Put the Frontline Health Worker Into the Post-2015 Framework

This post previously appeared in the Huffington Post and on the Skoll World Forum.


As world leaders gather this week to discuss the achievement of the Millennium Development Goals and the Post-2015 Framework, no subject of conversation will be more important than the need for more frontline health care workers. In the last two decades, the world has made tremendous progress in reducing child and maternal mortality, due in no small part to the contributions of the local health worker delivering lifesaving care. Millions of people in impoverished countries are alive today because a midwife was by their side when they gave birth, or they were vaccinated as infants by a nurse, or because their families learned from a community health worker to adopt healthy behaviors like breastfeeding, hand washing, birth spacing, and sleeping under a mosquito net.


I saw the lifesaving power of local health workers first-hand last month when I visited Save the Children’s programs in Pakistan, a country with some of the worst health indicators on the planet. According to our latest State of the World’s Mothers report, the lifetime risk of maternal death–the probability that a 15 year old woman will eventually die from a maternal cause–is 1 in 110 in Pakistan. Compare this to the United States, where it’s 1 in 2,400 and you see my point. Pakistan’s children aren’t any better than their moms. For every 1,000 children born, 72 of them will die before they reach the pivotal age of five, more than ten times the rate of their American counterparts.


But as harrowing as these statistics are, you would never know it from visiting the maternal and child health clinic in Haripur district. It is one of the most impressive facilities I have seen anywhere in the world at the primary care, or village, level. The spotlessly clean unit is staffed by two female doctors and several nursing staff as well as a pharmacist–all health care workers. A warehouse stocked with supplies is available on-site and the facility provides services 24/7 as needed. Women come here for prenatal visits, for family planning counseling and products, and to give birth in a simple, clean and safe facility with excellent care. Three women were in labor the day I visited and when I saw the care they received, I knew I would have felt comfortable having one of my own children there.


Unfortunately, not everyone in Pakistan–or the rest of the world for that matter–is as lucky to have a health worker in such close proximity. By some estimates, there is a shortage of at least 1 million frontline health workers in the developing world. And many existing health workers are not trained, equipped and supported to deliver basic lifesaving care close to the community. The consequence of failing to close this gap is grave. Every 3 seconds, a child’s death is prevented thanks to care provided by a frontline health worker. When a health worker is not accessible, the situation is, predictably, far less rosy.


The challenge for all of us in the business of saving mothers’ and children’s lives is to ensure that every person, no matter where they live in the world, is within reach of a health worker. We can–and should–start at the UN General Assembly, and continue the drumbeat at the Third Global Forum on Human Resources for Health in Recife, Brazil in November. But, it will take more than a few high-level meetings to make this a reality. That’s why Save the Children, in partnership with the Frontline Health Workers Coalition, created The REAL Awards, a first-of-its-kind, annual global awards platform designed to develop greater respect and appreciation for the lifesaving care that health workers provide in the U.S. and around the world. Anyone can take a few moments to nominate an inspiring health worker and help spread the word about the countless unsung heroes who go above and beyond the call of duty. It will make a REAL difference.

A Mom’s Best Or Worst Day

The following blog first appeared on The Huffington Post.


Every day, thousands of women celebrate one of life’s most amazing experiences — becoming a mother. But every 30 seconds a mother’s first moments with her baby are cut short, on the very day she gives birth.


Until now, we didn’t know how common this heartbreaking experience is in the United States and around the world. But Save the Children’s new report shows that one million babies die the day they are born.


State of the World’s Mothers 2013: Surviving the First Day also shows that today we have the evidence and cost-effective tools to save up to three quarters of newborn babies, without intensive care.

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The Real Breastfeeding Scandal

The following blog first appeared on The Huffington Post.




Last year, Time magazine’s “Are You Mom Enough?” cover practically shouted “Scandal! Women breastfeeding too long!”


The unforgettable image stirred up controversy and I’m sure it sold magazines. But are moms and kids any better off?


Now, imagine funneling all that outrage and punditry into something that really helped mothers and their babies when it came to breastfeeding — especially in the developing world where it can literally save lives.

The real scandal is not breastfeeding late, but that too many moms don’t get the support needed to breastfeed early — or to keep breastfeeding, should they want to.


In our new report, “Superfood for Babies,” Save the Children estimates that 830,000 babies could be saved every year if they were breastfed in the first hour of life. The colostrum, or first milk, provides a powerful shot of antibodies that can stave off deadly disease. And immediate breastfeeding more often leads to exclusive breastfeeding for six months, which can save even more lives.

