PROGRES requires a keen gender perspective

By Alanna Savage and Andrew Gaydos

Alanna Savage is a Senior Communications Specialist for the FCI Program of Management Sciences for Health (MSH) and Andrew Gaydos is a Project Support Associate at MSH.

In our ambitious vision to reach all people, everywhere, it is ever more necessary to examine the varying life experiences–the actual realities–of the people whose health we work to improve. Part of this examination requires a critical look at how gender plays out in the power structures of society, the daily lives of people, and more concretely, in the “who, what, where, when, and how” of health-seeking behavior and access to essential reproductive and maternal health care.

Maternal mortality in Mali remains high–587 women die for every 100,000 live births–but only 28 percent of sexually active women of reproductive have satisfied their demand for family planning.  Women and girls continue to confront widespread sexual and gender-based violence, including female genital mutilation/cutting (FGM/C); in 2015, about 126,000 women and girls received prevention services, protection, and care related to FGM/C. And thanks to the work of the FCI Program of MSH, traditional and faith leaders are advocating for family planning and coming together to provide support to survivors of gender-based violence and to identify early warning signs of imminent violence.

Gender inequality undoubtedly plays a role in high maternal mortality and unmet need for family planning and the continuance of sexual and gender-based violence. As long as women and girls must continue to fight for equal voice and an equal share of opportunity and power, their lives and health will remain under threat. Gender influences health outcomes, access to care, providers’ treatment of patients, relationships among health workers and supervisors, and health career barriers and opportunities.

Photo by Catherine Lalonde

Continue reading “PROGRES requires a keen gender perspective”

We are fearless. #FearlessFeb

Photo by Joey O’Loughlin

We are celebrating Fearless February to rally the global community around advocacy for reproductive, maternal, newborn, child and adolescent health!

This month, the FCI Program of MSH will feature stories about fearless champions, powerful evidence, and advocacy wins from the Rights & Realities archive. Follow #FearlessFeb on Twitter and Facebook to read the story of the day.

Join us on Twitter and Facebook, and tell us:
What makes you fearless? What does “fearless” mean to you?
Subscribe to Rights & Realities (on the homepage, right column) to receive emails of new posts.

 

Trump’s global gag rule silences doctors and midwives and harms their patients

By Catharine Taylor

Catharine Taylor is Vice President for health programs at Management Sciences for Health. This post originally appeared on STAT News

Midwifery students in Sierra Leone, which has one of the highest maternal mortality rates in the world. Funding for safe pregnancy and delivery worldwide is threatened by President Trump’s reinstatement of the global gag rule. (Photo by MARCO LONGARI/AFP/Getty Images)

President Trump’s reinstatement of the Mexico City Policy, better known as the global gag rule, came as no surprise to anyone working in the field of global health. We have been through this before — in 1984, when the policy was first put into effect by President Reagan, and then in 1993, 2001, and 2009, when it was repealed, reinstated, and repealed again.

The Mexico City Policy is called a gag rule because it limits not just what organizations and health providers do but what they are permitted to say. It prevents foreign organizations that receive US government funding from performing abortions — even if they are using funds from non-US government sources and even if abortion is completely legal in their countries.

The global gag rule also steps right between a woman and her doctor, nurse, or midwife, preventing these frontline health providers from telling their patients about the full, legal range of health options available to them. It forbids trusted advisers from giving honest, comprehensive health advice and information. I started my career as a nurse-midwife, and then worked in maternal and newborn health programs in Africa and Asia, so I know what this will mean for the lives and health of women and their families. Continue reading “Trump’s global gag rule silences doctors and midwives and harms their patients”

Counting every maternal death: Strengthening maternal mortality surveillance and response in the Caribbean

By Aishling Thurow

Aishling Thurow is a Project Support Associate at Management Sciences for Health. 

