Gender Equality

Venez à la rencontre de Marguerite Diarra. Son but est de former davantage de sage-femmes et d'améliorer l'accès aux soins maternels au Mali.

cbales — Fri, 08 Mar 2024 13:00:21 +0000

Venez à la rencontre de Marguerite Diarra. Son but est de former davantage de sage-femmes et d'améliorer l'accès aux soins maternels au Mali. cbales March 08, 2024

March 08, 2024

À l'occasion de la Journée internationale de la femme, nous célébrons des femmes comme Marguerite qui nous inspirent à #InvestInWomen.

Par une matinée ensoleillée à l'école Vicenta Maria de Ségou au Mali, Marguerite Diarra démontre la gestion active de la troisième phase de l’accouchement en utilisant un Mama-U, un simulateur obstétrique/gynécologique représentant l'utérus d'une femme.

Marguerite forme des sage-femmes qualifiées prêtes à s'occuper des femmes au Mali, en particulier dans les communautés rurales. Elle a grandi à Beleko, dans la région de Dioila, et est devenue sage-femme en 2016. Aujourd'hui, elle est enseignante permanente et se spécialise dans les soins obstétriques.

Le Mali n'a pas assez de sages-femmes.

Le Mali, comme d'autres pays d'Afrique de l'Ouest francophone, ne dispose pas d'un nombre suffisant de sage-femmes qualifiées ou d'autres agents de santé. Il n'y a que 6,1 sage-femmes, infirmières et médecins pour 10 000 personnes, ce qui est bien inférieur au nombre recommandé, et la pénurie est encore plus grave dans les zones rurales. Cette situation entrave l'accès équitable des femmes aux services de santé, notamment aux soins maternels et à la planification familiale, et contribue aux taux élevés de mortalité maternelle.

Au Mali, plus de 500 femmes sur 100 000 meurent lors de l’accouchement. De plus, la formation initiale traditionnelle n’outille pas assez les agents de santé pour faire face aux conditions de travail réelles.

Le projet Classroom to Care (C2C) d'IntraHealth, financé par la firme pharmaceutique Takeda, aide 12 écoles privées de santé comme Vicenta Maria à adopter une approche de l'éducation basée sur les compétences.

L'approche par compétence est basée sur les besoins de la population.

Alors que la formation initiale classique consiste à élaborer des programmes par matière ou par objectif, les programmes de l’approche par compétence (APC) sont élaborés en fonction des besoins de la population et des compétences requises. Dans la formation classique, l'enseignant transmet les connaissances, tandis que l’APC est orienté sur la facilitation de l'apprentissage de l'élève.

C2C a formé 250 enseignants comme Marguerite au Mali, au Niger et au Sénégal sur cette approche.

Photo par Amadou Iam Diallo pour IntraHealth International.

"Ces formations m'ont vraiment aidée à comprendre mon rôle d'enseignante, à prendre conscience de mes lacunes et à appliquer de nouvelles compétences", explique-t-elle. "Auparavant, les enseignants faisaient tout, mais avec l’APC, nous avons appris à placer l'étudiant au premier plan de sa propre formation. C'est à l'étudiant de prendre les devants, et à l'enseignant de le guider et de l'orienter. Cela a changé notre façon de préparer et de dispenser les cours", explique Marguerite. Cette nouvelle approche a rendu les cours plus interactifs et plus bénéfiques pour les étudiants.

"Nous mettons l'accent sur la pratique, qui est très importante dans leur apprentissage pour devenir des agents de santé compétents."

Marguerite supervise également les étudiants dans les centres de santé communautaires, les centres de santé de référence et l'hôpital de Nianankoro Fomba. "Je suis chargée de positionner les étudiants et de suivre le développement de leurs compétences. De temps en temps, nous nous rendons sur le terrain, car nous mettons l'accent sur la pratique, qui est très importante dans leur apprentissage pour devenir des agents de santé compétents".

Le projet a constaté que de nombreuses écoles de santé manquaient d'équipements de première nécessité. Il a donc déjà fourni des modèles anatomiques et d'autres matériels didactiques pour créer des laboratoires de compétences dans les écoles.

"Le laboratoire de compétences va beaucoup nous aider", déclare Marguerite. "Nous avons déjà beaucoup d'équipements par rapport à d'autres écoles, mais il y a encore des lacunes. Par exemple, nous n'avons pas l'équipement nécessaire pour faire l'insertion de DU, le retrait ou encore l'examen d’autopalpation des seins. Nous n'avons pas non plus certains mannequins, et nous en avons besoin pour préparer les étudiants aux stages sur le terrain, afin qu'ils sachent ce qu'il faut faire lorsqu'ils prodiguent des soins aux patients".

