The Living Proof Project recently posted a new video, this one set in Malawi. It explores something called The Kangaroo Mother Care program, which “teaches mothers how to increase the body temperatures of their newborns by wrapping the babies to their bare chests.” The skin-to-skin contact helps reduce hypothermia, among other benefits.

It’s a pretty remarkable video. Check it out:

This great blog post comes to us from Dr. Juan José Amador, Director of Health Systems and Technology in Nicaragua at PATH

During my childhood in Nicaragua, I used to see a shocking sight: Groups of people carrying child-size coffins through the streets toward the cemetery. Families-usually the poorest in my community-mourning the deaths of their youngest members. Almost always, diarrheal disease was the cause.

Back then, these funeral processions were common. Diarrhea was a lethal epidemic, most often striking babies before they reached their first birthdays. We had few resources and little information to stop it.

When I became a doctor, we didn’t think that our country could overcome the disease. Three years ago, however, things began to change.

With PATH’s partnership, Nicaragua began vaccinating newborn babies against rotavirus, the most common cause of severe diarrheal disease, and helping families understand how better hygiene reduces risk. PATH partnered with health workers to introduce new saline solutions and other remedies for keeping young bodies hydrated and healthy.

And it’s working. We’ve cut the number of children who die from diarrhea in half. Hospital diarrhea wards are now empty, thanks to lifesaving rotavirus vaccine and other simple interventions:

Read Wilson’s story here, and check out the slide show here.

My hope for Nicaragua is a generation of healthy children who can learn better, smile bigger, and grow up strong-without the threat of death from diarrhea. Many years ago, we didn’t believe this was possible. But in a few short years, we have changed the history of my country.

On Day 5 of our listening/learning trip to Africa, we visited the Tema General Hospital (a (RED)/Global Fund site), located 22 miles outside of Accra in the largest port, industrial city in Ghana. Built in 1954, the hospital is currently undergoing renovations in an effort to better serve the increasing number of patients. An eye care center was recently completed and the Minister of Health just announced plans to construct a new, modern maternity block.

These are some photos from a PMTCT (prevent mother-to-child transmission) program funded by the Global Fund. The PMTCT program at Tema General Hospital provides voluntary counseling, testing, treatment and services to prevent the transmission of HIV from mother to child.

-Morgana Wingard

June 16 was the Day of the African Child. This year’s discussion, “Africa Fit for Children: Call for Accelerated Action Towards Their Survival,” was jointly hosted by the African Union and the African Diplomatic Corps, the Global Health Council, Save the Children, and the US Coalition for Child Survival. The panel discussion, moderated by Dr. Charles MacCormack, President and CEO of Save the Children, included Her Excellency Amina Salum Ali, Ambassador of the African Union to the United States, Her Excellency Hawa Ndilowe, Ambassador of Malawi to the US, His Excellency Abdoulaye Diop, Ambassador of Mali to the US, Gloria Steele from USAID, and World Health Organization (WHO) Ambassador Liya Kebede.

Here are some highlights:

Her Excellency Amina Salum Ali: The Day of the African Child marks the third year celebration of good practices in Africa. During the past 5-7 years many countries, including Malawi, Botswana, Libya, and Ethiopia, have seen a reduction in child mortality. If Africa continues in this way, it will be on its way to achieve the Millennium Development Goals (MDGs) by 2015. However efforts on the ground need to be strengthened; Africa is capable of even more.

Her Excellency Hawa Olga Ndilowe: Africa has faced many challenges in health care and although there has been progress, more work lies ahead. Over the past few years Malawi has mainly focused on reducing child mortality and morbidity. To do this, the country has adopted three main community-level areas of focus:

• Prevention of mother to child transmission of HIV/AIDS
• Breast feeding: Generally, the recommendation in Malawi is that women living with HIV should not breast feed. This proves to be a big challenge as breastfeeding is usually the most affordable option.
• Increased access to clean water and sanitation, medications and education.

