Recently, the Drug Regulatory Authority of Pakistan (DRAP) intensified its nationwide efforts toward combating the illegal sale, manufacturing and distribution of contaminated and falsified medicines in the country. DRAP implemented increased surveillance, intelligence-led enforcement and stricter regulations to combat, in other words, the fake drug crisis in Pakistan.
Background
The Ministry of National Health Services reports that 85% of medicines in Pakistan are either counterfeit or substandard. According to DRAP, 50% of the medication samples tested were fake — including life-saving treatments for cancer, cardiovascular diseases, mental illnesses and infections.
The issue of counterfeit medicines has been harming the health of Pakistanis for decades. Contaminated drugs often include arbitrary dosages of certain ingredients and deadly additives that can cause fatal effects, such as respiratory paralysis or death. A victim of fake medicine would need additional treatment to cure the damage from these drugs, which takes a toll on both the individual already suffering from an illness and the Pakistani health care system. Even if a fake drug has no effect at all, it is still dangerous, as a patient could unknowingly be left untreated for a serious disease.
Fake Drugs Affect the Poor the Most
The fake drug crisis in Pakistan disproportionately affects the poor, who cannot afford branded medicines or, in some cases, receive certain drugs from pharmacies for free. In 2012, a public cardiology pharmacy in Lahore distributed a contaminated drug to the poor. As a result, 125 people died due to fatal bone-marrow suppression.
Counterfeit drugs are also most often found in rural areas, where drug regulation is less strict. For these reasons, people living in poverty often have to resort to cheaper, falsified drugs, according to Wolters Kluwer Health.
To combat this, Muhammad Omar Larik recommended that the Pakistani government establish pharmaceutical support programs for the poor, as mentioned in his study published in the Journal of the Pakistan Medical Association.
Raids, Seizures and Closures
In recent crackdown efforts on the fake drug crisis in Pakistan, DRAP raided several pharmacies and local medicine shops. If lab testing revealed that the store sold falsified drugs, DRAP would shut it down.
DRAP sealed multiple establishments across the country, including the Al-Waali Care Concepts medical supplies store in Lahore. There were more drug regulation violations behind each closure, such as operating without a valid drug license and unlawfully storing medical devices. When officials raided Al-Waali Care Concepts, they brought legal action against the owner and started a formal investigation into the store.
In a surprise raid, a federal drug inspector shut down a pharmaceutical factory in Nooriabad for its illegal production of unregistered high-dose tramadol tablets. The production of this opioid is illegal nationwide due to smuggling concerns, public safety risks and especially its abuse abroad. DRAP suspects the factory produced the tablets with the intention of shipping them to foreign drug markets.
DRAP lab-tested several pharmaceutical products and consequently banned three newly-found counterfeit medicines: batch 251986 of Duphalac syrup, batch 091 of Taskeen Dard tablets and batch 01 of Pain-Nil tablets. The authority seized the identified batches of the medicines, removed them from the markets and tracked down the suppliers.
In Karachi, officials seized a large quantity of medicine that was sold across the city. In Lahore, DRAP caught individuals selling Urografin, an iodine-containing injection, and a dealer selling unregistered infertility medication, Lipiodol Ultra Liquid, beside a hospital, Dawn reported.
Provincial drug control officials also confiscated several batches of medicines meant to treat allergies, anxiety disorders, kidneys, fevers, body pain, bacterial infections and ulcers. Lab testing revealed that these medications were fake and completely ineffective. According to DRAP, these drugs were illegally produced and falsely labelled under well-known pharmaceutical brands.
Identifying Fake Drugs
A significant lack of public awareness also feeds into the fake drug crisis in Pakistan, as the public is not aware of the severity of the issue and unsure how to differentiate counterfeit medicines from real, safe medication.
As one solution, Dvago, a reputable pharmacy and medical store in Pakistan, outlined several warning signs to look for when identifying counterfeit drugs. These include packaging irregularities, missing or fake security seals, inconsistencies in the medicine’s appearance, an incorrect batch number or expiry date, extremely low prices and a lack of a proper leaflet or labels.
When purchasing medication, the store urges the public to only buy from licensed pharmacies, consult a pharmacist beforehand, verify the drug manufacturer, use track and trace systems with unique codes and most importantly, report suspicious medicines.
Increasing the Quality of Health and Life in Pakistan
Overall, the DRAP crackdown on illegal pharmaceutical drugs is a significant step toward increasing the quality of health and life for Pakistanis, especially for those living in poverty. Unfortunately, the fake drug crisis in Pakistan persists due to inadequate legislation, ineffective law enforcement and drug regulators’ failure to effectively interpret and implement the law.
Nevertheless, with consistent drug surveillance, more pharmacists, stronger law enforcement, trained drug regulators and a solid infrastructure for drug control, Pakistan can achieve its goals.
– Umaymah Suhail
Umaymah is based in Karachi, Pakistan and focuses on Good News and Global Health for The Borgen Project.
