DREAMS Fights Against AIDS
Today, approximately 36.9 million people are living with HIV globally and 25 percent of that number do not even know their status. Of those millions, HIV infects about 1,000 young girls and women each day and accounts for 74 percent of new HIV infections among adolescents in sub-Saharan Africa. HIV/AIDS continues to be at the forefront of global public health issues in the world today and appears to be most prevalent in low and middle-income countries. However, the organization DREAMS fights against AIDS and initiatives like the United States President’s Emergency Plan for AIDS Relief (PEPFAR) is helping it accomplish its goals.

What is PEPFAR?

PEPFAR emerged in 2003 and has received strong support ever since, resulting in the United States becoming a global leader in the response to the HIV/AIDS epidemic and PEPFAR being a model for development programs around the world. PEPFAR has helped transform the response to HIV/AIDS by working with over 50 countries, as well as causing a significant decline in new HIV diagnoses among young girls and women through the DREAMS partnership.

The DREAMS Partnership

DREAMS is a public-private partnership between PEPFAR, the Bill and Melinda Gates Foundation, Girl Effect, Johnson & Johnson, Gilead Sciences and ViiV Healthcare to implement an ambitious HIV/AIDS reduction program. This initiative launched in 2014 on World AIDS Day and targets 10 African countries in which 65 percent have extremely high HIV rates, especially among young girls and women. This movement aims to support affected women, as well as prevent any further spreading of HIV/AIDS. It has resulted in the integration of DREAMS activities into the plans of the involved countries.

The DREAMS Impact

The DREAMS organization fights against AIDS in 10 countries including Kenya, Lesotho, Malawi, Mozambique, South Africa, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe. These countries’ populations account for more than half of all new HIV infections that occurred in young girls and women globally in 2015.

DREAMS’ plan consists of multiple solutions surrounding the main problem of the HIV/AIDS epidemic in the world. It delivers a package that combines evidence-based approaches addressing structural drivers that directly and indirectly increase the risk of HIV in girls, such as poverty, gender inequality, sexual violence and a lack of education. More specifically, this comprehensive package of interventions has four focus groups including educating girls and young women through a range of activities to prevent their risk of HIV and violence, targeting men and boys within the community for treatments, strengthening families through social protection programs and the implementation of parenting programs related to adolescent HIV risk and shifting norms to mobilize communities and change to prevent violence and the further spread of HIV/AIDS.

Currently, 80 percent of young girls and women ranging from 15 to 24 years old and living with HIV are in sub-Saharan Africa. By the end of 2016, new HIV incident recordings in young girls and women decreased by 25 percent in the hardest-hit countries and further reduced by 40 percent by the end of 2017.

The DREAMS Innovation Challenge

While DREAMS has made significant progress since its formation, HIV/AIDS is still infecting an alarming number of young girls and women every day. Fifty-five organizations won the DREAMS Innovation Challenge and are now implementing solutions in six main focus areas such as strengthening leadership and capacity of community-based organizations (such as nonprofit or grassroots organizations) to support the expansion of intervention, ensuring girls’ access and smooth transition into secondary school, creating new methods to engage men in HIV testing and counseling and treatments, supporting pre-exposure interventions, providing employment opportunities to young women to decrease their risk of exposure to HIV and increasing the availability and use of data to inform, increasing impact and further producing innovative solutions.

Selected solutions resulting from this challenge were those that introduced new innovations in the 10 countries where DREAMS fights against AIDS. It also offers sustainable, long-lasting solutions and countries can implement them rapidly within two years. More than 60 percent of the challenge winners are small, community-based organizations that not only received funding but also became new PEPFAR partners.

