USAID has supported peace-building along Kenya’s northern borders for over a decade. The current program focuses on communities on the Kenya-Uganda and Kenya-Somalia borderlands and enables residents to take peace into their own hands. USAID helps communities on opposite sides of the border select, plan, build and manage projects for joint use. These “peace dividend” projects include schools, marketplaces, and clinics.
All photos by Aernout Zevenbergen and Abraham Ali from Pact.
Peter Salama, Unicef Representative to Ethiopia, makes closing remarks at "African Leadership for Child Survival" held in Addis Ababa, Ethiopia on January 18, 2013. Photo credit: UNICEF
Last Friday, it was a real honor for me to take part in the closing ceremony of the African Leadership on Child Survival – A Promise Renewed (ALCS/APR), together with H. E. Kesetebirhan Admasu, Minister of Health in Ethiopia, my esteemed colleague Dennis Weller, USAID mission director to Ethiopia, and my African colleagues in health and development.
In June 2012, during the first Call to Action – Promise Renewed meeting in Washington D.C., Dr. Tedros had committed that Ethiopia would host an African Leadership for Child Survival Conference that was linked to the AU summit. That promise is now fulfilled and I wish to thank Dr. Tedros and Dr. Kesete and all of the colleagues at the Ministry of Health for making this all African meeting a reality and a success.
The pledge signed by the African countries present and the consensus reached by the conference are both significant and historic. The event has marked a new era for the African continent in which it is no longer acceptable for any child to die an untimely and preventable death.
As we have seen at this meeting, in many ways the progress made in the health sector in Ethiopia, as well as many other African countries, has become a powerful global symbol of what can be achieved in resource-constrained environments and has given many international partners renewed faith in the development enterprise.
To accelerate progress we need to do some things differently. Dramatic reductions in preventable child deaths can be achieved through concerted action in five critical areas, outlined in the global roadmap: geographical focus, high burden populations, high impact solutions, gender equality, and mutual accountability and financing.
The theme of equity, in all its dimensions, has come out very strongly through the conference conclusions on geography, gender equality and high burden populations. We know that as much as we have made global progress on child survival in recent decades so too have we seen an increasing concentration of child deaths in Africa which now accounts for around half of all the world’s child mortality.
During the three days, we have also seen that the highest rates of death are now overwhelming in fragile states and conflict-affected countries and regions. This demands that our attention also be placed on governance issues and on human security. There is a major role here, not only for the United Nations but also for regional institutions, and is why the role of the AU will be even more paramount as we move forward on this initiative. Indeed we are very hopeful that with the Ethiopia government taking over the chair of the AU in 2013, maternal and child survival will be seen as not only a health and development issue but as a peace and security issue. It seems auspicious that the African Leadership on Child Survival has taken place right before the AU heads of state meeting next week. I sincerely hope that the recommendations of this conference are shared with the AU leadership and head of states for their endorsement.
We have seen the strong leadership of African governments in this process. This is not an initiative led by UNICEF or USAID or any other partner, and it is very refreshing to see that this initiative and the commitments being made are home-grown. All countries have existing strategies and plans for improving maternal, newborn and child health. Integration of the ALSC/APR initiative with local processes, rather than setting up vertical mechanisms, will be important. Government should also coordinate efforts of various partners and the different initiatives and synthesize them into a coherent whole at the country level.
One of the most exciting aspects of the meeting and the overall process for me is to have seen the peer to peer dynamic in action. I know the lesson learning and sharing of good practices from country to country will continue over the coming months and that many countries are planning study visits to other African countries. We should nurture this dynamic at all costs. I believe the seeds of success and of sustainability for us in African have been planted by all at this meeting. By working hand in hand, we can and we will end all preventable maternal, newborn and child deaths, and thus complete the work begun under the child survival revolution.
This post originally appeared on Mom Bloggers for Social Good.
This week child survival is under critical review in Addis Ababa, Ethiopia during the African Leadership for Child Survival – A Promise Renewed summit. This meeting, held at the African Union headquarters and convened by the Ethiopian government along with UNICEF and USAID brought together African Ministers of Health to enter into discussions about markedly improving child survival rates. The summit ends Friday.
Between 1990-2011 child mortality has decreased 39% in sub-Saharan Africa. Photo credit: Mom Bloggers for Social Good
Between 1990-2011 child mortality has decreased 39% in sub-Saharan Africa. According to UNICEF, 1 in 8 children in sub-Saharan Africa die before their fifth birthday from five leading causes: pneumonia, pre-term birth complications, diarrhea, intrapartum-related complications, newborn infection and malaria…continued
Read more to learn which key tweets and infographics are emerging from the summit at the#promise4children hashtag.