Photo: Flickr
The Role China Is Playing In Alleviating Poverty in Cambodia
Background
Over the past 40 years, China has lifted 800 million people out of extreme poverty, classified by the World Bank as living on less than $1.90 per day. This achievement was driven by a model which blends rapid economic growth with tangible improvements to well-being, targeted to each local community. As a result, China announced at the end of 2020 that it had already met the poverty targets of the U.N. 2030 Agenda for Sustainable Development ahead of schedule.
Learning from its own experience, China has trained more than 400,000 professionals from more than 180 countries and regions in poverty alleviation methods. It has launched village-by-village pilot projects designed to promote its experience in poverty reduction strategy overseas.
One such initiative is the Cambodia-China Friendship Village for Poverty Alleviation project in Tanorn, in the southern province of Takeo, Cambodia. Implemented by Cambodia’s Civil Society Alliance Forum (CSAF), with funding from the China Foundation for Peace and Development, the project began in 2021 and developed programs in infrastructure, education and health care sectors.
The Impact: Poverty in Cambodia
Before its implementation, the remote village had poor quality roads that made it difficult for farmers, who comprise 70% of the population, to sell their products. This isolation created extreme economic insecurity. Following road improvements, brokers are now able to drive trucks to purchase crops directly from farms, increasing market access and income stability.
For residents such as Sokhim, mother of four children who lives in the village and used to depend on rice farming, these changes have been transformative. With improved infrastructure and economic conditions, she now runs a grocery store and says that the project has improved livelihoods across the village.
Tanorn’s experience reflects a broader national trend: poverty in Cambodia has declined significantly in recent years, with the number of people living in poverty falling from 5.6 million to 2.8 million over approximately seven and a half years.
Strategy
However, despite development assistance from China having positive impacts on villages like Tanorn, its intervention in Cambodia has been closely intertwined with foreign policy goals and investment strategy.
In recent years, financial support from China has been used to establish a strategic and comprehensive production network in Cambodia. The Cambodian People’s Party (CPP), which has been in power continuously since 1979, has welcomed and protected Chinese investment. This relationship has allowed the creation of an autonomous and profitable ecosystem for Chinese companies operating in the country, deepening economic interdependence.
China’s influence extends beyond infrastructure and commerce. Through the opening of cultural centres promoting Chinese language and culture, university partnerships and funding of research centres and think-tanks, China has strengthened its soft power footprint. These tactics contribute to regime legitimacy in Cambodia, reinforcing political stability that is conducive to China’s long-term strategic interests.
Moreover, Chinese financial and material aid has had notable political implications. The CPP has welcomed China’s support as Beijing has overtly backed the party’s continued rule and opposed the actions of opposition parties. This reciprocal relationship has led to the adoption of governance practices resembling aspects of China’s authoritarian model, such as internet regulation, media control and censorship, and opacity in trade and business.
The Future
At a time when the World Bank’s 2024 Poverty, Prosperity and Planet report notes that global poverty reduction has slowed to a near standstill, China’s development interventions are creating positive change. However, the Cambodian case suggests that while poverty alleviation is delivering tangible improvements, it is also playing a role in reinforcing China’s political and strategic control abroad.
– Jenna O’Flynn
Photo: Flickr
Extreme Heat and The Lady Health Workers of Pakistan
Intensifying Heatwaves in Pakistan
Pakistan is highly vulnerable to extreme heat, with heatwaves becoming more frequent, prolonged and intense in recent decades. Pre-monsoon months often see dangerously high temperatures in combination with high population densities, as seen in cities such as Karachi and Lahore. Several severe events in recent years have emphasized the scale of this risk, including the 2015 heatwave that devastated the southeastern Sindh province and ultimately claimed more than 1,000 lives. In more recent years, Pakistan experienced a heatwave in June 2025, during which temperatures in many parts of the country exceeded 113°F.
Prolonged periods of extreme heat place significant strain on urban and rural communities alike, affecting infrastructure and health systems. Climate change is expected to intensify these trends, increasing the likelihood of longer and more severe heatwaves and expanding the geographic areas affected. For populations with limited access to cooling, reliable electricity or adequate health care, these conditions create public health risks and highlight the need for stronger heat-health preparedness measures.
Extreme Heat and Maternal Health Risks
Extreme heat poses significant risks during pregnancy due to the body’s changes in temperature regulation and fluid balance. During pregnancy, fetal development increases fluid requirements, making it more difficult for the body to dissipate heat. This increases susceptibility to dehydration and heat stress. High temperatures may disrupt hormonal regulation and impair the function of the placenta, potentially reducing oxygen and nutrient delivery to the fetus.
Evidence also links exposure to extreme heat with several adverse pregnancy outcomes, including gestational diabetes, preterm birth and stillbirth in some cases. Heat exposure can also increase the likelihood of infections and complicate care during labor. Because public health care systems in Pakistan are often described as overwhelmed, these risks may increase further. As temperatures continue to rise with climate change, these issues underscore the importance of recognizing pregnancy as a period of heightened vulnerability to extreme heat and ensuring appropriate support for pregnant populations.
