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Efforts to Stop Mother-to-Child HIV Transmission in Indonesia

Mother-to-Child HIV Transmission in indonesiaIn 2023, about 570,000 people in Indonesia were living with HIV. Recognizing the urgency, the Indonesian government intensified its efforts to support individuals and prevent mother-to-child HIV transmission. Community organizations play a crucial role in this endeavor, providing care and treatment access to those in need.

The Situation in Indonesia

Since 2008, UNICEF has supported the governments of Papua and West Papua in Indonesia in establishing a Prevention of Mother-to-Child Transmission of HIV (PMTCT) program. This program emphasizes HIV prevention, diagnosis and treatment within communities. Providing antiretroviral treatment during pregnancy can significantly reduce the risk of mother-to-child transmission. Ideally, since 2009, HIV testing should be part of antenatal care for pregnant women in Indonesia. However, more than a decade later, 37% of pregnant women still do not receive HIV screening. In 2022, only 18% of mothers with HIV accessed antiretroviral therapy.

Current Action to Prevent HIV Transmission

The National Alliance to End AIDS in Children, established in 2023, unites government, international organizations and civil society to improve access to health services and mental support for women and children living with HIV. The alliance focuses on three primary priorities:

  1. Advocating for the specific needs of adolescent girls and children living with HIV.
  2. Raising awareness by disseminating information about PMTCT (Prevention of Mother-to-Child Transmission), Early Infant Diagnosis and sexual education.
  3. Empowering communities to support children living with HIV effectively.

Importance of the Community

With renewed political commitment, supporting community-based services becomes crucial to providing necessary care and support for women and children living with HIV. Mobilizing community health workers is essential not only to prevent transmission but also to assist those affected by the disease. Organizations like Lentera Anak Pelangi (LAP), operating since 2009, play a vital role in this effort. As Indonesia’s first multidisciplinary service provider focusing on children with HIV, LAP collaborates with volunteers, sponsors and partners to enhance the quality of life for those living with the disease.

Key Focuses of LAP

  • Improving the Quality of Health and Nutrition. LAP offers health and nutrition assessments, family counseling and support during child hospitalizations. The organization also educates on sanitation and hygiene. Additionally, LAP provides monthly free medical checkups, non-BPJS laboratory testing and financial support for medications.
  • Advocating for ARV treatment. Its program raises public awareness about treatment options and conditions through training, social media campaigns and mass media efforts. It also extends its outreach to schools by educating both staff and students.
  • Ensuring the psychosocial well-being of children and their families. The program teaches children life skills and includes a school that monitors their development. It offers vocational training tailored to each child’s talents and interests. Additionally, the organization facilitates peer support groups for parents.

Providing a Community

A mother describes how her daughter’s confidence has grown since joining LAP, highlighting the friendships they have both formed with others in similar situations. Another parent comments on the bonds her son has created and the benefits he has received from LAP’s educational and nutritional support. Despite the stigma in Indonesia, where 33.5% of adults believe children with HIV should not attend school with uninfected children, programs like LAP play a crucial role. They counter isolation and stigma while ensuring families receive necessary support and help prevent the disease’s spread.

– Amelia Short

Amelia is based in Bradford, UK and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Midwife Programs in Underserved Communities

Midwife Programs in Underserved CommunitiesMidwives play an essential role in providing health care to women. Their work is critical in areas without access to traditional hospitals and for women who need alternative expertise. The World Health Organization (WHO) recommends training an additional 1.3 million midwives by 2030 to address the shortage of health care professionals. The following documentaries feature midwife programs in underserved communities.

Navigating Birth and Conflict in the West Bank

This documentary, filmed in Feb. 2024, tracks experienced midwives as they navigate the challenges of providing care in the war-torn West Bank. Across four hospitals, these professionals manage their personal anxieties and professional duties. Indeed, they ensure pregnant women receive necessary health care despite the conflict. Each midwife program reveals how these women adeptly adapt to severe conditions. Despite the lack of private hospitals and ongoing war, they serve approximately 8,000 women per month, overcoming significant institutional challenges.

The midwife programs tackle hurdles such as unpredictable birth events, an unorganized health care system and a dampening of morale among expectant mothers. Additionally, personal hurdles include military checkpoints during commutes and delays in payment from employers. A primary concern is the mental and emotional well-being of mothers and midwives as they navigate the uncertainties of childbirth, poor health care access and the dangers of a sustained war effort around their homes and hospitals. Midwife programs such as Midwives for Peace actively work to make up for the lack of resources and to support new mothers. 

Making a Midwife

This documentary follows student midwives as they train and work to receive certification to practice in Haiti. Women like Jusléne prepare to work independently in their communities. According to the documentary, one in 83 women die during childbirth in Haiti. Half of these deaths can be attributed to health complications, such as Eclampsia. Though many women experience complications with known treatments, many of these procedures are not offered to the poor and low-income families within Haiti.