Continuing on its innovative path to preventing and reducing the spread of HIV/AIDS, PEPFAR recently announced its investment of nearly $2 billion to empower and support women and girls, with it channeling nearly $200 million through the DREAMS partnership. This will allow more girls to avoid contracting HIV at birth, keep more adolescents HIV free and support vulnerable women and children while treating HIV positive women. Additionally, the partnership has recently grown to provide more than $800 million to 15 African and Caribbean countries since its founding in 2015. PEPFAR has helped 2.4 million babies to be born HIV free from HIV-positive mothers and has saved about 17 million lives through its efforts as DREAMS fights against AIDS. Thankfully, this organization shows no sign of slowing down in the fight against HIV/AIDS for young girls and women around the world.

– Adya Khosla
Photo: Flickr

Every day, 830 mothers die during childbirth or during their pregnancy while 15,000 children die of preventable diseases such as diarrhea, pneumonia and malaria. Yearly, 2.7 million newborns die and 1 million babies die the minute they are born. With these frightening statistics in mind, families need the Reach Every Mother and Child Act because it is a solution to these issues that gives mothers and children a chance to live safe and healthy lives.

Background

The Reach Every Mother and Child Act (S.1766) is a bipartisan bill led by Sen. Susan Collins (R-ME), Sen. Marco Rubio (R-FL), Sen. Chris Coons (D-DE), Sen. Jerry Moran (R-KS), Sen. Jeanne Shaheen (D-NH), Sen. Richard Blumenthal (D-CT), Sen. Michael B. Enzi (R-WY), Sen. Johnny Isakson (R-GA), Sen. Richard J. Durbin (D-IL) and Sen. Chris Murphy (D-CT). At the time of writing, the bill has 49 other co-sponsors in addition to the aforementioned original sponsors.

A previous version of the bill (H.R.4022 / S.1730) gained strong bipartisan support in the 115th Congress, with 212 co-sponsors of the House of Representatives version and 49 co-sponsors of the Senate version.

The bill was reintroduced in the 116th Congress and outlines a five-year plan to eliminate preventable maternal and child deaths in countries across the world. S.1766 would also work to establish a plan that would allow children to live healthy and happy lifestyles by 2030. This Act is especially necessary for places in Central Africa where maternal and child death rates remain at an all-time high.

Benefits

One of these countries is Sierra Leone which has the highest maternal and child mortality rate in the world with 1,360 deaths per every 100,000 births. Sierra Leone remains one of the world’s poorest nations, which means that many expectant mothers do not get the care they need to deliver a child safely. Limited access to basic health care needs also leaves young children at risk during the first 1,000 days of their lives.

The country with the second-highest death rate in the world is the Central African Republic where out of every 100,000 births, 882 result in death. Access to proper health care for women as well as for their children is severely lacking, considering that it is the third poorest nation in Africa. Of note, 45 percent of children are born at home due to a lack of women’s clinics or difficulty access same. There are also only eight OBGYNs in the entire country. Other countries that have incredibly high maternal and child death rates are Chad, Burundi, Liberia, Somalia and South Sudan.

On the brighter side, the majority of these statistics have decreased significantly; child mortality rates have been cut in half since 1990. Families need the Reach Every Mother and Child Act because it would allow for mothers and children in these impoverished nations to receive the care they so desperately need while also providing a foundation for them grow and continue to live healthy lifestyles. Because the U.S. already has the expertise in ending preventable maternal and child deaths, we must play a larger role in this global fight to help mothers and their children.

 

Send an email to your Senators today asking them to support the Reach Every Mother and Child Act.

 

– Sydney Toy
Photo: Flickr

Infant Mortality in NepalOver the past 10 years, infant mortality in Nepal has decreased. The number of infants dying before they reach age one has been reduced by more than 50 percent. In 2006, the United Nations Populations Fund ranked Nepal as the most affected by infant and maternal mortality in South Asia. Not many people know what chlorhexidine does for Nepal. However, chlorhexidine is becoming more common in routine care nationwide. Over 1.3 million newborns throughout Nepal benefit from this product.