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And the REAL Award Goes to…

The following blog first appeared on The Huffington Post.



Awards season is in full swing.


On Sunday night, Hollywood’s elite came together and celebrated last year’s accomplishments on the Big and Small screens at the 70th annual Golden Globe Awards. While millions from around the world tuned in and debated whether the most deserving winners were chosen, a smaller, but no less important, awards program was about to take place just a short drive south of the action.


The inaugural REAL Awards honorees were announced last night in Laguna Niguel, Calif., where nine U.S.-based health workers were named for their extraordinary service in health care. They may not be household names, but they matter enormously to the patients they serve. People like Carri Butcher, our winner in the hospice care category, who created a day spa at her own home in Arkansas for her dying patients so they could be treated to a little pampering before they passed. Or Esther Madudu, a midwife in rural Uganda, who is one of the nine global honorees we named last September. Esther’s clinic often has no power, so she delivers babies in the middle of the night by the light of her mobile phone screen.


The REAL Awards is a chance to shine the spotlight on the men and women who go to work every day to perform the greatest role of all — saving the lives of others. They may not grace the covers of magazines, but their work still deserves to be celebrated, especially since they’re needed now more than ever.


We’re currently experiencing a severe shortage of doctors in this country. While we can’t ignore this crisis, one way to address it, at least in the short term, is to rely more on other health workers — nurses, physician assistants, nurse practitioners, community health workers, pharmacists — to perform the tasks that don’t require a doctor, as a recent New York Times editorial suggests.


No one knows the importance of health workers more than those in the developing world, where the dearth of doctors is even more stark. By some estimates, the world is short more than millions of health workers, including one million frontline health workers, who deliver care in some of the hardest-to-reach communities, oftentimes with limited resources. In fact, frontline health workers are the first — and often, only — point of contact to the health care system for millions of people.


Their role is invaluable. It is estimated that every three seconds, a child death is prevented thanks to care provided by a

How to ‘Beat’ Child Mortality

The following blog first appeared on The Huffington Post.


Can the sound of a child’s heartbeat inspire the world to save children’s lives? Can it inspire you? Children’s heartbeats recorded in Malawi and Guatemala inspired the band OneRepublic to write a song with a beat like no other. If “Feel Again” grabs you enough to download it, you can help save children’s lives.


The song provides the soundtrack to Save the Children’s new Every Beat Matters campaign. The aim is to raise awareness about the millions of children around the world who die needlessly before their 5thbirthday, and what can be done to save them. The timing is right for this campaign launch, and not just because it’s Infant Mortality Awareness month. Yesterday, the United Nations released their latest child mortality estimates, which show — for the first time — that child deaths have fallen below 7 million per year. While this figure is still far too high, it reflects the tremendous progress the world has made in reducing preventable child deaths. We can and must now finish the job.

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Every Beat Matters


Mary Beth Powers, Newborn & Child Survival Campaign Chief

Washington, DC 

Wednesday, August 29, 2012 

Who doesn’t love a song with
a great beat?  How about a beat that can help save children’s lives? 
OneRepublic’s new single “Feel Again” has both.

We’re so excited about the
release of this song this week.  It’s a hit in the making and was actually
inspired by real heartbeats of children in Guatemala and Malawi.  Listen
closely as the track opens, and you will hear one of these heartbeats. 
What’s more, when you download the song, a portion of the proceeds will benefit
Save the Children.

In the coming weeks,
OneRepublic will help us roll out our new Every Beat Matters campaign
for newborn and child survival.  You can already make a difference by
visiting EveryBeatMatters.org to
download the song and join the campaign.

Every Beat Matters is focused on giving every child the chance to
survive.  The campaign showcases the frontline health workers who are key
to making that possible in communities around the world.  With proper
support, these local heroes can prevent and treat the major causes of 7 million child deaths each year.  These
include pneumonia, diarrhea and malaria–illnesses that are rarely fatal for
children in the United States.   

We hope you’ll stay in touch
so we can share news, stories and tools you can use to help children
survive.  The best way is to like our Facebook page at www.facebook.com/EveryBeatMatters
and to follow @EveryBeat on Twitter. 

Please join us if you believe
that every child’s heartbeat matters!

Getting Ready for BlogHer ‘12

I am incredibly excited to connect with all of the amazing women at BlogHer ‘12, an annual conference that brings women in social media together. One of the most powerful ways to deliver a message in social media is through video. That’s why I want to share this video with you, which we’ll screen at BlogHer ’12. It includes shots of multiple health workers from all over the world. I met one of them, Madalitso Masa, along with her son Patience, who lives and works in a rocky and mountainous part of Malawi where she helps prepare women for a healthy pregnancy.

