Targeting Gestational Diabetes During Antenatal Care: Experience from Ethiopia

By Mebrahtu Abraha Gebremikael, Elke Konings and Christie Roberts, Management Sciences for Health (MSH)

This article originally appeared on the blog for the Maternal Health Task Force (MHTF)

Photo by Warren Zelman

Even as more women in Ethiopia are receiving antenatal care (ANC) services, coming earlier in their pregnancies and more frequently for care, maternal mortality remains high. The leading causes of maternal death include hypertension, eclampsia, hemorrhage and obstructed labor, all of which are more common among women with gestational diabetes, or high blood sugar that is detected during pregnancy. Gestational diabetes can also have serious effects on babies, including abnormal birth weight, congenital malformation, respiratory distress syndrome or stillbirth. Evidence suggests that gestational diabetes is highly treatable and, since it is associated with other conditions, there may be opportunities for integrated treatment approaches. But pregnant women in Ethiopia are rarely screened for this condition, which contributes to gaps in diagnosis and the measurement of prevalence. In fact, it is not clear how widespread the problem is around the world: Varying estimates show gestational diabetes affecting less than 1% to as many as 28% of pregnant women globally. Continue reading “Targeting Gestational Diabetes During Antenatal Care: Experience from Ethiopia”

In Mali, community volunteers strive to stem the practice of female genital mutilation

Community volunteers display flipcharts they use to inform community members about harmful consequences of gender-based violence, including female genital mutilation. Photo by Adama Sanogo/MSH

I started practicing female circumcision when I was 20 years old. I learned the practice from my grandmother and mother as a way to make money. One day, after seeing the consequences of circumcision, I realized the extent to which women and girls suffered in terms of health, psychology and morale. So I am committed as a community focal point in the village of Waïlirdé and as a woman and mother to fight against this practice that is harmful to health.

My main responsibility is to share information and knowledge with members of my community.  Informing people about the consequences of female circumcision allows those who suffer to seek the help they need and help prevent future occurrences.  Additionally this can help people understand the link between current health issues and circumcision.  Above all, I work to raise everyone’s awareness of the danger of the practice to spare young girls from facing this torture.  

–Fatouma, Waïlirdé village, Mali

In the Mopti region of central Mali, about 88% of women aged 15-49 have undergone female circumcision–or female genital mutilation (FGM); almost 69% of these women were circumcised by the time they were five years old (Mali DHS, 2012-2013). As such practices are deeply rooted in the cultural, religious, economic, and social heritage of Mopti, ending them requires strong and concerted community engagement and action.

The FCI Program of MSH mobilizes leaders and communities in Mopti to advance women’s and girls’ health and rights and to end sexual and gender-based violence (SGBV) and harmful practices such as female genital mutilation (FGM) and child marriage. With funding from the Embassy of the Netherlands in Bamako, and in partnership with the Malian non-governmental organization Conseils et Appui pour l’Education à la Base (CAEB), the FCI Program of MSH leads the Debbo Alafia Consortium of multi-sectoral, national, and international organizations to carry out social and behavior change activities and to provide essential medical and psychosocial support to women and girl survivors of gender-based violence, female genital mutilation, and other harmful practices. Leveraging political and religious leaders’ significant influence on public opinion and acceptance, Debbo Alafia also strengthens political commitment and recruits champions to publicly call for the end of harmful practices and promote sexual and reproductive rights for women and girls.

UNICEF and the SGBV Humanitarian Subcluster (awarded through UNFPA) have supported the FCI Program’s work with trained community volunteers, like Fatouma, to discourage the practice of FGM by informing community members about the harmful short-term and chronic health consequences, such as excessive bleeding, infections, swelling, menstrual problems, maternal health complications, even death. These volunteers also refer SGBV survivors to free medical, psychosocial, and legal support services; providers of these services work with the FCI Program of MSH to ensure they are giving respectful, confidential, and safe care to survivors of SGBV.

Community volunteers, forming protection teams that support SGBV prevention and response, have successfully stopped circumcision ceremonies. During a Debbo Alafia meeting of partners and government officials last year, FCI Program staff received news about a circumcision ceremony in progress in the village of Koro. Debbo Alafia partners and government officials went to the ceremony site to convince the circumciser to stop and the parents to take their girls home. Although several girls had already been cut, several more were spared.