How Chlorhexidine Helps Nepal

Chlorhexidine is an antiseptic used in hospitals to disinfect the skin before surgery and to sanitize surgical tools. In countries like Nepal, it is used to prevent deadly infections by protecting the umbilical stumps of newborns. It is safe and affordable. Chlorhexidine comes as either a gel or a liquid. It is easy to manufacture and simple to use. Mothers, birth attendants and others with little training in low-resource settings benefit the most from this antiseptic.

Research and Trials

Between November 2002 and March 2005, Nepal Nutrition Intervention Project, Sarlahi (NNIPS) started a community-based trial. The trial hoped to determine the effects of chlorhexidine on newborns. Nepal Health Research Council and the Committee on Human Research of the Johns Hopkins Bloomberg School of Public Health approved the trial. A local female researcher approached women who were six months into pregnancy for enrollment, to explain the procedures and obtain their oral consent.

Education also became a part of the research testing for those in the chlorhexidine trials. Parents in this group received educational messages about clean cord care.

Results

The NNIPS enrolled 15,123 infants into the trials. Of these infants, 268 resulted in neonatal death. Of the surviving infants, researchers found that there is a 24 percent lower risk of mortality among the chlorhexidine group than those who use dry cord-care (no soap and water, chlorhexidine or any other liquid). Also, infant mortality in Nepal was reduced by 34 percent in those enrolled in the trial within the first 24 hours of their birth.

The trial data also provides evidence that cleansing the umbilical cord with chlorhexidine can lessen the risk of omphalitis and other infections. Omphalitis, a cord infection, was reduced by 75 percent when treated with chlorhexidine. The antiseptic was determined to have an overall positive and significant effect on the public health of the country.

Impact in Nepal

In 2009, after results of the trials released, the USAID supported the Government of Nepal to pilot a chlorhexidine program. Saving Lives at Birth: a Grand Challenge for Development, an NGO, included chlorhexidine into routine care nationwide two years later. The Government of Nepal has advocated and promoted the usage of chlorhexidine by packaging the products as a maternal health product. They are now even educating health care workers on the application of the product.

The country received a USAID Pioneers Prize for lowering the neonatal death rate significantly. In 2007 the mortality rate was 43.4 per 1,000. In 2018, it lowered to 27.32 per 1,000.

Global Impact

What chlorhexidine does for Nepal goes beyond its borders. Nepal has also impacted countries such as Nigeria, Pakistan, the Democratic Republic of the Congo and Bangladesh. These countries are now using chlorhexidine to lower the infant mortality rate and create healthier societies.

In 2013, Nigeria started chlorhexidine pilot programs to also lower its neonatal death rate. The infant mortality rate is determined by newborn deaths per 1,000 people born. Nigeria once had the third-highest number of infant deaths (75.3 per 1,000). However, the infant mortality rate now is ranked as the eighth-highest at about 64.6 deaths per 1,000.

Chlorhexidine is reducing infant mortality in Nepal and other countries.

– Francisco Benitez
Photo: Flickr

Women and WaterOver 600 million people struggle to access clean water for drinking and sanitation worldwide. While for many this is a communal problem, the burden of finding and collecting water often falls onto women. In developing nations, gender inequality becomes apparent when observing water management within communities. Women are responsible for this vital resource, yet often excluded from larger water management decisions. Engaging women in community water management solutions empowers them and establishes greater equity in developing communities.

The Burden of Water

Women and children bear the majority of the burden when it comes to water collection. Every day, they collectively spend almost 200 million hours locating and obtaining water for their communities. Over 50 million more hours are spent searching for sanitary places to relieve themselves. Hours devoted to collecting water take away time from education, employment and family. Additionally, in some areas, water scarcity is so severe that women have to settle for dirty and contaminated water for drinking, cooking and cleaning, exposing them to water-borne diseases and parasites.

Providing sources of clean water and sanitation to women in developing nations has the potential to do much more than reducing health risks. The hours women and children reclaim when they get access to clean water in their homes or villages can instead be used to pursue higher education, start small businesses or even grow food for their families. One study conducted by UNICEF in Tanzania found that cutting down the time needed for collecting water from 30 minutes to 15 increased rates of girls attending school by over 10 percent. However, since women are rarely actively included in the process of supplying and financing water management solutions, their perspectives are not addressed in the long run.