Omission of Pregnancy in Heat-Health Action Plans
The National Heatwaves Guidelines released by the Pakistani government do not make direct reference to pregnancy during extreme heat events. The guidelines recommend that “individuals should check on neighbors, especially the elderly, children and those with chronic illnesses,” but they do not mention people in the perinatal period. The report encourages community care for “vulnerable residents,” but it does not define which groups fall into this category.
This highlights an ongoing issue within Heat-Health Action Plans (HHAPs) across the globe. As extreme heat events occur more frequently, many countries have implemented national HHAPs, as urged by the World Health Organization (WHO). However, while WHO guidelines outline strategies to protect pregnant individuals from extreme heat, a recent review found that of 83 eligible HHAPs from 24 countries, only 52% recognized the need to protect this population during heatwaves. Furthermore, none of the HHAPs comprehensively addressed the risks heatwaves pose to maternal, newborn and child health.
The Lady Health Workers of Pakistan
Pakistan’s Lady Health Worker (LHW) Program, established in 1994, plays a critical role in delivering maternal health services to communities across the country, particularly in rural areas and urban informal settlements. The program deploys more than 100,000 trained female community health workers who live within the communities they serve, each covering roughly 1,000 people. Although they are not physicians, they provide services that health professionals may not be able to deliver consistently at the household level. This includes conducting regular household visits to provide health education, basic preventive care and referrals to formal health facilities.
LHWs focus heavily on maternal and newborn health. They counsel pregnant individuals on the importance of antenatal care while monitoring pregnancies and linking families with clinics or midwives when complications arise. They are trusted members of their communities and provide care directly at the household level. As a result, LHWs often serve as the first point of contact for pregnant populations during environmental or health crises.
LHWs guide hydration, rest and heat-related illness. They also monitor vulnerable pregnancies and facilitate timely referrals to health facilities, helping ensure continuity of maternal care even when extreme heat and strained hospitals make access to services more difficult.
– Charlotte Bunn
Photo: Flickr
DRAP cracks down on the fake drug crisis in Pakistan
Background
The Ministry of National Health Services reports that 85% of medicines in Pakistan are either counterfeit or substandard. According to DRAP, 50% of the medication samples tested were fake — including life-saving treatments for cancer, cardiovascular diseases, mental illnesses and infections.
The issue of counterfeit medicines has been harming the health of Pakistanis for decades. Contaminated drugs often include arbitrary dosages of certain ingredients and deadly additives that can cause fatal effects, such as respiratory paralysis or death. A victim of fake medicine would need additional treatment to cure the damage from these drugs, which takes a toll on both the individual already suffering from an illness and the Pakistani health care system. Even if a fake drug has no effect at all, it is still dangerous, as a patient could unknowingly be left untreated for a serious disease.
Fake Drugs Affect the Poor the Most
The fake drug crisis in Pakistan disproportionately affects the poor, who cannot afford branded medicines or, in some cases, receive certain drugs from pharmacies for free. In 2012, a public cardiology pharmacy in Lahore distributed a contaminated drug to the poor. As a result, 125 people died due to fatal bone-marrow suppression.
Counterfeit drugs are also most often found in rural areas, where drug regulation is less strict. For these reasons, people living in poverty often have to resort to cheaper, falsified drugs, according to Wolters Kluwer Health.
To combat this, Muhammad Omar Larik recommended that the Pakistani government establish pharmaceutical support programs for the poor, as mentioned in his study published in the Journal of the Pakistan Medical Association.
Raids, Seizures and Closures
In recent crackdown efforts on the fake drug crisis in Pakistan, DRAP raided several pharmacies and local medicine shops. If lab testing revealed that the store sold falsified drugs, DRAP would shut it down.
DRAP sealed multiple establishments across the country, including the Al-Waali Care Concepts medical supplies store in Lahore. There were more drug regulation violations behind each closure, such as operating without a valid drug license and unlawfully storing medical devices. When officials raided Al-Waali Care Concepts, they brought legal action against the owner and started a formal investigation into the store.
In a surprise raid, a federal drug inspector shut down a pharmaceutical factory in Nooriabad for its illegal production of unregistered high-dose tramadol tablets. The production of this opioid is illegal nationwide due to smuggling concerns, public safety risks and especially its abuse abroad. DRAP suspects the factory produced the tablets with the intention of shipping them to foreign drug markets.
DRAP lab-tested several pharmaceutical products and consequently banned three newly-found counterfeit medicines: batch 251986 of Duphalac syrup, batch 091 of Taskeen Dard tablets and batch 01 of Pain-Nil tablets. The authority seized the identified batches of the medicines, removed them from the markets and tracked down the suppliers.
In Karachi, officials seized a large quantity of medicine that was sold across the city. In Lahore, DRAP caught individuals selling Urografin, an iodine-containing injection, and a dealer selling unregistered infertility medication, Lipiodol Ultra Liquid, beside a hospital, Dawn reported.
