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Working With the Private Sector to Improve Maternal, Newborn, and Child Health
Innovations From Development to Delivery
›“Challenging and dynamic partnerships [with the private sector] are difficult to pull together, but when you look at sustainability, impact, and effectiveness, they can also be great levers of change,” said Kari Stoever, senior advisor for global advocacy at the Global Alliance for Improved Nutrition (GAIN) at the Wilson Center on March 22. [Video Below]
Stoever was joined by panelists Laura McLaughlin, environmental engineer at Cascade Designs, Inc., Hugh Chang, director of special initiatives at the NGO PATH, and Laura Birx, senior food security and nutrition specialist at the U.S. Agency for International Development (USAID) for a discussion of the private sector’s role in developing innovative health technologies to increase access to safe water, prevent infectious diseases, and improve maternal health nutrition.
Collaborating to Provide Safe Water
“NGOs have different strengths and different perspectives from the private sector, and we’ve found an area where we can really complement each other,” said McLaughlin. Cascade Designs, Inc., collaborated with PATH to create a smart electrochlorinator, which produces a chlorine solution to purify water using just salt water and a simple battery, because “we wanted to make a bigger difference than we could do with philanthropy alone,” said McLaughlin.
“Products need to be designed specifically for the end user, particularly for women and children, who are often times left out of the design process,” said McLaughlin. Cascade’s smart electrochlorinator was designed with this in mind. One charged battery can treat up to 40,000 liters of water, 200 liters at a time. The device is easy to use, requires simple resources, is significantly more affordable than existing solutions, and lends itself to an entrepreneurial business model that can deliver safe water to small community households. The current prototype is being field-tested in 10 countries globally, with the aim of providing safe water in resource-poor communities while generating income for local entrepreneurs.
The PATH-Cascade partnership was successful in part because it combined “private-sector expertise in efficiency, cost-effectiveness, and meeting market demands” with knowledge about the health needs in developing countries, said McLaughlin. By “pushing each other to a common end goal, this partnership really multiplied our strengths.”
Engaging the Private Sector
“One of the reasons we work closely with the private sector…is because we recognize an efficiency of resource usage that comes with building bridges between the public sector and the private sector,” said Chang of PATH’s work with Cascade and others. Engaging the private sector to advance health technologies can complement PATH’s goals, like encouraging healthy behaviors and strengthening health systems, he said. “But, we are not averse to profits,” he added, stressing that partnerships with NGOs can be mutually beneficial. “We understand for this to be sustainable, these companies need to make a profit.”
PATH is working with the private sector to develop injection and vaccine technologies that “produce a product that not only benefits the recipient of the vaccine but also produces a revenue stream,” said Chang. The SoloShot, for example, is a low-cost, disposable syringe that locks after a single injection, preventing needle reuse and contamination that can increase the risk of HIV, hepatitis B, and other infections. To address the challenge of maintaining the proper refrigeration of vaccines in low-resource settings, private sector collaboration has helped to develop the vaccine vial monitor (a sticker that changes color when a vaccine has been exposed to too much heat) and to create more stable vaccine formulas that are less vulnerable to extreme temperatures. “By combining innovation with on-the-ground presence,” concluded Chang, “private sector engagement can be a powerful tool for global health.”
A “Win-Win Partnership”
“There is a tremendous role for the private sector to play in the intersection of agriculture and health as they relate to nutrition,” said Birx. Engaging the private sector can be a “win-win partnership,” she said. The Obama Administration’s hunger initiative, Feed the Future, for example, uses the resources, expertise, and innovation of the private sector to encourage sustainable, market-driven approaches to reducing poverty and food insecurity, said Birx.
USAID sees innovation as a “research-to-use continuum,” said Birx. “When we look at innovation, it’s not just about the development of a specific product, but about the entire system that goes around that product,” she added. New technologies must not only respond to a major development challenge in poor and rural communities but need to be affordable, culturally appropriate, gender sensitive, easy to use, and durable.
