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Bringing Washington to Kuala Lumpur

By: Crystal Lander and Brigid Boettler

This post was originally published on the Management Sciences for Health Women Deliver 2013 Conference blog here.

For seven days last month, Management Sciences for Health was proud to host six Congressional staffers as they participated in a study tour to Malaysia—to learn about how the country has made major global health investments and how those investments have saved the lives of women and families.

The staffers—Adriane Casalotti, Legislative Director (Rep. Lois Capps, D-CA), John Ariale, Chief of Staff (Rep. Ander Crenshaw, R-FL), Maggie Dougherty, Legislative Aide (Senator Marco Rubio, R-FL), Aaron Allen, Legislative Assistant (Rep. Juan Vargas, D-CA), Kelli Ripp, Legislative Aide (Rep. Aaron Schock, R-IL), and Melinda Cep, Policy Advisor (Rep. Rosa DeLauro, D-CT)—took part in 17 different educational briefings, networking receptions, dinner panels and meetings.

Study tour delegates and MSH staff during the study tour.

Study tour delegates and MSH staff during the study tour.

Staffers met with over 50 technical, political, advocacy, and global health experts and heard personal stories from mothers, patients, and global health advocates from around the world. A noted highlight of the tour included a meeting with US actor/singer/humanitarian Mandy Moore, who described firsthand the benefits of malaria bednet distribution projects in Central Africa.

An added benefit of  this informational tour of Malaysia was the staffers’ opportunity to attend the 3rd Women Deliver Conference, this decade’s largest event on maternal health and women’s rights. Along with over 4,500 attendees from around the world, the US staffers were able to attend sessions of their interest.

Thanks to the Ministry of Health of Malaysia and the Negeri Sembilan Family Planning Association (the leading voluntary family planning, sexual and reproductive health organization in Malaysia), the study tour included visits to Putrajaya, the small town of Seremban, and the historic city of Melaka to visit government and NGO reproductive health clinics and youth centers. During a tour of the Negeri Sembilan Family Planning Association, the staffers joined a group of neighborhood youth to identify important “social ills” that children and adolescents face in Malaysia. All of these site visits served as vivid demonstrations of the benefits of Malaysia’s investment in maternal and child health.

IPPF clinic 3

Trip delegates with local youth at the Negeri Sembilan Family Planning Association

As the study tour came to a close, the staffers found themselves informed, inspired, and better able to understand the cross-cutting investment that is maternal health and women’s rights.

“Just think of all the good that could come from advocating for ensuring that women and girls have the right to access maternal and reproductive healthcare … women’s rights and access to maternal and reproductive healthcare must be a highlight of our global development agenda,” John Ariale blogged during the tour. “The issue is too important to ignore, or be mired in obtuse political innuendo. With the right focus and attention we can ensure that sexual and reproductive health is readily available and sustainable for all women.”

Crystal Lander is the director of policy and advocacy, and Brigid Boettler the outreach and events specialist, at MSH

Women’s Rights and Access to Maternal and Reproductive Healthcare

By: John Ariale

John Ariale was a study tour delegate. This post is cross-posted, with permission, from his personal blog, Vantage Points. The original post can be found here.

As someone who has worked on international development issues from my desk in Washington, I was excited to participate in the 2013 Women Deliver Conference last week in Kuala Lumpur, Malaysia.

The conference afforded me an amazing opportunity to listen and talk to a variety of people from 149 countries about their experiences and views related to the health and well-being of women and girls. A recurring theme that emerged from the week was the issue of women’s sexual and reproductive health. I have never written about reproductive health before, but I’ll credit that up to never spending a week at a conference focused on maternal and reproductive health before this experience.

Since returning home, I have spent a lot of time thinking about the issue of reproductive health and I firmly believe that we need to start thinking about this issue in a different way – through the lens of a woman or a young girl in a developing country, and with an eye on equality.

In the U.S., we all face the reality that a majority of young adults engage in sexual relations outside marriage, and we educate our kids to wait to have sexual relationships – preferably until marriage. But as parents, we also want to ensure that they know how to protect themselves when they decide to engage in such activities.

This was a key part of the international dialogue I participated in; however, on the international front, in many poor or developing countries, access to reproductive health includes a very different reality.

That reality is that girls and women’s rights are systematically violated in too many places around the world today. (I would encourage anyone reading this or interested in this issue to check out the trailer, and the movie called Girl Rising, an innovative new feature film that highlights the struggles of women and girls around the world). In some cultures, it is still considered acceptable for a husband to beat his wife for not having sex. In too many places, girls are forced into marriage at far too young an age. HIV disproportionately impacts women. In many cultures, when reproductive health options are available, a woman’s male partner often vetoes her decision to use those options.