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Today it was an honor for me to join African colleagues in health and development at the opening of the African Leadership for Child Survival – A Promise Renewed. Minister of Foreign Affairs Tedros Adhanom, Minister of Health Kesetebirhan Admasu, and the rest of the Ethiopian Government should be congratulated for hosting this meeting to accelerate the reduction of Africa’s child mortality rates.
Ethiopia's Minister of Foreign Affairs Dr. Tedros Adhanom opens the African Leadership for Child Survival meeting in Addis Ababa, Ethiopia. Photo credit: UNICEF
Ethiopia has made great progress in tackling child survival and strengthening their health sector. Since the development of Ethiopia’s first national health policy in the mid-1990s, Ethiopia and the United States Government have partnered to increase and expand access of quality health services to Ethiopians nationwide. The United States is proud to have a long-standing health program in Ethiopia with many of our agencies working in the health sector: CDC, DOD, Peace Corps and my agency, USAID.
Last June, Ethiopia joined India and the United States in cooperation with UNICEF to host a Child Survival Call to Action in Washington. More than 700 global leaders came together and challenged each other to reduce child mortality to 20 deaths per 1,000 births, or lower, in every country around the world by 2035. Assuming countries already making progress continue at their current trends, achieving this rate will save an additional 5.6 million children’s lives every year.
In the last two decades, Sub-Saharan Africa has experienced a 39 percent decline in the under-five mortality rate, a tremendous achievement that has been called part of the “the best story in development.” But despite this progress, we know that some countries are doing better than others. By joining together to share best practices, we can create a strong coalition to help each other’s children live to see their fifth birthdays.
An investment in Africa’s children is an investment in Africa’s future. I am pleased USAID is supporting the African Leadership on Child Survival meeting – and we are committed to being Africa’s partner in this effort for years to come.
School children gathered in Ethiopia. Photo Credit: Nicole Schiegg/USAID
Since 1990, the number of child deaths in sub-Saharan Africa has dropped by 39%. Many African countries are within reach of the 2015 millennium development goal to reduce the under-five mortality rate by two thirds. Yet even with the availability of proven, inexpensive, high-impact interventions for maternal, newborn, and child health, their adoption is slow and high rates of childhood illness and death persist in a number of countries. In sub-Saharan Africa 1 in 8 children die before they reach their fifth birthday.
In an effort to catalyze global action for child survival, the Governments of Ethiopia, India, and the United States together with UNICEF convened the ‘Child Survival Call to Action’ in Washington, D.C. in June 2012. Under the banner of ‘Committing to Child Survival: A Promise Renewed‘, more than 160 governments signed a pledge to renew their commitment to child survival, to eliminate all preventable child mortality in two decades.
To maintain this momentum, the Government of Ethiopia, and former Minister of Health Tedros Adhanom, whose leadership raised Ethiopia’s profile in child survival in the continent, committed to convene the ‘African Leadership for Child Survival—A Promise Renewed’ Meeting January 16-18, 2013, in Addis Ababa, the seat of the African Union.
Ministers of Health from 54 African countries have been invited to come together with peers and global experts to ensure child survival is at the forefront of the social development agendas across the continent and renew the focus of African leaders to head their own country’s efforts and sustain the gains made over the last two decades.
In advance of tomorrow’s African Leadership on Child Survival meeting in Addis Ababa, Ethiopia, the Ministry of Health organized a media site-visit to showcase their community health extension program and its impact on the country’s tremendous reductions in child mortality.
I was taken away from the hustle and bustle of Addis to the Aleltu district, which is north in the Oromia region. The visit began at a health center, then a health post and finally I visited households in a kebele (village). I saw firsthand how the health extension workers along with the voluntary community health promoters, called the “women health development army,” are key to Ethiopia’s health infrastructure. Health extension workers have finished secondary school, or grade 10, and have been through one-year of training that covered 16 components under four categories: family health; disease prevention and control; sanitation and hygiene; and health education. This is called the health extension worker package.
Members of the press interview women at a health center in Mikawa, Ethiopia. Photo credit: Nicole Schiegg
At the health center in Mikawa, the capital of Aleltu, I observed kids getting immunized and women accessing prenatal care. Two women with their newborns in the waiting area agreed to be interviewed by the press. Both commented on how they learned about family planning from the center and how birth spacing leads to healthier children. They planned to wait three years before their next child by using family planning methods offered by the center, which is funded by USAID as part of an Integrated Family Health Program through JSI and Pathfinder International.