The Midwives for Haiti is a program dedicated to combating high child mortality rates in Haiti. These future midwives, both women and men, are eager to apply their new skills in communities desperate for quality care. They learn from seasoned instructors experienced in field deliveries. By partnering with traditional matrons, Midwives for Haiti ensures a robust training of attendants. The program melds formal midwifery education with an understanding of local cultural traditions. Additionally, the training equips new matrons to engage effectively with pregnant women and their families. As locals themselves, these midwives handle cultural beliefs sensitively, providing accurate diagnoses and care. In the long term, this process aims to strengthen a struggling health care system and alleviate pressures on local actors and voodoo doctors who may lack medical knowledge. 

The community-centered approach to education and training creates an atmosphere of uplift and persistence for each trainee. Michael, a featured trainee, wishes to go out and find people who need medical care but who may not have the resources to maintain steady access. Like many of the featured midwives, his goal is to educate local women on the best practices for a healthy pregnancy. The hope is that they can learn how they can position themselves and their children to live a life of health and nutrition. 

Nadene, the founder of Midwives for Haiti, established the program with two primary goals. The first is to address the critical shortage of health care providers. The second goal is to foster self-agency among midwives. As students graduate and begin their practices, they gain the tools needed to achieve financial independence. This empowerment is particularly transformative for women, who often experience financial independence for the first time as they serve their communities.

Con Madre

Con Madre documents the experiences of a group of women who live and train at a Guatemalan school for midwives. The documentary depicts a strong bond between the women as they live together and progress through its program. 

According to the National Center for Biotechnology Information, more than 50% of births in Guatemala are home births. Women unable to attend a formal hospital rely on midwives to guide them through pregnancy. Furthermore, they offer care in the weeks following birth. Despite the necessity of their work, midwives in the area resist perceptions by medical professionals who do not understand or accept their expertise. 

The three-year midwife program equips students to lead with a vision of empowerment and possibility, emphasizing women’s health rights and future work. Beyond their formal training, each midwife-in-training shadows a “traditional” midwife to absorb ancestral knowledge from local villages and communities. This ancestral training fosters respectful, trusting relationships between new midwives and their local patients.

Looking Ahead

Through the dedication and specialized midwife programs highlighted in these documentaries, midwives provide critical health care to underserved communities globally. These ongoing programs empower local midwives, enabling them to navigate complex community challenges while preserving cultural practices. As they address gaps in maternal and newborn health, midwife programs enhance care and promote long-term, community-centered health care solutions that bring safety and support to mothers and infants in underserved communities.

– Karina Dunn

Karina is based in Mesquite, TX, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr

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USAID and Maternal Mortality in Ethiopia

USAID and Maternal Mortality in Ethiopia Across the developing world, the health of mothers and the risks of childbirth remain a difficult challenge. Developing nations experience a lack of modern health care centers, inaccessible medical training, diseases that the developed world has eradicated and food insecurity, among other hindrances to healthy pregnancies and deliveries. Despite recent improvements, Ethiopia continues to experience these difficulties. It is for this reason that the United States Agency for International Development (USAID) has built up various programs that work to improve the health of mothers and reduce maternal mortality in Ethiopia. 

The Situation

In the last 20 years, the number of mothers who die from childbirth in Ethiopia has dropped from 29,600 mothers in 2002 to about 10,000 in 2020. Likewise, maternal mortality measures such as the maternal mortality ratio (number of mothers who die from pregnancy-related causes per 100,000 live births) have more than halved in the last two decades. Currently, there are 401 deaths per 100,000 live births in Ethiopia. Despite these levels remaining high in comparison with developed nations, which experience just 24 deaths per 100,000 live births, these improvements are extremely significant. In addition to the work of the Ethiopian government and other NGOs and nonprofits working across the country, USAID has made major contributions to improve maternal mortality in Ethiopia. 

Health Care Worker Program

An aspect of the discussion surrounding maternal mortality in Ethiopia is the state of health care across the country. Currently, there is a global median of 48.6 health care workers per 10,000 people. Ethiopia only has 9.2 workers per 10,000 people. These numbers indicate a stark shortage of health care workers, which has serious implications for expectant mothers and birthing women. When there are so few health care workers, it is impossible to ensure that pregnant people receive antenatal care, access a sterile birthing facility or receive quality health care during and after labor.

In response to the ongoing situation, USAID has built up two programs in Ethiopia, known as USAID’s Transform Primary Health Care and Transform Health in Developing Regions projects. These projects focus on underserved areas of Ethiopia to expand basic health care needs, strengthen the abilities of health care workers and provide support for health care programs through planning, budgeting and managing. This program is a major source of aid in rural parts of the country, where women experiencing pregnancy and childbirth are at an increased risk of maternal mortality. 

