Maternal & 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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Established in 1972, Global Health Council (GHC) is the leading membership organization supporting and connecting advocates, implementers, and stakeholders around global health priorities worldwide. GHC represents the collaborative voice of the community on key issues; we convene stakeholders around key priorities and actively engage with decision makers to influence global health policy. Learn more at www.globalhealth.org. Follow GHC on Twitter or “Like” us on Facebook for more information.

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The Reach Act: Investing in Maternal and Child Health

This post was written by Melissa Chacko, Policy Associate at Global Health Council.

Over the past few decades great strides have been made in maternal and child health: since 1990, the deaths of mothers and children under age 5 worldwide have been cut by more than half. The decrease in maternal and child mortality rates is a product of simple evidence-based solutions and inexpensive interventions. However, there is still a significant amount of work to do to ensure that no woman or child dies from a preventable death in our generation. Nearly 300,000 women continue to die annually due to complications during pregnancy or childbirth and 99% of these maternal deaths occur in the developing world. Access to quality care is essential for women and children as they are an integral part to building strong and prosperous communities. To reach the overarching goal of ending preventable deaths may seem idealistic, but it is achievable if we maximize the return on U.S. investments in maternal and child health programs.

In 2014, an advisory panel analyzed USAID’s Maternal and Child Health program, and found areas of improvement that would maximize the progress of the program. Since then, the program has undergone the process of implementing reform and exploring innovative financing tools to bring new resources to the field. However, with these measurements and expansion, also comes a need for greater coordination and accountability.

The Reach Every Mother and Child Act (S.1730) would create that accountability and coordination, as well as codify the reforms, all of which will keep USAID on track to reach its goal of reducing preventable child and maternal deaths and maximizing impact. In early August, Senators Susan Collins (R-ME) and Chris Coons (D-DE) led a bipartisan group of 10 Senators in reintroducing the Reach Every Mother and Child Act.

The Reach Act:

1) Requires a coordinated U.S. government strategy for contributing to reducing preventable child and maternal deaths;
2) Establishes rigorous reporting requirements to improve transparency, accountability, efficiency, and oversight of maternal and child health programs;
3) Ensures USAID focuses on the scale-up of highest impact, evidence-based interventions to maximize the return on existing U.S. investments;
4) Establishes the position of Child and Maternal Survival Coordinator at USAID to reduce duplication of efforts and ensure that resources are being used to maximum impact; and
5) Helps USAID explore and implement innovative financing tools, such as pay for success contracting, to leverage additional public and private resources, complementing existing U.S. assistance.

A similar version of the legislation was introduced in Congress last session (S.1911 and H.R. 3706) and received strong bipartisan support in both chambers.

In almost every field of health, women and children are the most vulnerable in areas that lack essential healthcare resources and systems. We can change this narrative by passing the Reach Act. The lasting impact of this legislation will be seen through the thousands of women and children who will live longer and healthier lives, due to access to quality care. With the Senate back in session, outreach for Senate cosponsors on the Reach Every Mother and Child Act is in full swing. It is important to rally support on this issue and vocalize the importance of bipartisan support on the Reach Act.

We encourage you to contact your Senators to voice your support for the Reach Act. You can find contact information for the Senate here.

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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.

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CDC Protects People from Disease Threats and Outbreaks in the U.S. and Around the World

This blog post was written by Carmen Villar, MPH, Deputy Director for Strategy, Policy and Communication, at the the Center for Global Health, Centers for Disease Control and Prevention.

Opinion polls show that the Centers for Disease Control and Prevention (CDC) is one of the federal government’s most admired and trusted agencies.

Since its founding in 1946, CDC’s history as America’s premier public health agency has been tightly intertwined with its work abroad. CDC experts were on the frontlines in the efforts to eradicate smallpox, the only disease in history to be eliminated. Now CDC experts are actively engaged in current efforts to eradicate polio, a disease that once ravaged the United States and countries worldwide. Today wild polio virus remains active in only three countries: Pakistan, Nigeria, and Afghanistan, and only five cases of wild polio virus have been reported this year, which is a record low number. These encouraging results reflect a novel partnership, the Global Polio Elimination Initiative (GPEI),that holds promise for future efforts to protect people’s health.

GPEI is a public-private partnership led by national governments with five partners – the World Health Organization, Rotary International, U.S. CDC, the United Nations Children’s Fund, and the Bill & Melinda Gates Foundation – who have locked arms to defeat polio. CDC’s record and commitment to global health is also evidenced in its work combatting HIV/AIDS, TB, malaria, neglected tropical diseases such as River Blindness, and its more recent, and widely reported, efforts to defeat Ebola in West Africa and Zika in numerous countries.

CDC has more than 1,700 staff stationed in more than 60 countries, including scientists, disease detectives, laboratory technicians, and other experts who are on the frontlines working to detect disease outbreaks at the earliest possible moment, to respond to them decisively, and to stop them from spreading. That mission is driven by the same principles CDC uses wherever it works – rigorous science, accurate data, quality training, and strong collaboration with partners.

Yet when it all works as designed, as it often does, the results can be hard to see. The best outcomes are an absence of disease outbreaks and the accompanying fear about their impact, an abundance of healthy people who contribute to U.S. interests by supporting more stable governments and more robust economies, and a lower chance of disease erupting and spreading.

CDC’s values and guiding principles are the same as they’ve been from the beginning – working to protect Americans by rapidly detecting and containing new health threats anywhere in the world before they can come to the United States. The focus is on providing strong, effective public health systems and on training healthcare professionals who can identify outbreaks in their own countries to prevent those threats from crossing borders.

