Administrator Raj Shah this week helped deliver the first liter of clean drinking water under a Global Development Alliance (GDA) between the US Agency for International Development (USAID) and Procter & Gamble (P&G) to improve health in Myanmar.
Over the next two years, USAID and P&G will make joint investments of at least $2 million on health projects aimed at providing clean drinking water through provision of P&G Purifier of Water packets, promoting better hygiene behaviors;,and building capability to deliver improved health services to mothers and children. These projects will be implemented on the ground by PSI.Read More
February 28, 2014
Major gains have been made against malaria, but it has come at a cost. A new study shows that drug-resistant bacteria are a growing concern as antibiotics have become the automatic choice for treating a child with a fever. From VOA:
Research from Tanzania, published in the New England Journal of Medicine, shows that most illnesses are caused by viral infections. Antibiotics do not kill viruses, and overuse of these important drugs is decreasing their effectiveness.
Until recently, malaria has been so prevalent in many African countries that health workers assumed any child with a fever had it. But after a decade of intensive efforts and billions of dollars of global investment, malaria rates are declining across the continent.
A recent report found lower rates in 40 of 44 African countries studied.
But that leaves doctors with a new set of challenges: If malaria is not causing a child’s fever, what is? And how should it be treated?
“Their tendency is to prescribe an antibiotic instead of an anti-malarial,” said infectious disease expert Valerie D’Acremont with the Swiss Tropical and Public Health Institute, “which is also bad, because we just shift from one problem to the other.”
Where D’Acremont works in Tanzania, antibiotic resistance is so serious that she estimates half her patients with pneumonia do not respond to the first-line drug. Second-line drugs are more expensive or not available.
But without better data on what made Tanzanian kids sick, no one could say how often antibiotics were the wrong treatment.
So D’Acremont and her colleagues studied about 1,000 children seen at two clinics in Tanzania, one urban and one rural. They performed exams and blood tests, cultures, molecular tests and more to identify all the types of illness and their causes.
About 10 percent of the children had malaria.
For the rest, far more illnesses were viral than bacterial. About half had respiratory infections, mostly caused by viruses such as influenza.
So the authors recommend that except in severe cases, children should be sent home without antibiotics and seen again a few days later if they don’t improve on their own.
A statement from Karl Hofmann, PSI President and CEO
PSI believes that all people share equal human rights and that no person should be subjected to discrimination or violence on the basis of sexual orientation or gender identity.
Men who have sex with men are among the highest risk groups for HIV transmission, and discriminatory laws such as those recently adopted in Nigeria and Uganda will increase stigma, incite violence and have a negative health impact.
Such laws also undermine progress toward universal health coverage for all, a national health objective sensibly embraced by Uganda, Nigeria, and many other countries in Africa.Read More
February 27, 2014
Uganda’s health minister said that gays will not be discriminated against by medical workers despite passage of a law that further punishes homosexuality in the East African nation. Some say they are already experiencing discrimination. From the AP:
The medical workers who knew he was gay ignored him, attending to those who arrived after him as they openly gossiped about his homosexuality.
Pepe Julian Onziema, a prominent gay activist in Uganda, said Wednesday he recently was forced to confront some nurses at a private clinic after they neglected to serve him in apparent hostility toward his sexual orientation.
Now that Ugandan President Yoweri Museveni has signed a new law imposing harsh sentences for gay sex, life is expected to become even more difficult for the country’s homosexuals, including getting health care. The Ugandan government has issued assurances that health workers will not discriminate against homosexuals, but some gays say they are not confident about that.
Uganda’s health minister, Ruhakana Rugunda, told The Associated Press on Wednesday that gays will not be discriminated against by medical workers despite the strengthening of criminal penalties against homosexuals.
Rugunda said that a clause which would have required medical workers to report homosexuals to police was removed from the bill that became law on Monday.
“We are saying that as far as health is concerned, they are at liberty,” he said, talking about gays. “They should give full disclosure to their nurses … We do not discriminate against patients on the basis of sexual orientation. That’s why we are encouraging gay Ugandans to take advantage of the health systems.”
But Onziema, who is one of the few openly gay Ugandans, said he and other homosexuals have experienced prejudice when seeking health care.
“I once went to a clinic where I stayed in the queue (line) for hours and people who came after me were being served,” he said. “You stand in the queue and they ignore you. And you hear them saying, ‘That is a gay person. We can’t serve him. We shall not serve him.’”