Preventable Disease Programs

Another important aspect of maternal health is infant and child health. Currently, 24% of all preventable deaths in Ethiopia are women and children. It is for this reason that USAID intervenes in Ethiopia with various vaccination and nutrition programs for both mothers and children. In 2023, USAID reached three million to provide mosquito nets, 62% of births measured received DTP3 immunizations before age 1 and nearly 700,000 women gave birth in a sterile U.S.-funded facility. USAID also funds the Core Group Polio Project to improve vaccination (namely in rural areas), provide outbreak response and eventually eradicate polio from Ethiopia. These programs do the vital work of avoiding preventable deaths in not only mothers across Ethiopia but also their young children.

Nutrition Program

A key aspect of both maternal and child health is nutrition. Nutrition is an extremely difficult obstacle to overcome in a country like Ethiopia, where droughts, conflict and extreme poverty are constant challenges. For this reason, USAID works through its Feed the Future Growth through Nutrition Program to boost the nutrition of pregnant women, mothers, infants and young children. This program focuses on education programs that ensure good nutrition via nutrient and vitamin-rich foods are household staples. With only 11% of the USAID budget for maternal health in Ethiopia, this program reached 6.1 million children under 5 in 2023 alone. Despite difficulties in ensuring good nutrition which impacts the health of mothers and children, USAID has put in important work to improve the health of mothers and therefore lower maternal mortality in Ethiopia. 

Looking Ahead

Maternal mortality remains a critical challenge in the developing world and Ethiopia is no exception. However, organizations like USAID are making significant strides in creating a safer environment for mothers. Their efforts are crucial in improving health care, reducing preventable diseases and enhancing nutrition.

– Carlie Duggan

Carlie is based in Newtown, PA, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Cash Transfer Program Empowers Women and Children in Sudan

Cash Transfer Program Empowers Women and Children in SudanSevere conflict in Sudan, erupting in 2023, has displaced millions of Sudanese in the past year. Reports from the International Rescue Committee indicate that the recent conflict displaced a total of 12 million people in Sudan, with 10 million of those remaining in the country. With only 2 million of the total 12 million displaced externally, the situation in Sudan represents one of the largest internal displacements in the world. Humanitarian crises such as the situation in Sudan require special consideration for groups like women and children who are more vulnerable. Maternal and infant mortality rates in Sudan have grown and become increasingly concerning as trends continue to stagnate or even decline. Promoting and supporting mothers and children in developing countries like Sudan is the central goal of the Mother and Child Cash Transfer Plus Program.

Maternal and Infant Mortality Rates in Sudan

The United Nations (U.N.) Sustainable Development Goals (SDG), a set of priorities for progressive global development by 2030, identifies maternal and infant mortality under SDG 3: Good Health and Well-Being. The goal set forth by the U.N. states that by the year 2030, the global maternal mortality ratio will be less than 70 for every 100,000 live births.

A 2020 study by the World Health Organization revealed that the maternal mortality ratio in Sudan is 270.40 for every 100,000 births, highlighting a serious concern for the country. Considerable obstacles hinder progress in achieving this SDG target. The stagnating trends over the past five years also indicate major challenges in promoting good health and well-being. These rates reflect a lack of proper health care, sanitation and clean water in Sudan, necessitating a multifaceted approach to achieve progress.

The infant mortality rate in Sudan, as an indicator of SDG 3, is the probability, per 1,000 live births, that a newborn baby will live past the age of 5 and stands at 51.56 per 1,000 live births, according to the 2022 study by the U.N. Interagency Group for Child Mortality Estimation. Similar to its maternal mortality rate, Sudan has major challenges left concerning these rates with the long-term objective for this indicator being 2.6 out of every 1,000 live births. In contrast to maternal mortality rates, infant mortality rates have been steadily decreasing since the year 2000 providing hope for Sudan’s future.

The Mother and Child Cash Transfers Plus

The Ministry of Social Development, along with UNICEF and its partners invest in and value the importance of the first 1,000 days of a human life. The first 1,000 days of life hold invaluable periods of neurodevelopment, health and opportunity making the protection of this time critical. In April of 2021, under the consideration of the first 1,000 days of life, the Commission on Social Safety and Poverty Reduction under the Ministry of Social Development created the Mother and Child Cash Transfer Plus (MCCT+) program to support and empower women and children in developing countries.

The MCCT+ program first launched in eastern Sudan, targeting areas with the highest levels of malnutrition and the greatest need for aid. In Sudan, the flagship program actively supports those in need with cash transfers, sharing important information and the overall care of women and children. The program has supported 50,000 pregnant women in just the first phase of the program.

UNICEF shares the story of Mahasin Mohamed Al-Rayih, a 26-year-old mother in Sudan who founded the MCCT+ program before the delivery of her firstborn child. Mahasin expressed that the program center aided her in creating a delivery plan for her upcoming birth and provided her with the funds to purchase necessities for lactation and raising her newborn child. 