D'ici la fin du projet de cinq ans, C2C vise à ce que 580 enseignants du Mali, du Niger et du Sénégal soient formés sur l’APC, que 9 720 étudiants bénéficient d'une formation de qualité et qu'un laboratoire de compétences soit installé dans chaque école.

Parallèlement, il se concentre également sur la promotion de l'équité, de la diversité, et de l'inclusion (EDI) afin d'augmenter le nombre de diplômés en soins infirmiers et de sage-femmes, en particulier les femmes issues de communautés marginalisées. C2C a effectué des analyses situationnelles de l'EDI et utilise les résultats pour élaborer des plans spécifiques aux écoles. Ces plans permettront d’appliquer les meilleures pratiques de l’EDI afin de rendre les 12 écoles partenaires plus inclusives pour les étudiantes, d'améliorer leur bien-être ainsi que leurs résultats scolaires.

By Amadou Iam Diallo

Technical advisor for communications

By Carol Bales

Strategic communications manager

Maternal, Newborn, & Child Health Health workforce development International Women's Day Gender Equality Midwives Nurses Mali

Is In The Media

Photo par Amadou Iam Diallo pour IntraHealth International.

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Meet Marguerite Diarra. She’s On a Mission to Train More Midwives and Increase Access to Maternal Care in Mali

cbales — Fri, 08 Mar 2024 11:47:15 +0000

Meet Marguerite Diarra. She’s On a Mission to Train More Midwives and Increase Access to Maternal Care in Mali cbales March 08, 2024

March 08, 2024

For International Women’s Day, we’re celebrating women like Marguerite who inspire us, and donors, to #InvestInWomen.

On a sunny morning at the Vicenta Maria School of Ségou in Mali, Marguerite Diarra demonstrates active management of the third stage of labor using a Mama-U, a training model representing a woman’s uterus after childbirth.

Marguerite is on a mission to produce more skilled midwives who are ready to care for women in Mali, particularly in rural communities. She grew up in Beleko, in the region of Dioila, and became a midwife in 2016. Now she’s a permanent teacher at the school, specializing in obstetrical care.

Mali doesn’t have nearly enough midwives.

Mali, like other countries in Francophone West Africa, doesn’t have nearly enough skilled midwives or other health workers. There are just 6.1 midwives, nurses, and doctors to serve 10,000 people, far below the recommended amount, and the shortage is even worse in rural areas. This hinders women’s equitable access to health services, including for maternal care and family planning, and contributes to high rates of maternal mortality.

More than 500 women die for every 100,000 live births in Mali. And, traditional preservice education has not prepared health workers for real-life work conditions.

IntraHealth’s Classroom to Care (C2C) project, funded by Takeda Pharmaceutical Company Limited, aids 12 private health schools like Vicenta Maria in adopting a Competency-Based Approach (CBA) to education.

The Competency-Based Approach to education is based on population needs.

Whereas classic preservice training involves developing programs by subject or objective, CBA programs are developed based on population needs and the needed competencies for job requirements. In classic training the teacher provides the knowledge, while CBA teaching is based on facilitating student learning.

C2C has trained 250 teachers like Marguerite across Mali, Niger, and Senegal on the CBA approach.

Photo by Amadou Iam Diallo for IntraHealth International.

“These trainings really helped me understand my role as a teacher, become aware of my shortcomings, and apply new skills,” she says. "Previously, teachers did everything, but with CBA, we learned to put the student at the forefront of their own education. It's up to students to take the lead, and the teacher to guide and direct them. This has changed our way of preparing and delivering lessons," Marguerite says. This new approach has made classes more interactive and beneficial for students.

"We emphasize practice, which is very important in their learning to become competent health workers."

Marguerite also supervises students in community health centers, reference health centers in each district, and Nianankoro Fomba Hospital. "I am responsible for positioning students and tracking their skills development. Occasionally we go on field visits, because we emphasize practice, which is very important in their learning to become competent health workers.”

The project found that many health schools were lacking the equipment they needed for students to practice and has already provided anatomical models and other teaching equipment for establishing skills labs at the schools.

“The skills lab will help us a lot,” says Marguerite. “We already have a lot of equipment compared to other schools, but there are still gaps. For example, we don’t have the equipment required to insert or remove an IUD, or for demonstrating to women how to conduct breast self-examinations. There are also mannequins that we don’t have, and we need them to prepare students for their field placement, so when they are providing direct care to patients, they know what to do.”

By the end of the five-year project, C2C aims to have 580 teachers across Mali, Niger, and Senegal trained on the CBA, 9,720 students benefiting from quality training, and a skills lab at each school.

Meanwhile the C2C is also focusing on promoting diversity, equity, and inclusion (DEI) to increase the number of nursing and midwifery graduates, particularly women from marginalized communities. C2C conducted DEI situational analyses, and is using the results to develop school-specific plans that apply DEI best practices. to make all 12 partner schools more inclusive for women students and boost well-being and academic performance.

