South Africa ramps up its response to HIV and AIDS

In a move that United Nations officials say is the biggest and fastest expansion of AIDS services ever attempted, South Africa is opening up a new front in its response to HIV. In the past month, some 500 hospitals and clinics have begun dispensing antiretroviral drugs, and the government has trained hundreds of nurses to prescribe the drugs, work that was formerly the domain of doctors, the New York Times reported yesterday. The plan is to train enough nurses so that all of South Africa’s 4,333 health clinics will be able to dispense antiretroviral medicines.

South Africa is home to an estimated 5.7 million HIV-positive people, the largest number in the world. More than half of South Africans living with HIV are women, and 20 percent of pregnant women accessing public health services in 2008 tested positive for HIV. South Africa also has a high rate of sexual and domestic violence toward women, which increases women’s vulnerability to HIV infection.

Since 1998, EngenderHealth has worked in South Africa to transform men’s attitudes and behaviors to reduce gender-based violence and HIV infection rates. We have also introduced innovative approaches for improving men’s access to HIV counseling and testing and care and treatment services. We applaud South Africa’s increased efforts to respond to HIV and the campaign that was kicked off on Sunday to test 15 million of the country’s 49 million citizens for the virus by next June. We also know from our experiences in places where doctors are scarce that properly trained nurses and midwives can offer high-quality health care.

Read more about EngenderHealth’s work to train nonphysicians to perform male circumcision in Kenya.

At the Huffington Post, More Commentary from Dr. Ana Langer on the Maternal Mortality News

Today at the Huffington Post: Dr. Ana Langer, EngenderHealth's president, explains the importance of the latest maternal mortality research published in the Lancet -- and how it inspires us to keep moving ahead.

For decades, the maternal health community has been stuck on the number 500,000 -- the estimated number of women dying from pregnancy and childbirth each year -- a stubborn figure that keeps us up at night, that horrifies us, that refuses to budge. That changed this week.

Read the full article.

At Salon.com, Dr. Ana Langer's Perspective on the Maternal Mortality Numbers

At Salon.com, EngenderHealth's president Dr. Ana Langer provided some perspective on the maternal mortality numbers in today's headlines, including why the U.S. is lagging.

Dr. Ana Langer, president of EngenderHealth, an international reproductive healthcare organization, said that better record keeping might account for some of the increase in the U.S. The window for classifying maternal mortality has been extended from 42 days after a woman gives birth to one year. Also, in recent years, U.S. death certificates began tracking whether or not a woman of reproductive age is pregnant at the time of death. As for global changes, Langer points to an increase in contraceptive use, women's education and the use of skilled medical providers during birth. However, she was quick to point out that it's somewhat deceptive to say that maternal mortality is declining worldwide. The reality is that it's "declining in some countries with large populations."

Read the full article.

Global Maternal Health Conference 2010

This summer the Maternal Health Task Force at EngenderHealth and the Public Health Foundation of India are hosting the Global Maternal Health Conference 2010 in New Delhi, August 30—September 1. The meeting is expected to bring together approximately 500 maternal health experts and advocates for an unprecedented global technical and programmatic meeting focused exclusively on maternal health.

The Global Maternal Health Conference 2010 aims to build on gathering momentum around United Nations Millennium Development Goal #5, improving maternal health. The meeting is being designed to build consensus around what is needed to make real improvements in the health and lives of pregnant women.

A steering committee has been established and will be confirming the conference themes, and a call for abstracts will be issued soon. The organizers envision a robust youth presence, with the Young Champions of Maternal Health and Indian professionals recruited by the Public Health Foundation of India participating. A scholarship program is also planned to ensure broad participation from around the world.

Stay tuned to this space and the Maternal Health Task Force website for upcoming details.

Men As Partners Video profiles by UNiTE to End Violence

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A digital story from EngenderHealth’s Men As Partners program in South Africa is the featured video of the week on the Say NO—UNiTE to End Violence against Women YouTube channel. In this video, a young woman from South Africa tells of the abuse she suffered by the men in her life, the trauma she endured, and the healing she has been through as a gender activist. Learn about Thoko's story, share comments, and view other empowering videos at http://www.youtube.com/SayNoToViolence.

Transforming Women's Lives in Niger

With one of the highest rates of maternal death in the world, a woman in Niger has a one in seven chance of dying in childbirth or pregnancy during her lifetime.

By age 16, more than half of girls in Niger are married, and many have already borne children. The overwhelming majority of these births are at home—not at health facilities. Nationwide, barely one-third of births are assisted by trained health professionals.

This International Women’s Day, we celebrate individuals in Niger who are helping women fight these odds and transforming lives. This photo essay profiles nurse-midwives who participated in a recent training by EngenderHealth’s Fistula Care Project, which is supported by the U.S. Agency for International Development (USAID), as well as young Nigerien women who are benefiting from fistula repair surgery and better maternal health services. With EngenderHealth’s—and your—help, women and girls here can have a better tomorrow.

Fourth Africa Conference on Sexual Health and Rights

Teshome Woldemedhin is Youth and Gender Advisor for EngenderHealth in Ethiopia. Here, he shares his perspective on the Fourth Africa Conference on Sexual Health and Rights, which has been held in Addis Ababa, Ethiopia, this week.