At the Wogiti Dera health post, where they focus on maternal and child health in collaboration with the Mikawa health center, I met a 25-year old health extension worker named Mandarin. She showed me charts depicting data from the progress in her village. Practicing what she teaches, Mandarin is one of the women in the village who delivered her baby at the health center. When asked if she aspired to be a doctor, Mandarin replied, “Of course, anything is possible.”
Finally, I visited a household in the Wogiti Dera village, designated a “model household” because it successfully completed a checklist of 16 good behaviors consistent with the 16 components in the health extension worker package. Examples of good behaviors in the package include: women delivering their babies with a skilled birth attendant, children being vaccinated, and the household practicing good sanitation and hygiene.
What was consistent throughout the visit was an emphasis on data to measure impact and performance. This information feeds up to the regional and national level to populate a scorecard to measure Ethiopia’s progress in reducing maternal and child mortality in the region. The community health extension program is one of many best practices that will be shared at this week’s African Leadership on Child Survival meeting.
In parts of Zimbabwe where market conditions allow, the World Food Programme is arranging for cash to be given to those in need. In this way, people make their own decisions about buying their food – and the local economy benefits too.
This originally appeared on the U.S. Global Leadership Coalition blog.
As policymakers discuss how to avoid the fiscal cliff, including sequestration, U.S. development agencies are continuing to take steps to make development and humanitarian assistance more effective. In the wake of the famine in the Horn of Africa, a typhoon in the Philippines, and even Hurricane Sandy at home, USAID’s new policy (PDF) – one that actually isn’t an acronym – “Resilience” is about using existing development dollars more effectively in disaster prone regions, so that less humanitarian assistance is needed in the future.
Almost half our funding consistently goes to countries classified as “long term recipients” of U.S. humanitarian aid, with 75% of USAID’s humanitarian aid going to 10 countries over the last decade. Making it easy to predict “where and who” is likely to be affected: Sub-Saharan Africa. Tragically, this region has experienced more than “1,000 disasters“ over the past four decades. These fairly cyclical humanitarian crises disproportionately impact areas defined by chronic poverty and conflict. Such despair can strip humans of their dignity and create conditions that extremists exploit – something that rings all too true in the Horn of Africa.
USAID/OFDA, in partnership with Catholic Relief Services, also provided hygiene kits, water containers, sleeping mats, and water purification tablets to families in a village on the outskirts of New Bataan city which bore the brunt of the storm. Photo credit: Lisa Gabriel, USAID/OFDA
The cycle, however, also includes America’s response – the world’s largest humanitarian aid donor – complete with public awareness campaigns (e.g., “FWD Campaign”, USAID’s multimedia response to the 2011 drought). The American public’s generosity is extraordinary, as is the dedication of those working on the frontlines of humanitarian disasters. But this new policy is about getting at the root causes of the circumstances that can lead to the need for humanitarian interventions and then, deploying new technologies and forging new partnerships to break this cycle.
And as we saw in Ethiopia, it is possible. In 2005, Ethiopia began a resilience program, Productive Safety Nets Programme. As a result, when the worst drought in 60 years hit Ethiopia and its neighbors and plunged over 13 million people in East Africa into crisis, the resilience program paid off. This collaborative initiative between the Ethiopian government and international donors – including USAID – resulted in noticeable improvements to the program’s targeted areas during the 2011 drought and a more cost-effective response of $53 per person. This compares with $169 per person during the United Nations and NGO-managed response to the crisis – in spite of earlier warnings (PDF) of the impending disaster.
But what’s the ultimate goal? USAID Administrator Rajiv Shah says success will be measured by whether USAID is able “to put ourselves out of business” by reducing the number, volume, and length of time of the “infusions of humanitarian assistance needed in the future.” Translating it down to the local level, as His Excellency Elkanah Odembo, Kenyan Ambassador to the United States, told the audience at the policy’s launch event, a key indicator will be whether the next drought to strike the Horn of Africa – and you can count on one – leads to smaller numbers of displaced persons crossing the border into his country.
As America strives to get our own fiscal house in order, the fact of the matter is that we’re also nearing a critical mass for relief and development funding. Meaning, “doing more of the same,” to quote Administrator Shah, is no longer an option. Nor should it be.