These strategies have been successful. Malawi has witnessed significant improvements in its mortality rates: maternal mortality has reduced from 234 deaths per 100,000 live births in 1992 to 122 deaths per 100,000 live births in 2006. In addition, infant mortality has reduced from 134 deaths per 1,000 live births in 1999 to 69 deaths per 1,000 live births in 2006. These figures are proof that we have the tools to save the lives of millions of women and children, we only have to reach them.

His Excellency Abdoulaye Diop: Through partnerships with UNICEF and Save the Children, the Ministry of Health is embarking on a national child survival strategy. Vulnerable groups – particularly mothers and newborns – will be a focus of integrated care at the community level. To care for both mother and child, community health care should be strengthened and focused on child immunizations, bed nets, and treatment. The Ministry of Health is eager to strengthen international partnerships, such as with Save the Children, and not only increase the frequency of care, but also the quality.

Gloria Steele: Many advocates have moved beyond rhetoric and into action and are getting results: there is renewed support for maternal and child health care – Congress increased its budget by 25% last year. Additionally, in 2008, the President’s Malaria Initiative (PMI) reached 25 million people in one year alone. However, there is still a long way to go – 50 million children still suffer from malaria. Using resources more efficiently and integrating all our initiatives – including education, food security, and global health – can yield more results. Also, building capacity in these regions, including health systems, will help produce sustainable results.

Liya Kebede: “No woman should die giving life.” 99% percent of maternal deaths occur in developing countries, and about half of these deaths occur in Sub-Saharan Africa. and 45% of women in sub-Saharan Africa deliver their babies in the absence of skilled attendance. The death of a mother severely affects the lives of her children: children who lose their mothers are five times more likely to die in infancy, more likely to miss out on life saving vaccinations, and less likely to go to school. Action is important now, especially as the H.R. 1410 Bill: Newborn, Child and Mother Survival Act, sponsored by Congresswoman Betty McCollum, is on the agenda for Congress.

-Pooja Gupta & Eloho Ovhori

Our first on-the-ground post from our delegation traveling through Ethiopia and Ghana. Learn more about our trip here.

Yesterday we spent time at the Mother-to-Mother program at Adama Referral Hospital in Ethiopia. The hospital is a comprehensive HIV/AIDS service site, currently providing over 12,000 people with HIV care and more than 7,300 people with antiretroviral therapy.

The Mother-to-Mother program offers support groups for expectant mothers who are newly diagnosed with HIV. Mothers already living with HIV gather with expectant mothers recently diagnosed with HIV to mentor, educate and listen to each other.

Visiting with the mothers at the Mother-to-Mother program was a rare opportunity for an intimate discussion. We were able to speak on a personal level with mothers suffering from HIV, but these women didn’t speak of suffering. They spoke of surviving. They were gathered together to support one another through the experience of having a child while being HIV positive. I was moved by their stories and their perseverance. They were attending support groups twice a week, working to be strong mothers to their children and helping to spread the word about HIV prevention. As our discussion ended, one woman asked that we not forget them. My memory is strong. It was a true honor.

-Kathleen Biden

UPDATED: Here’s Maggie Williams on her visit to the Mother-to-Mother program

And here is Senator John Sununu on the Mother-to-Mother program

A new report by Save the Children UK released today argues that reductions in child mortality can be accelerated if regular, predictable transfers of cash, or cash transfers, are provided to households or individuals by the government. Unlike traditional welfare programs, cash transfers in this case are conditional upon parents seeking and receiving certain services for their children. If children do not regularly attend school or get regular check-ups at health clinics, the cash transfer program will not pay out.

Cash transfers work to break down one barrier to families’ ability to access social services, namely the cost of the service. By addressing the ‘demand-side’ of issues related to alleviating poverty, cash transfer programs offer a complement to the ‘supply-side’ interventions which focus on increasing the availability of health, education, and nutrition services and programs.