Provincial drug control officials also confiscated several batches of medicines meant to treat allergies, anxiety disorders, kidneys, fevers, body pain, bacterial infections and ulcers. Lab testing revealed that these medications were fake and completely ineffective. According to DRAP, these drugs were illegally produced and falsely labelled under well-known pharmaceutical brands.
Identifying Fake Drugs
A significant lack of public awareness also feeds into the fake drug crisis in Pakistan, as the public is not aware of the severity of the issue and unsure how to differentiate counterfeit medicines from real, safe medication.
As one solution, Dvago, a reputable pharmacy and medical store in Pakistan, outlined several warning signs to look for when identifying counterfeit drugs. These include packaging irregularities, missing or fake security seals, inconsistencies in the medicine’s appearance, an incorrect batch number or expiry date, extremely low prices and a lack of a proper leaflet or labels.
When purchasing medication, the store urges the public to only buy from licensed pharmacies, consult a pharmacist beforehand, verify the drug manufacturer, use track and trace systems with unique codes and most importantly, report suspicious medicines.
Increasing the Quality of Health and Life in Pakistan
Overall, the DRAP crackdown on illegal pharmaceutical drugs is a significant step toward increasing the quality of health and life for Pakistanis, especially for those living in poverty. Unfortunately, the fake drug crisis in Pakistan persists due to inadequate legislation, ineffective law enforcement and drug regulators’ failure to effectively interpret and implement the law.
Nevertheless, with consistent drug surveillance, more pharmacists, stronger law enforcement, trained drug regulators and a solid infrastructure for drug control, Pakistan can achieve its goals.
– Umaymah Suhail
Photo: Flickr
Gender Equality in Nigeria: Fighting For Female Safety
Gendered Issues in Nigeria
Gender equality in Nigeria remains an ongoing struggle. According to Girls Not Brides, 12% of girls marry before the age of 15 and 30% before 18. These statistics are influenced by poverty and education rates, with 71% of women with no formal education reporting having married before the age of 18. According to the United Nations Population Fund (UNFPA), one in three women experiences physical violence by the age of 15, often related to domestic circumstances.
Poverty is a driving factor, as 46% of the population lives below the poverty line. Economic pressures can lead families to arrange early marriages, which perpetuates unequal gender norms and limits women’s educational and professional opportunities.
Women for Women International
Women for Women International (WFWI) is a nonprofit organization established in 1993 that works to support women across 17 countries affected by conflict or injustice. Since 2000, WFWI Nigeria has reached more than 84,306 women. Its flagship program, Stronger Women Stronger Nations (SWSN), promotes gender equality in Nigeria through vocational and financial skills training, academic education, health education and support networks for vulnerable women.
WFWI has also taken action to address the root causes of gender inequality by engaging men. Given the data on domestic abuse, forced marriage and gender-based violence (GBV), WFWI identified that creating allies within the male population in Nigeria is integral to resolving gender inequality.
According to a study published in the Pan African Medical Journal in 2022, the highest prevalence of physical or sexual intimate partner violence was reported in Sub-Saharan Africa, at 65.64%. In Nigeria, information from the 2018 National Demographic Health Survey shows that 33% of women between 15 and 49 experience physical or sexual violence. The prevalence rate of GBV is 74.4% among survivors under 18, further reinforcing the risks for girls in early marriages.
WFWI’s men’s engagement program launched in Nigeria in 2002 with the aim of educating men on women’s health, the social and economic issues women face, and how men can offer support. The program creates focus groups and targets men in the community with religious, military or civil society backgrounds, creating a pathway for these men to advocate for women’s rights and gender equality in Nigeria.
Results of SWSN and Men’s Engagement
SWSN has had a measurable impact on gender equality in Nigeria since its launch in 2000. Change agents, women who received SWSN training and spread it through the community, have navigated the challenge of educational equality by establishing a mixed-gender primary school in the state of Bauchi. These agents were responsible for bringing nearly half of the 92 students to this school.
The program has reached more than 92,000 Nigerian women, with more than 5,000 graduating from SWSN in 2024. WFWI reports that graduates doubled their monthly earnings through newly acquired business skills, and 83% of graduates reported feeling actively involved in their public and private lives, compared with 36% at enrollment. Women’s knowledge of their political and national rights increased from 55% to 92%.
In the men’s focus groups, results have also been positive. WFWI acknowledges that women’s empowerment is not only achieved by reducing men’s power but that gender equity also benefits men’s health, household environments, financial matters and communities. Nearly 53,000 men have been reached since 2002, with more than 17,000 joining the project in Nigeria. One man, Murhula, has claimed that “my life has really changed” from his participation. His realization that “We thought that certain jobs are just for men […], but today I can say that the work a man can do, a woman also can do it.”
