South-South Cooperation in Maternal Health and HIV/AIDS

“The Tunisia – France – Niger: The Kollo Project for safe motherhood and reproductive health project” was presented by Mr. Fethi Ben Messaoud, PCC for Tunisia and Senetaire General, Office National de la Famille et de la Population at the September 2008 PPD Partner Country Coordinators' Meeting for the Africa Region.

South-South Approaches to Innovative Health Solutions
MediaGlobal: Voice of the Global South
By Lucy-Claire Saunders

22 December 2008 [MEDIAGLOBAL]: At the United Nations Development Programme (UNDP) Special Unit for South-South Cooperation’s first ever Global South-South Development (GSSD) Expo, experts presented four successful projects on HIV prevention and maternal health that exemplify South-South cooperation.

Among the four projects, Campaign to End Fistula was recognized as a model for championing collaboration between countries in the Global South, receiving an award of excellence from the United Nations Development Programme.

“Fistula requires our attention because it is a condition that takes away the dignity and the self-esteem of those who are affected by it,” Bunmi Makinwa, the Africa regional director for the campaign said. “It leaves women incontinent, ashamed and isolated from their communities. Fistula is a stark example of our failure in the public health system in poor countries.”

Fistula is a condition where a woman cannot control the flow of her urine and/or feces due to an injury brought about by prolonged labor. The Campaign to End Fistula, which aims to makes the debilitating condition as rare in developing countries as it is in the industrial world by 2015, is active in more than 45 countries in Africa, Asia and the Arab world.

“We are casting the net wider to incorporate more countries,” Makinwa said. “Recent training sessions in Mali highlight country-level efforts to develop the capacity of fistula service providers though South-South cooperation.”

For example, in Liberia’s surgical wards, they use specialized nurses to assist the surgeon during the operation. This is a service that does not exists in Mali so the program had a Liberian specialist train counterparts in Mali so that hospitals can introduce the new technique in the way they do business.

Three other projects exemplifying South-South cooperations in the health sector were also featured at the afternoon session. Dorcus Phiri, coordinator of the Teacher Capacity Building Project, gave an update on a program that uses live television broadcasts to reach out to teachers and students about HIV/AIDS in Botswana. Using a Brazilian model, the daily television program empowers teachers to break down the silence associated with HIV and AIDS by facilitating an open dialogue in a classroom setting.

“The program increased levels of conversation between teachers, pupils and parents on sexual reproductions health,” Phiri told MediaGlobal. “If we empower teachers with the skills, knowledge and the relevant attitudes for addressing HIV, then they would be better placed to deal with HIV issues in the classroom.”

Named, “Live Talk Back,” the program features a different panel every day who talk about HIV/AIDS and other reproductive health issues. Teachers, students and parents across the country are invited to participate in a live discussion using phone-ins, Short Message Services and e-mails.

Speaking about another project across the world that also deals with AIDS, Mariangela Simao, director of the National STD/AIDS Programme in Brazil, described a multi-country program that address HIV prevention throughout Latin America.

“For us in Brazil, the words of the famous archbishop, Dom Helder Camara, summarize how we think of South-South cooperation: ‘No one is so poor that he has nothing to offer. No one is so rich that he never needs help,’” she said.

The program, which is called, “Lacos –Sul-Sul,” works with partnering countries to ensure universal access to prevention treatment, HIV prevention with adolescents and children, generate demand for services and mobilize participation of those who use the service.

The results have been encouraging, said Simao. In two of the more remote regions in Nicaragua, where LSS support has been provided, HIV testing for pregnant women has increased from 20 per cent to 42 per cent and from 5.3 per cent to 24 per cent. On a side note, Simao mentioned that in regions where LSS is not active, this rate has actually dropped form 3.4 per cent to two per cent.

As well as addressing AIDS, the South-South cooperation projects also addressed maternal and child health. Niger, for example, has one of the lowest life expectancies in the world. The infantile mortality rate is 247 for 1,000 live births while the maternal mortality rate is about 700 for 100,000 live births.

Source: MediaGlobal: Voice of the Global South at http://www.mediaglobal.org/article/2008-12-23/south-south-approaches-to-innovative-health-solutions

Opinion Article: Population legislation vital for development

Population legislation vital for development

Publication date: Monday, 24th November, 2008

The New Vision (Uganda)

By Jotham Musinguzi

The year 2009 marks the 15th anniversary of the International Conference on Population and Development (ICPD). While very few people know the acronym, much less the goals and outcomes of this United Nations conference held in Cairo, Egypt in 1994, most people, particularly those in developing countries, have benefitted from the agreement of 179 countries (including Uganda) to the ICPD programme of action.

The ICPD programme of action has been an essential scale for countries’ population legislation and policy and has proved critical to the global improvement of sexual and reproductive health and rights and gender equality.

The population conference was groundbreaking in its introduction of a new human rights-based approach to population and development — the links between women’s status, reproductive health, environmental destruction, poverty, and social and economic development were first recognised by the global community at the ICPD. The principal goal of the ICPD — universal access to reproductive health services by 2015 — is reinforced in the Maputo Plan of Action, which agreed that poor sexual and reproductive health is a leading killer in Africa. The Maputo Plan was later ratified by African heads of state.

In Uganda, infant mortality fell from 122 deaths per 1,000 live births in 1989 to the current rate of 76 deaths per 1,000 live births. In 1995, the use of modern contraceptive methods among married women in Uganda was 7.8%, this has now increased to 17.9%. And due to the strong partnership between the Government, civil society and international organisations, more people have access to reproductive health information and services to help them fulfill their decisions on the number and spacing of their children and to protect themselves from sexually transmitted infections such as HIV/AIDS.