The Save the Children report offers the following five recommendations:

1. Maternal and child benefits should be an integral part of child survival efforts in countries experiencing high rates of maternal and child mortality. Targets for expanding coverage should be set by the government in a way that makes sense for their national budget and administrative capacity.
2. Cash transfers should be implemented in combination with other policies and programmes.
3. Equity should be incorporated into the existing MDG framework so that the poorest and marginalized are not left behind. Reporting statistics on whether the poorest groups are receiving services intended for them should happen routinely.
4. The Partnership for Maternal, Newborn, and Child Health should include child and maternal benefits in the package of interventions it recommends for the Countdown to 2015 countries.
5. On the donor side, social protection programs – including cash transfers – should receive increased investment.

-Lisa Fleisher

The World Health Organization’s expert advisory panel on immunizations announced today that all children should receive a vaccine that can prevent a severe type of diarrhea and vomiting caused by the rotavirus.

Every year, 600,000 children die from severe diarrhea caused by rotavirus around the world.  Although most of these deaths occur in developing countries, rotavirus also afflicts children in the developed world.  In the United States, 55,000 children are hospitalized because of rotavirus infections every year. 

Research to determine whether the rotavirus vaccine is safe and effective in countries with high child mortality has proven successful: cases of severe diarrhea were reduced after administration of the vaccine.  Funded by the GAVI Alliance, and conducted by PATH, WHO, and GlaxoSmithKline, as well as many research institutions in South Africa and Malawi, this research “clears the way for vaccines that will protect children in the developing world from one of the most deadly diseases they face,” said Dr. Tachi Yamada, President of the Global Health Program at the Bill and Melinda Gates Foundation.

As one of the diseases that causes the greatest number of deaths and illness in the developing world but receives little attention and resources, the prevention and treatment of diarrheal diseases is a priority area for the Bill and Melinda Gates Foundation.  Their work involves funding research to determine the causes of diarrheal disease in developing countries, supporting the development of a vaccine, including the rotavirus vaccine, and efforts to develop medicines and other treatments for diarrheal disease.

Delivering the rotavirus vaccine with a package of other essential interventions including improving water and sanitation to children in need in Africa and Asia will be critical for reducing child mortality.

<em>-Lisa Fleisher</em>

Last week I attended a high-level taskforce meeting on climate change and innovative financing that was part of the 62nd World Health Assembly in Geneva, Switzerland. This precedes a big conference in Paris this week on innovative financing for health.

Dr Philippe Douste-Blazy, Special Advisor to the Secretary-General of the UN in charge of Innovative Financing, proposed the creation of the I-8 Group for the Millennium Development Goals, which brings together United Nations agencies and civil society representatives.

The 8 finance mechanisms are (be prepared for a mouthful):

1. The International Finance Facility for Immunization, supporting the Global Alliance for Vaccines and Immunizations
2. UNITAID
3. The Advance Market Commitments for vaccines
4. The ‘Debt 2 Health’ initiative of the Global Fund to Fight AIDS, Tuberculosis and Malaria
5. (PRODUCT) RED
6. The Responsible Social Investment initiative of the Agence Française de Développement
7. The use of revenues from the Carbon Market
8. The Millennium Foundation for Innovative Finance for Health

Last week’s meeting in Geneva was the first meeting of the group. And it was certainly an impressive set of people sat around the table, including Ban Ki-moon (Secretary-General of the UN), Dr Margaret Chan (Director-General of the World Health Organization) and Michel Sidibé (Executive Director of UNAIDS).
Due to the current economic crisis, Ban Ki-moon pointed out that traditional forms of financing for health are under threat as commodity prices are falling and overseas development assistance is under pressure. He made a plea for innovative ideas and for innovative financing to close the gap between what is available and what we need to meet the Millennium Development Goals. He also emphasized that there is a need for creativity around innovative financing and new opportunities but that it is also critically important to strengthen current mechanisms.

