In the Center for Strategic & International Studies’ (CSIS) “Smart Global Health” blog, Phillip Nieburg, senior associate of the CSIS Global Health Policy Center, discusses a recent report (.pdf) he wrote, titled “Improving Maternal Mortality and Other Aspects of Women’s Health: The United States’ Global Role,” “that addresses key challenges to improving maternal mortality and women’s health worldwide and talks about what the related priorities of U.S. foreign policy should be.” He says, “Rather than continuing what appears to me as a piecemeal approach to global aspects of reproductive health, with separate programs to address, e.g., gender-based violence, women and HIV/AIDS, maternal mortality, family planning, cervical cancer, girls’ education, etc., I argue in my report that the United States should develop and implement a comprehensive global plan for women’s health that includes males as well as females, using coordinated prevention and care programming for each stage of the reproductive health life cycle” (10/25).
Maternal, Newborn and Child Health
In its ongoing series examining efforts to eradicate polio, NPR’s “All Things Considered” aired a story on Wednesday looking at how health care workers in Pakistan are attempting to overcome challenges to immunizing the child population. “Last year, the government declared a national emergency, and with the help of international institutions, embarked on an aggressive vaccination campaign,” NPR’s “Shots” blog reports, adding, “So far, the results have been promising. The number of new polio cases is about a third of last year’s total of 198.” The blog continues, “But the new campaign, like previous efforts, hasn’t been able to overcome one critical problem: getting into parts of Pakistan’s lawless tribal regions along the border with Afghanistan to vaccinate the children there” (Northam, 10/17). On NPR’s “Morning Edition” on Thursday, the news service looks at UNICEF’s recruitment of “social mobilizers,” who are working to inoculate 34 million Pakistani children (Northam, 10/18).
In an opinion piece in the Huffington Post’s “Global Motherhood” blog, David Olson, a global health communications consultant who worked as a communications adviser to the Reproductive Health and Rights Alliance in Kenya earlier this year, describes how “abortion rights [in the country] have been liberalized in certain cases in a Constitution approved in a public referendum two years ago.” He continues, “The new constitution says clearly that ‘the life of a person begins at conception’ and ‘abortion is not permitted unless…'” Olson writes, “And that innocuous ‘unless’ is what keeps the abortion issue alive in Kenya, almost two years after the constitutional referendum: ‘…unless, in the opinion of a trained health professional, there is need for emergency treatment, or the life or health of the mother is in danger, or if permitted by any other written law.'”
“Uruguay’s Congress voted narrowly on Wednesday to legalize abortions during the first 12 weeks of pregnancy, a rare move in largely Catholic Latin America that underscores the country’s liberal leanings,” Reuters reports. “President Jose Mujica, a former leftist guerrilla fighter, has said he would sign the bill into law,” the news service notes (Castaldi, 10/17). “[T]he bill approved by Uruguay’s Senate came after a pointed debate among legislators, producing a compromise that disappointed both abortion-rights groups and opponents, who have vowed to carry out a referendum to overturn the legislation,” the New York Times writes, adding, “Legislators carefully worded the bill, describing it not as legalization of abortion but as a decriminalization measure.” The newspaper writes, “The bill effectively legalizes abortion in the first trimester, permits abortion through 14 weeks of pregnancy in cases of rape and allows later-term abortions when a woman’s health is at risk” (Romero et al., 10/17).
Aissata Sall Yade, a communications assistant for the Senegal Urban Reproductive Health Initiative, part of IntraHealth International, writes in the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog about Aissatou Dia Fall, a head midwife at Senegal’s Gallo Dia Health Center in Yeumbeul, and her efforts to improve access to health care for women in the community. She has reached out to different organizations for monetary assistance for her clients, Yade notes, adding, “Strategies like Aissatou Dia Fall’s will help improve Senegal’s national contraceptive prevalence rate, which is currently only 12 percent. It will also help reduce one of the world’s highest maternal mortality rates (410 deaths per 100,000 live births) and reduce the fertility rate (an average of five children per woman)” (10/17).
“While reports from the United Nations as well as the Institute for Health Metrics and Evaluation (IHME) indicate that maternal deaths are declining around the world, far too many women continue to die from complications related to pregnancy and childbirth,” Ana Langer, director of the Women and Health Initiative at the Harvard School of Public Health, writes in the Huffington Post’s “Global Motherhood” blog. “In fact, every 90 seconds a young woman dies unnecessarily when she is giving life,” she continues, noting, “More than 90 percent of these deaths could be avoided, if all women had timely access to good quality care.”
“I’m encouraged by the focus on children’s health alongside other pressing global issues” at the U.N. General Assembly meeting last week, Dagfinn Hoybraten, vice president of the Norwegian Parliament and chair of the GAVI Alliance Board, writes in the Huffington Post’s “Impact” blog, adding, “These discussions come in the wake of UNICEF’s latest report on declines in child mortality around the world.” He provides some statistics from the report and notes, “In June, the governments of the United States, India, and Ethiopia, along with UNICEF, launched a renewed global commitment to child survival at a meeting in Washington.”
In the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog, Leslie Elder, a senior nutrition specialist at the World Bank, and Yurie Tanimichi Hoberg, a senior economist at the World Bank, write about the intersection of policies and programs in nutrition and agriculture, saying they “are not always closely coordinated.” They continue, “Without the explicit consideration of nutrition objectives and indicators from the outset, investments in agriculture are less likely to achieve nutrition impact,” and describe how the SecureNutrition Knowledge Platform aims “to address critical operational knowledge gaps regarding how to improve the nutrition of vulnerable populations using nutrition sensitive investments in agriculture, and how to measure the impacts of agriculture and food security interventions on nutrition.” They note “SecureNutrition is a community of members from the nutrition, agriculture and food security metrics communities, working with 14 partner organizations, including the Bill & Melinda Gates Foundation, GAIN, Save the Children, USAID and the [World Food Programme]” (9/28).
“The implementation of an ambitious bill that guarantees cheap food grains for India’s poor could be pushed back to the next fiscal year, a top government adviser said,” the Wall Street Journal reports. “[I]mplementing the bill in the fiscal year starting April 2013 would make financial and political sense for the government, which is facing a yawning budget gap and federal elections before May 2014,” according to the newspaper, which adds the bill is “likely to be introduced in the budget session, which is due late February, C. Rangarajan, chairman of the Prime Minister’s Economic Advisory Council, said in an interview.” After a general debate, parliament would have to approve the bill, which “aims to provide subsidized grains to more than 60 percent of India’s 1.2 billion people, with special provisions for pregnant women, destitute children and others,” for it to become law, the newspaper writes, adding, “A government spokesman declined to comment on the matter Friday” (Sahu/Guha, 10/27).
Government, Development Sector Leaders Should Turn To Bangladesh Program For Solutions To Avoidable Childhood Death
For solutions to help end avoidable child deaths, “government and development sector leaders should heed the lessons of a massive-yet-innovative program” in Bangladesh, called SHOUHARDO, a Bangla word for “friendship,” “that is not only helping children … reach their fifth birthdays but also ensuring they grow healthier, and in many cases, taller,” Faheem Khan of CARE Bangladesh, who heads the SHOUHARDO program, writes in this Christian Science Monitor opinion piece. The first phase of the program, which is run by CARE, USAID, and the government of Bangladesh, was implemented from 2004 to 2010 and “represented the largest non-emergency USAID food security program in the world,” Khan writes.