- 11/08/2016 International Youth Day: Helping Girls to Choose their Childhood over Wifehood or Motherhood
- 08/08/2016 What happens to community projects when external funding ends? Considering the sustainability of participatory women’s groups in rural Nepal
- 2/8/2016 It's World Breastfeeding Week!
- 01/07/2016 Women and Children First launches a new strategy
- 10/06/2016 Malaria Epidemic in Northern Uganda
- 16/05/2016 Women Deliver 2016
At 17 years old, Nobel Peace Prize winner Malala Yousafzai asserted, “We cannot all succeed when half of us are held back. We call upon our sisters around the world to be brave – to embrace the strength within themselves and realize their full potential.”
On International Youth Day, Women and Children First wants to do just that: celebrate both the boys and the girls with just a bit more emphasis on the girls. Grace Kyallo talks about how Women and Children First's work helps young women and girls avoid early pregnancy, stay healthy and get an education which will enable them to play their part in achieving sustainable development.
The theme of the 2016 International Youth Day is “The Road to 2030: Eradicating Poverty and Achieving Sustainable Consumption and Production”. The focus is on the leading role of young people in ensuring poverty eradication and achieving sustainable development through sustainable consumption and production.
There are over 62 million girls around the world who are not in school. A large portion of those girls are not in school because of early marriage and pregnancy. However, imagine how many girls of the 62 million would preserve their youth if they were educated. How far would they dream if they knew they had the opportunity? How hard would they work if they did not have the responsibility of being a wife in their teenage years? How many girls would become students instead of mothers if provided with reproductive health information? Whatever the answer may be, we can be sure that it is substantially less than 62 million girls.
At Women and Children First (WCF), we not only recognize that knowledge is a tool, but we also work to equip young women with the information they need to forge successful futures. Part of the Sustainable Development Goals (SDGs) is to empower all women and girls. Women and Children First aims to accomplish this through education. We can prevent early marriage and pregnancy by providing reproductive health information which will allow girls to focus on their education and dreams.
Worldwide, 12% of women between the ages of 15-49 who are married or in a marriage-like relationship, who want to avoid a pregnancy do not have access to or are not using an effective method of contraception. The unwanted pregnancies are disproportionate among young, unmarried girls who lack access to contraception. At the age of 15 years old, a girl should be able to choose a lifestyle that is not limited to wifehood or motherhood.
In the WCF women’s groups, we inform women and girls about the best way to look after themselves before, during, and after pregnancy. Reproductive health topics within the groups range from contraceptives to HIV/AIDS awareness. The women and girls are encouraged to seek medical attention during and after pregnancy and for childbirth, and to also get checkups at clinics for sexually transmitted infections. We want to make sure that we provide women and girls with the reproductive health awareness they need to make informed decisions.
A large portion of the maternal deaths which happen every two minutes of every day, are actually girls. Girls under the age of 18 are more likely to suffer complications during pregnancy or childbirth. In order to address this issue, WCF’s work includes a focus on Adolescent Health. For example, all of the 197 women’s groups in Bangladesh have identified under-aged marriage as a key problem. To address this issue, the women have established a referral service so that they report child marriage or teenage pregnancy to a government official, therefore promoting gender equality.
Cultural barriers prevent girls and women who are pregnant for the first time from attending women’s groups. However, people are beginning to discredit these taboos and recognize the health benefits of young women attending women’s groups. For instance, in Bangladesh, adolescent girls are less likely to attend women’s groups. Yet, from April 2015 to March 2016, of 22,010 girls from the age of 10-19, an astounding 24% of all girls attended the groups. WCF is delighted with this result, as it means these young women are getting sexual and reproductive health information and are more likely to get healthcare when they need it.
Through advocacy, health systems and women’s groups, WCF does its best to ensure that access to reproductive health education and services does not prevent 62 million girls from choosing an education first and crafting their futures.
On this International Youth Day and beyond let’s focus on keeping the youth young, especially the girls!
Annemijn Sondaal, who researched the sustainability of women's groups with Joanna Morrison at the UCL Institute of Global Health, tells us more about women's groups once they have been set up and left to their own devices.
“It’s not a drug, it’s not a vaccine, it’s not a device. It’s women, working together, solving problems, saving lives” (Richard Horton, editor-in-chief of the Lancet, May 2013). Participatory women’s groups all over the world have been enabling women to engage in dialogue, exchange their ideas and experiences and enable them to take action to improve their community’s health. The University College London Institute of Global Health and its partners, have shown that participatory women’s groups can, with participation of at least a third of pregnant women, cut maternal deaths by half and newborn deaths by over a third.