By Amadou Iam Diallo

Technical advisor for communications

By Carol Bales

Strategic communications manager

Maternal, Newborn, & Child Health Health workforce development Private-Sector Approaches International Women's Day Gender Equality Midwives Nurses Mali Niger Senegal

Is In The Media

Photo by Amadou Iam Diallo for IntraHealth International.

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IntraHealth Reached 317,443 Health Workers in 2021, Extending Health Care to Millions

kseaton — Wed, 29 Jun 2022 15:11:35 +0000

IntraHealth Reached 317,443 Health Workers in 2021, Extending Health Care to Millions kseaton June 29, 2022 June 29, 2022 Chapel Hill, NC

During 2021, the second year of the COVID-19 pandemic, IntraHealth International reached 317,443 health workers in 42 countries, helping to make high-quality health care available to more people around the world. Our programs led to:

$33,399,555 in financial aid provided for student health workers through IntraHealth programs
2,524,424 COVID-19 vaccines distributed through IntraHealth programs
223,677 men provided with voluntary medical male circumcision to prevent HIV infection
2,264,216 messages sent to and from health workers via mHero, WhatsApp, or other digital health tools
898,190 individuals tested for HIV and received results
8,231,279 family planning users through IntraHealth programs
1,389,009 new users of contraception
504,185 children under 5 treated for malaria

Even before the pandemic, the World Health Organization estimated a shortfall of 18 million health workers by 2030. Now, 15 million more health workers are needed in low and lower-middle income countries alone to respond to the needs of the health system and achieve universal health coverage.

IntraHealth International reached 317,443 health workers in 42 countries.

“The difficulties many countries have faced in responding to COVID-19 and rapidly delivering vaccines, tests, treatment, and supportive care have shone a spotlight on vulnerabilities in health systems and workforces around the world,” says Polly Dunford, IntraHealth’s president and CEO. “But we know that by investing in and supporting health workers—including and especially community health workers, nurses, and midwives—we can make great strides in COVID-19 response and in achieving universal health coverage.”

In 2021, IntraHealth focused on expanding digital health tools, responding to global health security threats, and training and supporting local health organizations. We expanded our iHRIS software to 25 countries, who now use it to manage their health worker personnel records, trained 9,000+ health workers on COVID-19 response, and worked with 74 local organizations to help them prepare to receive funding from USAID and PEPFAR.

See more 2021 results in our full annual report.

IntraHealth believes everyone everywhere should have the health care they need to thrive. Our mission is to improve the performance of health workers and strengthen the systems in which they work.

Banner photo: Jeanne Uwimana is a gender-based violence officer at the Isange One Stop Center at the Nyanza District Hospital. Photo by Innocent Ishimwe for IntraHealth International.

Health Areas Family Planning & Reproductive Health HIV & AIDS Infectious Diseases Maternal, Newborn, & Child Health Mental Health Noncommunicable Diseases Nutrition Community Health Digital Health Education & Performance Health workforce development Gender Equality Global health security Health Workforce & Systems Health WorkersNamuwaya Nsabu weighs her 9 month old baby before receiving immunization services at Nakaloke Health Center III in Mbale, Uganda. Photo by Esther Ruth Mbabazi for IntraHealth International.

IntraHealth Stands for Reproductive Health and Rights

kseaton — Mon, 27 Jun 2022 18:35:42 +0000

IntraHealth Stands for Reproductive Health and Rights kseaton June 27, 2022

June 27, 2022

Everyone everywhere deserves access to the health services they need to thrive—including safe abortion.

The June 24, 2022 US Supreme Court ruling to overturn Roe v. Wade ends the constitutional right to abortion in the United States—a health service that both the United Nations and the World Health Organization have determined to be a human right and an essential part of high-quality health care.

We at IntraHealth International staunchly oppose this ruling. Our vision for over 40 years has been to expand access to health services and make them available to everyone everywhere—this decision from the US Supreme Court goes against everything we stand for.

We know that here in the US, this ruling will make safe abortion services almost—or, in many cases, completely—inaccessible for the pregnant people who need them. And the ruling will come down hardest on communities who have already faced discrimination and barriers to fundamental human rights. Already, around 47,000 people die globally from unsafe abortion and 5 million are hospitalized for serious complications such as bleeding or infection, according to the International Federation of Gynecology and Obstetrics.

We also know that the devastating effects will creep outward. Such a systemic assault on anyone who is or may become pregnant will hinder the progress of global health and gender equity initiatives around the world. This ruling could affect communities in every low- and middle-income country with whom we at IntraHealth partner.

This makes IntraHealth’s work even more urgent. We are determined to keep working.