Women and girls in developing nations are more likely to become mothers at a young age. We know that pregnancy during adolescence has serious health impacts for girls and their babies. There are complications from pregnancy and childbirth – which is the leading cause of death among girls, aged 15-19 in developing countries.

Approximately one in three women will experience gender-based violence in her lifetime. In some pacific countries, more than 60% of women and girls experienced violence at the hands of their partners.

I met a woman from the Congo at the conference. We were discussing access to female contraception and she explained to me that access to female condoms in her village have been transformative because women and girls are now using these resources when walking miles to the wells to get water. The incidence of rape is so great, that these women and girls have decided to use female condoms to avoid unwanted pregnancies.

In developing countries, desire for smaller families and the motivation for healthy spacing of births has steadily increased. Yet, 222 million women in developing countries do not have the ability to determine the size of their families, or have a say in the planning of their families.

MDG 5 — Improve Maternal Health — has two sub targets. Target 5A set a target of reducing maternal mortality by three-fourths by 2015, while Target 5B set a target of universal access to reproductive health.

The achievement of the MDGs is strongly underpinned by the progress that the world makes on sexual and reproductive health. It is a pillar for supporting the overall health of communities, in particular, that of women. Ill health from causes related to sexuality and reproduction remains a major cause of preventable death, disability, and suffering among women. Apart from the health consequences, poor sexual and reproductive health contributes significantly to poverty, inhibiting affected individuals’ full participation in their own social and economic development.

I was surprised to learn that the world has not made as much progress on this front as is needed to meet MDG5 by 2015. Many countries in sub-Saharan Africa and South Asia have shown little progress in recent years; some have even lost ground. Globally, the rate of death from pregnancy and childbirth declined between 1990 and 2005 by only 1% per year. In order to be on track to achieve MDG 5, a 5.5% annual rate of decline was needed from 2005 to 2015.

During my week at the conference, our group was fortunate enough to have a conversation with Melinda Gates. We were all enlightened and her comments during our conversation were extremely helpful to me. Mrs. Gates stated that when she talks about health with women from developing countries, they explain to her that their job is to feed the children. They explain that if they cannot space out their births, they cannot work or properly care for and feed the other children. In many places, Melinda explained that while condoms might be readily available, women – due to cultural perceptions – couldn’t even fathom negotiating the use of condoms because it means they are suggesting that their partner might have AIDs or that she is trying to say she has AIDs.

The Gates Foundation does not fund abortions, and has it right when they state that we need to put girls and women at the center of this debate. We need to start trusting one another and realize that “family planning” is not code for anything else in this debate.

As the week progressed, I became certain that the only way for the world to begin to correct this problem is for us to start trusting one another and to look at this issue as an equality rights one, not something else. Advancing equality among boys and girls and men and women is a goal we can all support.

I am confident that if we are successful in achieving equality, many other aspects of this problem begin to fall into place. Perhaps, once achieved, we might even begin to have a significant impact on achieving MDG5.

Just think of all the good that could come from advocating for ensuring that women and girls have the right to access maternal and reproductive health care. Treating women and girls all around the world equally might eradicate early and forced marriage, keep girls in school, give women a say in their family planning, and end gender-based violence.

One of my take-aways from the conference was that women’s rights and access to maternal and reproductive healthcare must be a highlight of our global development agenda. The issue is too important to ignore, or be mired in obtuse political innuendo. With the right focus and attention, we can ensure that sexual and reproductive health is readily available and sustainable for all women.

Recap: May 31 – Day 7, Friday

The whirlwind, week-long, study tour concluded on Friday with a local NGO site visit to the Negeri Sembilan Family Planning Association and Reproductive Health Association Melaka Clinic and Youth Program outside of Kuala Lumpur. Delegates toured the NGO’s health clinics and youth center to gain an overview of the NGO and its work. There, they met with NGO staff and the patients who are benefiting from the health services. Both this site visit, and Monday’s visit to the Putrajaya Health Clinic, gave delegates the unique opportunity to witness Malaysia’s health successes first hand. Overall, the week was success as the delegates left with a greater understanding of Malaysia’s health system and reproductive, maternal, newborn and child health successes, and the importance of investing in women and girl’s health worldwide.

Recap May 31 Day 7 Youth Clinic 1

Youth at the Negeri Sembilan Family Planning Association and Reproductive Health Association Melaka Clinic and Youth Program.

Full group at the NGO site visit.

Full group at the NGO site visit.

Global Maternal Health in 2013

By: John Ariale

John Ariale was a study tour delegate. This post is cross-posted, with permission, from his personal blog, Vantage Points. The original post can be found here.