Women’s groups are run and attended by women (and sometimes men), identifying their own strategies to address maternal and child health problems, mobilising local resources to deliver the strategies and then reviewing their own work before deciding what to do next.
The outcomes of this type of participatory community capacity-building are likely to be sustainable when external funding ends, but the long-term effect of interventions or their sustainability are rarely investigated. This means that little is known about optimal times and methods to withdraw support, the capacities needed, and support mechanisms necessary for sustainability.
Mother and Infant Activities (MIRA), a Nepali NGO, established participatory women’s groups in rural Makwanpur, Nepal in 2001. Local woman were trained and paid to facilitate the groups and were supported by a MIRA supervisor. In 2008, MIRA enacted a handover strategy when the project ran to the end of its funding. Twelve to eighteen months passed with no intervention, and we were interest to know what had happened to the groups.
Had they continued meeting and organising activities?
If they were still meeting, how had they sustained their activities?
If they had stopped meeting, why?
Eighty per cent of the women’s groups were still ‘active’ (groups who formally conduct meetings, work on strategies and keep meeting minutes). Anecdotal evidence suggests that these groups are still active to this day.
Local importance: Women had experienced how the groups improved maternal and newborn survival. This motivated them to continue meeting and enable the next generation to learn about how to look after themselves and their baby.
Financial independence: Many groups had established maternal and child health funds. Being able to save, and have some financial independence, attracted women to the group and motivated them to continue meeting. One woman told us: “When we save, we don’t have to depend on our husbands. We don’t have to beg for money.” Many groups had increased their fund to support community activities unrelated to maternal and newborn health.
Leadership capacity: Active groups were led by a strong female community health volunteer or community leader. Or members themselves were confident in owning and leading the group. One group member said: “MIRA showed us the way. They showed us the right track, and we are now confident to walk that track. Because of this, the group is still running.”
Those groups who were not meeting, or meeting infrequently, felt that they had not been given enough time to reach the level of confidence and capacity necessary to continue activities and meetings. These groups told us they wanted more skill-based training: “If there would be [skill-based] training for the chairperson, treasurer, secretary on how to run the group, than we would have planned to do more.”
It is important to consider how interventions can continue after project support stops. In Makwanpur, the participatory nature of the group and being embedded in the community were not enough to sustain groups. They also needed leadership capacity, a unifying activity (such as the fund) and a strong belief in the value of their meeting to sustain.
Although maternal and child survival improved markedly during the Millennium Development Goal era (2000 – 2015), Millennium Development Goals 4 and 5 remain mostly unfulfilled and maternal, newborn and child mortality rates remain unacceptably high.
Of the more than 130 million pregnancies and births occurring each year, an estimated 303,000 result in the mother’s death, 2.6 million in stillbirth and another 2.7 million in a newborn death. Almost six million children die before the age of five and 70,000 adolescents die from pregnancy related causes. The majority of these fatalities occur in poor communities in developing countries and are largely avoidable.
Women and Children First is dedicated to addressing these issues. Established in 2001, the charity has an excellent 15-year track record of providing technical support and assistance to partners to deliver projects which have a proven impact on maternal and newborn health.
Women and Children First works primarily in poor rural communities in Africa and Asia to improve the health of women, children and adolescents.
Our priority is to work in settings where inequalities exist in reproductive, maternal, newborn, child and adolescent health. Our target groups are girls and women (aged 10 - 49 years), particularly those who are pregnant or new mothers, newborns, and children under five years of age.
We focus on enabling women, children and adolescents to survive and thrive:
- Survive – our work reduces maternal, newborn and under-five mortality and the prevalence of HIV, TB and malaria
- Thrive – our work seeks to reduce malnutrition, promoting universal access to sexual and reproductive health-care services and rights, good quality early childhood development for girls and boys and universal health coverage
- Transform – our work contributes to eradicating extreme poverty, eliminating harmful practices and discrimination and violence against women and girls and achieving universal and equitable access to safe and affordable drinking water and to adequate and equitable sanitation and hygiene.
We do this in three ways:
- We support the formation and facilitation of women’s groups using a participatory learning and action approach that empowers communities to take action to improve reproductive, maternal, newborn, child and adolescent health.
- We promote improvement in the quality and accessibility of reproductive, maternal, newborn, child and adolescent care provided in health facilities.
- We support our partners to advocate at local and national level to strengthen policies and provide adequate resources for reproductive, maternal, newborn child and adolescent health.