And finally, we know that this ruling will not reduce the number of abortions in the US or around the world. The Guttmacher Institute has found that countries that restrict abortion access have the highest rates of unintended pregnancy, whereas rates are lowest in countries where abortion is broadly legal. “In countries that restrict abortion,” the institute reports, “the percentage of unintended pregnancies ending in abortion has increased during the past 30 years from 36% in 1990–1994 to 50% in 2015–2019.”

“Decades of research consistently show that abortion bans and restrictions don’t reduce unintended pregnancy or demand for abortion, and they certainly do not help people improve their health,” says Dr. Herminia Palacio, president and CEO of the Guttmacher Institute. “Rather, they impose significant hurdles to obtaining care, causing stress for people in need of abortion and leading some to experience forced pregnancy and all its troubling consequences.”

The way to reduce unintended pregnancy or demand for abortion is through comprehensive sexual education, access to contraception, access to sexual and reproductive health services, and—most importantly—through protecting human rights for everyone everywhere.

“I am heartbroken at this ruling, and at the continued erosion of human rights in our country,” says Polly Dunford, IntraHealth president and CEO. “It makes IntraHealth’s work even more urgent. We are determined to keep working to support health workers around the world and ensuring people everywhere have the human rights and health services they need to live happy, healthy lives.”

By The Editorial Team

IntraHealth International

Family Planning & Reproductive Health Gender Equality Health Workforce & Systems

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Health Workers in South Sudan Help Counter the Risks of Violence and HIV Infection for Female Sex Workers

kseaton — Wed, 01 Jun 2022 14:30:22 +0000

Health Workers in South Sudan Help Counter the Risks of Violence and HIV Infection for Female Sex Workers kseaton June 01, 2022

June 01, 2022

When Poni was attacked by one of her clients, program staff sprang into action.

Poni’s* job as a female sex worker in Juba, South Sudan, is often dangerous. Gender-based violence is common and Poni, along with over 4,000 other female sex workers in Juba, sometimes experiences life-threatening situations while working.

Because of ongoing conflict and insecurity, violence against women and girls in South Sudan is widespread. Sex workers are particularly at risk of violence due to the stigma that surrounds the profession. They also often face other risks, such as HIV infection. HIV prevalence among female sex workers in South Sudan is 11.8%, higher than the global rate of infection among women and girls.

Because of this,

access to health services is crucial for sex workers.

Recently, Poni was attacked by one of her clients. She had a fractured arm and knew she needed help, so she turned to a peer supervisor and crisis response focal person, Wasuk,* who connected her to the psychological and emotional support she needed.

Wasuk works for IntraHealth International’s Advanced HIV and AIDS Epidemic Control Activity, which helps mitigate gender-based violence and provides HIV prevention, care, and treatment services for female sex workers in Juba, Nimule, Yambio, Wau, Rumbek, and Bor.

The activity provides services for over 10,500 female sex workers.

He helped Poni speak to relevant authorities and referred her for medical attention at the Juba Teaching Hospital. He also accompanied her to a different hospital for follow-up, monitored the progress of her fractured arm, and advised Poni on how to deal with such clients in future.

The activity provides services for over 10,500 female sex workers. This includes HIV testing, condom promotion, lubricant distribution, health education, screening and treatment for sexually transmitted infections, counseling, linking clients to care and treatment, and family planning services.

I’m thankful IntraHealth has brought these HIV and gender-based violence services closer to us.

“I’m very grateful for IntraHealth’s enormous support to me and all the other female sex workers,” Poni says. “We encounter customers who pose threats to our lives and business. I’m thankful IntraHealth has brought these HIV and gender-based violence services closer to us.”

Poni, who is HIV-positive and has been on antiretroviral treatment since 2020, receives medication from an IntraHealth-supported facility in Juba and is responding well to treatment. She represents the 1,249 female sex workers who are now on antiretroviral treatment thanks to this activity. Activity staff work with peer leaders in their communities to integrate comprehensive HIV services by coordinating with health facilities at the project sites.

Living in a country where HIV and survivors of gender-based violence are often stigmatized, female sex workers like Poni now have these services delivered door-to-door.

“Just like me, other female sex workers won’t have to spend money on transportation to access HIV services at the facilities as the community HIV services, additional to condoms and lubricants are brought to our doorsteps,” Poni says. “The female and male condoms, when used correctly, will prevent us from contracting or spreading HIV.”

*Name changed to protect anonymity.

The Advanced HIV and AIDS Epidemic Control Activity is funded by the US Agency for International Development.

By Gladys Achan

Communications Officer

Advancing HIV & AIDS Epidemic Control Activity HIV & AIDS Gender Equality Safety and Conflict Health in Conflict Workplace Safety Health Workers South Sudan

A health worker counsels a client at a Hospital in South Sudan. Photo by Trevor Snapp for IntraHealth International.

