WHO Bulletin features Youth Editorial on the Global Strategy

The May 2016 issue of the Bulletin of the World Health Organization was published today.  The Volume 94, Number 5, May 309 – 404 journal has a special theme devoted to  the health of women, adolescents and children, focused on the implementation of the Global Strategy (2016 – 2030).

South African social justice writer and Girls Globe blogger, Zanele Mabaso’s article is featured amongst the high-level editorial publications, which ascribes the inclusion of adolescent outcomes in the global strategy to young people’s participation titled “Young people’s contribution to the Global Strategy for women’s, children’s and adolescents’ health (2016 – 2030)”   with contributions from co-authors Temitayo Erogbogbo and Kadidiatou Toure.

The issue additionally features young medical doctor from Benin, Dr Joannie Bewa sharing how campaigns for sex education and free contraception are changing reproductive health prospects for young people in Benin.

The Youth Editorial on Young people’s contribution on the Global Strategy for women’s, children’s and adolescents’ health (2016 – 2030) can be found here.

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Women’s Groups: Scaling Up to Save More Mothers’ and Babies Lives

Post Written By: Esther Sharma, Board Member for Women and Children First UK

As an expectant mum, with an excited toddler eagerly awaiting the arrival of his new baby, I am more mindful than ever before of the fortunate position I am in, living in the UK with access to great healthcare and lots of support. However, as many of us are acutely aware, with the MDG’s well and truly behind us now, there is still a huge amount of work to be done to ensure that this is the experience of all women and their babies across the world.

How many women have the choice about when to start having children, how many children to have and how far apart to space them? Or access to antenatal care and a skilled birth attendant to ensure a safe birth? And what about healthcare facilities for those requiring medical assistance? And vital support in the early days of motherhood?

Since 2002, Women and Children First has been working in some of the poorest countries of the world to empower women, using Women’s Groups – a powerful, low cost, participatory community mobilization approach. Rather than being a ‘top down’ approach, Women’s Groups seek to empower women to find long lasting approaches to maternal and newborn health issues. The women identify local strategies to address these problems, take action on the local strategies and evaluate their impact. Throughout the life cycle of the groups, based on their interests, women prioritize and discuss different topics on infant and maternal health. In order to capture the interest of the group and communicate effectively, storytelling, role plays, the use of picture cards and song and dance are often used.

WC First-2Such is the effectiveness of this approach, (studies of seven communities show that you can cut deaths among newborns by one third using this low cost method), it has been formally recognized by the World Health Organization as being an important component in designing global maternal and child health programmes.

Women and Children First are scaling up this vital approach by providing advice and training to other organisations across the globe (including those in Guatemala, El Salvador, Nicaragua, Malawi, Ethiopia, Uganda, Sierra Leone, Honduras and Myanmar), passing on the deep knowledge and expertise that they have gained about Women’s Groups over the years to ensure that more women than ever before have the opportunity to shape the future of maternal and newborn health in their communities.

Mikey Rosato, Director of Programmes and Technical Assistance, says, “It’s a privilege to be able to pass on Women and Children First’s expertise in delivering Women’s Groups. Our aim is to save as many mothers and babies lives as possible and what better way to do this than by sharing an approach that is proven to work. It is so exciting to see the enthusiasm from our partners in the field who will be on the frontline in saving lives and helping us to reach the goal of an equitable world where all women and children have good health, no matter where they live.”

This training has been very well received. Mikey has recently returned from the World Health Organization where he shared expertise in how to run Women’s Groups, which he says, “This was an important step towards our goal of good health for all women, adolescents and children. With the support of the trainees from WHO, UNAIDS and World Vision we can now work in partnership to bring the women’s group approach to more communities where the greatest inequalities exist in health and mortality.”

Women’s Groups are by very nature designed to replicate themselves across communities to reach more and more women. Now that Women and Children First are providing training to other organizations, Women’s Groups will not only spread across communities, but across the world, bringing about much needed change to maternal and newborn health. To donate to these initiatives please visit  www.womenandchildrenfirst.org.uk.

Chewed Rice, not Exclusive Breastfeeding in Laos

In villages in southern Laos, breastfeeding mothers are as ubiquitous as thatched roofs and playing children. In my time among villagers, I have never seen a breastfeeding mother cover up or go inside to continue feeding. Breastfeeding stigma seems non-existent. On front stoops and in gathering places, babies get their fill, comfortably ensconced in slings or resting on laps.

This freedom to feed however, isn’t reflected in Lao’s exclusive breastfeeding rates: just 39% of babies benefit from early initiation of breastfeeding and only 40% are exclusively breastfed until 6 months.

With child mortality rates in Laos among the highest in the region – nearly 79 deaths per 1,000 children under 5 – the government has taken measures at improving child survival.  One such initiative is a joint Lao government-UNICEF program to promote exclusive breastfeeding.

In a 2012 presentation on the progress of this joint program, Dr.Khamseng Philavong from the Lao Ministry of Health tied breastfeeding to improving child survival:

“Evidence indicates breastfeeding as the most important preventive intervention with potentially the single largest impact on reducing child mortality.”