Our week in Kuala Lumpur is almost over and we’ve had an amazingly busy and informative week of meetings, briefings and field visits. Whether visiting with the Malaysian government’s ministry of health, touring government facilities, sharing thoughts with one of the 4,000 delegates from around the world, or participating in roundtable discussions with experts in the field, I have been immersed in the issue and focus of the conference.

In 2000, all UN Member States committed to eight Millennium Development Goals (MDGs), which aim to significantly reduce extreme poverty and disease, ensure environmental sustainability, and enhance international coordination around development by 2015. That means that 189 countries committed to ending extreme poverty worldwide through the achievement of these MDG’s. The MDGs are the FIRST and ONLY international framework for improving the human condition of the world’s poor.

MDG 5 — Improve Maternal Health — set a target of reducing maternal mortality by three-fourths by 2015. And that has been one of the key focal points of this conference. Every year, between 350,000 – 500,000 girls and women die from pregnancy-related causes.

Medical solutions exist, but increased government attention is needed to implement policies to improve the supply of and demand for services that will help. While the numbers of deaths are decreasing, the progress is not enough or fast enough to meet the MDG goal by 2015. Almost all maternal deaths occur in developing countries; especially vulnerable are poor women. In fact, maternal mortality represents one of the greatest health disparities between rich and poor and between the rich and poor populations within every country.

Interestingly enough, providing the essential services needed to make significant improvements in maternal health are estimated to cost less than $1.50 per person in the 75 countries where 95% of maternal mortality occurs. The great majority of maternal and newborn deaths can be prevented through simple, cost-effective measures.

For instance, using a country closer to home, in Haiti, the maternal mortality rate is the highest in the Western Hemisphere with 350 deaths per 100,000 live births. In comparison, the rate in the U.S. is 12.7 deaths per 100,000 live births and Afghanistan’s rate was 1,600 deaths per 100,000 live births (2002). Several programs in Haiti have trained over 700 traditional birth attendants to assist with child birth since only 37% of all births in Haiti take place in a health facility.

Thanks to these attendants, pregnant women in Haiti have increased access to trained assistants who assist with safe deliveries. Identifying signs of high-risk pregnancies, and referring at-risk pregnant women to health facilities for care. In Afghanistan, thanks to skilled birth attendants and access to education about pregnancy, the maternal mortality rates went from 1,600 deaths per 100,000 live births in 2002 to 327 deaths in 2010.

Achieving MDG 5 is not only an important goal by itself, it is also central to the achievement of the other MDGs: reducing poverty, reducing child mortality, stopping HIV and AIDS, providing education, promoting gender equality, ensuring adequate food, and promoting a healthy environment.

The U.S. is a leader in funding these programs, but this is not just a U.S. government problem. It’s one that will take government, in partnership with other donors, governments, academia, the private sector, religious institutions, civil society and individual advocates.

Failure to invest in the maternal health of women in developing countries is a missed opportunity for development in those countries that need critical development gains the most.

Recap: May 30 – Day 6, Thursday

The last day of the Women Deliver 2013 Global Conference focused on looking to 2015 and beyond. Of all of the Millennium Development Goals (MDGs) set to expire in 2015, MGD 5 is the furthest behind and it is critical to take a stock of why it is not being reached. To do so, delegates attended panels, plenaries, and sessions highlighting why the well-being of girls and women should be a top developmental priority in the new development framework. Delegates attended “To the Point” sessions which were similar in structure to TEDTalks.  There, they heard MSH President and CEO Dr. Jonathan Quick speak about Why Universal Health Care is a Women’s Issue.

During the afternoon, the delegates had the opportunity to meet one-on-one with Melinda Gates and Chris Elias from the Gates Foundation. During the meeting, they were briefed on the Gates Foundation’s work and gained a better understanding of the role foundations play in advancing global health priorities. The day concluded with an interactive dinner discussion hosted by the Global Health Corps, Pathfinder International, and PSI, entitled “Smells Like Teen Spirit – A Look at the Role and Importance of Youth in Global Development Efforts. Delegates and youth facilitators discussed the unique services and interventions that young people need, why rolling out and implementing youth-specific policies are key,the important role young people play in health and development efforts, and where young people fit into the post2015 development agenda.

Melinda Gates speaking at the Women Deliver 2013 Conference after meeting with the group.

Melinda Gates speaking at the Women Deliver 2013 Conference after meeting with the group.