Looking Ahead
With the continuation of SWSN and the men’s engagement program, progress toward gender equality in Nigeria extends beyond policy into education, homes and communities. WFWI’s model demonstrates that addressing gender inequality requires engaging both women and men.
– Jaya Noonan
Photo: Unsplash
Managing Maternal Hypertensive Disorders in Venezuela
This alarming reality demands immediate intervention. Organizations including UNICEF are already responding, deploying strategies to expand healthcare access and strengthen training in obstetric neonatal and pediatric emergency care. Here is more information about maternal hypertensive disorders in Venezuela and how they are being addressed.
The Government
To understand Venezuela’s healthcare emergency, one must first understand its economic catastrophe. For decades, oil revenues financed nearly two-thirds of the government budget. In 2014, when oil prices collapsed and the central bank responded by printing more money, the country entered one of the worst hyperinflation periods in modern history. Ordinary Venezuelans have felt these impacts the most as political turmoil has been further exacerbated by exchange rate volatility and the recent capture of Nicolas Maduro.
Due to this, more than one quarter of the population need humanitarian assistance. Significantly, the most severe impacts befall the health systems from this economic collapse. Domestic general government health expenditure under Maduro was merely 3.6%, with out-of-pocket spending accounting up to 30% of health expenditure. For Venezuelans where the official minimum wages remain below $2/month, this basic healthcare need remains inaccessible. Furthermore, known as the ‘brain drain’ roughly half of the country’s doctors have emigrated, leaving hospitals understaffed and unable to perform basic tasks such as routine obstetric check-ups. For pregnant women and children, especially in indigenous communities, this has had detrimental effects.
Hypertensive Disorders
Hypertensive disorders affect 1.4 billion people globally. However, prevalence is skewed toward low- and middle- income countries. Such disorders are huge risk factors for developing heart disease, stroke and, in pregnant individuals, pre-eclampsia. These disorders are frequently and easily missed as key symptoms presenting as vision loss and headaches. Tests for such disorders require equipment which is inaccessible in rural areas of Venezuela and when untreated, leads to seizures and hemorrhage.
In Venezuela, hypertensive disorders cause roughly 20% of maternal deaths with other confounding causes being maternal hemorrhage. This had evident effects as shown by the growing ratios of maternal mortality. This impacts 226.7 individuals per 100,000 live births and worsening by +25% points since 2019. Simple low-cost training to help healthcare workers identify early warning signs of hypertensive diseases combined with targeted education campaigns for pregnant women, could meaningfully improve outcomes and empower women to advocate for their own care.
Who Is Helping?
Despite the fact that many organizations have received just 17% of the >$600 million that Venezuela’s humanitarian response plan requires, many organizations, governmental and non-governmental alike are implementing strategies to ameliorate the maternal health crisis. These strategies are offering hope for the future. Many individuals must walk miles to reach a suitable healthcare facilities, however pregnant women with hypertensive disorders cannot afford this time.
At Project HOPE, local health partners are receiving training and increasing accessibility to maternal healthcare at the Venezuela-Columbia border. Alongside initiatives provided by the International Medical Corps, hope is in sight for these vulnerable Venezuelan’s. Since its implementation, the International Medical Corps (IMC) has provided more than $1.8 million in equipment, medical supplies and facilities.
Medical units mobilized by this organization aid in improving maternal outcomes for those in remote areas, specifically indigenous communities. Furthermore, continuous efforts from UNICEF demonstrate significant advancements for access to healthcare with 129,871 children and 31,273 women accessing their implemented facilities in the first half of 2025. Increased training in partnership with the ministry of health resulted in 29,788 safe deliveries, 3,289 of which were from indigenous communities. If efforts like this continue to prevail, much needed relief may be provided to the mothers to be of Venezuela when aiming to reduce mortality due to hypertensive disorders.
Conclusion
While maternal hypertensive disorders are manageable themselves when early detection and low-cost diagnostic equipment is available, this is not available in many areas of Venezuela. This cannot be divorced from the broader poverty issue which lies within this country. Thus, Venezuela’s maternal health crisis is a story about compounding vulnerabilities. Economic collapse has gutted public health funding and hyperinflation pushing basic care out of reach. Sustained funding, continued education of local health workers and community level education for pregnant women offers credible paths forward to address maternal hypertensive disorders in Venezuela.
– Juliette Dall’Aglio
Photo: Flickr
Community Midwife Training in Nepal
Programs focused on community midwife training in Nepal are helping address these challenges. They are preparing local health workers to provide safe delivery care and newborn support in remote communities.
Maternal and Newborn Health Challenges in Rural Nepal
Nepal has made substantial progress in maternal health over the past two decades. According to global maternal mortality estimates, Nepal’s maternal mortality ratio declined from 553 deaths per 100,000 live births in 2000 to 186 deaths per 100,000 live births in 2017. This represents a reduction of about 66%.
Newborn survival has also improved. The World Health Organization (WHO) finds that Nepal’s neonatal mortality rate declined from 40 deaths per 1,000 live births in 2000 to 16.6 deaths per 1,000 live births in 2023. Despite these gains, many families in rural areas still struggle to access skilled care during childbirth.
