Advocacy strategies for advancing midwifery in Mexico

By Eliana Monteforte and Aishling Thurow

(Leer la versión de español aquí.)

Eliana Monteforte is a Senior Technical Advisor, and Aishling Thurow is a Project Support Associate at Management  Sciences for Health

Photo by Eliana Monteforte/ MSH

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”

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”

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”

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”

For the first time, communes in Burkina Faso’s Sahel region add family planning to their budgets

By Nongma Sawadogo

Version française

Nongma Sawadogo leads work on women’s and children’s health for the FCI Program of Management Sciences for Health (MSH) in Burkina Faso. This article originally appeared on the K4Health Blog.  

A family planning booth at a health fair in Burkina Faso. Photo: Center for Communication Programs, Courtesy of Photoshare

When I was in training to become a midwife, a flight attendant, with no money and in critical condition, arrived at the maternity ward of Yalgado Ouédraogo hospital in Ouagadougou after getting a botched abortion. My colleagues and I put money together to buy her essential medicines, but she eventually died–even after we administered the medicines. We were shocked. And I thought, we must do something to improve women’s reproductive health. When I think that this woman could have been saved if she’d had access to family planning earlier, I’m reminded of my reason for becoming a midwife–to save human beings.

But family planning doesn’t start with midwives or doctors. It starts with political will and with money. If political leaders want to  improve women’s access to contraception and reproductive health services in their communities, they can act on this commitment by making a line item for these services in their local budgets, the local government’s plan for how it will spend public money. Continue reading “For the first time, communes in Burkina Faso’s Sahel region add family planning to their budgets”

An ounce of (after-sex) prevention: At the Family Planning Summit, let’s talk about emergency contraception

By Elizabeth Westley

Elizabeth Westley is the director of the International Consortium for Emergency Contraception, where this article first appeared. 

To meet the global Family Planning 2020 goals, a full range of family planning methods must be available, including user-controlled, short-acting methods. The Guttmacher Institute’s analysis , Adding it Up, estimates that 214 million women of reproductive age in developing regions want to avoid pregnancy but are not using a modern contraceptive method.  Half of unmarried women with an unmet need for family planning report infrequent sex as the reason that they do not use a family planning method. A quarter of married women not using contraception fall into the same category.  Not feeling themselves at high levels of risk, these women may wish to avoid the appointments and waiting times, dependence on providers, side effects, discomforts, and other commitments that long-acting contraceptive methods sometimes entail. Other women may not be using modern contraception because they are unaware of their options or are faced with inaccessibility due to distance barriers, poor health infrastructures, stock outs, or high prices. As well, many women are located in humanitarian and fragile settings where contraceptive access can be challenging.  For many women and girls not currently using a long-acting contraceptive method, a simple, discreet, user-controlled, low-commitment, one-time “on demand” form of contraception that can be accessed easily and quickly is a critically important option. This method already exists: emergency contraception. Continue reading “An ounce of (after-sex) prevention: At the Family Planning Summit, let’s talk about emergency contraception”

Building Health Systems that Work for Mothers, Newborns and Midwives

By Catharine Taylor

Catharine Taylor, a former practicing midwife, is the Vice President of the Health Programs Group at Management Sciences for Health (MSH). This post originally appeared on MSH’s Global Health Impact Blog

A midwife leads a pregnancy club in eastern Uganda. (Photo: Kate Ramsey/MSH)

For many people living in poor and underserved regions – whether rural communities or growing cities – midwives are the health system. Continue reading “Building Health Systems that Work for Mothers, Newborns and Midwives”

Femmes saines, nations en santé

Par Fatimata Kané

Fatimata Kané est directrice  du programme FCI de MSH au Mali.

Photo: Catherine Lalonde

Mettre un enfant au monde est tout un travail différent. Tout le monde peut aider quelqu’un qui est malade, mais tout le monde ne peut pas faire le travail d’une sage-femme–guider une femme et son bébé en toute sécurité pendant la grossesse et l’accouchement. Je sais ce que signifie garder les femmes et les bébés vivants et en bonne santé parce que je suis une sage-femme. Continue reading “Femmes saines, nations en santé”

Beyond reproductive and maternal health: Non-communicable diseases and women’s health

On March 15, 2017, Management Sciences for Health (MSH), the Ministry of Foreign Affairs of Denmark, Women Deliver, Novo Nordisk, and the NCD Alliance, of which MSH is a steering committee member, hosted a panel discussion during the Commission on the Status of Women to call for the integration of the prevention and treatment of non-communicable diseases (NCDs) into the reproductive, maternal, newborn, child, and adolescent health continuum of care. The following post summarizes the key messages from the side event and offers recommendations for further action.

Photo by Kristina Sperkova (via Twitter)

Women are essential to a vibrant, healthy economy. Women are producers, caretakers, and consumers–and when they are oppressed and devalued, the economy stalls. Women’s full participation in the workforce is contingent on their ability to realize their fundamental human rights, including the right to health. Continue reading “Beyond reproductive and maternal health: Non-communicable diseases and women’s health”