Access to Clean Water’s Impact on Women

When women get the opportunity to elevate their responsibility for water beyond collection and into management, their potential can blossom. Water.org features stories of the impact access to clean water can make on the lives of women. In India, they found that women are often forced to collect water from outside their communities due to a lack of funds for installing water taps near their homes.

This inspired the creation of WaterCredit, a service providing affordable, short-term loans going towards constructing taps that offer long-term access to clean water in developing communities. Women like Manjula make up nearly 90 percent of borrowers, reducing the need to travel so far outside their communities to obtain water. This gives them the time and energy needed to manage personal businesses, which earn enough income to easily repay the loan from WaterCredit. Water.org reports that WaterCredit provided around 4.6 million loans, amassing a total value of 1.7 billion dollars, demonstrating what a feasible and impactful solution this service offers.

Emmitt Kussrow
Photo: Flickr

Living Conditions in Mali
Mali is a West African nation that is abundantly rich with culture and history; however, it is ranked at 16 out of the world’s 20 poorest countries. As a result of a vulnerable economy, the citizens of this vibrant nation have endured continuous economic hardships. Listed below are details regarding the top 10 facts about living conditions in Mali.

Top 10 Facts About Living Conditions in Mali

  1. Those with Epilepsy in Mali struggle to receive adequate treatment. In Mali, It is estimated that 15 out of 1,000 people are afflicted with epilepsy, including young children. Unfortunately, in developing countries, only six percent of those with epilepsy receive sufficient medical treatment. The poor living conditions in Mali for these individuals are caused by social stigmas and supernatural ideologies that have remained prevalent in Africa despite advances in clinical treatment. The Ministries of Health and Education are collaborating with traditional healers to create educational campaigns that oppose the spreading of misinformation about epilepsy.
  2. Rural women have a harder time accessing health care services. Approximately 90 percent of Mali’s destitute population lives in rural areas. Many women living in rural areas are unable to afford modern preventive and maternal health care. Alternatively, they resort to using traditional medicines. During illness or pregnancy, women in these communities depend on social support from their daughters and mothers-in-law. Furthermore, the husband is responsible for gathering financial assistance from his family to support his ailing wife.
  3. Malnutrition causes significant health risks for children. Predicted increases in hunger could have disastrous impacts on the well-being of Mali’s youngest citizens. Children between the ages of six and 59 months are more at risk for anemia, with a prevalence of 82 percent. Out of the 16,391 children surveyed for malnutrition, 376 were suffering from severe to acute malnutrition and another 1,646 with moderate acute malnutrition in 2013-13. Policymakers may concentrate on implementing adaptive measures that focus on projected areas of climate change and food vulnerability that could reduce the financial and health repercussions of climate change in Mali.
  4. Hazardous conditions are affecting adolescents. Adolescents in Mali are at risk for water, sanitation and hygiene (WASH) associated diseases. Approximately 2.8 billion cases of diarrhea affect children annually. Infections associated with WASH are often exacerbated by unsanitary conditions in schools. The Ministry of Primary Education has reported that only 44 percent of primary schools in Mali have access to a water point and that a bathroom was only installed in 58 percent of the schools. The WASH program was implemented to provide hygiene improvements such as establishing water points and toilets and providing hygiene products to schools.
  5. There are significantly low educational completion rates. From 2006 through 2007, the completion rate for primary education in Mali was only 54 percent. Educational obstacles are especially severe for children living in rural areas. It is estimated that more than 890,000 children in Mali from ages seven to 12 are not enrolled in school; that is four out of 10 children who are not receiving a basic elementary education. Educational improvements and increased education funding are important factors in improving the living conditions in Mali. However, in 2006, only 8.5 percent of all international aid was allocated to Mali’s education sector.
  6. Household income doesn’t translate to child well-being. The living conditions in Mali are generally assessed by the poverty level of each individual household. However, the unique needs of children are not always addressed by household level incomes. For example, regions such as Tombouctou have poverty rates below the average at 33 percent, but a child deprivation level of 72 percent. Whereas, in Sikasso, where the poverty rates are at 86 percent, 37 percent of the children are not deprived. Prospective analyses of Mali’s child poverty levels can serve as potential intervention guides.
  7. Extreme poverty is on the decline. An individual living on less than $1.90 a day is considered to be in extreme poverty. Between 2011 and 2013, the extreme poverty rate in Mali increased from 47.8 percent to 50.4 percent. However, as a result of successful agricultural production, the rate fell to 42.7 percent in 2017. Industrialized agriculture is imperative to improving the living conditions in Mali.
  8. Mali’s agricultural outlook is positive. Nearly two-thirds of Mali is covered by the Saharan desert. However, despite the geographical barriers, Mali has the highest agricultural potential of the Sahel Region where 80 percent of Malians rely on rain-fed agriculture to make a living.
  9. The economy is improving. The living conditions in Mali have been significantly influenced by economic and monetary changes. Mali’s economic climate is improving; since 2014, Mali has had a 5 percent increase in economic growth every year. Furthermore, Local banks are starting to expand their lending portfolios, and the investment climate is profiting from the monetary and economic improvements due to an increase in foreign investment.
  10. Rural citizens adapt to climate variability. Mali has undergone significant environmental, cultural and economic changes. Citizens in rural areas often depend on natural resources for their livelihoods. Therefore, to cope with the climate changes that affect their resources, citizens along with development planners are adapting strategies to support sustainable local investments.