Recap: May 29 – Day 5, Wednesday

The fifth day of the tour started with a briefing at the US embassy, where delegates met with US Ambassador to Malaysia Paul W. Jones and other US officials. After the briefing, delegates headed back to the convention center to attend the Women Deliver Conference. The second day of the conference discussed reducing unmet needs to contraception for the 220 million women who lack access. In particular, the day focused on Millennium Development Goal 5, which calls for universal access to reproductive health to allow women to plan the number and spacing of their pregnancies. The panels and sessions explored how the global community can continue to address and decrease this unmet need and ensure that women around the world have safe and healthy pregnancies. In the evening, delegates attended the 2013 Impact Awards Reception, hosed by PSI and Women Deliver. The Impact Awards honored individuals from an array of sectors integral to women’s global health efforts.

Tour delegates with Chelsea Clinton at the Women Deliver 2013 Conference.

Tour delegates with Chelsea Clinton at the Women Deliver 2013 Conference.

Recap: May 28 – Day 4, Tuesday

The fourth day of the study tour marked the first day of the Women Deliver 2013 conference, which convened more than 4,500 participants from 149 countries to discuss women’s empowerment and the health and well-being of women and girls, with a particular look to the future of the development framework. Delegates attended high level plenaries, concurrent panels, and engaged in a lunch dialogue with Rosmanh Mansor, first lady of Malaysia. The first day’s theme highlighted the investments made in the health, education, empowerment, and rights of girls and women around the world. Delegates learned how healthy girls are more likely to attend school, have safe pregnancies and deliveries, and grow up to have healthy and educated children. They learned that when we invest in women and girls, they survive, and simply put, families, communities, and countries thrive.

The evening concluded with a dinner panel discussing the delivery of maternal, newborn, and child health services in fragile, post conflict states. Panelists presented on the challenges faced, and success achieved, in the delivery of maternal, newborn and child health (MNCH) and reproductive health (RH) services in fragile states, such as Afghanistan, Haiti, and Democratic Republic of the Congo. Delegates left the dinner with a stronger understanding of the political, economic, and health conditions in fragile states, the major barriers to MNCH and RH service delivery, and the roles leadership and governance play in saving the lives of women and children.

Opening of the Women Deliver 2013 Conference.

Opening of the Women Deliver 2013 Conference.

First Lady of Malaysia (center in blue) at the Women Deliver 2013 Conference.

First Lady of Malaysia (center in blue) at the Women Deliver 2013 Conference.

In Kuala Lumpur, U.S. Congressional Staffers Briefed on Maternal Health Challenges in India

By Sandeep Bathala

This post is cross-posted, with permission, from New Security Beat, the Wilson Center’s Environmental Change and Security Program’s blog. The original post can be found here.

It’s funny when you bump into your neighbors on the other side of the world. Today I spoke about the Global Health Initiative’s recent collaboration with the Population Foundation of India at a regional briefing on health in South and Southeast Asia before the 2013 Women Deliver conference in Kuala Lumpur, Malaysia. The special roundtable was part of a week-long study tour for a group of U.S. Congressional staffers that work on foreign affairs.

Management Sciences for Health, CARE, the Center for Health and Gender Equity(CHANGE), the Global Health Council, PATH, Population Services International (PSI), andWomen Deliver all partnered to bring this study tour to Kuala Lumpur during the Women Deliver conference for briefings and site visits that demonstrate the importance of investing in global health. I participated in a briefing that provided the staffers with important insight on the diversity of the health needs of countries in South and Southeast Asia.

Progress and Challenges in India

Drawing on our dialogue in New Delhi last month and a forthcoming report summarizing its recommendations, I discussed the recent progress and remaining challenges in maternal health care in India.

India has made big strides over the past decade to reduce maternal mortality. A decade ago, close to 75,000 women died every year during childbirth or due to pregnancy-related causes. By 2010, this number had fallen to 50,000. The country’s maternal mortality ratio fell from 301 maternal deaths per 100,000 live births in 2003 to 212 in 2009.

But despite this, India is not on pace to reach the maternal mortality Millennium Development Goal of 109 or fewer maternal deaths per 100,000 live births by 2015. Twenty percent of all maternal deaths worldwide still occur in India. To close this final gap, special effort needs to be made to reach disadvantaged communities.

The National Rural Health Mission (NRHM), its rural health care workers, and the Janani Suraksha Yojana (a conditional cash transfer program for institutional births) have contributed positively to improving the Indian women’s access to health care. According to the 2009 Coverage Evaluation Survey, nearly three out of four births took place in institutions – up from less than 40 percent in 2005-06. More than two-thirds (69 percent) of pregnant women received at least three antenatal checkups, and around 90 percent received more than two tetanus toxoid injections.

