at delivery, but the definition of skilled is questionable,” said Kyobtungi
“Without supporting the private sector,” Kyobutungi said, “we cannot address the maternal health challenges within these informal settlements.” Combined with an improved supervision and regulation system, providing private maternal health facilities with training, equipment, and infrastructure could help to improve the quality of services in urban slums, she concluded.
Reducing Health Inequalities
“While we have evidence that health services, on average, may be better in urban areas than in rural areas, this often masks wide disparity within the population,” said de Bernis. “Reducing health inequities between and within countries is a matter of social justice.”
When it comes to family planning, total fertility rates are lower in cities, but “the unmet need…is still extremely important in urban areas,” explained de Bernis. Many poor women in cities, especially those who live in marginalized slum populations, do not have access to quality reproductive health services – a critical element to reducing maternal morbidity and mortality rates.
Economic growth alone, while important to help improve the health status of the poor in urban settings, will not solve these problems, said de Bernis. To reduce health disparities within countries, de Bernis advocated for “appropriate social policies to ensure reasonable fairness in the way benefits are distributed,” including incorporating health in urban planning and development, strengthening the role of primary health care in cities, and putting health equity higher on the agenda of local and national governments.
Event Resources:Source: African Population Research Center, United Nations Population Fund.
Photo Credit: “Work Bound,” courtesy of flickr user Meanest Indian (Meena Kadri). -
Is Universal Access to Family Planning a Realistic Goal for Sub-Saharan Africa?
›“What do we require to ensure universal access to family planning services that are appropriate, affordable, accessible, and of good quality?” asked Michael Mbizvo, director of the Department of Reproductive Health and Research at the World Health Organization at the Wilson Center last month. [Video Below]
To talk about this difficult question and present research and programmatic evidence for sub-Saharan Africa, Mbizvo was joined by panelists Fred Makumbi, senior lecturer and head of the Department of Epidemiology and Biostatistics at Makerere University, Uganda; Oladosu Ojengbede, director of the Center for Population and Reproductive Health, University of Ibadan, Nigeria; and Frank Taulo, director of the Center for Reproductive Health and senior lecturer of obstetrics and gynecology at the University of Malawi.
Integrating Family Planning and HIV Services
Makumbi shared a number of findings on fertility preferences, behaviors, and contraceptive uptake in the context of HIV infection and care in Uganda. “Integrating family planning services into HIV services could help address the family planning needs of both HIV infected and uninfected,” he said.
According to new research conducted as part of the Rakai Community Cohort Study, despite significant gains in family planning use over time, there is still a high unmet need for contraception, irrespective of HIV status, in the Rakai district of central Uganda, said Makumbi. Male partner’s fertility desires were found to play an important role in pregnancy rates, and compared with previous studies conducted in the Rakai district, researchers saw an increase in pregnancy incidence and prevalence among HIV positive women, especially those on anti-retroviral therapy. HIV care that included voluntary counseling and testing was associated with significant increases in the use of family planning, and in particular, the use of condoms.
To effectively promote universal family planning in sub-Saharan Africa, “there is a need to strengthen family planning services in HIV care programs, with promotion of modern contraceptive methods, and with particular attention to women on anti-retroviral therapy,” said Makumbi. “Strategies to address desire for high fertility need to be developed, especially with regard to male involvement,” he added.
Multi-Pronged Approach to Universal Family Planning
“Family planning success in sub-Saharan Africa is a must for the region’s sustainable development,” said Ojengbede. “Poor commitment to women’s health in sub-Saharan Africa” has not only resulted in high fertility rates and poor maternal health indices but has also negatively impacted economic and human development in the region, said Ojenbede.
To increase access to and use of family planning, Ojengbede stressed the need to generate and sustain government commitment, promote legislation to support women’s autonomy, and implement policies to improve access to quality reproductive health services.
At the community level, Ojengbede said, the public health community must work to integrate family planning services into all reproductive health programs, including prevention of mother to child transmission; accelerate female empowerment programs; actively engage males in family planning access and uptake; and address social and cultural barriers that prevent widespread adoption of family planning.
“Traditional rulers can occupy a critical position to enact positive change in their communities and at the national level,” said Ojengbede. In Nigeria, for example, providing education about the health and economic benefits of family planning has helped traditional leaders embrace family planning and develop their own strategies to promote birth spacing in their communities.
“Universal family planning access must be achieved through a multi-pronged approach that should be colored with socio-cultural sensitivity, solid evidence, and sustainability,” concluded Ojengbede.
Eliminating Unmet Need: “Yes, We Can”
“It is time to prioritize issues that are affecting women and family planning is a very critical area,” said Taulo.
There are still many challenges to overcome before Malawi can achieve universal family planning access, including poverty, misconceptions and myths about family planning, lack of availability of reproductive health supplies, poor infrastructure, shortage of trained professionals, and religious and cultural barriers.
“Commodities are also very much dependent on the donor,” said Taulo, pointing to the challenges of insufficient funding and political will. “Failure to connect family planning to economic development and political stability is one of the main areas that we are struggling with,” he added.