During the first year of the program, 50,000 pregnant women, like Mahasin Mohamed Al-Rayih were helped through the Mother and Child Cash Transfer Plus program and another 13,000 recipients received cash entitlements. These numbers continue to climb exponentially as the program expands across Sudan and provides the much-needed support and resources for women and their children to have the greatest chances of success and survival.

Hope For the Future

Despite the current displacement crisis and the subsequent maternal and infant mortality rates in Sudan, programs and initiatives like the Mother and Child Cash Transfer Plus program prove that there are tangible strategies to support and empower women, mothers and children in meaningful and proactive ways.

– Juliana Granville

Juliana is based in Brooklyn, NY, USA and focuses on Good News for The Borgen Project.

Photo: Flickr

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Maternal and Child Health in Sierra Leone

Maternal and Child Health in Sierra Leone In Sierra Leone, the maternal mortality ratio improved from 1682 deaths per 100,000 live births in 2000 to 443 by 2020. Maternal health continues to be an area of focus when considering health care. Maternal deaths are the cause of 36% of all deaths of women aged 15 to 49 in Sierra Leone. Causes of maternal deaths include hypertension and obstetric hemorrhage. The COVID-19 pandemic exacerbated the problems of maternal and child health, with economic growth slowing and disrupting essential health services. 

Changing Approach: Skilled Antenatal Support

Zainab Turay, a 28-year-old mother, says the birth of her second child was successful because she regularly attended the free antenatal sessions at Freetown’s George Brook Community Health Centre. In the rural areas of Sierra Leone, Traditional Birth Attendants (TBAs) continue to advise women despite not being trained to deal with the many complications that can arise in pregnancy, such as bleeding after childbirth. Antenatal classes help prepare women for childbirth. Between 2013 and 2017, the number of births delivered by skilled attendants increased by 32%. 

Integrating Technology to Improve Maternal Care

In March 2023, the United Kingdom’s Foreign, Commonwealth and Development Office published its International Women and Girls Strategy 2023 to 2030. The strategy is centered around the rights of women to basic freedoms. The Saving Lives in Sierra Leone program is one example of how reproductive rights are being prioritized. Over one year, 1284 midwives received training. Alongside this, the Emergency Obstetric and Newborn Care scheme mentored 260 health care workers. This additional training and mentoring has strengthened the number of people trained to deal with issues that arise during pregnancy and after childbirth. 

In Sierra Leone, 41% of emergency obstetric and newborn care facilities lack access to one or two basic EmONC signal functions. Therefore, the Saving Lives in Sierra Leone scheme aims to provide these facilities to create quality care. The country trained 949 midwives at the end of 2019, but estimates suggest that 3,000 are needed to adequately care for women. This significant increase in trained midwives reflects the achievement of the Saving Lives program. 

Sierra Leone launched the Pregnancy Registration and Service Tracking application (PReSTrack) on July 2, 2024. This application enables real-time tracking of pregnancies and flags high-risk conditions. Moreover, PReSTrack is part of Sierra Leone’s mission to decrease the maternal mortality ratio (MMR) to below 300 deaths per 100,000 live births by 2025. The use of this technology aims to make health care more efficient.

Project HOPE’s Effect

Project HOPE is a global health and humanitarian NGO making significant strides in improving maternal health in Sierra Leone. The organization offers courses such as Helping Babies Breathe and Helping Mothers Survive, training health workers to manage complications. It also established the country’s first Kangaroo Mother Care (KMC) units. With a scarcity of incubators in Sierra Leone, KMC, which involves wrapping premature babies skin-to-skin with their mothers, is vital for saving lives. Given that there are only 0.7 doctors available per 10,000 people, the work of Project HOPE is crucial.

In December 2021, the World Bank approved $60 million to enhance maternal and child health services in Sierra Leone. This will be achieved through the Sierra Leone Quality Essential Health Services and Systems Support Project. The initiative supported two million people. Of the total funds, $10 million targeted the consequences of the global pandemic, providing COVID-19 tools and ensuring that the most vulnerable received the essential health services they needed.

The Future of Maternal and Child Health

The future of maternal and child health in Sierra Leone looks optimistic, due to the efforts of NGOs and other groups. Initiatives like Saving Lives in Sierra Leone and applications such as PReSTrack are enabling more people to access vital health care, thereby improving maternal and infant mortality rates.

– Amy Fox

Amy is based in Birmingham, UK and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Child Human Rights Defenders in Brazil

Child Human Rights Defenders in BrazilFounded in 1991, the Committee on the Rights of the Child oversees the implementation of the Convention on the Rights of the Child. The Convention’s Preamble advocates for raising children in a spirit of peace, dignity, tolerance, freedom, equality and solidarity. Every two years in Geneva, the Committee conducts a Day of General Discussion (DGD) focusing on children’s issues related to the Convention on the Rights of the Child. Child Human Rights Defenders play a significant role in these discussions. The Defenders bring attention to the practical applications of the Convention in their lives and communities.