As women and girls in the North and surrounding regions remain particularly vulnerable to sexual and gender-based violence (SGBV) and often do not seek or receive appropriate care, the FCI Program of MSH is leading a study, with support from Amplify Change, to investigate the barriers that deter SGBV survivors from accessing care. Using the findings from this study, the FCI Program of MSH will bring together local actors to develop advocacy and program strategies to reduce these barriers to care.

Standing with Women and Girls to End AIDS

By Sarah Konopka

Sarah Konopka, MA, is Principal Technical Advisor for HIV & AIDS Management Sciences for Health’s (MSH) Global HIV & AIDS Program. Follow Sarah on Twitter . This article originally appeared on MSH’s Global Health Impact blog. 

Photo Credit: Mark Tuschman

There was an awkward silence and then soft giggling as the girls looked at each other. I had just finished talking about strategies for persuading sexual partners to use a condom. Laughter during these skills-building and girls empowerment sessions with 30+ secondary school students in Morogoro, Tanzania was not uncommon, particularly given the sometimes sensitive topics of discussion, but this time, the joke was lost on me. Continue reading “Standing with Women and Girls to End AIDS”

« J’ai retrouvé ma personnalité et ma dignité ».

Photo: Adama Sanogo/MSH

For English, click here.

Le programme FCI de Management Sciences for Health (MSH) Sciences de la santé pour la santé, avec le soutien du Sous-cluster humanitaire SGBV (financé par UNFPA), travaille avec des points focaux villageois formés pour référer les survivants de les survivants de la violence basée sur le genre (VBG) 59 villages vers des services médicaux et psychosociaux gratuits dans 9 hôpitaux et pharmacies de Mopti. Une cliente de 15 ans et une survivante de viol familial racontent son histoire. Continue reading “« J’ai retrouvé ma personnalité et ma dignité ».”

“I got my dignity back.”

Photo: Adama Sanogo/MSH

Pour le français, cliquez ici.

The FCI Program of Management  Sciences for Health, with support from the SGBV Humanitarian Subcluster (funded by UNFPA), works with trained village focal points to refer SGBV survivors from 59 villages to free medical and psychosocial services at 9 referral hospitals and pharmacies in Mopti. A 15-year-old client of services, and survivor of familial rape, tells her story. Continue reading ““I got my dignity back.””

Ending gender-based violence and FGM in Mali, village by village

Martha Murdock is Technical Strategy Lead for regional programs at the FCI Program of Management Sciences for Health.

Communities in the Mopti region of central Mali—which is home to several ethnic groups and to many people displaced by 2012 violence in the country’s northern region—continue to grapple with widespread sexual and gender-based violence (SGBV), including forced and early marriage and other harmful practices. A majority of Malian girls are married by the time they reach 18, and 15% before the age of 15.  About 91% of women between 15 and 49 years old, as well as 69% of girls under 15, have undergone female genital mutilation (FGM). And, as is true in so many conflict-affected areas, widespread sexual violence has been a tragic and infuriating effect of war, dislocation, and migration.

After many years of work in Mali, both in the Mopti region and nationally, the FCI Program of Management Sciences for Health is committed both to reducing the incidence of SGBV and to mitigating its devastating effects on survivors. Because harmful practices are deeply rooted in the region’s cultural, religious, economic, and social heritage, ending them requires strong and concerted community engagement and action. But the impact of this work could not be any more powerful, as we learn again and again from the women whose strength, resolve, and resilience continue to inspire us.

An SGBV survivor arriving for medical and psychosocial care
Photo: Adama Sanogo/ Management Sciences for Health

Continue reading “Ending gender-based violence and FGM in Mali, village by village”

Scenes from Midwifery Training: Helping Mothers Survive

By Nongma Sawadogo and Alanna Savage

Nongma Sawadogo leads work on women’s and children’s health for the FCI Program of Management Sciences for Health (MSH) in Burkina Faso, and Alanna Savage is senior communications specialist for the FCI Program of MSH. 

Burkina Faso has unacceptably high national rates of maternal and newborn mortality, but health indicators are the poorest in the Sahel, North and East where many more women and children are dying from preventable causes due to poor quality of care.

