Women's, Children's, and Adolescents' Health: Our Impact

A health worker showing the app used during the SMC in the village of Guéné. Photo credit Jocelyn Akakpo

Originally published by the U.S. President's Malaria Initiative. While the rainy season brings welcome relief to farmers in northern Benin, the wet weather also brings an unwelcome guest: mosquitoes. These mosquitoes can spread malaria, a disease that threatens hundreds of thousands of children’s lives across the region.But malaria can be prevented with several interventions, including medications provided during seasonal malaria chemoprevention (SMC). When the summer rain arrives, health workers supported by USAID through the U.S.

“I look at my baby today, and what I see is the contributions of many. My family, health workers, my friends, and God - we made it!” -Beatrice KadzakumanjaOn November 17th, USAID’s Organized Network for Everyone’s (ONSE) Health Activity joined the global community to commemorate World Prematurity Day. This year’s theme, “Together for Babies Born Too Soon- Caring for the Future,” aims to increase awareness, reach, and engagement, including families and health workers, in the care of babies born prematurely.

 {Photo credit: Rejoice Phiri/MSH}Patuma Mustafa (left) meets with members of Kalembo Health Center Management Committee.Photo credit: Rejoice Phiri/MSH

Namaseko, nine months pregnant, was taking an afternoon nap at Kalembo Health Center in Balaka, Malawi when she suddenly needed a bathroom. As she carefully got up, she remembered that there was no toilet in the maternity wing; she would have to walk to the further side of the health center to use the pit latrines near the outpatient department.

 {Photo credit: MSH staff}A clinical aide from Madagascar's Atsimo Andrefana region attends an in-person workshop.Photo credit: MSH staff

Since the start of Madagascar’s COVID-19 outbreak in March of this year, ensuring the continuation of routine health care services has been a challenge. Restrictions on movement and travel have forced health providers to adapt and identify innovative measures for providing quality primary health care in the midst of an epidemic. While in-person training and clinical capacity-building exercises have been curtailed, a timely switch to virtual training and mentorship has helped the Ministry of Public Health (MoPH) and the MSH-led, USAID-funded ACCESS program meet these challenges and ensure the continuation of essential health services for women and children in remote regions of the country. When the onset of the epidemic threatened the deployment of 118 clinical aides in Atsimo Andrefana, Vatovavy Fitovinany, and Atsinanana regions, ACCESS and the MoPH rapidly developed and hosted virtual trainings and orientation sessions. These clinical aides—doctors, midwives, and nurses recruited to provide critical ongoing support to health facilities—help staff to implement activities needed to improve the quality of care, manage and integrate services, and strengthen data collection.

 {Photo credit: Vainqueur Degbeawo.}A container being unloaded in the department of Ouémé, Benin.Photo credit: Vainqueur Degbeawo.

In addition to knowledgeable staff, health centers need effective medical equipment to provide quality maternal and child healthcare. In Benin, equipment and supplies can vary from one hospital to another, resulting in preventable deaths of new mothers and their children. At Adjohoun Zone Hospital, Ouémé, a regional facility that serves more than 260,000 people, the lack of surgical equipment means that many pregnant mothers cannot access caesarean sections to avoid life-threatening birth complications.

A gynecologist consults a patient at the NISA Premier Hospital in Abuja, Nigeria. Photo Credit: Gwenn Dubourthournieu

Adolescents in Nigeria are caught between traditional culture and changing social norms brought about by urbanization, globalized economies, and an influential media-saturated environment. With evolving attitudes, including less restrictive sexual norms without comprehensive sexual education, there have been increased rates of unprotected sex, unplanned pregnancies, unsafe abortions, sexually transmitted diseases, and HIV/AIDS. These increased rates buttress the fact that at minimum, all adolescents require age-appropriate, comprehensive sexuality education achievable through access to youth-friendly health services designed to promote their sexual and reproductive health and rights (SRHR).In efforts to meet the sexual and reproductive health needs of young people in Nigeria, Women Friendly Initiative (WFI), through a small grant funded by the Global Financing Facility (GFF) and the Partnership for Maternal, Newborn & Child Health and managed by Management Sciences for Health (MSH), undertook a 12-month advocacy project beginning in July 2019 in Benue, Nassarawa, and Kwara States, and the Federal Capital Territory.

 {Photo credit: Sheila Mwebaze/MSH}Community health worker Betty Achilla examines a baby at one of the 31 households she supports.Photo credit: Sheila Mwebaze/MSH

Eight years ago, Betty Achilla was selected by her community to be a volunteer community health worker. She is currently serving 31 households in the Abim district in Northeastern Uganda. Betty is one of more than 60,000 volunteer community health workers in Uganda who play a vital role in extending maternal and child health services to hard-to-reach communities.As a community health worker, Betty was trained in the basics of diagnosing and dispensing medicines to treat common childhood illnesses such as malaria, diarrhea, and pneumonia and to identify danger signs in children and refer them to nearby health centers. To do her work, Betty must have an adequate and consistent supply of malaria rapid diagnostic tests, antimalarial medicines, oral rehydration solution, zinc, and antibiotics.

 {Photo credit: Samy Rakotoniaina/MSH}A mother and her child sit under their bednet in Vohipeno, Madagascar.Photo credit: Samy Rakotoniaina/MSH

While progress against malaria in the last 20 years has been significant, many people continue to suffer and die from this preventable and treatable disease. Malaria is among the leading causes of child mortality in Africa. In 2018, nearly 900,000 children in 38 African countries were born with a low birth weight due to malaria in pregnancy, and children under five still accounted for two-thirds of all malaria deaths worldwide.

{Photo Credit: Rui Pires}Photo Credit: Rui Pires

Excessive bleeding after birth is the leading cause of maternal mortality worldwide, killing nearly 200 women a day.

{Photo Credit: Rui Pires}Photo Credit: Rui Pires

In Uganda, 4 in 10 maternal deaths are caused by postpartum hemorrhage, or excessive bleeding after childbirth. Intravenous oxytocin is the treatment of choice for managing postpartum hemorrhage at a health facility but must be stored between 2oC and 8oC to remain effective. The country’s cold chain infrastructure is weak, however, particularly at lower level health facilities, where half of all assisted births occur. The majority of these facilities only have refrigerators that are specifically procured and used for the storage of vaccines.

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