The living conditions in Mali are based on an intricate junction of resource scarcity and economic mobility. With the support of global investors and the contributions of scientific researchers, improvements in industrial, educational and agricultural disparities are being made and better living conditions are being improved. However, further legislative conversations must occur in order to ensure the preservation of intervention programs and foreign investment continues.

– Sabia Combrie
Photo: Flickr

postpartum hemorrhaging
In the advanced world, a postpartum hemorrhage is a very manageable and preventable condition; however, postpartum hemorrhaging is a leading cause of maternal mortality. A staggering 99 percent of all deaths resulting from postpartum hemorrhaging occur in lower income countries. Postpartum hemorrhaging is responsible for 59 percent of maternal deaths in Burkina Faso, 43 percent in Indonesia and 52 percent in the Philippines.

Why Postpartum Hemorrhaging Is Common

In these developing countries, the increased frequency of postpartum hemorrhages is due to a lack of experienced obstetricians and caregivers who can properly treat the condition. There is also a lack of access to proper medications as well as care for those medications.

Oxytocin is currently the most common drug prescribed for preventing postpartum hemorrhages. The World Health Organization recommends that oxytocin be routinely administered and actively managed; however, oxytocin must be stored and transported at two to eight degrees Celsius, two conditions of which developing countries cannot accommodate.

A Possible Solution

A rival drug has been in the works to be as efficient as oxytocin in preventing excessive bleeding post childbirth as well as be more manageable in the living conditions of developing countries. The drug is a heat-stable carbetocin. This type of drug does not need refrigeration and can maintain its efficacy for at least three years when stored at 30 degrees Celsius. These requirements are far more realistic and achievable in developing communities.

The World Health Organization conducted a comparative study between the heat-stable carbetocin and oxytocin for prevention of postpartum hemorrhages. Approximately 30,000 women were sampled and given either drug to study the effects each had on prevention. It was concluded that the heat-stable carbetocin was not inferior to oxytocin.

Saving Mothers’ Lives

With such a high rate of deaths from postpartum hemorrhaging in developing countries due to the strict requirements for oxytocin that cannot be met, the heat-stable carbetocin will drastically improve the mortality rates. The new drug will be readily available and easily managed where it was once not.

