Maternal & Child Health

Why UHC Day is a Call to Action for the World’s Youth

This guest post was written by Arush Lal, Global Health Corps Fellow at Frontline Health Workers Coalition (FHWC) c/o IntraHealth International.  The post was originally published on the FHWC website. The Frontline Health Workers Coalition (FHWC) is an alliance of United States-based organizations working together to urge greater and more strategic U.S. investment in frontline health workers in developing countries as a cost-effective way to save lives and foster a healthier, safer and more prosperous world. FHWC is a 2017 Global Health Council member.

It’s no accident that Universal Health Coverage Day December 12 — falls on the heels of Human Rights Day. Universal health coverage (UHC), the goal of ensuring that all people can access essential health services without exposure to financial hardship, is a dignity and a right not afforded to many around the world.

Today, I remember Gabriel, a Panamanian boy half my age who first taught me how a fractured health system fails people. I met Gabriel in the waning hours of our fourth clinic day, where our team of passionate doctors and volunteers was visibly exhausted after treating hundreds of patients in the remote islands along Panama’s rugged coastline. I vividly recall watching him bear the sweltering heat as he waited to be examined, and felt proud when I saw him leave with a much-needed bottle of Albendazole and a bag of nutritional supplements for his sister back home. As I instructed the team to wrap up for the day, I suddenly noticed Gabriel running the winding path back to the clinic, stopping in front of me wide-eyed and out of breath. He urgently explained that his disabled grandmother needed medications to control her diabetes, but no health workers reached their part of the island. I asked him if he could bring her to the clinic before we left, but he informed me she was too weak to make the hour-long journey to meet us. I desperately wanted to help, but we were short-staffed, facing a surge of patients and a setting sun. As the leader of the group, I was faced with an impossible decision: provide the medication without an examination or send the boy home empty-handed. I was forced to choose the latter.

Gabriel is one of 400 million people who lack access to health workers, and that number grows every day. In fact, it’s estimated that the world will face a shortage of 18 million health workers by 2030, meaning a shameful rise in stories like Gabriel’s.

Where someone lives should never determine if they live, but although illness is universal, healthcare isn’t. As a vocal advocate for UHC, I now focus on health workers, because without them, health doesn’t happen. Frontline health workers are the first and only point of contact for many marginalized populations, often facing unsafe conditions with limited training, equipment, and resources needed to perform their lifesaving duties.

Investing in health workers isn’t just a cost-effective solution (the UN Secretary-General’s Commission on Health Employment and Economic Growth estimates a 9 to 1 return on investment), it’s essential to achieving the Sustainable Development Goals (SDGs) — eliminating poverty, fueling economic growth, reducing gender inequalities, and saving millions from preventable diseases.

In many ways, Gabriel reminded me of myself. Just as I, one of the youngest team leads in VAW, was busy overseeing our clinic operations to ensure rural populations had access to lifesaving care, so was he, a compassionate nine-year-old, spending his day scouting medications for his family rather than, well, being a kid. But where healthcare is scarce, everyone, including our youngest, must step up to the plate.

Arush Lal asks a question during a plenary at the Fourth Global Forum on Human Resources for Health in Dublin, Ireland, Nov. 13–17, 2017. Image Credit: Frontline Health Workers Coalition

With the support of Global Health Corps and IntraHealth International, I recently attended the Fourth Global Forum on Human Resources for Health, convened by the World Health Organization and several partners in Dublin, as a youth delegate and panelist. Along with 1,000 policymakers and advocates, we discussed possible solutions to the health workforce crisis and the pivotal role young people play.

Over half the world’s population is under 30, and young people have woefully untapped potential as crucial advocates and partners in achieving UHC. Youth aren’t just the leaders of tomorrow; they’re leaders today, as young doctors, policymakers, and researchers. Bold, innovative, and visionary, my peers are making noteworthy advances in the way we pursue global public health. Youth must be empowered to push for greater accountability, stronger policies, and sounder investments to improve access to frontline health workers and resilient health systems. Without over three billion of us at the table, world leaders will continue to struggle achieving their global health targets.

Innovative Education

As the next health workforce, young people must be actively involved in planning their future, and we should push for academic programs that cultivate students who are well-versed in the SDGs and UHC. This includes expanding models like the UN Regional Centers of Expertise, one of which I recently helped create in Atlanta, to bring the global goals onto college campuses. Similarly, there is a need to create effective education programs, like an undergraduate degree in global health systems and technology I proposed at Georgia Tech, aligning interdisciplinary curriculum with the goal of achieving UHC.

Taking Action

Young people should work with local governments and NGOs as implementers in the fight for UHC, because youth are effective at reaching vulnerable populations. IntraHealth is a shining example of how to mobilize young people as frontline health workers. Through its CS4FP Plus program, IntraHealth has trained 92 youth ambassadors to lead family planning campaigns, featuring advocates like 16-year-old Nina Kone of Burkina Faso, who pushes for gender equality while de-stigmatizing sexual education, and Abou Diallo, who ensures that young people have access to contraceptives and reproductive health services in Guinea.

A Voice For Change

Few things are more effective than a passionate young person with a platform and a voice to cut through cynicism and question the status quo. Youth can and should advocate globally, ensuring governments commit to the policies they enact.

The Dublin Declaration and an accompanying Youth Call to Action are promising examples of youth engagement in UHC done right. For the first time, “youth” appears as a key stakeholder in the Dublin Declaration — and for good reason too. Youth perspectives are catalytic in achieving the SDGs, and our fluency in social media to push our messages far and wide make us an asset to governments trying to drive change. The first generation faced with climate change and an innately powerful imagination for new technology, we apply innovative solutions to health systems gaps, creating database and information systems, training health workers online, and improving telemedicine.