“We have lots of challenges, but also many achievements,” said Taulo. Malawi has made important strides in expanding access to family planning by implementing community-based strategies and youth-friendly programs, developing public-private partnerships, engaging policymakers and traditional leaders, and encouraging media coverage of family planning issues.
“Education is another family planning product,” said Taulo. Moving forward, a “deliberate focus on girl child education” and promotion of women’s welfare can have a major impact on fertility reduction, he said.
“We can eliminate unmet need for family planning in Malawi, if we put our heads together, our thoughts together, and our energy together,” concluded Taulo.
Source: World Health Organization.
Image Credit: “Women’s Health Clinic” courtesy of flickr user advencap. -
Working With the Private Sector to Improve Maternal, Newborn, and Child Health
Innovations From Development to Delivery
›“Challenging and dynamic partnerships [with the private sector] are difficult to pull together, but when you look at sustainability, impact, and effectiveness, they can also be great levers of change,” said Kari Stoever, senior advisor for global advocacy at the Global Alliance for Improved Nutrition (GAIN) at the Wilson Center on March 22. [Video Below]
Stoever was joined by panelists Laura McLaughlin, environmental engineer at Cascade Designs, Inc., Hugh Chang, director of special initiatives at the NGO PATH, and Laura Birx, senior food security and nutrition specialist at the U.S. Agency for International Development (USAID) for a discussion of the private sector’s role in developing innovative health technologies to increase access to safe water, prevent infectious diseases, and improve maternal health nutrition.
Collaborating to Provide Safe Water
“NGOs have different strengths and different perspectives from the private sector, and we’ve found an area where we can really complement each other,” said McLaughlin. Cascade Designs, Inc., collaborated with PATH to create a smart electrochlorinator, which produces a chlorine solution to purify water using just salt water and a simple battery, because “we wanted to make a bigger difference than we could do with philanthropy alone,” said McLaughlin.
“Products need to be designed specifically for the end user, particularly for women and children, who are often times left out of the design process,” said McLaughlin. Cascade’s smart electrochlorinator was designed with this in mind. One charged battery can treat up to 40,000 liters of water, 200 liters at a time. The device is easy to use, requires simple resources, is significantly more affordable than existing solutions, and lends itself to an entrepreneurial business model that can deliver safe water to small community households. The current prototype is being field-tested in 10 countries globally, with the aim of providing safe water in resource-poor communities while generating income for local entrepreneurs.
The PATH-Cascade partnership was successful in part because it combined “private-sector expertise in efficiency, cost-effectiveness, and meeting market demands” with knowledge about the health needs in developing countries, said McLaughlin. By “pushing each other to a common end goal, this partnership really multiplied our strengths.”
Engaging the Private Sector
“One of the reasons we work closely with the private sector…is because we recognize an efficiency of resource usage that comes with building bridges between the public sector and the private sector,” said Chang of PATH’s work with Cascade and others. Engaging the private sector to advance health technologies can complement PATH’s goals, like encouraging healthy behaviors and strengthening health systems, he said. “But, we are not averse to profits,” he added, stressing that partnerships with NGOs can be mutually beneficial. “We understand for this to be sustainable, these companies need to make a profit.”
PATH is working with the private sector to develop injection and vaccine technologies that “produce a product that not only benefits the recipient of the vaccine but also produces a revenue stream,” said Chang. The SoloShot, for example, is a low-cost, disposable syringe that locks after a single injection, preventing needle reuse and contamination that can increase the risk of HIV, hepatitis B, and other infections. To address the challenge of maintaining the proper refrigeration of vaccines in low-resource settings, private sector collaboration has helped to develop the vaccine vial monitor (a sticker that changes color when a vaccine has been exposed to too much heat) and to create more stable vaccine formulas that are less vulnerable to extreme temperatures. “By combining innovation with on-the-ground presence,” concluded Chang, “private sector engagement can be a powerful tool for global health.”
A “Win-Win Partnership”
“There is a tremendous role for the private sector to play in the intersection of agriculture and health as they relate to nutrition,” said Birx. Engaging the private sector can be a “win-win partnership,” she said. The Obama Administration’s hunger initiative, Feed the Future, for example, uses the resources, expertise, and innovation of the private sector to encourage sustainable, market-driven approaches to reducing poverty and food insecurity, said Birx.
USAID sees innovation as a “research-to-use continuum,” said Birx. “When we look at innovation, it’s not just about the development of a specific product, but about the entire system that goes around that product,” she added. New technologies must not only respond to a major development challenge in poor and rural communities but need to be affordable, culturally appropriate, gender sensitive, easy to use, and durable.
But solutions don’t have to be complicated. “Often times it’s about a really simple technology that can improve accessibility,” said Birx. The nevirapine pouch, for example, a simple foil packet that allows health care workers to give women single doses of nevirapine syrup, can reduce the risk of mother-to-child transmission of HIV by more than half.
“There’s a lot of excitement, but we need to do some serious work to capitalize on [it],” said Birx. Moving forward, health, development, and private-sector organizations must work together to create innovative financing mechanisms, build institutions in developing countries, and encourage enabling policy environments.
