Sesame Street
Sesame Street uses its influence to improve global health through its unwavering support of Youth Day and Global Goals — both of which are recognized by the United Nations — to encourage young children to act as voices of change.

Youth Day 

Youth Day is celebrated on August 12, and this year’s theme is centered around the eradication of poverty and achieving sustainable consumption and production. Sustainable consumption means meeting Earth’s present and future needs by simply being aware of everyday actions that affect the planet and learning to minimize waste and pollution.

The beloved children’s show shared the following important message on Facebook: “With the help of our friends around the world, we hope children continue to be inspired and empowered to be the change they deserve!”

Iconic Sesame Street characters such as Big Bird and Elmo are pictured carrying signs that promote multiple Sustainable Development Goals like quality education, clean water, and sanitation.

Sesame Street and Sustainability 

The U.N.’s list of Sustainable Development Goals comprises 17 other objectives including no poverty, zero hunger, good health and well-being. According to the U.N., these plans to transform the world can be met with the collective efforts of government authorities and regular individuals alike.

Sesame Workshop’s shows use media outlets for the greater good in more than 150 countries. Since it first aired in 1969, Sesame Street has aimed to give disadvantaged children equal opportunities through numerous educational outreach programs. Additionally, Muppet characters are created to address specific and relevant concerns.

One such character is Khokha — lead Muppet of Sesame Street coproduction Alam Simsim — is a model for girls’ education in Egypt. Another Muppet, Kami, is an HIV-positive Muppet living in South Africa. She destigmatizes HIV/AIDS by telling children that it is okay to touch someone affected by the disease.

With everyone working together, the reality of a brighter future is more than attainable. Sesame Street is drastically improving global health by getting involved and spreading the word about the need to care for the planet and its people.

Mikaela Frigillana

Photo: Flickr

Healthcare in Bihar
Bihar is one of the poorest states in India as approximately 55 percent of the population lives below the poverty line. There is an overwhelming need for quality health care facilities and workers in this region. In the past ten years, the World Bank Group and the Bill and Melinda Gates Foundation have made great strides toward the improvement of healthcare in Bihar.

The World Bank’s collaboration with the Bihar Government led to an increase in the accountability and accessibility of healthcare from 2005 to 2008. By 2008, the number of outpatients visiting a government hospital grew from 39 per month to almost 4,500. The number of babies delivered in healthcare facilities also increased from some 100,000 to 780,000.

Bihar’s infant and maternal mortality rates are higher than India’s national average. According to the Sample Registration Survey in India conducted in 2013, 208 women per 100,000 died during childbirth. Furthermore, 28 out of every 1,000 newborns die within their first month of life.

Most of these deaths are preventable if basic care is provided to women and newborns during and immediately following childbirth. Unfortunately, the infrastructure of healthcare in Bihar falls short in nearly all required categories, including the number of health assistants and nurses.

According to the Huffington Post, there are not enough nurses in Bihar to allow for lengthy off-site training to prepare nurses for treatment of postpartum hemorrhage or premature births while also keeping health facilities adequately staffed.

In order to improve maternal health and newborn care, the Bill and Melinda Gates Foundation along with the Bihar Government launched a Mobile Nurse Mentoring Program called AMANAT.

Through AMANAT, nurses in public health facilities are mentored on-site by mobile nurse mentors, who ensure that basic standards of care are provided for pregnant women and newborns.

The program has greatly improved healthcare in Bihar for women and children before and after deliveries since its implementation in 2012. A few of these improvements include:

  • The administration of the correct use of oxytocin to induce labor has increased from 9 percent to 59 percent.
  • The use of sterile instruments by nurses during deliveries has increased from 13 percent to 43 percent.
  • The implementation of mothers breastfeeding has increased from 49 percent to 72 percent.

The number of stillbirths declined from 19 to 12 per 1,000 live births due to improvements in basic care practices. AMANAT was implemented in 160 public health facilities across Bihar and is expected to be administered in 240 over the course of this year.

There is a long way to go in creating a stable system of healthcare in Bihar. However, these crucial improvements made by the World Bank, the Bill and Melinda Gates Foundation and Bihar’s Government have saved and will continue to save countless maternal and newborn lives.

Kristyn Rohrer

Photo: World Bank

Risk of Premature BirthSera Prognostics, a women’s health company based in Utah, recently developed a blood test that can determine a mother’s risk of premature birth. The test, known as PreTRM, can be administered as early as 19 weeks into the pregnancy.