Given that breastfeeding is common practice and the government is promoting it why isn’t exclusive breastfeeding the norm in Laos?

One reason, according to the nurses we work with, is that there is a long tradition of feeding pre-chewed rice to babies as early as the first week of life.

Breastfeeding Mom, Tahoy District, Salavan, Laos
Breastfeeding Mom, Tahoy District, Salavan, Laos. Photo Credit: CleanBirth

A study by Kaufmann et al found that pre-chewed rice was given to 20-48% of Lao infants in the first week of life.  There is a belief that breast milk is not enough – that supplementation is needed.  While rice has long been the traditional addition to a baby’s diet, the marketing of breast milk substitutes is proving effective in urban areas.

The consequences of supplementation seem to be significant. According to another study, the practice of supplementing rice is tied to Laos’ high rate of stunting (low height for age as a result of chronic malnutrition) which stands at 44 %.  In Salavan Province where I work, stunting affects 54 % of children under 5, one of the highest rates in the country.

So what can be done to promote exclusive breastfeeding?  

My organization, CleanBirth.org which works to promote safe birth, trains Lao government nurses to promote the WHO’s breastfeeding strategy among their families. This includes:

  • Early initiation of breastfeeding within I hour of birth
  • Exclusive breastfeeding for first six months
  • Continued breastfeeding for two years or more
  • Safe, appropriate and adequate complementary foods beginning at six months.

The local nurses understand the efficacy of exclusive breastfeeding. They have told us that they believe that with education, families will eventually move away from supplementation.

This type of education is essential because when parents understand how to properly feed their children, children survive and thrive.

Featured Image: Lao government poster promoting breastfeeding at local clinic. Photo Credit: CleanBirth

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Efua Dorkenoo: The Woman Who Never Stopped

Efua Dorkenoo at TEDxUCLWomen, 6th December 2013. Photo: Upi Sandhu
Efua Dorkenoo at TEDxUCLWomen, 6th December 2013. Photo: Upi Sandhu

I remember the first time I heard about the legendary Efua Dorkenoo. It was 2007 and I was 9 years old, sitting in my back garden in Lagos, Nigeria, clutching my copy of her book “Cutting the Rose: Female Genital Mutilation, The Practice and its Prevention”. I was completely inspired by this brave woman who had chosen to write so poignantly about the practice of Female Genital Mutilation (FGM). At 9, I ran into the house and went into my bedroom, scrambling around for my black notebook. In my rather poor handwriting, I wrote one word ‘Mama’ and added her to the list of women who inspired me. And for years to come, I would continue to admire and be inspired by this woman who was incredibly beautiful – inside and out.

Efua Dorkenoo, OBE, known affectionately to many, as ‘Mama Efua’ was a shining light in the movement to end FGM, dedicating her life to the eradication of the practice. Often referred to as the mother of the end FGM campaign, she fought for decades and battled to ensure that FGM stopped being a minority issue that was ignored to an issue was recognized as a priority by governments and policy makers around the world. She co-founded the organization FORWARD (The Foundation for Women’s Health, Research and Development) in 1983, which became a leading organization in the fight against FGM. She ensured that FGM was put on the agenda for ministries of health while working at the World Health Organization (WHO) from 1995 to 2001 and she went on to become the Advocacy Director and subsequently Senior Advisor on FGM at Equality Now. She was awarded an OBE in recognition of her campaigning work against FGM.

Efua Dorkenoo’s tireless campaigning and work culminated in the launch of The Girl Generation on October 10. The Girl Generation, an African-led movement to end FGM in a generation was the lifelong dream and brain-child of Mama Efua. At the event, we celebrated the progress made towards ending FGM in a generation. And I know that we could never have reached that point without Mama Efua. Mama Efua was a woman who refused to be silent. She saw the devastating effects of FGM, she stood up and raised her voice to stop the suffering of her sisters worldwide and never gave up, no matter what came her way. She was a rare gem, a rare beauty. She did exactly what every human being should do – she stood up for what she believed in. FGM may not have ended in her generation, but Mama Efua has paved a path of gold, she has prepared the way and FGM will end in a generation, thanks to her.

Efua Dorkenoo was a giant. She was a visionary who strived to see the end of FGM. We stood on her shoulders and we will continue to stand on her shoulders to further her legacy. We will stand on her shoulders because when we do this, we will borrow her strength. It is her strength that will allow us to see the end to this practice. We owe it to her to end FGM in our generation.

I will remain eternally grateful to Mama Efua. Generations will remain eternally grateful to Mama Efua. It was her courage, her humility, her fearlessness and her passion that enables me to say that I am The Girl Generation, the generation of fearless girls, the generation of hope and change, the generation where FGM ends.

Mama Efua, you have changed the lives of millions of women and girls worldwide. You have showed us that it is possible to strive for equality and you have taught us the most important lesson: never, ever, give up.

Rest in perfect peace, Mama Efua. You will always be remembered.

It’s stopped raining now.

But the tap-tap sounds on my windowsill continue.

The raindrops continue to fill the puddles even though the rain has stopped.

It reminds of Mama Efua, the woman who never stopped.

And although she is no longer here to be our mother, our leader and our friend,

We will not stop.

Because she did not stop.