2018 Day of General Discussion Focus

In 2018, the Committee on the Rights of the Child’s Day of General Discussion (DGD) centered on protecting and empowering children as human rights defenders. This first global discussion in 2018 significantly raised awareness and understanding of the roles and activities of child human rights defenders. It established a clear definition of a child human rights defender and laid the groundwork for state obligations under the Convention on the Rights of the Child regarding these defenders. In addition, this 2018 initiative marked a phenomenal achievement: 60 children attended the DGD in person. It also featured the online participation of more than 800 individuals worldwide. The efforts of the DGD brought to light the experiences of children serving as human rights defenders.

Child Human Rights Defenders in Brazil

According to Child Human Rights Defenders (CHRDs), a child human rights defender is a child who takes action to promote, protect and fulfill human rights, including children’s rights.

  • Camila Moradia. A recipient of the Front Line Defenders Award for Human Rights Defenders at Risk in the Americas region in 2021, has been a child human rights defender in Brazil since she was 5 years old. Camila joined her mother in advocating for women’s rights and participated in social projects developed by the State Government of Rio de Janeiro. She also championed housing rights in the Alemão complex, advocating for 1,300 families. In 2015, she founded Women in Action in Alemão (MEAA). MEAA’s mission focuses on ending violence against women, empowering women and their families, strengthening their autonomy and ensuring basic rights. Additionally, the organization has successfully supported more than 400 women in Complexo do Alemão, a slum in Rio de Janeiro.
  • Gabriel. A 16-year-old child human rights defender emphasizes the absence of effective addressal of violence within schools. The pressure on children to sit, listen and remain silent diminishes the participation of children. This leads to the systematic absence of incorporating human rights education in the school curricula. 
  • Melissa. A 17-year-old child human rights defender highlights the importance of digital media for communicating useful information. Young individuals gather together to discuss matters concerning public policy-making. These discussions allowed these child human rights defenders in Brazil to highlight the need for new hospitals and to increase the employment of new teachers. This good practice provides feedback to the Government in Brazil from child human rights defenders in Brazil.
  • Mary Lawlor. The U.N. Special Rapporteur on the situation of human rights defenders, during her official country visit to Brazil, recognizes the gross violations against human rights defenders in Brazil. Human rights defenders in Brazil seeking dignity and pursuing justice are subject to denial and destruction. Mary Lawlor commends them on the level of resilience and solidarity that these human rights defenders show despite facing extreme violence and inequality.

Support for Child Human Rights Defenders in Brazil

Set up in 1983, Child Rights Connect has played an instrumental role in influencing child rights developments across the world. Some of its notable achievements include the participation of more than 200 children, child rights experts and practitioners, 74% being girls and women, to assess the obstacles faced by child rights movements and how to tackle these ongoing challenges. 

Child Rights Connect has empowered children worldwide to actively report to the U.N. Committee on the Rights of the Child. Additionally, 93% of civil society actors have reported that the technical assistance provided by Child Rights Connect has been extremely useful in connecting them with human rights mechanisms.

Contribution of the Alana Institute

The Alana Institute aims to create an equal, inclusive and plural world for children and established the Alana Center in 1994. Over the past 27 years, the center has actively engaged with local government and community stakeholders to focus on the development of children and families. This involvement, along with investments in socio-economic and geographic studies and collaborations with social actors such as residents and public agencies, has significantly improved the quality of life in the community.

Child Rights Connect and the Alana Institute have joined hands to improve the situation of child human rights defenders in Brazil. Empowering child human rights defenders in Brazil, engaging in a safe and sustainable promotion of human rights, engaging with the concerned authorities for effective recognition and providing support for the work of the child human rights defenders in Brazil is of principal focus.

Looking Ahead

The 2018 Day of General Discussion by the Committee on the Rights of the Child significantly raised awareness about child human rights defenders. Additionally, discussions defined their roles and the state’s obligations under the Convention on the Rights of the Child. Efforts by organizations like Child Rights Connect and the Alana Institute in Brazil highlight the ongoing commitment to empower these young defenders. Through initiatives that support education, digital communication and policy feedback, these organizations are helping children advocate for their rights and improve their communities.

– Caren Thomas

Caren is based in Dubai, UAE and focuses on Good News and Technology for The Borgen Project.

Photo: Flickr

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The Traditional Midwives of Ecuador

The Traditional Midwives of EcuadorIn the Amazonian regions of Ecuador, traditional midwives receive formal medical training and modern equipment to overcome the challenges posed by geographic isolation in rural communities. This integration of ancestral knowledge with contemporary medical practices enhances prenatal care, boosting the midwives’ abilities and encouraging rural residents to seek medical assistance when needed.