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To Strengthen HIV Services, This Ethiopian Organization is Taking 4 Steps to Focus on Gender Equality

kseaton — Mon, 10 Jan 2022 15:26:11 +0000

To Strengthen HIV Services, This Ethiopian Organization is Taking 4 Steps to Focus on Gender Equality kseaton January 10, 2022

January 10, 2022

How IntraHealth’s Accelerating Support to Advanced Local Partners project partnered with Mekdim Ethiopia National Association to improve their systems.

Ethiopia more than halved its number of new HIV infections in the country over the past decade. How?

A big part of the answer lies in the local organizations that are leading Ethiopia's national HIV response. Now, with the help of IntraHealth International’s Accelerating Support to Advanced Local Partners (ASAP) project, one Ethiopian nonprofit is focusing on gender inequality as a way to get even stronger results.

Mekdim Ethiopia National Association (MENA), a national nonprofit based in Addis Ababa, Ethiopia, is working with the Ethiopian Ministry of Health to improve health services for the estimated 670,000 people living with HIV/AIDS in the country. They lead eight other organizations in implementing a three-year HIV prevention, care, and treatment project that works to ensure HIV/AIDS treatment for everyone.

Within a short period of time, capacity building efforts enabled us to be a gender-inclusive organization.

In partnership with ASAP—which provides training and technical support to local organizations and governments so they can serve as prime partners for USAID and US President’s Emergency Plan for AIDS Relief (PEPFAR) programming—

MENA has made big changes to advance gender equality in their work. "Within a short period of time, capacity building efforts enabled us to be a gender-inclusive organization,” says Menelik Negussu Retta, MENA’s deputy executive director and program director. And they’re using these approaches to not only to strengthen their organization, but to reach more women and girls with HIV care and prevention services than ever before. Here’s how:

1. New gender-focused positions

Early in 2021, MENA hired a gender specialist to lead the organization’s gender mainstreaming efforts. This is one way MENA is not only incorporating a gender perspective into its institutional culture (including its policies, strategies, programs, project activities, and administrative functions) but also working to achieve greater gender equality in its programmatic outcomes.

“This is the first time I’ve seen job descriptions revised to include gender mandates in line with their responsibilities,” says MENA’s new gender specialist. “It really got the staff’s attention. I found revising job descriptions to be an easy and systematic way to effectively implement the gender policy.”

The gender specialist, who was recently made a member of MENA’s executive leadership team, works with staff from across the organization—including 20 newly appointed gender focal persons who coordinate gender mainstreaming at MENA’s offices in Shashemene, Jimma, Adama, Bahir Dar, and Desse—to implement the organization’s new policies and practices on gender equality.

2. Human resources and finance policies that promote gender equality

MENA developed a new anti-sexual harassment and abuse code of conduct, which all its employees have signed. For the first time, information about who to contact if sexual harassment or abuse occurs has been posted around the office both in English and Amharic, making it easier for staff or beneficiaries to report incidents to the human resources team.

In finance, MENA included money in the budget to cover gender mainstreaming activities. “Prior to ASAP, MENA did not have a budget for gender mainstreaming,” Mr. Menelik says. “Now, we do.”

3. Sharing best practices

MENA works with eight other local health organizations to improve their gender mainstreaming policies and practices by using the ASAP gender trainings they participated in to deliver similar trainings to the other organizations.

Through ASAP’s network of HIV service nonprofits committed to advancing gender equality in their work, MENA collaborates with other organizations to share what has worked for them in gender mainstreaming. Previously, there were only limited coordinated efforts to share this kind of knowledge and expertise between local organizations.

4. Gender-inclusive programming

MENA’s new gender mainstreaming efforts have led to more equity-focused approaches in their programming.

For example, as part of MENA’s renewed focus on gender equality, the organization is now training over 20,000 adolescent girls in Addis Ababa in self-defense to prevent violence against women, a significant cause of HIV infections.

“Gender mainstreaming technical support has helped MENA be more conscious of our work’s contribution to gender equality,” Mr. Menelik says. “Management has decided, from now on, gender mainstreaming will be integrated into all our programs.”

Thanks to Mr. Menelik Negussu Retta and other program and MENA staff members for providing information for this post. Yitaktu Tibebu, Afework Balcha, Carolina Mejia, and Catherine Brokenshire-Scott contributed to this article.

ASAP is funded by the United States Agency for International Development (USAID). The project has partnered with 47 local organizations and six government entities across 13 Sub-Saharan African countries to strengthen their institutional capacity in areas such as gender, program management, monitoring and evaluation, financial management, human resources, and business development. In Ethiopia, IntraHealth has worked with 12 local organizations to prepare them to receive direct funding from USAID for fiscal years 2019 and 2020. Of these local organizations, five local prime organizations were transitioned from fixed amount award/contract to cooperative agreements in the 2021 fiscal year.