But solutions don’t have to be complicated. “Often times it’s about a really simple technology that can improve accessibility,” said Birx. The nevirapine pouch, for example, a simple foil packet that allows health care workers to give women single doses of nevirapine syrup, can reduce the risk of mother-to-child transmission of HIV by more than half.
“There’s a lot of excitement, but we need to do some serious work to capitalize on [it],” said Birx. Moving forward, health, development, and private-sector organizations must work together to create innovative financing mechanisms, build institutions in developing countries, and encourage enabling policy environments.
Sources: PATH.
Photo Credit: “Mission to Ouanda Djallé,” courtesy of flickr user hdptcar. -
Eric Zuehlke, Behind the Numbers
Building a Gender Strategy for the Afghanistan Ministry of Public Health
›March 25, 2011 // By Wilson Center StaffThe original version of this article, by Eric Zuehlke, appeared on the Population Reference Bureau’s Behind the Numbers blog.
Recent media reports have focused on the stalled progress for women in Afghanistan and the shift in the international community’s focus as they take steps towards an eventual military withdrawl. Although there’s much work to be done, it’s important to note that there has been tangible improvement for women in Afghanistan. A decade ago, women weren’t allowed to go out in public alone. Girls weren’t allowed to attend school – now 57 percent of girls are in school. And gender issues are now being integrated into government policy.
At an Interagency Gender Working Group (IGWG) Plenary in honor of 2011 International Women’s Day hosted by PATH in Washington DC, Karen Hardee, a senior fellow at PRB and president of Hardee Associates, presented her involvement towards developing the National Gender Strategy for the Afghanistan Ministry of Public Health for 2011-2015. Much international development program and policy advocacy calls for attention to “gender,” but what does the term mean? “Gender isn’t just about women,” said Hardee, but is defined as the social roles that men and women play because of the way society is organized. But these roles aren’t set in stone; they can change over time.
Funded by USAID, the Health Services Support Project worked with the Afghan government to create a plan to integrate gender considerations into all public health programs and policies, focusing mostly on mental health and gender-based violence. Interestingly, the impetus of the process stemmed the initiative of a male official in the Ministry of Public Health who requested assistance to write a plan to integrate gender into the Ministry’s policies and programs. Having participated in WHO-sponsored gender training workshops in the past, he understood the importance of mainstreaming gender awareness for both men and women. It’s a great example of the tangible effects of the work being done on gender by NGOs and international donors.
Continue reading on Behind the Numbers.
Sources: The Guardian.
Photo Credit: “PRT, ADT women help celebrate Women’s Day in Kunar,” courtesy of flickr user DVIDSHUB. -
Integrated Approach Helps “Model Farmers” Increase Productivity in Ethiopia
›March 24, 2011 // By Schuyler NullTo reach the village of Grar Gaber from Addis Ababa, you drive up over the Entoto Mountains overlooking the capital then motor down two hours of new Japanese-built highway to the town of Fiche. From there it’s 20 minutes on a broken dirt road across rocky hills. I was joined there by about 20 others from the PHE Ethiopia Consortium’s general assembly (see day one and day two coverage here) and Population Action International, to visit an integrated population, health, and environment (PHE) development program run by LEM Ethiopia.
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The Youth of North Africa
Surging on a Knife’s Edge
›March 23, 2011 // By Christina DaggettThe Middle East/North Africa region is experiencing a “youth surge,” said Jack Goldstone, director of the George Mason University’s Center for Global Policy, at a recent GMU event. “In the last two decades the number of people in their late teens and twenties has increased… It’s doubled in Egypt; it’s grown by half in Tunisia; and nearly doubled in Libya,” he told Warren Olney on KCRW’s To the Point.Such youth surges are problematic because, Goldstone wrote in ECSP Report 13, “population distortions – in which populations grow too young, or too fast, or too urbanized – make it difficult for prevailing economic and administrative institutions to maintain stable socialization and labor-force absorption.”