While a normal pregnancy lasts about 40 weeks, premature births happen at or before 37 weeks. Fifteen million babies around the world are born prematurely each year, and one million deaths occur from the resulting complications, demonstrating the immense risk of premature birth.

PreTRM tests for two proteins: IBP4, an insulin-like growth factor, and SHBG, a sex-hormone binding globulin. By searching for particular patterns within these proteins, a mother can know her percentage of risk for having a premature birth.

Gregory C. Critchfield, the CEO of Sera Prognostics, said that about 50 percent of premature deliveries occur in women with no known risk factors. PreTRM can ensure such women are identified early on.

Premature birth is associated with a significantly increased risk of major long-term medical complications, such as learning disabilities, cerebral palsy and chronic respiratory illness, therefore identifying women at risk is key.

PreTRM underwent testing from 2011 to 2013 with 5,501 participants. Though the test currently costs $945 and is commercially available in the United States, Sera Prognostics is partnering up with the Bill & Melinda Gates Foundation to produce a version for lower-income countries.

According to Critchfield, one goal of the product is to reduce the economic and healthcare burden of premature births on infants, their family and society. In the U.S. alone, the cost of treatment was more than $26 billion in 2005, according to March of Dimes. The financial struggle is even greater in low-income countries.

PreTRM has the potential to ease the financial burden of premature birth for low-income countries, as well as deliver new information regarding the proteins expressed in pregnancy, what causes preterm birth and what can be done to improve a newborn’s future health.

Anastazia Vanisko

Photo: The Independent

midwifery
During the 14-year civil war in Liberia, the health system became increasingly fragile, and a lack of roads and transportation made it difficult for pregnant women to receive necessary emergency care. This issue has created a strong need for strengthened midwifery in Liberia.

As a result, Liberia had one of the highest maternal mortality rates in the world according to a 2015 USAID article, but the country is now trying to change that through investment in midwifery programs.

Currently, 44 percent of Liberian women give birth without a skilled attendant, and nearly one out of 138 mothers die from preventable causes during childbirth. Such issues could be avoided with basic or strengthened midwifery in Liberia, according to the World Health Organization.

Bentoe Tehounge, a trained midwife in Liberia, told WHO, “We need midwives who can ensure a safe pregnancy even before a woman is pregnant. People who can provide advice on family planning, nutrition, physical activity and preventing mother-to-child transmission of HIV.”

There are six midwifery schools in the Liberia, half of which are in rural areas, and less than 200 midwives for over four million people. Most of these midwives work in urban areas. Strengthening these schools, especially the rural ones, will improve access to quality care for women around the country.

Retaining these midwives is one step towards Liberia’s investment in the profession. According to WHO, many health professionals were driven out of the country due to the civil war and the Ebola crisis, and now midwives lack “safe accommodation and transport, are overworked and paid poorly and have limited opportunities for career advancement.”

A new B.S. program addresses a portion of these concerns by providing further professional development. The program graduates 50 to 75 registered midwives per class, which is expected to staff more than 700 health facilities in the country. To develop better teaching methods, Liberia is working with the Danish Midwives Association to pair Liberian and Danish midwives in order to learn more advanced skills, like preventing and treating hemorrhages. It is hoped that this new alliance will result in strengthened midwifery in Liberia.

In the United States, this final element is comparable to the apprenticeships or clinicals that midwives do to obtain a license. Mary Anne Brown, a midwife serving the Great Falls and Helena areas of Montana, said that degree programs require that their students find and work directly with a midwife to gain clinical experience.

Past midwife training in Liberia tried to work within a culture of home birth in Liberia (USAID reported that 63 percent of Liberian women gave birth outside of a health facility) and with the knowledge of traditional midwives.

The goal was to shift the focus to encouraging birth preparedness, recognizing and referring complications and providing appropriate emergency care through what USAID called “home-based life-saving skills.” By utilizing storytelling, case histories, discussion, role-play and demonstrations, midwives, expectant parents and community leaders were able to educate themselves at community meetings.

One of the greatest achievements of the previous midwife training in Liberia was its ability to connect traditional midwives to both health facilities and certified midwives. Certified midwives perform their own visits to discuss problems the traditional midwives are having, replenish supplies and reinforce the training.

The current programs are a part of WHO’s efforts to provide clear guidelines, tools and an evidence base to lead to strengthened midwifery in Liberia and around the world in order to improve care for pregnant women and reduce both maternal and neonatal mortality rates.

Anastazia Vanisko

Photo: Public Domain Images

Health_mother_ Child Mortality
USAID is working with the Ethiopian government to reduce maternal, neonatal and child mortality rates, according to their website. Ethiopia has one of the highest rates of maternal deaths in the world.

