Archive for category: Women and Children

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Addressing Maternal and Child Health in Burkina Faso

Ongoing Efforts to Address Maternal and Child Health in Burkina Faso Burkina Faso has the 11th-highest child mortality rate in the world. More than 5% of children die before their fifth birthday, and approximately 2% of infants die within their first month of life. Barriers to access to health care include distance to health care facilities, cost of health care, transportation costs, widespread poverty and delayed access to emergency obstetric care. The government is aware of this pervasive issue and has been working alongside other organizations for at least two decades to address the problems.

Displacement and Health Care Disruptions

Insecurity, climatic shocks and COVID-19 led to forced displacements across Burkina Faso. By 2020, more than 1 million people, especially women and children, were deprived of essential health care services due to facility closures, staff shortages and limited resources. Pregnant women delivered their babies in unsafe conditions, children did not receive critical vaccinations, and people with chronic illnesses experienced treatment disruptions.

Health Financing Reforms

Burkina Faso’s Ministry of Health and those who have partnered with it have responded in several ways. The government of Burkina Faso implemented three major health financing reforms to improve maternal and child health:

  • a national subsidy policy for maternity care, which translates to an 80% reduction in health care fees at health centers,
  • a results-based financing scheme,
  • free health care for maternal and child care for those under 5 in all public health facilities.

The result of this endeavor increased health care appointments, decreased household costs, reduced cesarean deliveries and intra-hospital infant mortality.

Training Midwives in Obstetric Ultrasound

In 2021, Burkina Faso’s Ministry of Health introduced a new initiative. The goal was to train midwives in basic obstetric ultrasound during consultations to improve pregnancy monitoring. These ultrasounds help determine gestation date, detect fetal abnormalities, ectopic pregnancies, assess fetal growth and determine the most suitable delivery method. In 2023, 18 midwives were trained. They performed more than 2,000 ultrasounds between January 2024 and March 2025. This led to the identification and management of 10 high-risk pregnancies.

Strengthening Health Systems

A shortage of equipment, staff and supplies also threatens the expansion of this initiative into other districts. In response to this threat, Burkina Faso began a new initiative funded by the Canadian Embassy with the goal of strengthening health care systems in regions of the country most affected by humanitarian crises. The goal was to improve access to primary health care services and provide lifesaving support to those who need it most.

This initiative was successful in that seven health care centers and 24 labs were equipped with essential medicines, medical-technical materials and lab supplies. A total of 371 community-based health workers received training to provide care and strengthen local community networks, including women’s groups. More than 30,000 people were reached, educating them about COVID-19 prevention, available health care services and reproductive health options.

This initiative strengthened disease surveillance and emergency response mechanisms. Health care workers conducted hygiene awareness campaigns using a megaphone and bicycles in remote areas. Since then, women’s groups and community leaders have initiated conversations about family planning and gender-based violence.

A Hopeful Outlook

Burkina Faso demonstrates concern for the well-being of its citizens. These relationships foster optimism and hope for both a better future and maternal and child health in Burkina Faso

– Danielle Milano

Danielle is based in Pineville, LA, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Unsplash

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Improving Women’s Health Care in Africa

Improving Women's Health Care in Africa The World Health Organization (WHO) reports that women disproportionately experience health complications and barriers to health care access compared to men. Globally, both poverty and sociocultural factors hinder women’s ability to receive quality health services and care. WHO identifies these factors as: 

  • “Unequal power relationships between men and women;” 
  • “Social norms that decrease women’s education and paid employment opportunities;”
  • “An exclusive focus on women’s reproductive roles and” 
  • “Potential or actual experience of physical, sexual and emotional violence.”

COWHA’s Mission in Africa

There are organizations globally committed to improving women’s health care. One of these is the Coalition for Women’s Health in Africa (COWHA). COWHA is invested in providing girls and women with equitable access to health care and increasing their well-being. This vision is driven by an approach rooted in knowledge, advocacy and action. This three-pronged approach thrives on a collaboration with organizations in the private sector and holding governance responsible for reimagining and supporting women’s health care. 

In its 2025 Webinar Report, the Coalition for Women’s Health in Africa insists on the necessity of domestic investments, calling African governments to expand access to quality health services for girls and women, ensure financial risk protection and reduce out-of-pocket expenditures for patients and advance equity by making the health care of the most vulnerable and underserved populations a priority.

By adopting and funding these strategic priorities, COWHA can better maximize its impact in countries such as Ghana, Kenya and South Africa. In these regions, special attention goes to providing services and treatment for girls and women experiencing breast and cervical cancer, other noncommunicable diseases and needs related to sexual and reproductive health, as well as maternal and newborn care.