In the case of Egypt, the youth surge put enormous pressure on a government system that could no longer guarantee jobs to every college graduate, said Goldstone. When government guarantees dried up, graduates found that their poor-quality degrees were of little use, especially in a system that prioritized connections and bribery. The result was an unemployment rate of 25 percent among Egyptian youth and a mounting sense of frustration with the economic system and the government.
This frustration found a symbol when Mohammed Bouazizi, a 26-year-old Tunisian, set himself – and an entire region – on fire after his third run-in with the police cut off his only source of income. Youth across North Africa and the Middle East, Goldstone said, could identify with Bouazizi’s desperation and frustration after years of dealing with a closed economic system and a corrupt government.
While overall economic growth has been strong in the region – a fact which had misled many observers (including himself, Goldstone admits) into thinking the region was more stable – these economic gains were apparently being captured by the ruling elite to a far greater degree than previously thought, said Goldstone. For example, it is estimated that ousted Egyptian president Hosni Mubarak and his family are worth between $40 and $70 billion.
Meanwhile, a burgeoning surge of young people were struggling to get by. Goldstone pointed to a Gallup poll conducted in 2010 in which only 12 percent of Egyptians and 14 percent of Tunisians would classify themselves as “thriving” – down from 25 and 24 percent, respectively, in 2007 and 2008.
While the Ben Ali and Mubarak regimes have fallen, these revolutions do not ensure the youth in these countries will have a prosperous future. They need not only access to capital, said Goldstone, but also access to information and social networks so that they can identify market opportunities and stay connected.
Immigration to more developed countries could also be an important avenue for economic growth and education. In a Foreign Affairs article, “The New Population Bomb,” Goldstone writes, “Given the dangers of young, underemployed, and unstable populations in developing countries, immigration to developed countries can provide economic opportunities for the ambitious and serve as a safety valve for all.”
The future of Middle Eastern youth, and that of the region at large, depends on the quality of their education and their ability to be productive, said Goldstone. They stand on “a knife edge,” he said, and the transition to democracy will not be smooth or easy.
Image Credit: “Protest Face Paint,” courtesy of flickr user Ahmad Hammoud.
Sources: The Economist, ECSP Report 13, Foreign Affairs, Gallup, International Monetary Fund, KCRW, Voice of America. -
The Continuing Challenges of Integrated Development
›March 20, 2011 // By Schuyler Null“How are we going to feed all these mouths?” asked Bekele Hambissa, director of the Environmental Protection and Development Organization in Addis, on day two of the PHE Ethiopia Consortium general assembly (read about day one here). Environmental resources are directly tied to Ethiopia’s population growth, said Hambissa, during a discussion of balancing efforts to address population growth, environment, and livelihoods. While poverty alleviation is an important goal of population, health, and environment integration (PHE), it must be environmentally sustainable, he said.
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USAID: Maternal Deaths in Bangladesh Decline by 40 Percent in Less Than 10 Years
›The original version of this article, by the USAID Global Health Bureau, appeared on the USAID Impact blog.
Bangladesh is on track to meet the 2015 deadline for UN Millennium Development Goal 5 (50 percent reduction in maternal deaths). The Bangladesh Maternal Mortality and Health Service Survey, jointly funded by the Government of Bangladesh, USAID, Australian Aid (AusAID) and the United Nations Population Fund (UNFPA), found that maternal deaths in Bangladesh fell from 322 per 100,000 in 2001 to 194 in 2010, a 40 percent decline in 9 years.
The decline in direct obstetric deaths is most likely the consequence of better care seeking practices and improved access to and use of higher-level referral care. The decline in total fertility rate due to the successful family planning program has reduced exposure to high risk pregnancies and has thus prevented a large number of maternal deaths.
Continue reading on USAID’s Impact blog.
Sources: Directorate General of Health Services – Bangladesh, UN.
