Las parteras son la primera línea en la atención en salud materna, y pueden constituirse en potentes defensoras de cambios ya que conocen los enormes obstáculos que atentan contra su capacidad de brindar una atención de cálida a cada mujer que reciben en su centro de salud o su comunidad. Ellas conocen perfectamente las necesidades en salud de las mujeres y sus bebés debido a que trabajan cada día para satisfacer dichas necesidades. Identifican las limitaciones en los sistemas de salud – en términos de recursos, personal, establecimientos y políticas- y permanentemente bregan para solventarlas. Y manifiestan abiertamente sus necesidades de capacitación, supervisión y políticas más justas, porque a esta labor que han dedicado sus vidas y representa su sustento.
El gobierno mexicano ha sido receptivo a la necesidad de fortalecer el rol de la partería profesional en el continuo de atención a la mujer, y las parteras han aprovechado esta voluntad política para hacer incidencia política a favor de su profesión en sus respectivos estados. En febrero de 2018, el Programa de FCI en MSH, con apoyo de la Fundación John D. and Catherine T. MacArthur convocó a equipos de parteras y profesionales de salud de cinco estados mexicanos a que desarrollaran planes estratégicos de abogacía. El propósito del taller fue promover políticas estatales que permitan a las parteras brindar una atención de calidad y respetuosa a las mujeres, las adolescentes y los recién nacidos. Continue reading “Estrategias de abogacía para promover la partería en México”
Eliana Monteforte is a Senior Technical Advisor, and Aishling Thurow is a Project Support Associate at Management Sciences for Health
Midwives can be powerful advocates for change because, as frontline health workers, they know all too well the enormous challenges that threaten their ability to deliver high-quality care to every woman they see in their clinic or community. Midwives understand the health care needs of women and newborns because they work to meet those needs every day. They see the gaps in their health care systems–in resources, staffing, facilities, and policies–because they continuously struggle to fill those gaps. And they speak the truth about their needs for training, support, and enabling policies–because this is the job to which they have dedicated their lives and livelihoods.
The Mexican government is receptive to strengthening the role of professional midwifery in the continuum of women’s health care, and midwives are ready to leverage this political will to advocate for their profession in their respective states. In February, the FCI Program of MSH, with support from the John D. and Catherine T. MacArthur Foundation, convened teams of midwifery providers from five Mexican states to develop advocacy strategies to advance state-level policies that enable midwives to provide high-quality, respectful care for women, adolescents, and newborns. Continue reading “Advocacy strategies for advancing midwifery in Mexico”
Professional midwives provide lifesaving care to women and newborns. The government of Hidalgo state, Mexico, has launched a comprehensive midwifery program that aims to improve maternal health outcomes while providing services to women along the continuum of care, from pre-pregnancy to delivery and the immediate postnatal period
With funding from the John D. and Catherine T. MacArthur Foundation, the FCI Program of MSH works with midwives and maternal health service providers to strengthen advocacy and build evidence for midwifery practice in six states in Mexico.
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.
Sarah Konopka, MA, is Principal Technical Advisor for HIV & AIDS Management Sciences for Health’s (MSH) Global HIV & AIDS Program. Follow Sarah on Twitter @HIVExpert. This article originally appeared on MSH’s Global Health Impact blog.
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”
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 ».”
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 the Mopti region of central Mali. A 15-year-old client of services, and survivor of familial rape, tells her story.Continue reading ““I got my dignity back.””
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.