The room was abuzz after Ethiopia's president, Girma Woldegiorgis, made the opening remarks at the Fourth Africa Conference on Sexual Health and Rights, getting things off to a promising start. The president called for increased access to sexual and reproductive health care for the poorest and most vulnerable, signaling the kind of political will that we need more of from our leaders. All too often, as Dr. Kebede Kassa of the Social Affairs Department of the Africa Union Commission later noted, "Political will is a scarce commodity."

Approximately 1,000 people are attending the conference from across Africa and elsewhere. I'm glad to see ministers of health from several countries in attendance, as well as high-ranking officers from the International Planned Parenthood Federation, World Health Organization, Joint United Nations Programme on HIV and AIDS, and other organizations.

In my opinion, some of the most valued participants are the youth EngenderHealth sponsored to attend--six young women and six young men ages 18-24, from our university project. This initiative works with universities and youth clubs and focuses on improving the sexual and reproductive health of youth by raising awareness, improving services at health clinics, and reducing gender-based violence. These 12 young people, who were also involved in planning the conference, can personally testify to the critical issues that African youth face.

I moderated a panel session on emerging issues in the area of youth's sexual and reproductive health. Some of the key issues raised included the vulnerability of young girls and the need to get young people more involved in advocating for better sexual and reproductive health services.

One of the most interesting sessions I attended was on "South-to-South" exchange: the importance of developing countries' sharing experiences and lessons learned. I think this kind of learning and partnership is one of the key outcomes of these kinds of gatherings. Instead of working on parallel tracks, we can all learn from each other. Identifying those strategies that are the most effective, then transferring and expanding upon them, can lead to smarter HIV prevention that better meets the needs of those most vulnerable.

The open dialogue of this conference is inspiring and served as yet another humbling reminder of why EngenderHealth's work in all areas of reproductive health is so vital--in Ethiopia and beyond.

Fistula in the Congo: A Response to Nick Kristof's Feb. 7 Column

It’s shocking what’s happening every day in the D.R. Congo. The sexual violence is shattering to both women and their communities. But people like Dr. Mukwege prove that we are not powerless and something can be done about it. It’s so important to support health facilities like Panzi Hospital and doctors like Denis Mukwege—who are beacons of light in a tremendously bleak environment.

EngenderHealth supports Panzi Hospital and another hospital in the Congo, HEAL Africa, through the Fistula Care project, funded by USAID. These two facilities are centers of excellence for fistula repair, drawing women from all over the country and region in need of treatment.

With USAID support, doctors and nurses at Panzi and HEAL Africa have been trained to strengthen maternal health and fistula repair services—dedicated, local professionals who will be there for the long haul. In addition, the project ensures that women have transportation to the hospital for treatment and helps them reintegrate back into their communities once they have had surgery.

Obstetric fistula also occurs when women can’t access timely emergency obstetric care—namely, cesarean sections—during long or obstructed labors. With better maternal health care, obstetric fistula cases (which still make up the majority of fistula cases in the Congo) could be averted altogether. To prevent such fistula cases in Congo and elsewhere, we work with doctors, nurses, and midwives to help them better manage complicated pregnancies and births. At the community level, the project helps rural health workers refer pregnant women with complications to hospitals that can provide comprehensive care.

Strengthening health systems by building on existing resources is the best way to both treat women with fistula and prevent new obstetric fistulas cases. And a holistic approach that improves fistula prevention—by improving maternal health care and reducing sexual violence—is crucial. In terms of providing surgical repair, it’s important to keep in mind that the vast majority of fistula surgeons live and work in the developing world. Seeing fistula cases on a daily basis, local health providers should be supported to treat and prevent fistula. It makes sense to enhance the capacity of in-country health care professionals like Dr. Mukwege who can make lasting changes, both in their country’s health system and in the lives of women and their families.


Bethany Cole
Senior Program Associate
EngenderHealth

(This post appeared February 11 as a comment in response to Nick Kristof's column in the New York Times.)

Dr. Ana Langer: One of the "21 Leaders for the 21st Century"

Please join all of us at EngenderHealth in congratulating Dr. Ana Langer, our president, for her recognition as one of the "21 Leaders for the 21st Century" by Women's eNews, an independent online news service. Every year, Women’s eNews selects and honors 21 outstanding people who have improved the lives of women and girls worldwide. This year, Dr. Langer was chosen for her leadership and dedication to improving the health of women and families in some of the world’s poorest communities. Ana’s profile is featured today under “Seven Who Rewrite the Rules,” which you can read here. Other honorees this year include: Kathy Cloninger (CEO of Girl Scouts), Tonya Lewis Lee (author and television producer), and Patricia Gruber (Peter & Patricia Gruber Foundation).

Fistula in Nigeria

Dr. Ana Langer and Brenda Drake, Chair of EngenderHealth’s Board of Directors, recently travelled to Nigeria, where the organization leads efforts to treat and prevent fistula. This Day, a leading Nigerian newspaper, covered Dr. Langer’s visit and the progress made in restoring the lives of women suffering from the condition. Check out the article.