Child health

U.S. HOUSE OF REPRESNTATIVES INTRODUCES LEGISLATION AIMED TO SAVE LIVES OF WOMEN AND CHILDREN AROUND THE WORLD

Washington, DC (October 13, 2017) – On October 10, Global Health Council (GHC) applauded U.S. Representatives David Reichert (R-WA), Betty McCollum (D-MN),Barbara Lee (D-CA), and Daniel Donovan (R-NY), who reintroduced the Reach Every Mother and Child Act (H.R. 4022) in the U.S. House of Representatives. This bipartisan legislation aims to accelerate the reduction of preventable child, newborn, and maternal deaths, putting us within reach of the global commitment to end these deaths within a generation.

“We are in reach of ending preventable maternal and child deaths—a great accomplishment in part due to U.S. leadership and investments in maternal and child health programs. Although we have drastically reduced the number of maternal, newborn, and child deaths, every day, 800 women die from complications of pregnancy and childbirth and more than 16,000 children still die from preventable causes,” said Loyce Pace, GHC President and Executive Director. “The Reach Every Mother and Child Act is an important step to ensure that we end these preventable deaths within a generation.”

The Reach Act builds upon the success of such global health initiatives as PEPFAR and the President’s Malaria Initiative (PMI), and would enact key reforms that increase the effectiveness and impact of USAID maternal and child survival programs. The U.S. Senate reintroduced the Reach Act in August.

Specifically, the legislation would require a coordinated U.S. government strategy that addresses ending preventable child and maternal deaths, as well as institute reporting requirements to improve efficiency, transparency, accountability, and oversight of maternal and child health programs. In addition, it would establish the position of Child and Maternal Survival Coordinator at USAID and ensure that the return on U.S. investments are maximized through a scale-up of the highest impact, evident-based interventions. The legislation would also allow USAID to explore innovative financing tools.

The Reach Act is supported by more than 50 diverse non-profit and faith-based organizations working to end preventable maternal, newborn, and child mortality at home and abroad.

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NCD Child’s Approach to Advocacy: Putting Children First

This guest post was written by, Jonathan D Klein, MD, MPH, FAAP, Executive Director, NCD Childa a global multi-stakeholder coalition championing the rights and needs of children, adolescents, and young people living with or at risk of developing non-communicable diseases (NCDs). NCD Child is a member of the Global Health Council.

NCD Child is a global multi-stakeholder coalition championing the rights and needs of children, adolescents, and young people living with or at risk of developing non-communicable diseases (NCDs).  Their message to civil society, governments, and WHO is unwavering – children are not small adults.  They require unique services, yet many national and global health policies fail to adequately account for these distinctive needs.  NCD Child actively engages and collaborates with governments, multilateral organizations (ie, WHO, UNICEF, other UN agencies), civil society, the private sector, and academic institutions to promote awareness, education, prevention, and treatment of NCDs in children, adolescents, and young people.  They support child health advocacy and policy at the global level via WHO and the UN as well as at the country-level through civil society and individual champions.  They are committed to involving youth voices across all their work, from engagement in the NCD and Sustainable Development Goal (SDG) agendas to their own governance and program activities.

Young people’s access to essential medicines and technologies for special health care needs are a particularly alarming and growing concern.  To tackle this challenge, NCD Child launched a Taskforce on Essential Medicines and Technologies during the 2017 World Health Assembly.  Whether it is insulin, an asthma inhaler, chemotherapy, heart surgery, or simple antibiotics, poor access or lack of availability to safe and appropriate medicines and technologies for children, adolescents, and young people hinders their chances of living healthy, productive and long lives.  There are several challenges to consistent, safe access to essential medicines and technologies – drug shortages, appropriate dosages for children, challenges in drug delivery, technology incompatible with systems, and products excluded from the WHO Essential Medicines for children lists.  The new taskforce, chaired by Dr. Kate Armstrong, Executive Director of CLAN (Caring & Living as Neighbors) and founding Executive Director of NCD Child, includes a diverse group of experts from government, academia, and civil society.  Kate’s vision that all children living with chronic health conditions should be afforded the same opportunities and quality of life as other children, helped NCD Child frame their mission and goals towards a rights-based approach to universal access and population health.  For the taskforce, this means addressing consistent, equitable, and affordable access to essential medicines and equipment for all children, adolescents, and young people living with NCDs – including attention to the rights and needs of all young people with special health care needs.  The initial report, scheduled for 2018, will discuss common barriers to access and propose collaborative, practical strategies to address the gaps.