David Beckmann is President of Bread for the World. Photo Credit: Bread for the World
Over the last month, we have watched communities along the New York and New Jersey coastline begin to rebuild from the devastating impact of Hurricane Sandy. It is a reminder that we are all vulnerable to natural disasters that can happen at any time. How communities survive and recover from these shocks depends very much on their resilience – their ability to cope and their systems for preparing, responding and rebuilding. In the United States, these systems are already in place and, for the most part, function well. This is not the case in many low-income countries.
Year after year, we see poor communities in developing countries deal with the effects of floods and droughts. Many of these weather-related problems are predictable, and so is the recurring “hunger season”—the period before the main harvest is ready—in parts of sub-Saharan Africa. All of these cause a great deal of suffering, including severe malnutrition which threatens the lives of the most vulnerable. In fragile states, vulnerability to shocks is even higher. Each year, humanitarian agencies mobilize relief efforts to save lives. Once the crisis is over, we go back to business as usual.
It shouldn’t be this way. People in the affected communities know all too well that every year the rainy season or monsoon cuts off their contact with nearby towns, or that every year the dry season leaves many families without access to enough food. With the right support, countries and local communities can build systems and develop responses that help people get through these difficult seasons. This way, they are not stuck in the powerless position of hoping, year after year, that emergency assistance will arrive in time.
In 2007 and 2008, many millions of poor people suffered because of a dramatic rise in global food prices, particularly for basic grains such as rice and wheat. They had no control over the causes of the price hikes, and they had very few coping mechanisms. Poor families spend a large percentage of their income on food, so when prices soared, they had to cut back on more nutritious foods, eat fewer meals, and go without other basic needs such as health care. The World Bank estimated that the food price crisis pushed more than 100 million people deeper into poverty.
The crisis served as a wake-up call — it risked reversing the tremendous progress the world had made in reducing extreme poverty and hunger. In fact, according to the U.N. Food and Agriculture Organization (FAO), progress against hunger stalled due to high and volatile food prices.
As a result, there has been a greater focus on the concept of resilience since 2008. It is very important that USAID now has its first policy and program guidance (PDF) on building resilience. Through Feed the Future and Food for Peace, USAID has already acted on important components of such an undertaking, with the focus on reducing malnutrition in the 1,000 days between pregnancy and age 2 and helping smallholder farmers improve their livelihoods and diversify diets in their families and communities. Social safety nets are also essential. With dramatic weather events and food price volatility only likely to continue and intensify due to climate change, the need to build resilience has never been greater.
Regina Anek, a deputy director for gender at South Sudan’s Ministry of Education in Eastern Equatoria, just saved a 14-year old girl from an early, forced marriage. She says she was empowered to intervene as the result of her participation in a USAID-supported mentor-training program for teachers and education officials aimed at encouraging girls not just to enroll, but also to complete, secondary school.
Mentoring is just one of the ways USAID is addressing financial, social and institutional barriers to gender parity in education through the Gender Equity through Education (GEE) Program.
School completion rates for girls in South Sudan are extremely low. Survey data indicates that the rate of completing the eight-year primary cycle is currently 30 percent for boys, while the girls’ completion rate lags far behind at 17 percent. Secondary school completion rates are even worse. This cannot only be attributed to the long conflict in this country, which prevented many girls from attending school, but also to other unique cultural and financial barriers.
One rampant cultural barrier is early marriage. Persistent poverty has been cited as a major reason for parents marrying off their daughters in exchange for money. Moreover, cultural norms in some places dictate marriage readiness for girls as young as 13. Communities often stigmatize older girls in schools, causing them to give up their education.
With USAID’s mentoring support and some tuition stipend, many girls now stay in school, and some who were married at an early age are now able to return and complete their secondary schooling.
Students in a classroom in northern Bahr el-Ghazal State, South Sudan. Photo Credit: Ezra Simon, USAID/South Sudan
The GEE program’s three components include:
Regina Anek was trained as a mentor, enhancing her skills to intervene in communities where girls face social pressure to leave school to get married.
“I was informed that a student from one of the schools in my state was about to be married off, and I hurried to convene a meeting with the family and community. Meanwhile, I asked the parents to allow me [to] accommodate the girl at my house so that she could continue attending school as we resolved her marriage case,” Anek said.
After weeks of negotiating and educating the community leaders and the girl’s parents on the importance of an educated girl to the family and society, the girl was allowed to return home and continue with school.
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