Young people: Be proactive and vocal advocates for change in achieving UHC, building relationships with diverse stakeholders and holding leaders accountable when they fail to deliver.

Established leaders: Engage youth more meaningfully, as key partners and not as an afterthought or disconnected silos. Mentor us, empower us, give us a platform.

For me, the story of Gabriel regularly reminds me of two truths we simply can’t ignore:

Emboldened youth today are our future — it’s time we start recognizing it.
Our world needs more health workers — it’s time we start showing it.

To Move Forward Is To Move Together: Creating Collective Action Through Roundtables

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

The global health advocacy community is diverse and functions as a conglomerate of roundtables, working groups, and coalitions (hereafter referred to as Roundtables). Roundtables can work independently or collectively, bringing advocates and researchers across various sectors together to discuss global health policy issues and to increase U.S. funding for global health accounts. The Roundtables’ impact on global health policy is a culmination of these groups’ work such as sign on letters, meetings on Capitol Hill, advocacy around legislation, and engagement with the administration. For organizations that advocate for U.S. investment in global health, the Roundtables amplify this work, as they provide strategy, build a collective voice, and push for a comprehensive holistic approach to global health delivery and care.

Provides Strategy

Roundtables give organizations the opportunity to share their knowledge with each other. Sharing this knowledge allows organizations to be current and devise collective action.

Aaron Emmel, Manager of Global Health Advocacy Initiatives at the American Academy of Pediatrics (AAP), explained, “Information sharing is essential for roundtables to move forward with advocacy strategies.” Aaron is a member of the Steering Committees for the Noncommunicable Diseases Roundtable and the Maternal, Newborn, and Child Health (MNCH) Roundtable, and the working group for A Global Agenda for Children (early childhood development). AAP also participates in other advocacy groups such as the International Family Planning Coalition; the civil society group organized by Gavi, The Vaccine Alliance; the Water, Sanitation and Health (WASH) Working Group; and the 1000 Days (nutrition) Working Group.

Aaron elaborated on how sharing knowledge brings different viewpoints to the table. “AAP shares information on pediatric health, from child survival to NCDs and chronic care. Other partners such as maternal health experts including the American College of Gynecologists, share complementary information that helps to tell a fuller story. Together we are able to add to each other’s credibility.”

Lisa Schechtman, Director of Policy and Advocacy, at WaterAid, who sits on the Steering Committee for the MNCH Roundtable and is also the co-chair for WASH Working Group, said, “Sharing information allows roundtables and individual organizations to be strategic and current in advocacy issues that organizations work on.” Lisa continued, “For smaller teams like WaterAid, and [as] one of the few organizations that work in the WASH space, having these spaces allow us to amplify our contribution as few WASH advocates are able to do that.”

Builds a Collective Voice

Roundtables build a collective voice around global health issues, bringing multiple focuses together to create stronger messages to send to Congress and the administration. Aaron emphasized this point, “Diverse voices show consensus around global health issues and allow us to validate programmatic evidence from different perspectives. There is not necessarily a national constituency for global health so it is important that roundtables allow for coordination, for members to come together and present evidence to policy makers and agencies to reinforce global health agendas.”

Lisa reinforced the power of collective voice and that “we are stronger together.” WASH is one example of this. Lisa added, “WASH focuses on the outcomes of providing services and most of these outcomes are linked directly to the goals of the MNCH Roundtable. The MNCH Roundtable helps to provide context to do what we do and MNCH-focused groups can learn from WASH and consider our inputs and strategies. This gives us credibility for the health benefits of WASH and our position in the global health community doing advocacy on WASH.”

Comprehensive Holistic Approach

Roundtables provide a space for points of integration and create holistic approaches to global health agendas. Aaron explained, “For the Reach Every Mother and Child Act (Reach Act), the child survival groups needed buy-in from the maternal health groups to create a strong message to legislators. Bringing diverse voices to policy makers shows that we are united around this issue. For NCDs, we serve as a bridge for maternal and child health; without the NCD voice, global maternal and child health policies and interventions would not necessarily include chronic illness, and without the maternal and child health voice NCD policies have not adequately addressed the unique needs of children and youth.”

On WASH integration, Lisa said, “Integration was the original reason we joined the MNCH Roundtable several years ago. Although members of the Roundtable do WASH service delivery there was almost no health organization working on WASH advocacy. WASH underlies the success of the MNCH and Nutrition community which builds more WASH champions and raises opportunities and issues.” By being a part of the MNCH Roundtable, Lisa said that “WASH is now at the table for the MNCH annual appropriations process.”

Moving Forward

To move global health forward, is to move together. Roundtables allow the global health advocacy community to come together, find areas of integration and collaboration, and build a collective voice. Lisa discussed this benefit and used WASH integration as an example. “Being a member of the Roundtables and of Global Health Council has worked hand in hand.” Lisa emphasized, “Both memberships increase the profile of WASH as a health issue and create new partnerships, in addition to the opportunity to work with Global Health Council staff.”

Looking forward, the global health advocacy community’s collective voice is now more important than ever. Aaron added, “We work in different spaces but we recognize that there is a shared agenda and vision to help and maintain the role of America as a trusted leader and partner for global health issues.”

Global Health Council works with the Roundtables to support information sharing, coordinate advocacy efforts, and be a part of the collective voice of the global health community. If you are interested in attending roundtable meetings or would like to find out more information please email advocacy@globalhealth.org.

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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About Global Health Council

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.

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.