Photo Credit: Adapted from “Mother & Son,” courtesy of flickr user Anduze traveller. -
Congressional Hearing: Clean Water Access Is a Global Crisis, Human Right, and National Security Issue
›March 17, 2011 // By Hannah MarquseeUnsafe drinking water causes nearly 1.8 million deaths each year from diarrhea, “a number that dwarfs the casualties associated with violent conflict,” said U.S. Representative James McGovern at a congressional human rights commission hearing earlier this month on water as a basic right. Nearly all of these deaths are children under the age of five, he said. “This is a war against families, children, and women on an ongoing basis,” said Representative Earl Blumenauer, also speaking at the hearing, titled “Realizing the Right to Safe Water and Sanitation.”
There are currently 884 million people in the world without access to safe drinking water, according to UNICEF, and 2.6 billion without improved sanitation. As population growth and climate change place added stress on fresh-water systems, by 2025, two thirds of the world’s population will live in water-stressed conditions, according to the Food and Agriculture Organization. “This is a severe global crisis,” said McGovern.
“A Human Right”
With 2011 World Water Day only weeks away, the hearing harkened back to Secretary Clinton’s widely quoted statement from World Water Day 2010, marking a commitment by the Obama administration to address global water issues:It’s not every day you find an issue where effective diplomacy and development will allow you to save millions of lives, feed the hungry, empower women, advance our national security interests, protect the environment, and demonstrate to billions of people that the United States cares. Water is that issue.
Four months after that statement, the UN passed a resolution to make access to water and sanitation a human right, not just a development priority. Said Catarina de Albuquerque, a UN independent expert who testified at this month’s congressional hearing, the resolution stipulates that water must be “available, accessible, affordable, acceptable and safe.” A “right to water” is an important “sign of political will,” that will place increased obligations on governments to improve access to water and sanitation, she said. But in the meantime, for the millions without access to safe water, “there is no change.”
According to the UN, the world is on track to meet the Millennium Development Goal target of halving the number of people without access to an improved water source by 2015. But de Albuquerque noted that the reality is not quite so optimistic. On a UN fact-finding mission, she encountered at least one family who by UN definitions had access to an “improved drinking water source,” yet their tap water was literally black. “Water quality is not being monitored” and for many of the people who do have access, it is simply “undrinkable,” she said.
In developed countries as well, there are significant barriers to access, especially for marginalized communities. On a recent mission to the United States, de Albuquerque found that America’s “voiceless” – people of color, Native Americans, and the homeless – face significant discrimination in access to water. “Society closes its eyes to them,” she said. Thirteen percent of Native Americans lack access to safe water, in comparison to 0.6 percent of non-native Americans, she said in a statement to the press releasing her findings. And in Boston, “for every one percent increase in the city ward’s percentage of people of color, the number of threatened cut-offs increases by four percent.” To make the necessary improvements to fill these gaps in America’s aging water infrastructure would cost $4 to $6 billion annually, she said.
A National Security Issue
Water “is a security issue as well as a human development issue,” said Blumenauer. Since, according to UNEP, 40 percent of the world relies on river basins that share two or more political boundaries, water management has enormous potential for both conflict and cooperation. Echoing Clinton’s World Water Day statement, McGovern championed the cross-cutting nature of water:The right to water is inextricably linked with other basic rights…including the right to food, the right to health, and the right to education.
The burden of collecting water in underdeveloped countries often creates a gender gap and exposes women and girls to violence and rape, he said. And it “has been the basis for many territorial and violent disputes between various peoples and even nations.”
Last month, a staff report by the Senate Foreign Relations Committee expressed a similar sentiment with the publication of their report, Avoiding Water Wars: Water Scarcity and Central Asia’s Growing Importance for Stability in Afghanistan and Pakistan. The report commends the Obama administration for recognizing the importance of water: “For the first time, senior government officials are recognizing the critical role that sound water management must play in achieving our foreign policy goals and in protecting our national security.” However, by exclusively focusing on Pakistan and Afghanistan’s water issues and “neglecting the interconnectivity of water issues between Central and South Asia, the U.S. approach could exacerbate regional tensions,” the report says.