In mountainous regions of Nepal, reaching a hospital or birthing center may require several hours of travel, sometimes on foot. Shortages of trained health workers and limited medical infrastructure in remote communities also contribute to gaps in maternal and newborn care.
Expanding Skilled Care Through Community Training
Nepal’s maternal health strategy includes training skilled birth attendants such as nurses and auxiliary nurse midwives. These skilled birth attendants help manage labor, identify complications and provide essential newborn care. Because many trainees come from the communities they serve, they often understand local languages and cultural practices, making it easier to reach families who might otherwise avoid institutional care.
These efforts have contributed to significant improvements in access to skilled birth support. Data from the Nepal Demographic and Health Survey (NDHS) show that the share of births attended by a skilled health professional increased from about 13% in 2001 to roughly 80% in 2022. Expanding access to trained midwives has played a major role in improving maternal and newborn outcomes across the country.
Safer childbirth also helps reduce poverty by preventing costly medical emergencies and allowing mothers to recover and return to work more quickly. This reduces the economic strain that childbirth complications can place on low-income households.
Nonprofit Partnerships Strengthening Maternal Care
International nonprofit organizations also support community midwife training in Nepal through partnerships with the country’s public health system. One organization working in this area is One Heart Worldwide. The nonprofit collaborates with Nepal’s Ministry of Health and Population to strengthen maternal and newborn health services in rural districts.
The organization works directly with government health facilities to improve the quality of maternal care. It does this by training skilled birth attendants, upgrading rural birthing centers and providing ongoing mentorship for health workers. Its programs also strengthen referral systems so that complicated pregnancies can be transferred more quickly to higher-level hospitals.
Another program working to support maternal health by expanding access to skilled care in underserved communities is CARE Nepal. The organization works with local governments and community health volunteers to improve prenatal care, promote safe delivery practices and increase awareness of maternal health services. CARE programs also focus on training health workers, supporting community outreach and helping connect pregnant women with nearby health facilities where trained midwives can assist during childbirth.
The Impact of Skilled Midwives
The availability of trained midwives plays a crucial role in improving maternal and newborn health outcomes worldwide. According to the United Nations Population Fund (UNFPA), midwives trained to international standards could deliver about 90% of essential maternal health services. They could also provide essential newborn care.
In addition to assisting during childbirth, trained midwives help strengthen local health systems by linking pregnant women with antenatal services, organizing checkups and helping families navigate referrals to larger hospitals when necessary.
A Healthier Future for Mothers and Newborns in Nepal
Continued investment in community midwife training in Nepal remains essential for improving maternal and newborn health outcomes in rural areas. Expanding training programs, strengthening health facilities and supporting partnerships between government agencies and nonprofit organizations can help ensure that skilled professionals attend more births.
Nepal’s progress in maternal health demonstrates how expanding access to skilled care can transform outcomes for mothers and newborns. As community midwife training initiatives continue to grow, safer childbirth and stronger maternal care are becoming increasingly within reach for families across the country.
– Tom Basu
Photo: Flickr
Proactive Poverty Reduction in China
With 90% of the country’s poverty concentrated in rural areas, providing effective welfare faces many obstacles. The Chinese government has stepped up to this task, creating a focused policy mechanism. This initiative, officially known as a regular mechanism for dynamic monitoring and targeted support to prevent a relapse into poverty (often abbreviated as SHIELD), embodies a proactive poverty reduction strategy in China.
This method of proactive poverty reduction has proven incredibly effective, offering a global model for safeguarding populations of any size. To achieve this, the SHIELD mechanism breaks down its approach into three core areas: dynamic monitoring, precise identification and targeted support, all funded and staffed by a multi-departmental effort.
Proactive Poverty Reduction in China
Impact and Effort
The SHIELD policy represents a major government priority, backed by substantial investment. The Ministry of Agriculture and Rural Affairs leads the effort, with support from most other government departments, including health and education. Since the transition period began in 2021, cumulative government investment in formerly impoverished areas has reached 850 billion yuan (approximately $127.5 billion).
Given the scale of this multi-departmental collaboration, the policy’s impact is evident. Under this system, authorities have identified seven million people as high-risk and are now providing support to them. SHIELD has also helped secure jobs for 33.05 million people, either through employment opportunities or community service roles. In addition, in isolated rural areas, systems established under SHIELD have increased access to safe drinking water to 94%.
The SHIELD policy represents the culmination of a multi-departmental effort and wise allocation of resources. The policy provides a comprehensive and replicable model of proactive poverty reduction in China, with support tailored to citizens’ needs. As a result, it may serve as a global roadmap for poverty alleviation, a goal the evidence suggests SHIELD is already moving toward.