This publication is made possible by the support of the American people through the United States Agency for International Development’s (USAID) Office of HIV/AIDS and the President’s Emergency Plan for AIDS Relief (PEPFAR) under the terms of Contract No. AID-OAA-I-14-00031. The contents are the sole responsibility of IntraHealth International and do not necessarily reflect the views of USAID or the United States Government.

By Clarke Glavin

2021 IntraHealth-UNC Summer Fellow

Accelerating Support to Advanced Local Partners (ASAP) Leadership and Governance Gender Equality Health Workforce & Systems Management and Performance Ethiopia

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Analysis of Gender-Related Inequalities and Discrimination in the Health Sector in Senegal: Toward Effective Human Resources Management

kmelton — Fri, 07 Jan 2022 20:59:01 +0000

Analysis of Gender-Related Inequalities and Discrimination in the Health Sector in Senegal: Toward Effective Human Resources Management 2021 kmelton January 07, 2022

Read about Senegal’s first gender discrimination and inequality analysis, conducted in response to the gender audit findings, in collaboration with Senegal's Ministry of Health and Social Action and the USAID-funded Neema project led by IntraHealth International. This technical brief provides an overview of the study methodology, key results pertaining to attitudes, work conditions as well as violence and discrimination against women in the health sector, as well as recommendations.

Veuillez cliquer dans la liste déroulante pour le français.

English

Technical Briefs: Senegal's USAID/Neema Project

Tutorat: A Comprehensive Approach to Empowering Health Care Providers and Their Facilities in Senegal

Honing the Enhanced Peer Outreach Approach to Increase HIV Testing Yield Among Key Populations in Senegal

Countries Senegal

Projects Neema

Topics Health workforce development Gender Equality Health Workforce & Systems

By Babacar Gueye, Abdou Gueye, Constance Newman, Sujata Bijou, Melanie Joiner

I’m a Nurse in South Sudan and I Connect Sex Workers to HIV Care and Treatment

kseaton — Wed, 03 Nov 2021 18:23:12 +0000

I’m a Nurse in South Sudan and I Connect Sex Workers to HIV Care and Treatment kseaton November 03, 2021

November 08, 2021

Violence, stigma, and other challenges I see every day as I provide HIV care to people in my community.

Every day, I go out into communities and talk with sex workers and their clients. I tell them about HIV and encourage them to get tested. And when I identify someone who is HIV-positive, I enroll them in antiretroviral treatment (ART), the drug regimen that will help them stay healthy and keep their viral load down, so they are less likely to transmit the disease.

I provide and connect the women to other services, such as family planning, screening and treatment for sexually transmitted infections, and services that respond to gender-based violence, which unfortunately many female sex workers in South Sudan face.

As a woman providing HIV/AIDS services in South Sudan, I’m proud of my work.

Here the HIV infection rate for the general population is 2.3%, but for female sex workers, it is 16%.

To reach the country’s goal of ending the HIV epidemic by 2030, we must connect those who are at high risk of contracting and spreading the virus with the right services. This includes identifying people who are HIV-positive (especially those who do not know their status), providing them with life-saving antiretroviral therapy, and helping them stay on their treatment. These steps will reduce AIDS-related deaths and prevent further transmission of the virus.

But to do this, we must confront major challenges—and look to some proven solutions.

CHALLENGES

Stigma and discrimination

Stigma and discrimination are the main challenges female sex workers face in starting and remaining on treatment. They are also a reason for the high incidence of gender-based violence.

These women face stigma from the public and even from health workers, who often see them as spoiled and blame them for infecting others. This only increases the HIV infection rate in the country, and ultimately adds to the heavy workload for health workers. It leads female sex workers to hide, stop seeking treatment (12.1% of sex workers avoid care because of stigma or discrimination), or to self-transfer to another facility in search of friendlier services.

Health worker shortage, low pay, and low motivation

There is a shortage of health workers in the public sector in South Sudan. And the health workers who do still work in the sector are overworked, underpaid, and stressed. This creates low motivation to work. In the health field, we say practice makes work better, so if health workers lack the motivation to stay on top of their training, knowledge, and skills, the quality of work is compromised.

Low motivation among health workers also leads to high staff turnover in our public health facilities, as health workers often leave for better opportunities offered by nonprofits and other companies. When a health worker resigns from their post, it’s hard to quickly replace them, which can cause further staff shortages and interrupt HIV treatment for clients.

Gender-based violence

In my work to provide HIV services for female sex workers in areas where they cluster, I am often mistaken for a sex worker and male clients end up negotiating for sexual acts with me. This puts me at huge risk for gender-based violence.

Female sex workers face this danger every day. Almost half of the female sex workers we screened in 2021 as part of our community-based HIV services project—the USAID-funded Advancing HIV & AIDS Epidemic Control Activity—experienced a form of gender-based violence ranging from physical, emotional, and sexual to economical. Once we’ve identified this, we refer them to psychosocial support services and, if needed, we provide them with post-exposure prophylaxis.

