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

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.

{Photo credit: Rejoice Phiri/MSH}Mobile teams broadcast information to community members regarding COVID-19 transmission, self-quarantine, and other preventive measures.Photo credit: Rejoice Phiri/MSH

On April 2, 2020, Malawi’s President Peter Mutharika confirmed the country's first cases of COVID-19.

 {Photo credit: Samy Rakotoniaina/MSH}A community health volunteer in Madagascar discusses family planning methods with a client.Photo credit: Samy Rakotoniaina/MSH

Community health workers (CHWs) are a critical part of the health workforce – not only do they bring accessible, quality services closer to where people live but they often serve as the early warning system for epidemics and are responsible for leading effective community responses.

Prior to the COVID-19 outbreak, pregnant women participating in group antenatal care sessions met to share experiences, receive health information, form social bonds, and track the progress of their pregnancies. Photo credit: MSH staff

The COVID-19 pandemic has affected every facet of daily life in Guatemala, including women’s access to antenatal care services (ANC). Under normal circumstances, MSH’s Strengthening Antenatal Care for Mayan Women Project, supports group ANC sessions, providing a safe space for women to receive peer support and accurate health information with the guidance of a nurse. However, with the current government restrictions in place due to the COVID-19 pandemic, it is no longer possible to meet.

Guatemala, like many parts of the world, is on lockdown, with curfews put in place by the Guatemalan government in response to the Coronavirus pandemic. Gatherings of any size are prohibited and these restrictions have affected MSH’s Strengthening Antenatal Care Project in the department of Quetzaltenango, which brings together pregnant Mayan women for group antenatal care (ANC) sessions.As of April 15, 2020, Guatemala has recorded 196 cases of COVID-19, including 5 deaths and 19 recovered patients.

{Photo credit: MSH staff}Photo credit: MSH staff

It’s early morning, but Rebecca Owolabi, a nursing officer at the Isokun Maternity Center in Ilesha in Osun State, Nigeria, is already providing group counseling on malaria prevention in pregnancy to women visiting the facility for antenatal care. She counsels them on the importance of sleeping under an insecticide treated bednet and seeking treatment at the first sign of malaria. Also, as preventive therapy, she hands two tablets of sulphadoxine pyrimethamine (SP) to the women, who then swallow them with water.

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