We should congratulate ourselves on these changes while recognising that Uganda, like most developing countries, requires much more progress on these sexual and reproductive health and rights indicators. Global progress has, in part, been hampered by underfunding and the effects of the HIV/AIDS epidemic.

Despite progress on many of the Millennium Development Goals (MDGs), less than a 10th of the distance to be covered to meet the MDG 5 of reducing maternal mortality globally has been met.

This MDG on maternal health is unlikely to be met, particularly in sub-Saharan Africa, without concerted efforts. A woman’s lifetime risk of dying from pregnancy or childbirth in sub-Saharan Africa is one in 16 while the risk in developed countries is only about one in 3,800. Maternal health is, therefore, an issue of great concern.

In Uganda alone, approximately 6,000 women die every year due to pregnancy complications. Women bleed to death, they do not have access to antibiotics to prevent simple infections; they often do not have the option of a caesarean section when it is necessary. It is a tragedy that women continue to die when maternal deaths and injuries are preventable when women have access to prenatal care, skilled attendance at births, and emergency obstetric care.

This means that Africans, must not only acknowledge our accomplishments in reproductive health, but we must take responsibility and work to address areas of greatest need. We can do this by sharing our experiences and good practices through South-South cooperation and learning from the successes of our brothers and sisters in other developing countries.

We need to look at example from countries like Malaysia, Thailand, South Africa and Sri Lanka, who have successfully lowered their rates of maternal ill-health through sustained financial and political commitment. Sri Lanka’s long-term commitment to safe motherhood services has, over four decades, decreased maternal mortality more than twenty-fold, from 486 maternal deaths per 100,000 livebirths to 24 per 100,000.

This shows that with effort and resources, large-scale improvements in public health are achievable, a lesson that we need to take seriously. South-South collaboration is a workable model for developing countries to partner and learn from each other as we all strive towards the attainment of the common ICPD goals and MDGs.

Reproductive health and rights play an essential role in the development of our countries. Yet, these critical development issues have not received the importance and priority they deserve, despite their centrality to poverty eradication.

Enhancing individual reproductive health and rights enables governments to achieve their population goals—such as preventing unplanned pregnancies and slowing population growth—and provides the necessary conditions for economic and social development. Improving the overall well-being of populations also improves the development prospects of our countries.

As representatives from 25 developing countries gather this week in Kampala at the International Forum on “ICPD @ 15: Progress and Prospects,” hosted by Partners in Population and Development, to review progress and agree to an agenda for how to move the ICPD programme of action forward.

As we come to the 15th anniversary of the conference in 2009, we must remain focused on the most vulnerable and overlooked populations and issues to ensure that a just, equitable, and sustainable development is the one we bring about. Ensuring sexual and reproductive health and rights is not only a moral imperative, it is economically sound. Economic and social development can only happen with a healthy and educated population.

We need donors and our governments to allocate sufficient resources, financial and otherwise, to support sexual and reproductive health and rights to fight poverty in our countries.

We must activate civil society to hold donors and governments accountable for the promises they have made. We must remain committed and vigilant, and demand that policies are in place and funds are allocated and expended in line with the commitments our leaders have made.

We must not relent on these efforts until women and their families in developing countries no longer fear marriage and pregnancy because of the high likelihood of death, illness and disability for themselves and their children.

We want to watch our sisters, wives and daughters experience the birth of their children as sources of joy, not as the cause of suffering and untimely death.

The writer is the Regional Director, Partners in Population and Development Africa Regional Office

This article can be found on-line at: http://www.newvision.co.ug/D/8/459/661115

News Article Prioritize maternal healthcare, First Lady tells policy makers

Prioritise maternal healthcare, First Lady tells policy makers

Publication date: Monday, 24th November, 2008

The New Vision (Uganda)

By Anthony Bugembe

LEADERS and policy makers from developing countries should address the high maternal and infant mortality rates.

This, according to the First Lady, Janet Museveni, will help to achieve sustainable development as the causes of the mortality are largely preventable.

“We cannot just sit back and watch as our women continue to die during pregnancy and child birth,” said the First Lady.

Mrs. Museveni was yesterday opening an international forum on population and development at the Imperial Royale Hotel that attracted political leaders and experts from 24 developing countries.

The health minister, Dr. Stephen Mallinga, decried Uganda’s poor progress on most health and social indicators.

“We still have a low contraceptive prevalence rate at 24%, low supervised deliveries at only 39%, high infant and maternal mortality at 76 and 435 respectively.”

“Although we have considerably reduced HIV prevalence to 6.4%, HIV/AIDS remains an epidemic in our country,” he said.

Mrs. Museveni said that Ugandan women continue to face risks during pregnancy and child birth.

“Uganda loses 6,000 women per year during pregnancy and child birth. These poor and powerless women continue to die, year in year out, most of them in remote villages.”

“For every woman who dies in pregnancy and child birth, six others survive but with chronic debilitating injuries and ill-health,” she said.

Mallinga noted: “As countries of the south, we need to realise that we have somewhat similar backgrounds. We should act in concert to promote a common health agenda.”

The theme for the conference is, ‘ICPD@15: Progress and prospects’. It is reviewing the progress of the International Conference on Population and Development (ICPD) held in 1994 in Cairo, Egypt.

“While we need to find new champions for family planning and promote greater resource mobilisation for reproductive health programmes, we need perhaps more importantly to re-inforce political commiments and promote good governance,” said Harry Jooseery, executive director, Partners in Population and Development (PPD).

Besides Reproductive health, the conference will address new concerns like food crisis and human security, climate change and environmental degradation and review the south-to-south cooperation as a modality of change.

Jotham Musinguzi, the PPD chief for Africa, said governments pledged at the 2000 Abuja declarationto commit 15% of national budgets towards health.

This article can be found on-line at: http://www.newvision.co.ug/D/8/13/661183