Permitting the usage of the heat-stable carbetocin has many benefits that will better developing countries in a multitude of ways. If used widely, the drug could very possibly put an end to this tragically common occurrence.

– Samantha Harward
Photo: Flickr

Maternal Healthcare in Mexico
Eight years ago, The Economist, a British business publication, described maternal healthcare in Mexico as “a perilous journey.” Although deaths in labor had decreased by over a third in the past 20 years, they still remained among the highest in Latin America. Preventable complications were common among women, especially those of indigenous descent, largely as a result of infrastructural and social challenges.

Maternal Mortality

Since then, substantial effort has been put into solving this problem, especially in anticipation of the 2015 Millennial Development Goals. Globally, maternal mortality is often the result of wider social problems related to extreme poverty. It especially affects poor rural women who lack access to modern medical facilities. Solving maternal mortality in Mexico requires implementing a wider health infrastructure that serves these disenfranchised groups.

In Mexico, one of the groups most vulnerable to labor complications is girls under fifteen years old. This is not a generational issue, but rather a result of the dangers of underdeveloped girls giving birth. Twenty percent of Mexican births annually are a result of teenage pregnancy. Half of the sexually active teenage girls in Mexico become pregnant and 11,000 of Mexico’s births each year are to mothers between 10 and 14 years old.

While a proportion of these teenage pregnancies are the result of consensual encounters, some of them are the result of chronic child sexual abuse. One study found that a third of Mexican girls (and about a fifth of Mexican boys) had experienced sexual assault. Unfortunately, comprehensive statistics on the sexual abuse of children are relatively rare for developing countries, but it is likely that these high rates contribute to the phenomena of teenage pregnancy in Mexico.

Teenage Pregnancy and Healthcare Improvements

Ultimately, the key to achieving better maternal healthcare in Mexico lies in preventing teenage pregnancy and providing healthcare infrastructure. On the latter, the Mexican government has already established several programs targeting the country’s rural poor such as the Oportunidades (Opportunities) program, and additional support from the Mexican social security program. Specific programs, such as PRONTO, train hospital staff to intervene in dangerous labors and have shown to help reduce maternal mortality.

However, the Mexican government has taken little action against ending teenage pregnancy. This represents a major blindspot in the path towards achieving improved maternal healthcare in Mexico.

Maternal mortality and labor complications are especially common among young mothers; mothers under 15 are twice as likely to die in labor as older mothers. Their babies are more likely to die as well. Many of these teenage pregnancies could be prevented with education and awareness programs, but most of Mexico’s initiatives are geared towards older girls.

Supporting Maternal Healthcare

Several NGOs have taken initiative in reducing Mexican maternal mortality both by tackling infrastructure issues and generational sexual abuse. Conferences such as this year’s International Best Practices Meeting bring together experts from various fields and international organizations to discuss the issue.

Specifically, the role of midwives in the prevention of labor complications has also been reinforced in Mexican society. Such a prioritization could increase women’s access to maternal healthcare in Mexico, especially in rural areas.

Ultimately, despite the challenges facing Mexican mothers, there is hope that the danger of pregnancy in the country can be further reduced. Improved maternal healthcare in Mexico can be achieved with infrastructure and education, factors that also help combat extreme poverty in the country; only then, can Mexico truly achieve its development goals.

– Lydia Cardwell
Photo: Flickr

Reach Every Mother and Child Act
About 830 women die every day from preventable causes related to pregnancy and childbirth. More than 17,000 children under the age of five die from treatable conditions. The Reach Every Mother and Child Act of 2017 aims to end these preventable deaths.