Practically, this means NCD Child wants policies ensuring that the health needs of young people are always included in health systems planning and accountability.  They recognize to affect policy, governments and other advocates need to fully appreciate why it is important to include children, adolescents, and young people.  How do current policies and frameworks exclude them?  What is the potential impact of not tailoring policies, health education, and health systems?  How many lives can be saved, improved, and extended if policies addressed the needs of all ages across the entire life-course?  The taskforce will serve to amplify NCD Child’s concerns by developing resources to educate governments, help guide policy development, and contribute to the WHO Essential Medicines list.

Prevention and treatment of NCDs helps children, adolescents, and young people live life to their fullest potential. These investments are also critical to successfully addressing preventable maternal and child deaths, and to effective, sustainable development.  At the July High Level Political Forum on SDGs, Dr Nata Menabde, Executive Director of WHO at the United Nations, closed the review of the health goal by noting that “every minister should be a health minister.”  When it comes to health in all policies, “put children first” is essential to all plans, whether for health systems, NCDs, or other global goals.

For more information and to sign up for the NCD Child listserv, visit www.ncdchild.org.

 

Seeking Today’s Midwifery Pioneers for Johnson & Johnson’s GenH Challenge 

This post was written by Alice Lin Fabiano, Johnson & Johnson Global Community Impact.

A good idea can come from anyone, anywhere.

Looking at the history of midwifery, we see that good ideas often come from people providing care every day in communities and clinics around the world. The ways in which midwives have pioneered a new idea or adapted an approach – and augmented health and wellness as a result – cannot be overlooked.

It was Marie-Anne Boivin, a French midwife, who invented the speculum used to assist childbirth. She also wrote multiple textbooks that became standard for midwifery students, and is cited as the first person to use a stethoscope to listen to the fetal heartbeat. And Mary Breckinridge, a nurse-midwife in the rural United States, saw the need for training and increased standards of care, and acted to create the Frontier Nursing Service. FNS went on to train hundreds of midwives and strengthened the concept and practice of nurse-midwifery in the United States.

These midwifery pioneers saw a need, and based on their intimate knowledge of both community and care, they acted and created something new to meet local health needs. They innovated.

We know that today, more and more women and infants are getting the care they need to survive and thrive. Still, every day, 800 women and nearly 8,000 newborns die from complications related to pregnancy and childbirth. There is much more that can – and must – happen to support and champion midwives as they save even more lives.

The question is: what will it take to get there?

At Johnson & Johnson, we know the ingenuity required to change the trajectory of health for communities will not come from the boardroom; it will come from the delivery room, the classroom, the clinic, or even a household. To change the realities of health, the world needs the insight, leadership, and creativity of everyday innovators on the front lines of care. In short, the world needs midwives.

Today at ICM, Johnson & Johnson is proud to open the GenH Challenge – a global social venture competition designed to seek out and incentivize novel, breakthrough solutions to persistent health challenges. As of today, the submission period is open – and we need the partnership of many great minds and hearts at ICM to make this happen. We’re calling on midwives, as front line changemakers, to share locally-tailored, globally- scalable ideas as together we seek to create the healthiest generation – “GenH.”

Executive Director Alice Lin Fabiano demonstrates mMitra, a mobile health innovation platform developed in partnership with ARMMAN, USAID, Johnson & Johnson, United Nations Foundation & BabyCenter.

Midwives played an integral role in the development of the GenH Challenge. Last year, I met with 20 midwives in Nairobi to discuss the challenges and opportunities they experienced while delivering care in their communities. We heard stories of the difficulties midwives working in low-resource settings experience. We also heard great stories of triumph and perseverance.  Stories about delivering quality care against all odds, and efforts to inspire young women to pursue midwifery. Midwives told us about their desire to not only be heard, but to be empowered to implement change.

We’ve listened to you, and we are excited to help provide the spark of investment you need to advance that vision of change. The GenH Challenge requires that all teams submitting ideas include a representative from the front lines of care. This specific prerequisite is because we fundamentally believe no sustainable change will be reached without the insight and knowledge individuals like midwives provide.

Quite simply, you are why the GenH Challenge is placing its big bet on the power that lives on the front lines of care.