The new law has already spread fear among gay Ugandans and many now are actively trying to flee the country, said Onziema.
Some recent research from PSI looked into the willingness to pay for intra-uterine devices (IUDs), a key family-planning measure, in Madagascar.Read More
February 26, 2014
A report from Save the Children shows that some one million babies die on their first day of life, each year. The group says the majority of the deaths can be averted. From the Guardian:
Although great strides have been made in reducing the numbers of children dying under the age of five in the past decade – numbers have halved from 12 million to 6.6 million, there has not been enough progress in reducing the preventable deaths of newborn babies, says the charity.
Most of the deaths occur in developing countries. Some lives could be saved by simple interventions such as handwashing to prevent infections and “kangaroo care”, where mothers “incubate” their premature babies by keeping them warm through skin to skin contact.
The charity says there needs to be an increase in the number of women delivering with the help of a trained midwife or health worker, as 1.2 million deaths occur during labour. In cases of obstructed labour, mother and baby are likely to die without a caesarean section.
Save points to the global shortage of health workers who have the skills to help. It is estimated that 7.2 million more midwives, nurses and doctors are needed.
Every year, 46 million women give birth without the assistance of a professionally qualified person, says its report, Ending Newborn Deaths. In sub-Saharan Africa, half of all births are not attended by a midwife or other properly qualified health worker; in Ethiopia, that drops to just 10%. But there are stark inequalities within countries;- in the richest fifth of households in Ethiopia, there are health professionals at 46% of births, compared with 2% among the least well-off.Justin Forsyth, the chief executive of Save the Children, said: “The first day of a child’s life is the most dangerous and too many mothers give birth alone on the floor of their home or in the bush without any life-saving help. We hear horror stories of mothers walking for hours during labour to find trained help, all too often ending in tragedy.
“It’s criminal that many of these deaths could be averted simply if there was someone on hand to make sure the birth took place safely and who knew what to do in a crisis.”
In countries such as the Democratic Republic of the Congo and the Central African Republic, women have to pay for emergency care – usually a caesarean – and there have been reports of some women being detained at the hospital until their families find the money.
Save the Children says the Millennium Development Goal to reduce child deaths by two-thirds by 2015 will not be met unless childbirth is made safer. By 2025, the charity says, every birth should be attended by a trained and equipped health worker and user fees for all maternal, newborn and child health services should be removed.
The Kisakye Clinic is part of the ProFam network, which is a social franchise network supported by PACE Uganda, an NGO affiliated with PSI, the large international NGO. PSI is building many networks like ProFam to improve the quality of care provided in the private sector.Read More
February 25, 2014
Ugandan President Museveni signed a piece of legislation that further punishes homosexuality in the country, on Monday. Activists campaigned the president to reject the bill, citing rights violations and public health concerns. From VOA:
Homosexuality is illegal in Uganda, but the new law imposes much harsher penalties, including 14-year prison terms for first-time offenders and life sentences for so-called “aggravated homosexuality.”
“Promotion” of homosexuality also has been criminalized, as well as failure to report a gay person to police.
Speaking Monday from the state house in Entebbe, Ugandan President Yoweri Museveni said he was signing the bill because the scientists he consulted had not found a gene for homosexuality.
“There are those who engage in homosexuality for mercenary reasons, especially here; the ones who are recruited mainly for poverty. And then there are those who become homosexual by both nature, some element of genetics, and nurture.”
The move comes despite years of intense pressure from Western countries and human rights groups not to sign the bill.
President Barack Obama has called the new law a “step backward” for Uganda, and said it would “complicate” relations between the two countries. At the moment the United States gives Uganda about $400 million annually in aid.
Gay and lesbian rights activist Kasha Nabagesera said Uganda’s homosexual community has been expecting this move for some time, and that they intend to challenge it in court.
“Right now we are just trying to remain calm, and then we will continue with our focus which is to challenge it in the constitutional court. We are just putting the final touches on our petition,” said Nabagesera.
The bill was passed by parliament in December without the necessary quorum, and many expect it to be ruled unconstitutional.
Nabagesera said the legal challenge will begin later this week.
After a long day of presentations and discussions to better understand the current situation and learn from each other’s experience in markets for sanitation, the second day of PSI’s recent sanitation conference took on an entirely different mood: it’s time to think outside the box, be innovative and apply the lessons we’ve learned to addressing the key blockages.Read More
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