With support from Johnson & Johnson and working closely with the Division of Family Health, the Ministry of Health, UNFPA, the School of Public Health and national midwifery associations, the FCI Program of MSH is leading an intensive training, supervision and mentorship program to improve midwives’ mastery of life-saving clinical skills. The training program covers three modules: (1) compassionate care for mothers and newborns, (2) Helping Mothers Survive, and (3) Helping Babies Breathe.

Continue reading “Scenes from Midwifery Training: Helping Mothers Survive”

A door-to-door campaign for antenatal care

This story originally appeared on the Management Sciences for Health website.

When her rapist was arrested, 16-year old Brigitte* thought the worst was behind her. But when she discovered she was pregnant, she had little choice but to drop out of school and work the family fields in her village, in the Manika health zone of the Democratic Republic of Congo (DRC). She certainly could not afford antenatal care (ANC) visits.

The DRC government has made maternal health one of its highest priorities, and partners like the USAID-funded Integrated Health Project Plus (IHPplus) have collaborated with the Ministry of Health to make that vision a reality. Knowing that ANC visits are out-of-reach for many women, IHPplus subsidizes free and reduced-cost care for expectant mothers. And knowing that many women are not aware of the benefits of ANC visits, IHPplus has organized a variety of campaigns to educate mothers-to-be. Continue reading “A door-to-door campaign for antenatal care”

Top tips for advocates working on emergency contraception

By Melissa Garcia and Cristina Puig Borrás

Melissa Garcia is Technical Adviser for the International Consortium for Emergency Contraception (ICEC), hosted by MSH. Cristina Puig Borrás is the Coordinator for the European Consortium for Emergency Contraception. This article orginally appeared on ICEC’s website

Photo: Susana Galdos/MSH

With the current largest generation of young people, there is much to celebrate on August 12, International Youth Day. In particular, there is the growing recognition that as agents of change, adolescents and young people and their organisations are essential stakeholders who contribute to inclusive, just, sustainable and peaceful societies. Crucially, advocates working on sexual and reproductive health (SRH) and reproductive rights (RR) advance access for young people in meaningful ways. Continue reading “Top tips for advocates working on emergency contraception”

Pour la première fois, les communes de la région Sahel au Burkina Faso, adoptent et ajoutent la planification familiale à leurs budgets

Par Nongma Sawadogo

Nongma Sawadogo dirige le travail sur la santé des femmes et des enfants pour le programme FCI de Management Sciences for Health (MSH) au Burkina Faso. Cet article est apparu sur le blog K4Health.

Un kiosque de planification familiale au salon de la santé au Burkina Faso. © 2011 Centre pour les programmes de communication, avec la permission de Photoshare

Quand j’étais en formation pour devenir sage-femme, une hôtesse de l’air,  sans argent et dans un  état critique, se présentait  à la maternité de l’hôpital  Yalgado Ouédraogo de Ouagadougou, après avoir eu recours à un avortement raté.  Mes collègues et moi avons cotisé de l’argent afin de lui procurer  ses médicaments essentiels, mais malheureusement elle a succombé à ses saignements (hémorragie)- malgré le fait que nous lui avons administré ses médicaments.

Nous étions choqués. Et je pensais que  nous devons absolument faire quelque chose pour améliorer la santé reproductive des femmes. Quand je pense que cette femme aurait pu être sauvée si seulement elle avait eu accès à la planification familiale. Cela m’a rappelé la raison pour laquelle  je voulais devenir sage-femme (maïeuticien)  – pour sauver des êtres humains.

Cependant,  la planification familiale ne commence pas avec les sages-femmes ou les médecins. En effet, elle commence avec les décideurs politiques et un budget adéquat alloué à cette fin. La planification familiale débute par une forte  volonté politique et de l’argent. Les dirigeants peuvent s’inspirer pour améliorer  l’accès aux services de contraception et de santé reproductive, mais ils doivent aussi  impérativement prouver cet engagement en les incluant parmi les éléments principaux de leurs budgets locaux et  explicitement sur le plan auquel le gouvernement  local envisage l’usage des fonds publics. Continue reading “Pour la première fois, les communes de la région Sahel au Burkina Faso, adoptent et ajoutent la planification familiale à leurs budgets”