– Eli Thomson
Photo: Flickr
Sudan Refugee Crisis Response Amid Famine and War
Even with the high displacement numbers, there is no current sign of a peace deal that would end the conflict. Displaced Sudanese are fleeing to overwhelmed refugee camps in nearby countries such as Chad, Ethiopia and South Sudan. Organizations and governments are working to accelerate the Sudan refugee crisis response to meet growing demand.
Intervention by Nonprofit Organizations
Because of the conditions in Sudan, a number of nonprofit groups such as the United Nations Crisis Relief, Doctors Without Borders and Save the Children are in the area providing resources. Because of the growing famine, groups are prioritizing food access. For example, Save the Children is providing food, water, shelter and medical services that reach 224,000 Sudanese. While this is already a large number, many more are in need of services.
Proposed Response Efforts
Sudan has experienced conflict in recent decades, including the Darfur War in 2003. Adding resources to the area is considered a strong investment because this is not the first period of displacement that Sudanese people have experienced. Building significant infrastructure in the region would help sustain responses to future crises. From there, governments and nonprofit groups could focus on long-term stability rather than immediate nutrition and medical needs.
The United Nations High Commissioner for Refugees (UNHCR) has developed a strategy it believes will best support the Sudan refugee crisis response. According to the UNHCR, there needs to be a focus on keeping borders open across seven countries to support asylum seekers. The U.N. and various nongovernmental organizations (NGOs) will then implement resources for displaced populations. This will include increased food access, medical care, expanded agriculture, general education and vocational education programs. To establish these programs without straining neighboring countries, the UNHCR has stated that a large investment must be made.
A Way Forward
The largest obstacle is the proposed budget for relief. The UNHCR estimates a need of $907 million to make this plan work. Because the number of displaced people is so large and issues like famine require quick action, significant resources are necessary. The most urgent needs, such as addressing famine, will be addressed with available and incoming resources, while funds can be raised for additional programs.
– Nicole Miller
Photo: Flickr
SDG 14 in South Africa: Fisheries and Sustainability
In South Africa, where unemployment rates are among the highest globally and poverty rates remain widespread, the health of marine ecosystems provides an undeniable economic opportunity. Efforts to protect life below water and reach SDG 14 in South Africa have not only become environmental priorities, but a broader strategy to support livelihoods for all generations.
Marine Resource Management Challenges
South Africa’s marine environment continues to face growing pressure through the exploitation of marine resources, changing weather patterns and plastic pollution. Overfishing remains one of the most significant threats to ocean ecosystems, with 34% of South Africa’s fish stocks either depleted or heavily depleted. Nearly half of South Africa’s marine sources are already fully exploited with another 15% overexploited, putting substantial pressure on key economic species like rock lobster and tuna. Local marine ecosystems are being reshaped along the country’s expansive coastline, driven by changing weather patterns. Fisheries are highly dependent on ecosystem health as the food web drives biodiversity and biomass.
Sardines play a crucial role in the region’s marine food web supporting a large portion of the country’s pelagic fishing industry. However, sardine biomass declined 25% of its historical maximum since 2004 along South Africa’s west coast, significantly impacting fish stocks up the food chain. As populations decline, annual catch quotas are reduced with significant decreases in employment opportunities in fisheries, processing plants and export sectors.
Only 46% of South Africa’s 122 million tons of plastic waste is recycled, leaving an estimated 79,000 tons every year to enter rivers, oceans and the environment. This makes South Africa one of the largest contributors of land-based marine plastic pollution. Beyond plastics, 86% of sewage treatment did not meet safety standards and continues to release effluent contaminants into rivers. These environmental pressures have consequences beyond biodiversity by threatening coastal economies that rely heavily on ocean resources. With unemployment in South Africa reaching around 32%, fisheries and marine tourism provide important sources of income.
How SDG 14 Initiatives Are Combating Challenges
In response to SDG 14, South Africa continues to invest in research and collaboration efforts to improve scientific understanding, expand marine protection efforts, and promote sustainable resource management. Most notably, South Africa has increased marine protected areas from 0.4% to 5.4% of its Exclusive Economic Zone, protecting more than 1.5 million hectares of marine critical habitat.
Researchers at the University of Cape Town play a key role in this effort by tracking ocean conditions to inform fisheries policies. One major initiative is the Marine and Antarctic Research for Innovation and Sustainability (MARIS) program. The Benguela Current system alone supports fisheries valued at more than $1 billion annually, highlighting the importance of research programs such as MARIS in guiding sustainable marine policy. Another key focus is the implementation of ecosystem-based fisheries management in the Benguela Large Marine Ecosystem through three primary objectives:
The nutrient-rich Benguela current supports hundreds of thousands of livelihoods across southern Africa. To ensure sustainable fisheries policies and regulations within the marine park is critical. As Melrus managing director Tomas Kjelgaard states: “It’s very important for us to have a long-term business. If we overfish like they have done in many places during the last 20 years, then we don’t have a business the day after tomorrow.” To protect the livelihoods of future fishermen, continued cooperation between government agencies, local stakeholders and neighboring countries such as Namibia and Angola is essential.