COVID-19

The spread of COVID-19 has kept us from reaching female sex workers at times, which in turn has kept them from crucial services. Total lockdown and fear of exposure to COVID-19 hindered access to HIV treatment, as public transportation was not allowed to operate. We shared information with communities, made personal protective equipment (hand washing facilities, hand sanitizers, face masks, etc.) available at hotspots, and limited the number of clients to groups of 5-10 at a time for services to limit congestion per ministry guidelines.

SOLUTIONS

Community-based programs

IntraHealth’s Advancing HIV & AIDS Epidemic Control Activity is the only PEPFAR-supported project focused on providing community-based ART to female sex workers in South Sudan. This method is not only working to increase the number of HIV-positive people on treatment, but it is also improving retention of clients on care and increasing the effectiveness and efficiency of the country’s efforts toward HIV epidemic control.

To date, 1,238 HIV-positive female sex workers are on ART in Juba County.

The Advancing HIV & AIDS Epidemic Control Activity is training frontline health workers to provide services in their communities that are free of stigma and discrimination to everyone, regardless of who you are and what you do. Those who test positive for HIV are initiated on treatment at the community level and monitored for good treatment outcomes. This increases demand for and access to health care services.

A focus on health workers

Health workers need better benefits, management, and leadership. Without proper support, most of us cannot dedicate our time to health services.

Good supervision improves health worker skills and services and provides opportunities for feedback. I imagine with better supervision and management, more health workers will be retained and we will not have to constantly rebuild relationships in the community to keep people on ART and sustain HIV prevention. Good supervision can help eliminate our biases and keep us at our best while serving our communities.

As a woman providing HIV/AIDS services in South Sudan, I’m proud of my work. Female sex workers respect, trust, and gain confidence when working with women health workers. I, and other health workers AHEC has trained, listen to them. They feel comfortable sharing their social and sexual issues with us and that creates a bond—one that can lead to healthier futures.

The Advancing HIV & AIDS Epidemic Control Activity in South Sudan is funded by the US Agency for International Development.

By Joice Yari

Key population outreach nurse

Advancing HIV & AIDS Epidemic Control Activity HIV & AIDS Community Health 2021 Year of the Health and Care Worker Gender Equality Health Workers Community Health Workers South Sudan

A nurse draws blood to test for HIV and begins counseling a client at the Saint Bakhita Health Centre in Yei, South Sudan. Photo taken by Trevor Snapp for IntraHealth International.

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New Program to Train More Student Nurses in Francophone West Africa, Bring Care to More Communities

kseaton — Thu, 16 Sep 2021 17:05:58 +0000

New Program to Train More Student Nurses in Francophone West Africa, Bring Care to More Communities kseaton September 16, 2021 September 22, 2021 Chapel Hill, NC

Through the new Classroom to Care project, IntraHealth International is partnering with Takeda Pharmaceutical Company Limited and 12 private schools in Mali, Senegal, and Niger to sustainably increase the number of qualified, well-trained nurses who can serve rural communities in these countries—all of which face a critical shortage of health workers. Takeda announced this week that IntraHealth is one of the recipients of their 2021 Global CSR Program, which will fund this work.

IntraHealth and Takeda will work with four schools in each of the three countries over the course of five years, helping them partner effectively with the public sector, achieve the appropriate accreditations, enhance competency-based curricula, create effective learning approaches, and graduate students from underserved areas—all as part of our effort to ensure that everyone everywhere has the health care they need to thrive.

“We are thrilled to be partnering with Takeda to help solve the shortage of highly trained nurses in rural communities in Mali, Senegal, and Niger,” says Polly Dunford, president and CEO of IntraHealth. “This partnership will revolutionize the way health workers are trained at private nursing schools, improve health care in the communities that need it most, and draw more brilliant young students to the profession.”

IntraHealth has been working with health workers in West Africa for over four decades. In Mali, Niger, and Senegal, we’ve collaborated with government and civil society partners to help the health sector achieve national health workforce goals by strengthening health systems and the health workforce and increasing access to lifesaving maternal and child health, family planning and reproductive health, and nutrition services. Highlights include:

More health workers for rural Mali

In Mali, IntraHealth and the Ministry of Health developed a national training policy and strategy to help rural regions develop, manage, and retain their own health workers. For example, the Gao Nursing School, which IntraHealth has supported since it opened in 2001, is now responsible for graduating 89% of all the health workers in northern Mali.

“The school has added 1,681 midwives, nurses, and lab technicians to Mali’s health workforce,” says Cheick Touré, IntraHealth’s Mali country director. “It was such a successful program that USAID asked us to scale it up and we supported 10 more schools in other parts of the country.”