To be more strategic about water assistance, the report recommends the United States: (1) provide technical support in data collection to better manage water; (2) help increase water efficiency and reduce demand for water; (3) recognize the transboundary nature of water issues and “provide holistic solutions;” and (4) “safeguard institutions against shocks to water supply and demand.”
Moving Forward
The Obama administration’s commitment to water issues, the UN’s recognition of water as a human right, and the 2005 Water for the Poor Act have all been important steps towards fulfilling the pledge of making access to safe water a human right. “We’ve come a long way,” Blumenauer (who authored the Water for the Poor Act) said at the hearing, but there is still significant work ahead.
“We’re going to have to be more strategic moving forward” in order to meet global water shortages, said Aaron Salzberg, special coordinator for water resources for the U.S. Department of State who testified at the hearing. Salzberg recommended that the U.S. government take steps to integrate water management with the food and health sectors; build political will; mobilize financial support; promote science and technology; and form partnerships with other governments and aid organizations. The United States must also “be smarter” about allocating funds based on the dual criteria of “need” and “opportunity.” Balancing efforts with partners to find out which countries have the greatest need and the least resources will allow limited U.S. funds to make the deepest impact, he said.
John Oldfield, managing director of the WASH Advocacy Initiative, urged Congress to increase funding for foreign assistance, continue appropriations for the Water for the Poor Act, and improve the effectiveness of existing water, sanitation, and hygiene (WASH) assistance. “Each dollar invested in water and sanitation leads to an 8:1 return from reduced healthcare costs and time savings,” he said. “The world does not need to bury millions more of its children in the coming years when we know how to prevent waterborne disease today.”
Sources: FAO, UNEP, UNICEF, United Nations, WHO.
Image Credit: Adapted from “School girl drinks water from new handpump,” courtesy of flickr user waterdotorg. -
Hu Angang and Liang Jiaochen, ChinaDialogue
China’s Green Five-Year Plan: Making “Ecological Security” a National Strategy
›March 16, 2011 // By Wilson Center StaffThe original version of this article, by Hu Angang and Liang Jiaochen, appeared on ChinaDialogue.
Five-year plans (FYPs), which set down and clarify national strategy, are one of China’s most important policy tools. Just as they have helped to drive China’s economic success over recent decades, so they will play a pivotal role in putting the country on a green development path. The 12th Five-Year Plan, now under consideration by the National People’s Congress, marks the beginning of that process in earnest (Editor’s note: Since this was originally published, the National People’s Congress voted in favor of the plan).
FYPs embody the concept of progressing by degrees, or developing step by step. This approach has been one of the driving forces behind China’s economic progress in recent decades and will now provide the platform for its green development. It is the methodology underpinning China’s socialist modernization: to reach a new step in development every five years. Unstinting efforts over a number of FYPs have driven China’s transformation.
Climate change presents a long-term and all-encompassing challenge for China. It demands a long-term development strategy and broad goals, as well as near-term action plans and concrete policies. Combining these is precisely the idea behind FYPs.
At the global climate change summit in Copenhagen in 2009, China demonstrated it has the long-term political will to respond to climate change; to work with the world to limit global temperatures to no more than two degrees Celsius above pre-industrial temperatures (the goal set out in the Copenhagen Accord). In November that year, the Chinese government formally put forward its medium-term targets on climate change: a reduction in energy intensity of 40 percent to 45 percent on 2005 levels by 2020, and generation of 15 percent of energy from non-fossil fuel sources by the same date.
Continue reading on ChinaDialogue.
Hu Angang is a professor at the Chinese Academy of Sciences and Tsinghua University and the director of the Centre for China Study. He has worked as the chief editor for China Studies Report, a circulated reference for senior officials. Liang Jiaochen is a PhD student at Tsinghua University’s School of Public Policy and Management.
Sources: Business Green, UN Framework Convention on Climate Change, World Resources Institute.
Photo Credit: Adapted from “China: CREME,” courtesy of flickr user IFC Infrastructure (Alejandro Perez/IFC).
Showing posts from category development.