Every maternal death must be documented to prevent the next one. In the Caribbean, where 175 women die for every 100,000 live births (WHO, 2015), understanding the reasons they died is essential to preventing more unnecessary maternal deaths in the future.

In 2013, the World Health Organization developed guidelines for maternal death surveillance and response (MDSR) to capture the number and systemic causes of maternal deaths and to strengthen policies and programs that will better respond to maternal health needs.

Delegates and organizers from the Technical Consultation on the Maternal Death Surveillance and Response Guidelines (MDSR): Region of the Americas. Dec. 9, 2016. Montego Bay, Jamaica. Photo by Aishling Thurow/MSH

In December 2016, the Latin America and Caribbean Regional Task Force for the Reduction of Maternal Mortality (GTR for its Spanish acronym), of which MSH is an Executive Committee member, hosted a technical consultation on guidelines for maternal death surveillance and response systems in the Caribbean. Held in Montego Bay, Jamaica, the workshop welcomed 20 delegates−Ministry of Health officials, as well as prominent maternal mortality surveillance experts−from Jamaica, Belize, Suriname, Guyana, and Trinidad and Tobago. The workshop aimed to strengthen maternal mortality surveillance and response systems in the sub-region, to improve maternal mortality data quality, and to strengthen policy development and implementation capacities at the national level.

Continue reading “Counting every maternal death: Strengthening maternal mortality surveillance and response in the Caribbean”

Emergency contraception is a simple part of post-rape care: Why is it not routinely provided?

By Melissa Garcia and Sarah Rich

Melissa Garcia is Senior Technical Officer for the International Consortium for Emergency Contraception and Sarah Rich is Senior Program Officer at Women’s Refugee Commission. This post originally appeared on the blog for the Sexual Violence Research Initiative

Emergency contraception (EC) can reduce the risk of pregnancy after unprotected sex, including in cases of sexual violence. Global guidance is clear that EC should be offered to women and girls within 120 hours of sexual violence to prevent the traumatic consequences of pregnancy resulting from rape.

Yet women and girls who have experienced unprotected sex, including through sexual violence, do not routinely have access to EC. The global aid communities must work together to increase access to EC for sexual violence survivors around the world, including for women and girls who are the most marginalized, like those living in crisis-affected settings. A range of strategies can be implemented to improve access to EC. Further research is also needed to identify, evaluate, and invest in new and innovative solutions. Continue reading “Emergency contraception is a simple part of post-rape care: Why is it not routinely provided?”

Webinar presentation – Misoprostol for PPH: Innovations for Impact

On December 15, MSH, Gynuity Health Projects and Jhpiego hosted a one-hour webinar to share innovations – interventions, technologies, and distribution approaches – that have the potential to increase access to and use of misoprostol for postpartum hemorrhage (PPH), the leading cause of maternal death. This webinar:

  • Highlighted innovative ways that countries are expanding access to and use of misoprostol for PPH
  • Showed how successful innovations can be scaled up for national impact

PRESENTERS
Esther Azasi
Knowledge Management Specialist & Associate Program Manager, One Million Community Health Workers Campaign-Millennium Promise, Ghana

Holly Anger
Program Associate, Gynuity Health Projects, USA

Gail Webber
Saving Mothers Project, Mara Region, Tanzania and University of Ottawa, Canada

Partamin Manalai
Monitoring, Evaluation and Research Director, Jhpiego, Afghanistan

MODERATOR
Shafia Rashid
Senior Technical Advisor, FCI Program of Management Sciences for Health (MSH)

Listen to the webinar and download the presentation slides here.

Misoprostol for postpartum hemorrhage: Empowering health workers to save lives

Shafia Rashid is a Senior Technical Advisor for the FCI Program of Management Sciences for Health.

In Senegal, approximately 1,800 women lose their lives every year while giving birth. The major cause of these deaths is uncontrolled bleeding after childbirth, or postpartum hemorrhage (PPH). More than half of Senegalese women live in rural areas and have limited access to well-equipped health facilities that can prevent or treat many of these deaths. Many women give birth, attended by matrones or volunteer birth attendants, in maternity huts. Recognized as essential health care providers by their communities, matrones have some formal training and are now registered with the Ministry of Health (MoH).