Geographical and Economic Challenges

The geographic isolation of rural areas in Ecuador often makes it difficult for residents to access hospitals. Approximately 36% of Ecuadorians, more than 6 million people, reside in these rural regions where 43% live below the poverty line. These areas are notably underserved, with 86% of public and 96% of private medical practices located in urban areas. Consequently, many pregnant women in these rural areas lack access to formal medical assistance during pregnancy.

The Role of Traditional Midwives in Prenatal Care

Traditional midwives in Ecuador, notably the Kichwa women in the Archidona region, are crucial for prenatal care and childbirth. Many inhabitants of the Ecuadorian Amazon lack formal education, with a 6% illiteracy rate among the rural population, which may limit their awareness of modern medical practices. By integrating traditional and modern medical approaches, this strategy can potentially alleviate skepticism about vital care and encourage more Ecuadorians to seek formal medical services, ultimately aiming to lower maternal and newborn mortality rates.

Empowering Midwives through AMUKAPIN

Despite the cultural significance of their services, Ecuador’s traditional midwives have observed a lack of recognition and inequality in the formal health care system. To address these ongoing challenges, these women established the Association of Kichwa Midwives of the Upper Napo (AMUKAPIN). Mamma Ofelia, the association’s president, has stated that they are often dismissed as “silly women” rather than acknowledged as legitimate caregivers. In the Archidona region of the Amazon, where 30% of deliveries occur at home, the necessity of these midwives is evident, as many women lack hospital access. The establishment of AMUKAPIN has started to garner recognition for its essential role in providing health care in rural Ecuadorian communities.

Training and Recognition by Health Organizations

Since 2021, the Pan American Health Organization (PAHO) has been enhancing the skills of Ecuador’s traditional midwives to boost prenatal care in the country’s most remote areas. Recognizing that midwives understand the risk factors for birth complications, PAHO has supplemented their traditional methods with medical knowledge and equipment. This initiative equips them with tools like stethoscopes and precise measuring tapes, enhancing their ability to monitor pregnancies while respecting cultural practices. Bremen De Mucio, PAHO’s Regional Advisor on Maternal Health, emphasizes the importance of trust and the integration of modern medical practices with traditional methods, which has proven successful in bridging the gap between traditional and modern health care in Ecuador.

Emergency Response and Cultural Integration

The women of AMUKAPIN, an organization of Amazonian midwives, have embraced cooperation with formal medical institutions. In cases of emergency or severe pregnancy complications, these midwives now organize ambulance services to transport mothers to hospitals. This improved response stems from their enhanced medical knowledge and a recognition of the importance of professional care in critical situations.

The integration of traditional and modern medical practices has brought numerous advantages to Ecuador’s rural communities. Previously, the contentious relationship between these two approaches often left patients confused and skeptical, sometimes deterring them from seeking necessary hospital care. The blending of these practices has lessened these issues, particularly for those in remote areas, fostering greater trust in the nation’s medical services. In Otovalo, traditional midwives can now accompany mothers into delivery rooms, enhancing their comfort and encouraging more hospital births, which could lead to lower maternal and infant mortality rates in Ecuador.

Looking Ahead

The integration of traditional and modern medical practices in Ecuador’s Amazonian regions has significantly improved prenatal care. This collaboration not only enhances the skills of traditional midwives but also fosters greater trust in formal medical services among rural residents. With continued support and training, these ongoing initiatives aim to reduce maternal and infant mortality rates, ensuring better health care outcomes for Ecuador’s remote communities.

– Ben Kane

Ben is based in London, UK and focuses on Global Health for The Borgen Project.

Photo: Flickr

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5 Organizations Empowering DRC Women

Empowering DRC Women
The Democratic Republic of the Congo (DRC) is a country in Central Africa that is rich in resources but still remains incredibly poor. A severe food crisis stems from government instability. In addition, violent armed groups often launch attacks and assaults on women and children. Luckily, there are several organizations empowering DRC women. This article takes a look at five of those organizations.

Severe Conditions for DRC Women

In 2018, more than 35% of women between the ages of 15-49 years reported being sexually or physically abused by an intimate partner. Further, almost 30% of girls under the age of 18 have been married or forced into a union. Finally, 70% of both women and men face food insecurity as well.

Here are five organizations that are combating these severe conditions and are actively empowering DRC women.

Kvinna till Kvinna Foundation

The Kvinna till Kvinna Foundation is an international organization that has been empowering DRC women since 2009. It calculates that 60% of women in the DRC live below the poverty line and have extremely low levels of political participation. The organization works to gain respect for women’s rights and end discriminatory gender practices. Kvinna till Kvinna helps women participate in learning exchanges that provide education and economic empowerment. It also helps finance certain activities of the Rien Sans les Femmes (Nothing Without Women) movement, a collaboration of Congolese women’s rights activists.