Sources: PATH.
Photo Credit: “Mission to Ouanda Djallé,” courtesy of flickr user hdptcar. -
USAID: Maternal Deaths in Bangladesh Decline by 40 Percent in Less Than 10 Years
›The original version of this article, by the USAID Global Health Bureau, appeared on the USAID Impact blog.
Bangladesh is on track to meet the 2015 deadline for UN Millennium Development Goal 5 (50 percent reduction in maternal deaths). The Bangladesh Maternal Mortality and Health Service Survey, jointly funded by the Government of Bangladesh, USAID, Australian Aid (AusAID) and the United Nations Population Fund (UNFPA), found that maternal deaths in Bangladesh fell from 322 per 100,000 in 2001 to 194 in 2010, a 40 percent decline in 9 years.
The decline in direct obstetric deaths is most likely the consequence of better care seeking practices and improved access to and use of higher-level referral care. The decline in total fertility rate due to the successful family planning program has reduced exposure to high risk pregnancies and has thus prevented a large number of maternal deaths.
Continue reading on USAID’s Impact blog.
Sources: Directorate General of Health Services – Bangladesh, UN.
Photo Credit: Adapted from “Mother & Son,” courtesy of flickr user Anduze traveller. -
Celebrating Ordinary Women Doing Extraordinary Things to Improve Gender Equality and Maternal Health Worldwide
›As coordinator of one of the few forums dedicated solely to maternal and reproductive health in Washington, D.C., I am particularly excited about this year’s 100th anniversary of International Women’s Day. This day commemorates ordinary women doing extraordinary things and acknowledges both the progress made and barriers still faced by women worldwide.
“When it comes to the boardroom meetings, government sessions, peace negotiations, and other assemblies where crucial decisions are made in the world, women are too often absent,” said Secretary of State Hillary Clinton during her remarks for International Women’s Day. “It is clear that more work needs to be done to consolidate our gains and to keep momentum moving forward.” [Video Below]
For mothers worldwide, some momentum has indeed been gained: Maternal mortality rates dropped from 526,000 a year in 1980 to 342,900 in 2008, according to a report by the Institute of Health Metrics and Evaluation at the University of Washington. In September of last year, a group of international leaders – including the UN and other multilateral institutions, donors, the business community, and NGOs – launched the “Global Strategy for Women and Children’s Health” and committed $40 billion to save the lives of 16 million women and children in developing countries.
At the sixth meeting of the Wilson Center’s Advancing Policy Dialogue on Maternal Health Series, Mayra Buvinic, sector director of the World Bank’s gender and development group, said: “Investing in women and girls is the right thing to do. It is not only fair for gender equality, but it is smart economics.” She said the World Bank has found that empowering women allows families to better endure economic crises and leads to better futures for their children as well.“When women have better education and health, mothers have greater household decision-making power and prioritize the well-being of their children,” said Buvinic. “In return, children have better educational attainment and are productive adults, building long-term economic growth.”
However, increased investment will only pay off when money is translated into action and stakeholders are held accountable for empowering women.
Since the inauguration of International Women’s Day 100 years ago, the low status of women in many parts of the world has remained relatively unchanged. Many women are still subject to male-dominated values that preclude them from making basic decisions about “who to marry, when to marry, when to have children, and how many children to have,” said Nafis Sadik, special envoy of the UN Secretary-General for HIV/AIDS, in an interview with the Population Reference Bureau. To change this, international development strategies need to prioritize improving gender equality, women’s status, and women’s voice in the political process.
I am grateful to be working in collaboration with extraordinary institutions such as the Maternal Health Task Force (MHTF) and United Nations Population Fund (UNFPA) who take real steps every day to help improve the lives of women and girls. In collaboration with these institutions, the Wilson Center’s Global Health Initiative is please to announce that it will partner with the African Population Health Research Center in Kenya to co-host a three-part dialogue series with local, regional, and national decision-makers on effective maternal health policies and programs. These in-country dialogue meetings will create a platform for field workers, policymakers, program managers, media, and donors to share research, disseminate lessons learned, and address concerns related to policy, institutional, and organizational capacity building for improved maternal health outcomes.
It is our goal that programs like these will continue to highlight neglected maternal health and issues and galvanize the community everyday – and not just on International Women’s Day.
Sources: Population Reference Bureau, UN, UN Population Fund, U.S. State Department.
Photo Credit: Afghan girl, courtesy of flickr user U.S Embassy Kabul Afghanistan, and Secretary Clinton’s video address courtesy of the U.S. State Department. -
Reality Check: Challenges and Innovations in Addressing Postpartum Hemorrhage
›Heavy bleeding after childbirth, also known as postpartum hemorrhage (PPH), is one of the leading causes of maternal deaths worldwide. Globally, approximately 25 percent of all maternal deaths are caused by postpartum hemorrhage, and many mothers bleed to death due to delays in seeking health care services. On January 25th, 100 representatives from the maternal health community – a majority working directly in developing countries – convened for an all-day meeting at the Wilson Center to discuss experiences in the field and perform “reality checks” on the challenges and successes of PPH programs.
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