For example, CDC’s Field Epidemiology Training Program (FETP), established in 1980, has trained more than 9,000 disease detectives to date in more than 70 countries. They provide critical frontline disease detection and surveillance, and, significantly, more than 80 percent of the FETP graduates continue working in their countries, with many moving into public health leadership positions. From 2009–2014, FETP graduates took part in more than 2,000 outbreak investigations, which kept their countries, and the world, safer and healthier.

It works with countries to immunize children and adults to protect them from vaccine-preventable diseases. Preventing diseases such as polio and measles allow children and adults to live healthy and productive lives. It means laboratorians from CDC’s world class laboratories work together to provide training and technical expertise to laboratorians in other countries to upgrade and expand laboratory services. This results in accurate and reliable laboratory networks, which are essential to finding and understanding disease threats, and in using resources for maximum public health benefit.

CDC’s dedication to global health can be measured by outbreak response mobilizations, staff trained and ready for deployment, person-days of response support, ensuring that all people have access to safe water and sanitation around the world, and collaboration with global partners.

An example is CDC’s participation in the Global Health Security Agenda (GHSA). Formed in 2014 with key contributions by CDC, GHSA is designed to implement the tools and practices necessary to prevent, detect, and respond to outbreaks at the earliest possible moment in countries throughout the world. To date, 31 countries are participating, with each pledging to meet universal standards for quality disease surveillance, a well-trained workforce, rapid and accurate public health laboratory capacity, and emergency response via emergency operation centers.

Another example is CDC’s Global Rapid Response Team (GRRT), a “boots-on-the-ground” program ensuring that, from a pool of 400 trained experts, 50 are on-call to travel anywhere in the world within 48 hours to confront an outbreak at its outset. The GRRT was mobilized more than 230 times in one year after it was created in 2016, and provided 8,000 person-days of response support in more than 90 outbreaks worldwide, including cholera, yellow fever, Ebola, Zika, measles, polio, and natural disasters. The GRRT also has experts in global health logistics, laboratory management and training, communication, and disease detection.With the world more connected than ever through travel and commerce, GHSA is a systematic effort to provide universal and tested standards to prevent, detect, and respond to disease outbreaks worldwide and to close gaps in these areas that allow disease to cross borders.

Taken together, all of CDC’s work abroad contributes to making the world and all Americans safer and more secure, healthier and more confident that threats to their health will be identified and resolved no matter where they live and travel.

Follow CDC Global on Twitter @CDCGlobal

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Trump’s global gag rule silences doctors and midwives and harms their patients

This blog was written by Catharine Taylor and cross-posted from STAT

President Trump’s reinstatement of the Mexico City Policy, better known as the global gag rule, came as no surprise to anyone working in the field of global health. We have been through this before — in 1984, when the policy was first put into effect by President Reagan, and then in 1993, 2001, and 2009, when it was repealed, reinstated, and repealed again.

The Mexico City Policy is called a gag rule because it limits not just what organizations and health providers do but what they are permitted to say. It prevents foreign organizations that receive US government funding from performing abortions — even if they are using funds from non-US government sources and even if abortion is completely legal in their countries.

The global gag rule also steps right between a woman and her doctor, nurse, or midwife, preventing these frontline health providers from telling their patients about the full, legal range of health options available to them. It forbids trusted advisers from giving honest, comprehensive health advice and information. I started my career as a nurse-midwife, and then worked in maternal and newborn health programs in Africa and Asia, so I know what this will mean for the lives and health of women and their families.

For more than half a century, the US has invested, with great success, in programs to increase access to family planning and improve maternal, newborn, and child health, as well as prevent malaria, tuberculosis, HIV/AIDS, and other infectious diseases. The evidence couldn’t be clearer: America’s commitment has prevented millions of unintended pregnancies and saved millions of lives. It has reaped substantial savings in health care costs from each dollar invested in building strong, sustainable health systems. US-funded programs have strengthened families and communities, increased stability and prosperity, and contributed to improved health security for the entire world, and for our country as well.

My organization, Management Sciences for Health, works in partnership with countries around the world on behalf of the American people to efficiently and effectively invest US funding in projects and programs that work to save lives, increase well-being, and build more stable and secure societies.

While my organization will continue to comply with US-government policy, we are deeply concerned about the impact of the reinstatement and expansion of the global gag rule. It will force foreign organizations — many of them our project partners — to make a terrible choice: accept US funds but withhold full, accurate health information from their patients, or reject US funds and thus provide care to far fewer women.

When the global gag rule was previously in force, it applied only to foreign organizations that received funds from the US budget for family planning assistance. That meant the effects were mostly limited to organizations focused on contraceptive services.

But President Trump’s expanded policy will apply to any foreign organization that receives any US global health funding. That could mean endangering maternal and child health programs, efforts to fight the Zika virus, and the expansive PEPFAR program to stop HIV/AIDS, perhaps the most successful health aid program in US history.

Here’s what happened when the narrower policy was in place before: Clinics were closed, services were reduced, and there were more unintended pregnancies and unsafe abortions.

will lose access to affordable, high-quality, comprehensive reproductive health care, and will be less able to make informed health choices. Health systems in countries that are now showing real, sustainable progress in improving population health will be weakened. Good organizations that do effective, lifesaving work will have to cut back their activities or go out of business. The US investment in global health will be much less effective.

Global health experts know that access to family planning and accurate, comprehensive health information saves lives. By restricting that access, the global gag rule does the opposite, harming the well-being and resiliency of families, communities, nations, and economies.

Organizations should not be disqualified from participating in US-funded health projects because they use their own funds to provide the accurate, comprehensive health information that their patients need, and services that are legal in their own countries. If they are, it is women who will pay the price.

Catharine Taylor is vice president for health programs at Management Sciences for Health, a nonprofit global health organization.

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