This new partnership with Takeda is an opportunity to scale up this successful approach in additional Sahel countries that are facing the same critical shortages of health workers in rural and underserved areas.

Integrated service delivery

As part of IntraHealth’s INSPiRE West Africa regional project, IntraHealth developed an integration model that includes health worker training curricula and job aids, data collection tools that reinforce integrated service delivery, and virtual and in-person mentoring and supervision.

After the model was introduced in Niger, immediate postpartum family planning increased by 96% in all INSPiRE-supported facilities in from 2018 to 2019.

Safe, home-based services during COVID-19

As part of The Challenge Initiative in Senegal, we’ve been training high-performing local health workers to coach community health workers and organize household visits, which help minimize large gatherings at health facilities during COVID-19. This also provides women who are unable or unwilling to visit a health center with family planning information, counseling, and infection-prevention guidance from a safe distance.

In collaboration with Takeda, IntraHealth will build on these experiences in the region to train more than 14,000 nursing students so they can provide high-quality health care to the clients in their communities and help schools continue to produce nursing graduates who can do so for generations to come.

IntraHealth will partner with Empower School of Health, a leading global digital learning and capacity-building organization, to develop an eLearning Management System and RMNCH learning modules to respond to project needs.

Mali Niger Senegal Education & Performance Gender Equality Health Workers Classroom to Care: Training to Expand Access to Maternal and Child Health

Online Harassment of Women Journalists Must End

kseaton — Fri, 06 Aug 2021 15:34:01 +0000

Online Harassment of Women Journalists Must End kseaton August 06, 2021

August 06, 2021

Why it matters for global health and what must be done to stop it.

When journalists began reporting on the high maternal mortality rates among Black mothers in the US, it brought greater public awareness and pushed public health practitioners and health workers to better address these inequities. It’s just one example of how journalism plays a critical role in society and in health care.

Since the beginning of the COVID-19 pandemic, we’ve relied on journalists for up-to-the-minute and clear information on how and where the virus is spreading, which vaccines are available, and where to go to get them.

Sadly, journalists—specifically women—are fighting a concurrent epidemic of their own: online violence and misogyny. And it affects COVID-19 and other health reporting by attempting to control, silence, and discredit our sources of information about the pandemic and other important global health information.

Women journalists in more than 120 countries have reported being attacked online at some point in many different forms , including:

Revenge pornography: The non-consensual creation, distribution, or threat to distribute sexual or nude media, including videos and photographs, that are often distributed by a malicious ex-partner.

Doxing: When one or several people seek out personal identifying information or private information about another person and then distribute it through mass media channels without their consent.

Deepfakes: Videos that switch one person’s face onto someone else’s face by using machine-learning techniques.

Gendertrolling: A form of harassment that entails sending or submitting provocative emails or social media posts with an intention to anger or upset the targeted victim, often involving rape and death threats targeted at women.

Cyberstalking: Similar to offline stalking, but through electronic means.

Cyber sextortion: The threat to expose sexual images to coerce victims to engage in sexual activity, provide additional sexual images, or agree to other demands of the perpetrator.

To truly understand the prevalence and impacts of this gender equity issue, UNESCO administered a global survey to women journalists that examined online violence. This study found that:

As a result of online violence, 30% of respondents reported self-censoring themselves online and 26% reported wanting to quit social media and journalism altogether.

Online violence that targets women has significant physical and psychological impacts. A study by Amnesty International found that across all countries surveyed, 55% of women who were targets of online violence experienced anxiety, panic attacks, or stress. This study also found that online misogyny contributed to difficulty sleeping and concentrating among victims of online harassment. So not only does this harassment affect global health reporting, it affects the health and well-being of the global health reporters themselves.

Why is this happening?

Online hate, often rooted in misogyny, is intertwined with disinformation campaigns that discredit women journalists and their work. Misogyny is defined as the aversion to, hatred of, or prejudice against women. For example, Liz Essley Whyte investigated and reported on the conspiracy theories and disinformation campaigns surrounding COVID-19 vaccinations. She then received emails, social media posts, and voicemails with abusive language. The goal of these perpetrators is to silence women and force them out of online spaces.

Since 20% of women journalists who experience online violence respond to this abuse by withdrawing from all online interaction, these perpetrators are getting exactly what they want—and the flow of information about important issues such as public health is blocked.

What can be done?

Governments should create legislation designed to protect women journalists online as well as offline.
Online platforms should prioritize abuse and harassment reporting systems, which allow complaints to be acted upon quickly and effectively.
Women journalists are essential to global health reporting, especially regarding the COVID-19 pandemic. They should be encouraged and assisted in reporting online violence to their employers as well as online platforms.

You can read more about UNESCO’s global survey here.

By Sydney Nadel

2021 IntraHealth-UNC Summer Fellow

Gender Equality

Photo by Tommy Trenchard for IntraHealth International.

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