“Women have a one-in-52 chance of dying from childbirth-related causes each year,” according to USAID. “Every year, more than 257,000 children under the age of five die and 120,000 die in the neonatal period. More than 60 percent of infant and 40 percent of under-five deaths in Ethiopia are neonatal deaths.”

This dire situation calls for extensive health care services. Ninety percent of Ethiopian women give birth in their homes in order to observe cultural traditions and be surrounded by company they trust. Health facilities can spread awareness about the value of institutional delivery in decreasing mother and child mortality rates; many mothers have never heard the benefits of skilled birth attendance and postnatal care.

Preventable complications like hemorrhage, infection, unsafe abortion, hypertensive disorders and obstructed labor are to blame for 80 percent of maternal deaths.

USAID has intervened in family, community and facility care by increasing accessibility of health services. A health extension program includes basic obstetric and newborn care, essential newborn care, management of neonatal and childhood illnesses, coverage of immunizations and the early identification and treatment of sick children, all of which go a long way to decreasing the child mortality rate.

Additionally, they funded the Integrated Family Health Project, an activity that seeks to promote and strengthen family planning and maternal, newborn and child health practices and services. With the cooperation of health programs throughout Ethiopia, the IFHP impacts about 40 percent of the country’s entire population.

The Health Ministry and various organizations provide health facilities with ambulances, equipment and skilled staff. The majority of communities in Ethiopia lay in rural regions that place women in a vulnerable position when a complication arises during childbirth, and many fatalities occur in the transfer to a health facility.

The Government of Germany recently contributed 10 million euro to UNICEF, bolstering its emergency response to drought affected regions in Ethiopia. This support will provide life-saving assistance to severely malnourished children and pregnant and lactating women. Lack of nutrition threatens close to half of a million children under the age of five and nearly 140,000 lactating women in the Somali area.

By providing preventive, promotional and basic curative health and nutrition services to mothers, infants and young children, USAID and other organizations like UNICEF are saving lives and combating illness and disability.

Emily Ednoff

Photo: Flickr

Hamlin Fistula EthiopiaHamlin Fistula Ethiopia is a charitable organization in Ethiopia dedicated to treating and preventing a specific childbirth injury known as obstetric fistula.

An obstetric fistula is a hole between “the vagina and rectum or bladder that is caused by prolonged obstructed labor, leaving a woman unable to control her urine or feces.”

According to Hamlin Fistula, “more than 75 percent of women with obstetric fistula have endured labor that lasted three days or more.”

The organization has built the world’s first fistula hospital and also has five regional centers in Ethiopia, providing healthcare to rural women.

Having the Hamlin Fistula Clinic in Ethiopia is vital because it is one the fastest growing economies in Africa. Unfortunately, the country has less than 7,000 trained midwives making the ratio of midwives to women having children very low.

According to the organization, “the childbearing population ratio is approximately 1:14,000, well below the World Health Organization’s recommendation of 1:5,000.”

This lack of services and health professionals has a direct impact on Ethiopian women. Approximately 9,000 women die in obstructed labor each year. Another 9,000 survive but with an obstetric fistula.

Hamlin Fistula Ethiopia provides a world class center of excellence for treating obstetric fistulas and training doctors to specialize in this surgery. Also, “the hospital also has the Hamlin College of Midwives and the Desta Mender – a farm and training center for long term patients.”

In addition, Hamlin Fistula offers rehabilitation services such as physical therapy, psychotherapy and job training. This helps patients rebuild their self-esteem, find meaningful employment and reintegrate into their village life.

“Over 700 Ethiopians are employed across Hamlin Fistula Ethiopia and only two of the staff are from overseas. Dr. Catherine Hamlin and Mr. Martin Andrews, the CEO.” It is with the generosity of donors that the Hamlin Fistula Ethiopia continues its work in treating and preventing obstetric fistulas.

“Mourning the stillbirth of their only child, incontinent of urine, ashamed of their offensiveness, often spurned by their husband, homeless, unemployable, except in the field, women with obstetric fistula endured, existed, without friends and without hope.”

However, thanks to Hamlin Fistula Ethiopia, Ethiopian women have the hope of receiving good, quality healthcare during childbirth. These women will be able to integrate themselves back into their families, communities and society at large, after delivery of their children.

Vanessa Awanyo

Sources: World Health Organization, Hamlin Fistula Ethiopia, Fistula Foundation
Photo: Flickr