By supporting smaller partner organizations in the DRC, Kvinna till Kvinna has definitively lowered gender-based violence against women and has boosted political participation for DRC women. For example, the partner organization AFEM (Association des Femmes des Médias du Sud Kivu) is a collaboration of female journalists. It uses a radio station, Mama Radio, as its platform to empower DRC women.  Mama Radio caught on and AFEM was able to report reduced violence against women.

AFEM coordinator Julienne Baseke noted, “Thanks to Mama Radio, we have been able to break the silence on sexual violence, people are better informed and sexual and reproductive health issues are no longer taboo. The authorities are also held accountable on sexual violence issues and the media are mobilized on violence issues.”

Women for Women International

Women for Women International empowers DRC women in numerous ways. Since 2004 it has supported more than 106,000 Congolese women. Its most recent impact evaluation reports increased access to credit, savings and assets.  Second, it reports an increase in women’s ability to pursue entrepreneurship. Finally, it shares that women are benefitting from improved diets and mental health access. In 2022, 256 women received advocacy training in land titling. It also expanded upon its health insurance projects which were able to reduce fees for women and their families by around 50%.

Women’s Peace and Humanitarian Fund (WPHF)

WPHF is an international organization that helps empower grassroots organizations to help women become more involved in political affairs. In the DRC, it works with Spotlight Initiative, another women’s rights organization to fund 30 projects that 51 women’s organizations in the DRC spearheaded. These organizations seek to eliminate violence against women and encourage political mobility for women. For example, WPHF supports our GRACE, which seeks to promote gender-based equality and peace in North Kivu. It also supports CAUSE RURALE, which focuses on providing humanitarian aid to reinforce stronger institutions for women.  Finally, WPHF supports AFPDE, in South Kivu and promotes the strength of women’s organizations.

Women Concern (WOCO)

This Congolese nonprofit has been empowering women in the DRC by focusing on women and girls in rural areas. It focuses on helping women and girls see their own potential and provide them with development opportunities. Its unique approach is to utilize men and boys to be partners and co-agents to ensure change. It believes that promoting positive masculinity will in turn create a safe environment for women and girls to seek out opportunities. Its ultimate goal is to end the ongoing cycle of violence against women in the DRC.

Women, Cradle of Abundance

Women, Cradle of Abundance is a DRC organization. It has been empowering women in the DRC by attempting the eliminate systemic poverty for women. The organization provides physical safety, medical care, counseling and community services for women. It also helps improve education for women and girls by supporting schools for disadvantaged children. Women, Cradle of Abundance provides women with micro-savings and microloans. For example, it has provided 199 microloans to Kinshasha women. This helped them start or expand their businesses.

Moving Forward

Between international organizations such as Kvinna till Kvinna, Women for Women International and WPHF as well as DRC organizations such as WOCO and Women, Cradle of Abundance, a lot has been accomplished to empower DRC women. Past and current successes pave the way for more positive change.

– Anna Richardson
Photo: Flickr

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Why Most Families with Single Mothers in Japan are Living in Poverty 

Single mothers in Japan
In Japan, 56% of families headed by single mothers are living below the poverty line. This is the highest of all the OECD nations, with the U.S. coming in a faraway second at 33.5%. Single mothers in Japan struggle enormously, despite living in one of the wealthiest countries in the world. This is the result of a toxic confluence of social expectations, corporate stigma and government negligence.

The Cause of Poverty Among Single Mothers in Japan

The original cause of this high level of poverty has roots in expectations about family environments. The social structure in Japan is very specific and well-established. There is an assumption, especially from the government, that every household consists of two people raising their children. In addition, it is widely expected and common for women to give up their careers and stay home to raise children. About 70% of Japanese women do just that. 

However, as the divorce rate rises in Japan, this expectation is becoming a direct driver of poverty. There is no existence of the legal concept of joint custody in Japan and women are most commonly fully responsible for their children post-divorce. Less than half of the women receive any alimony or child support payments at all.

As a growing proportion of Japanese women become the sole provider for their families, they are taking on more economic responsibility. However, their economic rights and opportunity have not increased in tandem. This is what leads directly to poverty for single mothers in Japan. Women usually are only able to secure low-paying and part-time work, if they can get a job at all. Only 43% of Japanese mothers that want to return to the workforce are able to. Even if the mothers manage to snag a job, women earn 30% less than men for the same work in Japan. 

Government Response to Divorce-Related Public Benefits

The government’s response to the issue worsened this phenomenon. As divorce rates rose and more single women applied for public benefits, the government implemented reforms to cut back on these social safety nets. In 2003, the government reduced allowances and tacked income and time limits to benefits. Even when available to mothers, twin stigmas about being poor and being divorced disincentivize struggling mothers from even accepting public benefits. Activists maintain that this stigma has led to only 200,000 of the 3.5 million eligible children receiving the financial assistance they are entitled to.  