Statistics in Women’s Health Care

Coalition for Women’s Health in Africa reports the rates at which women and girls across the African continent experience health complications. Indeed, according to the report, around 66% of all global maternal deaths occur in Sub-Saharan Africa, 26% of women in Sub-Saharan Africa experience unplanned pregnancies and 65% of all cancer cases in Africa occur in women.

However, the organization’s framework is actively improving women’s health care in Africa and reducing oppressive conditions. Investing in knowledge and research enables COWHA to disseminate integral data on women’s health across Africa. This identifies gaps in care as well as offering life-saving interventions to enhance health outcomes. COWHA engages in conversation with policymakers, amplifying the most pressing health challenges, barriers to access and ensuring that women’s health is a priority.

Looking Ahead

The Coalition for Women’s Health in Africa’s cross-sector collaboration with governments, health care institutions and NGOs enables the implementation of targeted interventions. As a result, COWHA champions improvements in women’s health care that can have long-lasting impacts on the social and living conditions of girls and women across Africa.

– McKenzie Rentie

McKenzie is based in Dallas, Texas, USA and focuses on Celebs and Politics for The Borgen Project.

Photo: Flickr

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Orphans in the DRC

Orphans in the DRC and the IWOFThe International Widows and Orphans Fund (IWOF) is a nonprofit organization that primarily focuses on supporting orphaned children and widowed women in the Democratic Republic of Congo (DRC). Congo is a country located in central Africa and it is bordered by nine countries: Central African Republic, South Sudan, Uganda, Rwanda, Burundi, Tanzania, Zambia, Angola and the Republic of Congo. 

Civil War

The DRC’s involvement in war is what has caused hardships for its civilians, especially women and children. The conflict has orphaned children and left many women widowed. Additionally, there has been an increase in violence and rape toward women and children during this period of war, which has lasted for more than 30 years. Around 7,000 people have lost their lives since January 2025. Women and children often face the greatest risks in situations like this.

Orphans in Congo

There are a variety of reasons why children in the Democratic Republic of the Congo become orphans. One main reason is that bad actors use rape as a strategy of war. As a result, many women become pregnant and abandon their babies on the streets due to embarrassment and social judgment. The country lacks organizations that protect orphans and communities often reject these children, leaving them with nowhere to go. Another reason for orphans in the DRC is poverty. When families are incapable of providing for their children, they resort to child abandonment.

Exploitation in the DRC

Due to their vulnerability, orphans are often exploited in various ways. In the DRC, adults take advantage of these children. Some law enforcement personnel have used them to disrupt political protests. Others exploit them as cheap, manual labor, often providing little or no pay. Some have also forced these children into sex and drug trafficking. The Congolese army has also used orphans as child soldiers. At one point, children made up as much as 40% of the army. They are often denied food, water and medical care. Recruits are trained to fight and carry out unlawful acts against civilians, exposing them to severe trauma and violence at a young age.

IWOF’s Mission

The IWOF began with one email in 2013. This email was from a friend and it detailed the story of 35 orphans in the DR of Congo, who were hidden from rebel soldiers in a wooded area. IWOF initially paid for school fees and uniforms. As the organization built a stronger relationship with the Grace Orphanage, it expanded its support. Since then, IWOF has constructed housing for 46 orphans, established a farm with animals and crops and built a learning center. The organization sends 97% of its raised funds directly to the Grace Orphanage in the DRC. The IWOF team also regularly visits and inspects the facilities.

Widows and Orphans Fund

IWOF not only supports orphans, but also supports widows. More than 5 million people have died in the civil war in the Democratic Republic of the Congo, which has been ongoing for more than 30 years. As a result, many women have lost their husbands, leaving them widowed. These widows live without a stable source of income and often turn to prostitution. The majority of these widows also have no education. There are roughly 120 widows staying at Grace Orphanage. IWOF opened a reading center in 2018 to provide them and their children with reading and writing help, meals, school supplies, toys and games, socialization and health information.

IWOF’s Accomplishments

Over the last 10 years, IWOF has:

  • Built four houses that support 46 children
  • Built two houses for staff
  • Remodeled the first house into an on-site library and administrative office
  • Built a reading center and supported 10 women through a reading and business program
  • Built an agricultural area that produces crops for food
  • Installed the first phase of a septic system
  • Built a communal kitchen that feeds 54 people daily, including children and staff
  • Installed a water well with a solar pump to provide fresh water to the orphanage and nearby community
  • Installed solar power to supply the houses
  • Built a gate and wall for security
  • Purchased two acres of land for future housing at Grace Orphanage

Looking Ahead

IWOF plans to expand further in the coming years. Its goal is to provide housing for up to 60 orphans in the DRC and for the orphanage to become self-sufficient. The organization plans to build another house to accommodate more children. It also aims to grow its reading and business program to include microloans and mentorship for widows, helping them successfully run their own businesses. Supplying vegetables and chickens is also part of IWOF’s future plans. The organization hopes to rely less on donations and move toward long-term self-sufficiency. 