7 Key Facts About The Reach Every Mother and Child Act

  1. The Reach Every Mother and Child Act is a bipartisan bill that has been introduced in both the Senate and the House of Representatives. If passed, the bill would create a five-year government strategy to end preventable newborn, child and maternal deaths globally by 2030. This act would focus on making existing programs more effective and emphasize the importance of “evidence-based interventions.” The United States’ government would work with governments of other countries, nongovernmental organizations (NGOs), international organizations and other entities to develop and implement this strategy.
  2. The act would require the U.S. president to appoint a U.S. Agency for International Development (USAID) employee to act as a Maternal and Child Survival Coordinator. The holder of this position would implement the government’s strategy to reduce maternal and infant mortality rates and oversee all programs relating to maternal and child health and nutrition.
  3. In 2015, countries around the world adopted the 17 Sustainable Development Goals (SDGs) as part of the United Nations’ 2030 Agenda for Sustainable Development. These various goals aim to end global poverty. As the United States helped develop these goals, it is crucial for the U.S. government to take measures to achieve them. The Reach Every Mother and Child Act is one method by which the U.S. can work to attain these goals, particularly Goal 3: “Ensure healthy lives and promote well-being for all at all ages.”
  4. More than 300,000 women die each year from preventable complications during and after pregnancy and childbirth. Such complications include high-blood pressure during pregnancy, bleeding during childbirth and infections after childbirth. Adequate healthcare can handle these difficulties. However, many poor women in rural, remote areas do not have access to adequate health care. By implementing plans to improve healthcare in such areas, the Reach Every Mother and Child Act can save the lives of hundreds of thousands of women around the world.
  5. Lack of access to quality healthcare is also detrimental to newborns and children under the age of five. More than six million children die before they reach the age of five each year, and 46 percent of these deaths occur during the neonatal period, the first month of a baby’s life. Complications during pregnancy and childbirth are the leading cause of deaths during the neonatal period.
  6. Extreme poverty is also a major cause of child deaths. Children who live in poverty often experience malnutrition, which makes them vulnerable to diseases including pneumonia, diarrhea and malaria. These diseases are the leading cause of death of children between the ages of one month and five years. These diseases are also preventable. The Reach Every Mother and Child Act would reduce the number of children who die from these diseases by alleviating poverty and improving access to medical services.
  7. Rep. Dave Reichert (D-WA-9), one of the members of Congress who introduced the bill in the House, asserts that the “Reach Act will give the world’s most in-need families the tools and resources to climb their way out of extreme poverty.” Enabling women and children to escape poverty gives these people the opportunity to contribute to and improve their communities. This in turn creates a “safer and more stable world by “strengthen[ing] security and stability.”

Support is Key

The Reach Every Mother and Child Act has strong support from more than 20 NGOs and from both Democrats and Republicans in both houses of Congress. The act would save millions of lives and is crucial to the reduction of maternal, infant and child mortality rates around the world.

– Laura Turner
Photo: Flickr

Single Mothers in Japan
Despite the stigma against single parents, single mothers in Japan are moving forward with the help of the Tokyo-based organization Single Mother by Choice and the new government-provided Child-Rearing Allowance.

Single Mothers in Japan

Since World War II, Japan has grown to be one of the wealthiest countries in the world. It boasts modern buildings, clean streets and is home to some of the richest people on earth. Yet, Japan’s poverty rate has consistently risen for the past 30 years, reaching 16.3 percent in 2017. However, the country still appears to be healthy and thriving. This dissonance between facts and appearances is due to the stigma surrounding poverty in Japan. Rather than admit to being poor, many people in Japan mask their financial needs hoping not to draw attention to themselves.

This problem is even worse for single mothers in Japan, who not only face greater cultural shame more consistently, but also have a harder time providing enough for their families. A whopping 56 percent of single-parent homes in which the parent is working live in poverty. As women have children, they often can no longer work the long, rigorous hours expected of Japanese employees. This time restriction then forces them to assume lower paid jobs with worse benefits — working women in Japan make 30 percent less on average than men doing the same job.

Cultural and Societal Norms

Japanese culture also dismisses female higher education, men often feeling “uncomfortable” to share the classroom with women; girls are pushed into two-year vocational schools instead. This setup is also seen as a benefit to women as they will then, allegedly, have more time to find a husband and start rearing children in the societally accepted timeframe. Such a collective attitude makes it more difficult for women to access education to higher paying jobs, and dismisses women who might pursue relationships and children outside of marriage.