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Recapping The 19th International AIDS Conference

Carl hennCarl Henn, Senior Director of Child Protection and HIV & AIDS

July 28, 2012

Washington, DC

The 19th International AIDS Conference (or “IAC”) ended on Friday, after a closing speech by President Bill Clinton. That brought to a close a week in which almost 25,000 participants attended daily “plenary” speeches in a huge hall, plus hundreds of smaller talks and presentations, and saw thousands of posters on aspects of HIV prevention, care, and treatment, from almost every angle imaginable.

The participants at IAC included people most Americans might expect would work on this issue, such as doctors, nurses, and scientists, as well as politicians, program planners, donor agencies, and celebrities, who visited thousands of AIDS displays by all types, and even enjoyed musical and dance performances. People came from 90 countries around the world, and from all aspects of American society as well.

The participants also involveda very large number of AIDS activists, including “LGTB”, or Lesbian, Gay, Bisexual, and Transgender people, who play a prominent part in HIV/AIDS meetings and activities. Also present were commercial sex workers and intravenous drug users, who are at high risk for HIV/AIDS. In the exhibition halls were drug companies who are often the targets of protests by many AIDS activists.

For me, personally, I met a large number of colleagues who work on HIV/AIDS, as well as some of their kids, who came to volunteer, and even a former US Ambassador and his wife who volunteered at IAC. I also met workers at the convention center, African Americans from Washington, DC, where there is a mini-AIDS epidemic. We talked about the need for HIV testing, to learn their status and to be HIV-free.

So it was a very diverse cross-section of people, and also an amazing learning environment for a week. How can we convey to you even a brief sense of what the meeting was about, and what we learned? Let’s take a look at some of the headlines and the people that made them (or at least presented them).


What does HIV/AIDS mean to America, Americans, and people from other parts of the world? It’s hard to summarize. What do most of us know about HIV/AIDS? That there is a virus (HIV) that destroys the immune system, leading to AIDS. There is still no vaccine, and no cure. For now, we prevent, provide care for, and treat it. There are 8 million people on treatment, called “ART,” and 7 million who need it.


Money is a big part of every discussion about HIV/AIDS. The cost of 8 million people on treatment, and everything else that is being done, is a huge figure, about $17 billion per year. But estimates of the total needed range another $7 billion per year, for a total of $24 billion, in order to “turn the tide” on AIDS.


What do “we” (meaning, Americans, the world, people infected with HIV (or PLHIV), and also children orphaned by AIDS) get for $17 billion a year? We get a range of drugs that PLHIV, including babies born with HIV, have to take every day for the rest of their life, in order to protect their immune systems. We get a vast array of programs to prevent HIV infection, and to care for and support those affected by it.


There are always discussions about morality when we talk about HIV/AIDS, including everything from the most conservative faith-based groups that oppose condom promotion, and condemn homosexual behavior, to the churches and congregants who visit PLHIV in their homes and provide hospice care. Sometimes the same churches operate on “both sides” of HIV/AIDS, showing compassion for PLHIV.


Death is always a main topic at AIDS meetings. Without access to life-prolonging treatment, PLHIV will eventually progress from asymptomatic, to symptomatic, to “full-blown” AIDS. We’ve all seen images of what AIDS does to its victims – the weak, gaunt figures, who in the past were often cast out of societies. The good news at this IAC is that far more PLHIV receive ART, so far fewer people are dying now of AIDS. Stigma (discrimination against PLHIV) is decreasing in Africa, but still persists in some parts of the world.


Women and kids were a big topic at the IAC, and they should be. HIV prevention and ART for moms protects them and their babies from infection with HIV. There is huge progress on getting adults on ART, but less in getting babies and kids onto ART early enough to save their lives. So, more needs to be done. Along with ART for moms and babies, the world needs to care for and support millions of AIDS orphans. Imagine the sheer numbers of AIDS orphans – estimatedat17 million – and imagine what their life would be like without our support. Imagine what life would be for your kids if they became orphans.

XIX International AIDS Conference – Day 2

GenericScott McGill, Senior Advisor, HIV/AIDS

Washington, DC

July 24, 2012

Every two years experts, governments, activists, and affected community representatives meet to take stock of the global AIDS response – these conferences are often known for particular breakthroughs or for global commitments and other landmarks.DSC00393  The 2012 International AIDS Conference will be known as the meeting that ambitiously committed to ‘The Beginning of the End of AIDS!’