Left with extremely limited employment options and meager government support, single mothers in Japan and their children are vulnerable to falling below the poverty line. 

Little Ones

Luckily, a nonprofit operating in the Tokyo area known as Little Ones is directly assisting single mothers and children in the everyday struggles they face. Little Ones focuses on supporting impoverished children by providing employment, housing and networking services to single parents in the country. Kunihisa Koyama, a social activist in Japan, founded the organization in 2008. The organization has since been able to house upwards of 300 single mothers. 

Little Ones has identified isolation as a key factor in mothers’ poverty and the organization hosts regular gatherings and barbecues to allow single mothers to connect and create a supportive community amongst themselves. Further, the organization supports employment by helping single mothers secure and prepare for interviews, even assisting with such small details as makeup techniques. To support mothers in housing, Little Ones assists with the housing search, ensuring that mothers can be in a place that meets their needs.

Looking Ahead

Finally, on top of all this meaningful work to reduce poverty among single mothers in Japan, Little Ones also works to raise awareness about this little-known issue. As there is not much coverage of the hardships that single mothers in Japan face, this organization is doing important work by getting the word out. It is inspiring to know that someone is working to support these mothers who face so many social and economic roadblocks. With continued work and progress on this issue, poverty in Japan will be sure to decline.

– Grace Ramsey
Photo: Flickr

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The Gender Wage Gap In Namibia

Gender Wage Gap In Namibia
Namibia ranks sixth in the Global Gender Gap Report of 2021, the highest-ranked African country for bridging the gap between women and men economic opportunity, educational attainment, health and political empowerment measure. In just nine years, Namibia has climbed 35 spots, excelling past Canada and the United States in the Global Gender Gap Report. A closer look at Namibia’s history provides insight into actions taken to bridge this gap and how the gender wage gap in Namibia still plays a role in society today.

Post-Independence Namibia Focuses on Gender Equality

Prior to Namibia gaining independence, many considered women the property of men. When Namibia gained full independence from South Africa in 1990, it implemented numerous changes aimed at improving gender equality, as well as equality for all, in the new constitution. Article 10 states that “[n]o persons shall be discriminated against on the grounds of sex, race, color, ethnic origin, religion, creed or social or economic status,” emphasizing Namibia’s commitment to equality.

Also, the Married Persons Equality Act became law in 1996. The act allows women to sign contracts, register a property in their name and act as directors of companies. Women in Namibia hold about 44% of the managerial professions.

In the year 2013, “Namibia’s ruling party, the South West Africa People’s Organisation (SWAPO),” implemented a 50/50 gender policy that requires “equal representation of men and women” in parliament. At the time of the policy creation, women filled only 25% of the positions in parliament. Currently, women occupy 44% of the seats in parliament, proving that the gender policy has been effective in adding more women to work in government roles. The government’s adoption of these policies aid in creating a more inclusive environment for women in Namibia, particularly in political and urban settings.

More Women Seek an Education

Women in Namibia are leading their male counterparts in post-secondary education with a tertiary education enrollment rate of 30% for women and 15% for men. At the largest university in Namibia, the University of Namibia (UNAM), 64% of the students are women while only 36% are men. Many women continue on to obtain their master’s degrees or doctoral degrees. Once out of school, the labor force participation rate for women drops below men at 57% and 64% respectively. Even though more women seek secondary education than men, women earn less than men in several industries.

While the gender wage gap in Namibia is less prominent than that of many other countries, the distribution of wealth is immensely unequal. According to the Gini index, which measures the degree of inequality in the distribution of family income, Namibia ranks second-highest in comparison to all other countries in the world. Namibia has one of the highest Gini index ratings because of its high unemployment rate, with women more likely to experience unemployment. About 64% of Namibians survive on less than $5.55 per person per day, which equates to slightly more than $2,000 a year. The average amount U.S. citizens spend on a summer vacation is roughly the same.

Namibians Continue to Reach for Gender Equality

Much like other patriarchal societies, when women and men reach for equality, there are often roadblocks along the way. While women in Namibia now occupy 44% of the positions in parliament, they are still shy of the 50% goal of the 50/50 gender policy. The gender wage gap in Namibia has narrowed significantly, but there is still massive inequality concerning family income distribution. There is also an underlying dialogue in Namibia that women are inferior to men. Sexual and gender-based violence is prevalent due to societal and cultural norms. In fact, among the age group of 15 to 49, 28% of women and 22% of men in Namibia believe a husband beating his wife as a form of discipline constitutes a justifiable act. These beliefs contribute to a culture of gender inequality, which often proliferates inequalities in the workplace and perpetuates traditional gender roles.

Fortunately, the government is continuing to implement policies beneficial to gender equality. Additionally, women are pursuing secondary education at astounding rates, which is crucial in combating gender-based disparities as well as decreasing the gender wage gap in Namibia.

– Amy Helmendach
Photo: Flickr