The organization Single Mother by Choice was founded in Tokyo in 2014 to empower women and fight the taboo surrounding being a single mother in Japan. The group provides a community for women who desire to lead lives outside of Japan’s norms, and supplies information on prenatal care.

Single Mother By Choice

The organization focuses specifically on women who have chosen before becoming pregnant to have a child and raise them on their own. This decision can be especially difficult as the only legal use in Japan for sperm banks are for married couples, so many women become pregnant with a partner they do not intend to marry. Members of the group desire to end the myth that children of single parents cannot be happy and that women must be lifelong wives to be mothers.

The Japanese government has also begun to implement changes to help the growing numbers of single parents. Incentive programs have been put in place to bring single-parent families into smaller towns in the country, which helps grow local communities and provides the parent with a job, car and covers moving cost.

Moreover, many cities have implemented child-rearing allowances for single parents. This welfare system supplies families in need with residual income so that they will be able to effectively care for their children. As social stigmas begins to change, single mothers in Japan will continue to fight to live in a country that respects all tracks to motherhood — married or not.

– Sarah Dean
Photo: Flickr

treating obstetric fistula
Obstetric fistula is a condition in which there is an abnormal opening in a woman’s birth canal due to prolonged, obstructed labor. When left untreated, obstetric fistula leads to skin infections, kidney disorders, incontinence and death of the child, and is responsible for around 6 percent of all maternal deaths.

This ailment is highly preventable and treatable, yet there are an estimated two million women living with it untreated in Asia and sub-Saharan Africa. An additional 50,000 to 100,000 women are diagnosed each year. These women are predominately underprivileged, poor and young.

Operation Fistula Raises Awareness of the Necessity of Treating Obstetric Fistula

Operation Fistula is one of the few organizations that has collected data on the condition. It has measured the burden on life that not treating obstetric fistula has had and compared that weight to that of other debilitating diseases. The organization found that living with obstetric fistula is ranked just below terminal cancer.

In developed countries, obstetric fistula is practically non-existent because women have access to the education and medical services that assure a healthy pregnancy. Unfortunately, these care services are not readily available to women in poverty-stricken areas.

Even with the establishment of care centers in the most prominently affected areas, the lack of attention that obstetric fistula receives is incredible. Because the condition is nearly unheard of in Europe and the U.S., there is limited global awareness and therefore very little capitalization. In fact, treating obstetric fistula receives less than1 percent of annual global health funding even though it is relatively inexpensive to care for.

Global Efforts Bring Treatments to Women in Need

To counter the mass neglect, Operation Fistula works to provide women with timely and high-quality treatment. It also plans to eliminate fistula altogether by 2045. The organization’s approach is data-centric and focuses on performance-based funding to surgeons who have successfully treated patients. This simple solution yielded four times the target amount of patient treatments between 2012 and 2014.

In addition, USAID’s Health Service Delivery project is working to make the proper medical services available by establishing treatment centers at multiple hospitals in Guinea, where obstetric fistula is extremely prevalent. The treatment centers allow women to undergo the reconstructive surgeries necessary for recovery.

Operation Fistula’s most recent effort in continuing its 2045 eradication plan is working with the government of Madagascar and the United Nations Population Fund to wipe out fistula in every region of the country.

Operation Fistula concentrates on the patient first and foremost. With its performance-based funding, Operation Fistula makes sure that each patient gets the best possible treatment rather than focusing solely on the number of patients treated. Through their endeavors, every woman that Operation Fistula has treated so far has gained back, on average, almost 11 years of healthy life.

While advancements in the global treatment of women with obstetric fistula have been made, there is still a need for prevention. Health professionals in affected areas are being trained continuously and efficiently in order to prevent and manage obstetric fistula, but the most basic method of prevention is through awareness.

– Samantha Harward
Photo: Flickr