– Ella Burke

Ella is based in Lawrence, KS, USA and focuses on Good News, Celebs for The Borgen Project.

Photo: Flickr

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Examining Child Marriage in Russia

Child Marriage in RussiaIn 2015, the headline “Chechen Police Chief Marries Teen Bride Amid Mounting Scandal” appeared in The Moscow Times, before appearing in The Guardian. The image at the top of the article displays a young girl, simply 17, next to the groom, Nazhud Guchigov. When the story first broke, reporters stated that Guchigov was 57, but later amended this to 46. Guchigov’s marriage was a hot topic for several reasons; allegedly, Guchigov utilized his authority as a police chief to intimidate his bride’s parents and he was already married to another woman, and Guchigov made divisive statements regarding the matter on his Instagram.

About Child Marriage in Russia

In Russia, 254,000 girls were married by 15, and 5.4 million were married by 18. Unfortunately, even the best resources and websites on the matter do not provide much information regarding the population of girls who are experiencing coercion to marry. According to Girls Not Brides, an organization dedicated to eradicating child marriage and advocating for young women in developing countries, under Russia’s Article 12 of the Family Code, both men and women must be at least 18 years old to marry. However, there is other legislation that provides loopholes. Under Article 13 of the Family Code, a boy and a girl can marry at younger than 18, but never younger than 14 under special circumstances.

When dealing with child marriage in Russia, the problem runs significantly deeper than laws concerning the age of consent and getting beyond that red tape. Poverty, gender inequality and deep-rooted practices are all factors that influence the rate of child marriage; these factors are incredibly prevalent in modern Russia.

In 2020, the percentage of Russians living in poverty was 12.1%. While poverty has been decreasing throughout Russia, despite the ongoing war with Ukraine, poverty disproportionately affects women. The persistent pay gap and income gap greatly impact the average earnings of women in Russia. The matter becomes worse. As women tend to make less money, a woman’s poverty is then passed down to her children, affecting their access to higher education. Consider this pattern regarding the cycle of child marriage. Higher education is a wonderful resource when offering girls careers and lives outside of being a housewife, yet Russia’s current economy stubbornly limits a woman to that role.

Poverty and Misogyny in Russia

Poverty also exacerbates misogyny, the root cause behind child marriage in Russia. Russia’s domestic violence rate reflects Russia’s sexism and misogyny. Domestic violence against women is abundant in Russia, where 10% of all domestic violence deaths globally take place. For reference, Russia comprises 2% of the world’s population. There is abundant evidence revealing the link between poverty and domestic violence, and living in poverty can intensify violence towards women to immense extremes. Barbara Niess-May of the Safe House Center provides specific data points to make this point clearer: “In short, being poor further entraps the survivor in the abuse, and often lengthens any process she may go through to escape.” Returning to Russia’s domestic violence, the poverty disproportionately affecting women easily becomes a tool, manipulated by the abuser to keep the victim beneath him.

In a study by Marina Pisklakova-Parker, titled “Gender Issues in Russia,” she found that “71 percent of Russians share the opinion that the main purpose of a woman is to be a mother and a good housewife.” More concerningly, she also reported that “The Russian Human Rights Commissioner Tatiana Moskalkova publicly stated that since 10 April 2020, the number of domestic violence cases had more than doubled from 6,054 to about 13,000 per month.”

The Work of the ANNA Center

Despite the previously mentioned statistics, there is a growing feminist movement within Russia. The government has pledged to end child marriages in Russia by the year 2030; the United Nations has also made it a global goal to end all child marriages. Foreign aid plays a critical role when advocating for girls and women inside Russia, and the efforts have not been in vain. According to Bearr.org, there are 2% fewer domestic violence murders and 6% fewer rapes. Marina Pisklakova-Parker, the previously mentioned researcher, created The ANNA Center, the first domestic violence shelter for women in Russia, in 2015. Following the ANNA Center is the Zona Prava, the Consortium of Women’s Non-government Organizations, Nasiliu and the You Are Not Alone Network as the leading Russian NGOs combating violence against women, which includes child marriage. 