Government-led education campaigns continue to spearhead community-driven initiatives in South Africa. Particularly, coastal cleanup programs removed 111.85 tonnes of waste from beaches and waterways during volunteer cleanup campaigns in 2024 and has employed more than 200,000 volunteers across the country. Additionally, academic programs such as SEAmester have helped train more than 500 students from 15 institutions, supporting next generation of marine scientists and securing employability across the sector.
The Future of South Africa’s Life Below Water
As South Africa continues to strive towards reaching the SDG 14, oceanic health and prosperity are becoming increasingly important toward reducing poverty and supporting sustainable economic development in South Africa. Despite universal challenges of overfishing, the changing climate and pollution, ongoing targeted research, informed policy decisions and community initiatives show that progress is possible. With expanding marine protected areas, stronger fisheries management, and education programs training the next generation of ocean stewards, South Africa is charting a course toward a healthier ocean and stronger coastal communities.
– Alyssa Forget
Photo: Unsplash
Child Marriage in Tajikistan: Multi-Sector Solutions Gain Momentum
Courts Tighten Approval Standards
Some families in Tajikistan use Family Code Article 13, which allows marriage in exceptional circumstances, to arrange child marriages. In 2024, courts rejected 15% more of these requests after the ombudsman became involved. Poverty plays a significant role, with 80% of 17-year-old brides coming from conservative regions like Rasht and Khatlon, where families struggle financially. Enforcement efforts helped 1,200 girls return to school in 2023, and makhalla councils turned down 350 underage marriage requests following new legal reforms.
Education and Health
UNICEF holds theater performances in 300 villages each year, reaching 150,000 people with plays about the health risks and missed educational opportunities linked to child marriage. After these events, surveys show that 68% of parents chose to delay their daughters’ weddings by at least two years. Girls Not Brides trains 5,000 imams to speak against child marriage, reaching two million worshippers each week. As a result of these efforts, local councils now receive 25% fewer underage marriage requests as more elders support delaying marriage.
Additionally, the World Bank’s Adolescent Girls Initiative provides $30 monthly stipends to 50,000 families who keep their daughters in school after age 15. The program has raised secondary school enrollment by 18% in Khatlon and Sughd. Vocational centers train 10,000 teenagers each year in tailoring, agriculture and information technology, and graduates earn 35% more than early-married peers within two years. Child marriage in Tajikistan rates among stipend households fell from 22% in the poorest quintile to 11%.
In the Rasht Valley, mobile classrooms provide evening classes in 120 villages, helping 85% of working girls at risk of marriage at age 14 to finish school. Government scholarships provide uniforms and textbooks to 100,000 at-risk students, raising school retention from 65% to 82% between 2022 and 2025. The program also offers nutritional support, which has lowered anemia rates by 28% among participants through fortified meals.
In 2025, health ministry clinics screened 120,000 adolescent girls for reproductive risks related to child marriage in Tajikistan and distributed 300,000 booklets about health risks. Specialized camps treated 1,100 women for childbirth complications caused by teen pregnancies. Hotlines received 7,500 calls from minors seeking help to escape forced marriages. HIV screening is now part of these programs, reducing mother-to-child transmission rates by 22% among young brides in targeted districts.
Making Progress
From 2017 to 2020, Tajikistan prosecuted 36 cases under Article 168 for child marriage and 27 cases under Article 169 for marrying minors. Officiants can receive up to five years in prison. Following recommendations from the Committee on the Elimination of Discrimination Against Women (CEDAW), authorities increased oversight of nikah ceremonies and rejected 20% more parental petitions that cited cultural tradition. These enforcement steps help Tajikistan fulfill its 2023 Universal Periodic Review commitment to apply the age 18 rule across all 58 districts.
Surveys from the State Statistics Committee show that school dropouts caused by child marriage fell by 8% since the digital marriage registry started in 2023. New agreements with Kyrgyzstan and Uzbekistan now block 90% of duplicate underage marriage applications by using shared databases. Donor-funded mobile registration units also help track child marriage in remote areas like the Pamir and Zeravshan mountains.
Tajikistan is sharing its court protocols for denying underage marriages at Central Asia summits through 2025 and is working to align marriage registration rules with neighboring countries. The Aga Khan Foundation runs 15 safe houses that shelter 900 escapees each year, offering counseling and helping families reunite. Awareness campaigns about child marriage now reach 65% of households. A 2025 poll found that 62% of household heads support marriage after age 20.
Looking Ahead
Tajikistan plans to lower child marriage rates to below 7% by 2030 through court enforcement, financial support, mobile education and community awareness, in line with Sustainable Development Goal (SDG) 5. As more girls finish secondary school and enter the workforce, social norms are shifting. Girls who graduate from secondary school are three times less likely to marry before 18. Tajikistan’s multisector approach could serve as a model for other parts of Central Asia addressing similar challenges.
– Niaz Youssefian
Photo: Flickr