This work will contribute to achieving the UN’s Sustainable Development Goals 3 and 5.
Read our full strategy here.
You can help us put women and children first. Act now!
Grace Kyallo* tells us how Women’s Groups Use Breastfeeding to Save their Babies’ Lives
Not only does Women and Children celebrate World Breastfeeding Week, we celebrate the positive implications of breastfeeding for minimalizing infant mortality.
UNICEF and the World Health Organisation (WHO) agree “Breastfeeding is not only the cornerstone of a child’s healthy development; it is also the foundation of a country’s development.” With 1,180 active women’s groups in Bangladesh, Malawi, Ethiopia and Uganda and 48,000 members attending the groups, Women and Children First positions women to play a role in establishing that foundation - an important contribution to achieving the UN Sustainable Development Goals. Our maxim is, “Saving the lives of mothers and babies” and our women’s groups recognize that breastfeeding plays a vital role in ensuring their newborns get the best start in life.
Women’s Groups Prevent Infant Mortality
In their groups, new mothers learn successful breastfeeding practices. They learn to feed the baby breast milk within the first hour of birth and, more importantly, why this is crucial to ensuring the survival of their precious newborns. Armed with their new knowledge, women can address breastfeeding issues as they arise. For instance, if women find that their babies have diarrhoea or they themselves have breast infections, they know they should ask a health worker to help them get breastfeeding right.
The health workers also debunk cultural breastfeeding practices such as discarding colostrum which is fundamental to the growth and development of the child. According to WHO “Colostrum, the yellowish, sticky breast milk produced at the end of pregnancy, is recommended as the perfect food for the newborn” but some communities see it as dirty and instead may feed their babies contaminated water or cow’s milk, which can cause a host of dangerous problems for a newborn baby. Mothers in women’s groups become aware of harmful feeding practices and disseminate the information to their communities to deter other mothers from making similar mistakes. The women also support each other with the rewarding yet difficult task of motherhood. As a result, mothers learn the best methods to care for their children and ensure the longevity of their health, therefore reducing infant mortality rates.
Tipping the Mortality Scales
Breastfeeding is the most beneficial and cost effective tool for mother and baby. Economically, the practice is free and reliable long term because the mother will continue to produce breast milk as long as her baby keeps feeding. In high-HIV, low-income settings such as Malawi, 30 per cent of HIV positive breastfeeding mothers transmit the disease to their babies. While this number is exceedingly high, it is much lower than if mothers opt for mixed feeding. Giving the newborn both solid foods and milk may lead to other fatal illnesses like diarrhoea that have a much higher risk of infant death. Also, mixed feeding slows, and even stops the production of breast milk in mothers. This is detrimental in low-income households because they may not always be able to afford solid food but will not have sufficient breast milk to feed the baby. Therefore, breastfeeding is the best course of action to keep the most infants healthy.
From a health perspective, breastfeeding is imperative to provide a baby with immunity from a variety of diseases. When a baby is born, it is extremely susceptible to illnesses because of its weak, almost non-existent, immune system. Fortunately, breast milk activates the child’s immune system because of the abundance of white blood cells, protein, vitamins, antibodies, and antioxidants that occur naturally in breast milk. By boosting its immune system, breastfeeding acts as the primary vaccination for the baby.
Breastfeeding serves both the mother and her baby as it helps to prevent one from living without the other!
*Grace Kyallo is a Women and Children First intern.
Women and Children First’s Senior Programmes Manager has just returned from a trip to Northern Uganda. This is what Ruth had to say:
“This trip was an especially important one. The Acholi sub region, where we are working, has been affected by a serious malaria outbreak since 2015. This has affected about one million people within the Gulu district registering the highest number of malaria cases with 118,787 malaria patients. The emergency response is overwhelmed by the severity of the problem.”
“I saw this with my own eyes. Health centre waiting rooms are teeming with mums and children awaiting malaria testing and treatment and all of the women’s groups I visited, prioritised malaria as their number one problem facing their community at the moment.”
“Seen here in the photo are men & women working together in Bolipe village to identify maternal and newborn health problems. The main problem is malaria”
Women and Children First is working with Amref Health Africa in Uganda to run 150 women’s groups to improve maternal and child health in Gulu and Amuru districts in northern Uganda. The women’s groups are providing an essential forum for communities to raise awareness about malaria prevention as well as providing a channel for the community to raise their malaria concerns with health workers and decision makers.
This three-year project is funded by the Big Lottery Fund.
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