Margaret Chan noted that there were 19 men around the table and only one woman, herself. She talked about maternal mortality and made the stark point that in some countries, women are not allowed to give birth when in labour unless they have the permission of the man.

Michel Sidibe, followed on from Chan, and said that this meeting could not have been more timely. The AfDB recently projected that another 27 million people in Africa are at risk of ill health and poverty. Predictable and sustainable financing is key and this innovative financing scheme must help build a fairer globalization. He concluded by saying the following: “If we are going to reach the Millennium Development Goals, we must avoid duplication, resist competition, and put people at the centre”.

-Eloise Todd

The Mother’s Day Every Day Campaign (led by the White Ribbon Alliance and CARE), and the Huffington Post continue their “Mother’s Day Every Day for Healthier Families, Communities and Nations” blog series this week with a post by Amb. Mark Dybul, and a post by Sarah Brown.

Excerpts from Mark Dybul’s post, full piece here:

Some of us in the United States might be preparing to celebrate Mother’s Day with a backyard party and are worried about pesky mosquitoes after rains across the country. We should consider ourselves lucky to view mosquitoes as pests: in much of the world, mosquitoes cause malaria and malaria causes around 500 million illnesses and more than 1 million deaths each year.

Malaria is particularly devastating in Africa, where it kills a child every 30 seconds — several by the time you finish reading this posting. Pregnant women are particularly vulnerable because pregnancy reduces a woman’s immunity to malaria, making her more susceptible to infection and increasing the risk of illness, severe anemia and death. For the child, maternal malaria increases the risk of stillbirth, premature delivery and low birth weight. And 80 percent of malaria deaths are among children under 5. Malaria is a major cause of maternal and child death.

Excerpts from Sarah Brown’s post, full piece here:

I’m starting to see more and more discussion on the blogs and in women’s magazines about third wave feminism. It’s like those of us lucky enough to benefit from our mother’s efforts to urge and discover greater freedoms for women are suddenly all thinking ’so now what?’

For me, the discussions of new feminism give us a chance to talk about one of the great insights of the old sort: that women without economic power in the end tend to be denied social, political and personal power too. So if we seriously want our century to be a women’s one, we need to think about what injustices remain for women in the developing world.

I listened recently to the group of African First Ladies gathered together for a health summit in the US and watched them work out how to build their programs and figure out how to put maternal health at the heart of what they do. They recognized readily that this is the keystone to addressing everything else. At some point we must change how we measure our existing work – our programs for international development, for education for all, for combating HIV/AIDS, malaria and polio, for economic empowerment and cultural change. We need to know how well we are doing on maternal mortality, or we won’t know how well we are doing in bringing real justice.

-Margaret McDonnell

The Mother’s Day Every Day Campaign (led by the White Ribbon Alliance and CARE), and the Huffington Post continue their “Mother’s Day Every Day for Healthier Families, Communities and Nations” blog series this week with this post by Representative Lois Capps:

Excerpts below, full piece here

Each May, we celebrate and honor mothers. The treasure of motherhood is something that people of every political philosophy and walk of life can agree on. But despite this veneration of motherhood, giving birth can still be dangerous, especially in places where it is difficult to access healthcare.

Every minute of every day, a woman somewhere in the world dies as a result of pregnancy or childbirth–amounting to more than half a million fatalities each year. In developing nations, a woman’s lifetime risk of dying from reproductive problems is as high as one in seven, and problems with pregnancy and childbirth are the leading cause of the disease burden among women.

But the problem is far from isolated to the developing world. While the average risk of a woman dying in childbirth is 1 in 8000 for industrialized countries, the risk in the United States is much higher: 1 in 4800. In fact, the U.S. ranks 41st in the world in terms of maternal mortality.

-Margaret McDonnell, US NGO Partnerships & Faith Relations Team