Over the past two years, a consensus has developed that anti-retroviral treatment (known as “ART”) is also a prevention strategy. New technologies show promising results. These include using HIV treatment drugs with higher risk individuals to prevent the spread of HIV infection. While these are exciting innovations, we also need to scale up other prevention strategies, and combine those with other medical approaches to achieve the greatest impact on slowing and ultimately reversing this epidemic.

Even if a vaccine or cure for HIV infections is found tomorrow, there is still the need for prevention as well as strengthening of healthcare systems.

Save the Children has prioritized prevention of HIV transmission among youth, especially those who are vulnerable or most-at-risk for HIV transmission. 

At the conference workshop “Leading the Way in Asia – Mapping, Mobilizing and Building Capacity in Young Key Affected Populations” we took part in discussions led by youth with many stakeholders and partners which resulted in a consensus on a number of important issues:

  • More information is needed to identify the youth most affected by HIV & AIDS
  • Policies and laws need to support HIV programming and not block them
  • Services need to be youth friendly
  • The meaningful engagement of young people is critical in developing the next generation of young leaders for the AIDS response and beyond.

IMG_8398Two young delegates from the Philippines, Jeffry and Philip, said, “young people also need to be seen as more than HIV risks – they need other support and services that would help them avoid being in situations which make them more vulnerable including safe housing, education, other health and support services, legal protection and opportunities to make a living and contribute to their communities’.

Over the last two days Save the Children has been involved in many activities – including presentations on the challenges and legal barriers in providing prevention services to those selling sex in Bangladesh, Vietnam and Papua New Guinea, and school based programs for children and youth in Georgia. Simon - FSW decriminalization

There are a number of questions and challenges posed to us as a child-focused agency – how do new technologies and innovations fit in our approaches? How do we address the multiple needs of younger key affected populations beyond solely their HIV risks and address the factors that make them more vulnerable?  How do we not lose focus on the behavioral and social issues? How can we better understand and access those youth who are hidden, ignored, and misunderstood?

XIX International AIDS Conference – Day 1

Ronnie lovichRonnie Lovich (Senior Advisor HIV/AIDS) and Alice Fay

Washington DC

July 23, 2012

We come together at the 2012 International AIDS Conference with 20,000 colleagues, implementers, activists, ready to listen, and share our experiences of what works. As we gather for this week of meetings, we eagerly await news of scientific advances, global successes, and evidence of best practice and effective response. We also need to keep the fire that moves so many to respond to the HIV and AIDS pandemic burning. On this first day, we have not been disappointed.

After 30 years of responding, we can now look at ‘hyper-endemic’ countries such as Zambia and for the first time say that we have more people being treated than being diagnosed with new infections. And it is possible to say that adhering to treatment could possibly mean living a long life. But we have a new conviction and a new way of looking at treatment – treatment must be viewed as prevention.

Nowhere is this truer than in the case of ending parent to child transmission. The faster we can get a mother on treatment, the sooner we can reduce the risk of ransmission to her baby.

Some compelling facts:

  • In 2011, 330,000 children were born with HIV; a decade ago that number was 600,000. Now to prevent mother to child transmission there is “Option B+” which provides full treatment during pregnancy and continues for life. We have an unprecedented opportunity with the new B+ therapy, which is simple and can be started in the antenatal clinic setting, and demonstrates that the best treatment is prevention.
  • Under the Global Plan to end pediatric AIDS, a goal has been set for reducing transmission to , and treatment rates of 90% to keep mothers alive. However, as a number of our colleagues have illustrated, preventing mother to child transmission is a cascade of services….but the cascade can be imperfect. We may start off with good antenatal coverage but few receive the continued support they need. At each step ofintervention, we lose more women and their infants, and too few infants are tested soon enough. 

There is another missing piece that requires our attention. The majority of youth who are living with HIV do not yet know their HIV status. There has been a lot said about adolescent sexual and reproductive health, and the need to take into account the needs of younger people, who are so often excluded from adult programs including preventing mother to child transmission. We met a young Ugandan woman living with HIV; she gets her Anti RetroviralTreatment and other HIV related services from a clinic for people over 15. She said that since the clinic has opened, people her age feel much more comfortable accessing services. She also expressed her frustration that there is little
representation of the voices of young people living with HIV.

Which is why sharing our exhibition space with our young colleagues from YouthLead is so special. These inspiring individuals will be able to share their experiences living with HIV, their strategies for
addressing the stigma and helping others as peer educators.

More to come tomorrow…