The impact of these shelters is no small feat, and sparked great change throughout the country of Russia. Pisklakova-Parker’s ANNA shelter is open to all women, no matter their income or residential address, two factors that make state shelters inaccessible to many women. To gain entry to a state shelter, women had to bring documentation of their husbands’ finances. In implementing this rule, many women are so longer able to utilize the shelter’s safety, as it would demand that they confront their abusers about their leaving. ANNA has no such rule, and is open to whoever needs the shelter. There is no public information containing how many women ANNA has helped, but in interviews, Pisklakova-Parker speaks positively of the growth of the shelter.

Nasiliu

Operating alongside ANNA, Nasiliu is an online resource for victims of domestic violence. Anna Rivinia established Nasiliu in 2015, beginning as a media project that focused on raising awareness of domestic violence in Russia. As recently as April 18, 2024, Nasiliu has expanded to global outreach for all Russian-speaking victims across the world. Most admirably, Nasiliu provides education on how to combat domestic violence legally within the framework of the Russian legal system.

– Peyton Worsham

Peyton is based in Jacksonville, FL, USA and focuses on Good News for The Borgen Project.

Photo: Unsplash

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Empowering Widows and Orphans in Nigeria: The Fight Continues

Empowering Widows and Orphans in Nigeria: The Fight Continues“Religion that God our Father accepts as pure and faultless is this: to look after orphans and widows in their distress and to keep oneself from being polluted by the world,” reads James 1:27. This Bible verse inspired Apostle Folorunso Alakija to found the Rose of Sharon Foundation (RoSF). Motivated by faith, Alakija launched the foundation to alleviate the hardships faced by widows, their children and orphans in Nigeria.

The Reality Facing Widows and Orphans

More than 15 million widows, about 21 million children and 17.5 million orphans live in Nigeria. Many in these groups face poverty due to economic hardship, a lack of resources and harmful cultural practices. Gender-based violence (GBV) compounds the difficulties. Around 30% of Nigerian women and girls experience physical, emotional or sexual abuse. Many survivors of GBV—about 55%—do not seek any support to end the violence. Cultural practices, such as widowhood rites, continue to restrict women’s advancement socially, economically and politically.

Folorunso Alakija

Alakija is a Nigerian businesswoman, philanthropist and one of Africa’s highly prominent entrepreneurs. Her endeavors in business cover the real estate, oil exploration and printing industries. Dipping into many hats, she was also a fashion designer and made the “Rose of Sharon House of Fashion” a household name in Nigeria. In collaboration with her husband, they founded the Rose of Sharon Glorious Ministry International and the next step was to tend directly to widows and children. 

RoSF Programs Driving Change

RoSF uses baseline data collection, capacity-strengthening programs, advocacy and community engagement to understand and address the needs of widows and children. In partnership with local governments and international NGOs, the foundation has helped more than 900 widows access microcredit schemes and interest-free loans to expand their businesses. More than 340 graduates have also benefited from RoSF’s programs. Mentorship and educational initiatives have had a life-changing impact. Agbayi Agu, a widow from Lagos, said, “[RoSF] has been a second God to my life… they are the ones who changed my mentality in a time of despair, that I can still forge ahead.”

The Importance of Legislative Protection

Legislation plays a key role in protecting women and promoting equality. Yet, as of 2023, women account for only 3.6% of Nigeria’s House of Representatives and 7.3% of the Senate, far below the global average of 27%. The Violence Against Persons Prohibition (VAPP) Act, passed in 2015, was a landmark achievement. RoSF and other NGOs championed the law, which protects widows from violence, discrimination and harmful practices. Before VAPP, widows endured cruel rites, such as sleeping beside a husband’s corpse to prove innocence, being confined indoors, or undergoing forced head shaving. The Act introduced punishments for perpetrators and offered legal protections for victims and their families.

Threats to Progress and Continued Advocacy

Although the VAPP Act was passed at the federal level, it took nearly 10 years for 35 out of 36 states to domesticate and enforce it. In 2024, Senator Jibrin Isah of Kogi East proposed repealing the VAPP Act, citing “legislative errors” and claiming the law lacked comprehensiveness. In response, RoSF and partners like the Malala Fund and Invictus Africa are working to defend the VAPP Act. Bukky Shonibare, Executive Director of Invictus Africa, advocates for amendments and stricter enforcement, rather than repeal.

Building Toward a Brighter Future

Since its founding, RoSF has grown from serving three widows to reaching nearly 1,000 widows directly, empowering more than 4,200 women overall. Indeed, through vocational training, scholarships and economic support, the foundation is creating opportunities for widows to rebuild their lives. Future goals include expanding NGO partnerships, reducing reliance on self-funding, strengthening social protection laws and rallying policymakers to support widows and orphans in Nigeria.

– Rachael Wexler

Rachael is based in Chicago, IL, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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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