On Sunday, June 9 I was asked to speak on the final plenary at the Christian Connections for International Health (CCIH) conference. The plenary “Faith-Based Organizations and the Power of Stories” focused on how people use communication to share their stories. The panel was made up of great minds in the communication world: John Donnelly, Communications Advisor to Jim Kim at The World Bank, Adrian Kerrigan, Senior Vice President for Advancement at the Catholic Medical Mission Board (CMMB), and moderator David Olson, Global Development Communications Consultant at Olson Global Communications.

A man talks on a mobile phone while sitting on a railway track in north Kolkata, India.

© 2010 Rajarshi Chowdhury, Courtesy of Photoshare

Before the panel, I was worried I may not make the cut with such a distinguished panel. However when the questions started I realized we had similar struggles to spreading the messages of our organizations and we agreed on a lot of the solutions. The panel began by asking all of us what advice we had for those organizations with limited resources for communications.  Many of the examples and suggestions to the audience were about working with the resources you have by repurposing information, choosing one or two communications platforms to focus on, and meeting your audience where they are. My main message throughout was about being very deliberate in creating a plan when choosing to use a platform.

K4Health has partnered with 117 organizations to create over 50 Toolkits, which are practical collections of trusted public health resources, chosen by experts, arranged for easy use. USAID’s Maternal and Child Health Integrated Program (MCHIP) manages the Respectful Maternity Care Toolkit, highlighted here in a post by Susan Moffson, MCHIP Senior Program Officer, published on the USAID Impact Blog.

Abuse and disrespect during maternity care has been documented and observed globally. In response, USAID’s flagship Maternal and Child Health Integrated Program (MCHIP) is launching the Respectful Maternity Care (RMC) Toolkit. This package of materials is designed to provide clinicians, trainers, managers and other stakeholders involved in the provision of maternity care with the tools necessary to begin implementing RMC in their area of work or influence. This toolkit contains program learning documents, such as: surveys and briefs on country experiences; training materials; tools to assess and improve RMC within programs and services; job aids; and a resource list.

Women who chose to give birth at home without a skilled health care provider, as well as their newborns, are more likely to suffer complications and die. In less developed countries, there may be many reasons women chose not to give birth in a health facility, such as distance, and lack of transport or money to pay for health services. However, all too often a lack of respectful care from frontline health workers—such as doctors and midwives—cause women and their families to distrust the health care system and opt for more risky homebirths, with unskilled traditional birth attendants (TBAs). Women often choose to deliver with TBAs not only because their services cost less, but also because they provide RMC and follow up care, and are trusted and known within their communities.

Mozambican mother holds her newborn. Photo credit: Jhpiego

Multiple factors may contribute to disrespect and abuse within healthcare services. Health systems may be underequipped, and healthcare workers may be overwhelmed due to inadequate pay, lack of infrastructure, or insufficient staff and supplies. An attitude of disrespect for clients and patients may permeate the healthcare system, and healthcare workers may not receive any guidance or supportive supervision related to RMC or their work in general.

The goal of this toolkit is to empower frontline health workers to provide RMC, allowing women and their families to experience better maternity care and to choose to deliver with a skilled provider at home or, preferably, in a health facility. The ultimate impact of more women using skilled birth services during child birth will be reduced newborn and maternal deaths.

June 5^th is the 41st World Environment Day, which the United Nations General Assembly established in 1972 to mark the opening of the Stockholm Conference on the Human Environment. At that time world population was a mere 3.85 billion people. As the millennium changed in 2000, the total was over 6 billion and just 13 years later, it had topped 7 billion. Close your eyes for 12 more years, and we will be at 8 billion. The good news is that the rate of population growth is slowing, but even so, by 2050 there will be over 9 billion people on the planet, according to most estimates.

What has all this to do with World Environment Day?

In just a few weeks, an entire slope of eucalyptus trees can be felled and cut for transport out to charcoal makers in the hills of Burundi. In some countries in the region the lower price of charcoal is rapidly increasing to match the cost of cooking with gas. Without replanting forests, the price of wood will continue to rise. Several development agencies are focusing on more efficient ways to make charcoal and are funding tree planting projects to reduce the deforestation.

© 2010 Jean Sack, Courtesy of Photoshare

The facts today are pretty much the same as when the Population Information Program (a K4Health predecessor project) published the Population Reports issue: “Population and the Environment: The Global Challenge” back in the fall of 2000. Except there are now a billion more people in the world.

“As the century begins, natural resources are under increasing pressure, threatening public health and development. Water shortages, soil exhaustion, loss of forests, air and water pollution, and degradation of coastlines afflict many areas. As the world's population grows, improving living standards without destroying the environment is a global challenge,” according to that report.

A more up-to-date resource on linkages between population, health, and the environment is K4Health’s innovative Population Health and Environment Toolkit, which has links to over 260 resources, many of which explore the advantages and reasons for integrating population, health, and environment projects.

“More than 1 billion people—one-sixth of the world population—live in ecological hotspots, many of which are remote areas of critically important biodiversity under intense pressure from human activity. Biodiversity loss is a pressing global problem, with species extinctions happening at record levels. Threats to biodiversity include: population pressures from natural growth and human migration; unsustainable natural resource practices, such as slash-and-burn farming; ineffective governance structures and inadequate authority to protect local resources,” according to the toolkit developed under the auspices of the USAID-funded BALANCED Project.

May 23^rd is the first-ever International Day to End Obstetric Fistula, but for the majority of the 2 million or more women suffering from this devastating condition and the 50,000 to 100,000 new cases each year, the UN General Assembly-designated day will most likely come and go without their knowledge.

Twelve post-operative women at the Addis Ababa Fistula Hospital in Ethiopia are ready to go home. They have had their obstetric fistulae repaired, and they have been given new dresses (the constant leakage of body waste, caused by fistulae, ruins clothing). Only a few have live babies. Most have given birth to stillborn babies.

© 2004 Ruth Kennedy, Courtesy of Photoshare

Obstetric fistula is a hole in the birth canal (either between the rectum and vagina or bladder and vagina) caused by prolonged labor without prompt medical intervention, usually a Caesarian section. The woman is left with chronic urinary and/or fecal incontinence and in most cases a stillborn baby, according to the UNFPA-led Campaign to End Fistula, which is marking its 10^th anniversary this year.

As my colleague, Rebecca Shore, wrote in a 2011 K4Health blog post, “Continuous incontinence makes normal life a struggle, and women with fistula may also suffer from recurring infections, paralysis in the lower legs, and infertility. To make matters worse, many afflicted women also find themselves divorced or abandoned.” 

Over the past decade the UNFPA campaign has directly supported over 34,000 women to receive fistula treatment, and partner agencies have supported thousands more, but as the figures above illustrate much more needs to be done. (A contribution of $10 will help feed a recovering fistula patient for two weeks, $60  pays for a Caesarian section to prevent the problem. The average cost of fistula treatment—including surgery, post-operative care, and rehabilitation support—is $300. Donate here.)