In our 130 years, we’ve learned that the next big idea can come from anyone. The GenH Challenge builds on a legacy of innovating and developing solutions for people on the front lines of care. With $1 million in prizes, winning teams will receive not only financial resources, but technical assistance from Johnson & Johnson to ensure that you, the changemakers, are able to turn ideas and vision into reality. We invite our fellow pioneers of ingenuity to apply their entrepreneurial spirit as the lever to achieve health equity.

So what’s your answer to our question? Tell us.

Committed to serving the most vulnerable in South Sudan

This blog was written by GHC member IMA World Health (IMA). IMA’s work in South Sudan is funded by Global Fund/Population Services International, Global Fund/UNDP, Office of U.S. Foreign Disaster Assistance, UK’s Department for International Development/Mott MacDonald, UNFPA, and World Bank/South Sudan Ministry of Health.

In the midst of ongoing violence in South Sudan, an estimated 2.3 million people have been forced from their homes. Most are not involved in the conflict in any way: beautiful souls, living in fear, struggling to survive.

One of their most basic needs as they wait for more peaceful times is access to primary health care.

While more than 700,000 have fled the country due to the war, another 1.6 million are internally displaced, struggling to carry on in makeshift settings. IMA World Health and our partners have continued to provide basic health services to thousands of displaced people in the Upper Nile and Jonglei states. Curative and preventive primary health care, nutrition services for children, reproductive health services, delivery of essential medicines, management of neglected tropical diseases, malaria prevention, and training of health workers continue despite conflict that has displaced staff, destroyed facilities and all but severed logistical lifelines.

IMA works alongside South Sudan’s Ministry of Health, civil society, donors and other critical partners to staff health centers, maintain operations and work to provide health and healing, regardless of who is fighting whom. While working to ensure quality health services are available in the immediate-term wherever people are, IMA’s longer-term goal is to strengthen the capacity of health systems through the states.

IMA's model is to employ local health care staff who are already there—internally displaced people, which gives people a chance to serve their home communities. (MAF/LuAnne Cadd)

IMA’s model is to employ local health care staff who are already there—internally displaced people, which gives people a chance to serve their home communities. (MAF/LuAnne Cadd)

But there are many challenges.

A lack of security in the country continues to be the greatest hurdle. Tensions remain high in some areas, limiting access. “Without a secure environment, you are challenged to do the supervision that you are supposed to do and some activities can’t be done,” Dr. Mounir Christo Lado Lugga, IMA’s Country Director in South Sudan, said. Activities such as door-to-door campaigns, for instance, aren’t an option.

Even apart from the current unrest, the annual rainy season makes basic functions difficult. “When it rains, the terrain is so bad that movement becomes a challenge,” Lado said. Large swaths of Jonglei turn into swamps. Almost all airstrips are dirt—until they become mud. As a way to work around impassable roads, IMA has taken to the Nile to transport medicines and supplies into Jonglei and Upper Nile states. But that’s also not an option now, as barges have become a target for the warring sides.

“River transport is not operational,” Lado said.

County Health Departments had vehicles, such as motorcycles and boats, that staff members and health workers needed for their work, but most of these were looted. And the solar refrigerators that were used to keep temperature-sensitive vaccines and medicine cold during transport have been either damaged or stolen.

As if immobility and insecurity aren’t daunting enough, there is also the issue of the country’s economic crisis. There is a daily floating rate of the South Sudan Pound, Lado explained, which makes procurement difficult. By the time a vendor is selected, the prices have changed. “You do your calculation on a daily basis,” he said. The annual inflation rate in South Sudan surged to 661.3 percent in July 2016.

But hope is persistent and commitment undaunted.

Before the crisis that began in mid-December 2013, Upper Nile and Jonglei states were showing improvement in health service delivery. Lado said all the health indicators were good and, despite all of last year’s challenges, IMA and our partners, such as Sudan Medical Care, were still able to meet 70 percent of the targets for health indicators. This statistic not only shows that health services continue but also that the team in South Sudan is still able to maintain essential communications despite the fog of conflict.

A staggering 20 percent of South Sudan’s population is displaced in some form, according to the 2016 Global Peace Index released in June. The men, women and children who are caught in the middle of this ongoing conflict deserve to lead healthy and productive lives. Despite great adversity, IMA and our partners continue to support the people of South Sudan.

“You cannot imagine the resilience that is necessary,” Lado said. “It’s not easy, but we work together to make sure health services continue. Because they are desperately needed.”

 

GHC WHA Statement on Agenda Item 16.4 – Addressing the global shortages of medicines, and the safety and accessibility of children’s medication