To effectively prevent or treat PPH, women need access to uterus-contracting drugs, or uterotonics, such as oxytocin or misoprostol. The recommended uterotonic, injectable oxytocin, requires cold storage and technical skill to administer. Misoprostol is a safe and effective alternative where oxytocin isn’t available or feasible; it doesn’t need refrigeration and is easy to use—particularly important features for use in remote, rural areas.

From 2013 to 2014, the Government of Senegal’s Direction of Reproductive Health and Child Survival, in partnership with USAID and Gynuity Health Projects, examined the use of misoprostol (600 mcg oral) or oxytocin (10 UI) via Uniject® for prevention of PPH at the community level. Matrones were trained to assist with deliveries and administer the designated intervention. According to the study, both misoprostol and oxytocin in Uniject® were equally effective and safe in preventing PPH, and matrones  posted at the health huts were capable of administering the medicine they were assigned. Continue reading “Misoprostol for postpartum hemorrhage: Empowering health workers to save lives”

Uniting the Community to Prevent and Respond to Gender-Based Violence in Mali

Martha Murdock is Technical Strategy Lead for regional programs at the FCI Program of Management Sciences for Health. This post originally appeared on MSH’s Global Health Impact Blog

As a part of the international “16 Days of Activism Against Gender-Based Violence” campaign for the prevention and elimination of violence against women and girls, MSH is sharing its experience working to eradicate gender-based violence.

Photo credit: Adama Sanogo/MSH
Photo credit: Adama Sanogo/MSH

“We remember the hard times the women and girls of Douentza have experienced,” said Animata Bassama, a representative of the women of Douentza, referring to the fighting and ensuing gender-based violence (GBV) that plagued Mali in 2012.

Animata spoke to a crowd of 100 government officials, NGO representatives, health and finance officials, women’s advocates, and community members. A new center for GBV survivors, fortified by concrete and adorned in yellow and pink, was her backdrop. Continue reading “Uniting the Community to Prevent and Respond to Gender-Based Violence in Mali”

Advocacy success story: Kenya approves misoprostol for PPH

Melissa Wanda Kirowo is advocacy project officer for FCI Program of Management Sciences for Health in Kenya. 

This blog post provides an update to an earlier post.

The Kenya Constitution states that every person has the right to the highest attainable standard of health, including reproductive health. To realize this right, every person must have access to high-quality, life-saving medicines.

Photo credit: Mark Tuschman
Photo credit: Mark Tuschman

Recently, the government achieved great strides toward making this right to health a reality for its citizens. For the first time, the Kenya Essential Medicines List 2016 (KEML) included misoprostol in the oxytocics section, indicating its use for the prevention and treatment of postpartum hemorrhage (PPH), excessive bleeding after childbirth and a leading cause of maternal death. Misoprostol is stable at room temperature, available in pill form, and inexpensive. Because of these advantages and the drug’s wide availability, misoprostol may be a woman’s only chance for surviving PPH in settings with limited infrastructure and a shortage of skilled birth attendants–like many parts of Kenya. Continue reading “Advocacy success story: Kenya approves misoprostol for PPH”

WILD women with disabilities call for social inclusion through photos and stories

Ariadna Capasso is senior technical advisor for the FCI Program of Management Sciences for Health. 

Women and young persons with disabilities are particularly powerful voices in the movement for gender equality and social inclusion. Last month, I had the privilege to moderate a panel of outspoken activists with disabilities to commemorate the opening of the two-week photo exhibit, Brilliant and Resilient: Celebrating the Power of Women Activists with Disabilities, at the World Bank in Washington, D.C.

Continue reading “WILD women with disabilities call for social inclusion through photos and stories”