Wide disparities and inequities in women’s access to healthcare continue to persist, despite the overall progress. Sadly, access to health services still depends on a woman’s education, wealth, the community she belongs to, and where she lives. For instance, although in total 73 percent of Indian women give birth in institutions, the number is much lower (54 percent) among women who have no education, who belong to the lowest wealth quintile (55 percent), are a member of the Scheduled Tribes (57 percent), or live in rural areas (68 percent).

The poorest women–those belonging to Scheduled Castes and Scheduled Tribes–have yet to be brought into the fold of an inclusive healthcare system in many parts of the country. For example, over a period of eight months in 2010, 26 maternal deaths took place in the Barwani district hospital in Madhya Pradesh. Tragically, 21 of these 26 women belonged to Scheduled Tribes. Even more alarming is that an inquiry commissioned by the government found all 26 deaths were avoidable.

Regional differences are also important. States like Assam, Rajasthan, and Uttar Pradesh have maternal mortality rates over 300 maternal deaths per 100,000 live births. Attention also needs to be paid to transient populations, including women who temporarily migrate to their birthplace for delivery.

Expert Recommendations

As summarized by Executive Director of the Population Foundation of India Poonam Muttreja in a column for the Hindustan Times, seven strong conclusions emerged from the deliberations we helped organize in New Dehli:

One, we must recognize maternal morbidity as a serious health issue. For each woman who dies, an estimated 20 more suffer from infection, injury and disability during pregnancy and childbirth. Some women die, while for others, life is a living death experience. These complications range from fistula, uterine prolapse, painful sexual intercourse, reproductive tract damage and infections, anemia and even infertility. Maternal morbidity, like maternal mortality, can be easily prevented.

Two, we must integrate maternal health, reproductive health and family planning – now delivered as vertical programs – into a universal health coverage plan that recognizes woman’s health as a basic right. For example, anemia among girls needs to be addressed at a younger age. Waiting till they are pregnant and then treating them for the condition may be too late. Similarly, a substantial number of maternal deaths can be prevented by merely meeting the unmet need for family planning and providing access to safe abortion services. The government of India has taken a right step by announcing a comprehensive strategy on reproductive, newborn, child and adolescent health (RMNCH+A).

Three, we must focus on the marginalized. Within an overall framework of universal health coverage, India needs to adopt special and differentiated strategies to reach women in remote rural areas, those belonging to tribal communities, and the more disadvantaged groups in society.

Four, we must improve the quality of care by putting in place adequate guidelines, protocols, checklists and introducing a system of accreditation for facilities and services for both the public and private sector.

Five, address the shortage of human resources. Despite the more than 10-fold increase in institutional births over the past five years, there has not been a matching increase in staff strength. Skills of field functionaries such as auxiliary nurse and midwives (ANMs) have been lost as they have been instructed not to conduct deliveries. Many healthcare providers trained in the Indian systems of medicine fail to recognize clinical symptoms of an obstetric emergency.

Six, ensure greater accountability from the highest level instead of holding the frontline health worker or the Accredited Social Health Activist (ASHA) responsible. A greater involvement of the communities in monitoring the health services, which has begun under the NRHM, needs scaling up with adequate budget allocation.

Seven, gaps in knowledge must be addressed. Better monitoring and evaluation systems need to be introduced. A community perspective should be brought into the assessment of service delivery. A robust methodology should be developed for measuring morbidity and collecting real time data. More regular studies on maternal mortality and morbidity should be planned.

I also emphasized an eighth recommendation to the staffers: Social determinants to maternal health need to be addressed. Key among those are social customs, beliefs, and practices that occur across much of the world that contribute to poor health and inequity for women, including child marriage and early pregnancy, violence against women, and the political and economic disempowerment of women.

As Muttreja so eloquently says, “the last mile is always the most exhausting, exasperating and difficult to cover.” Collectively, we can do it. Whether here at global gatherings like Women Deliver or in New Delhi and Washington, DC, we need to continue to spread the message about the importance of investing in maternal health.

Read the Global Health Initiative’s full coverage from Women Deliver, part of our Advancing Dialogue on Maternal Health series with the Maternal Health Task Force and UNFPA.

Sources: Hindustan Times, UN.
Photo Credit: Schuyler Null/Wilson Center.

Sandeep Bathala is senior program associate for the Wilson Center’s Environmental Change and Security Program and Maternal Health Initiative.

Global Health Investments: Why It Matters to Main Street, USA

By: John Ariale

John Ariale was a study tour delegate. This post is cross-posted, with permission, from his personal blog, Vantage Points. The original post can be found here.

Getting here was a challenge and on the day we landed, we took advantage of our limited free time to explore the city. But on Sunday, the real work began! All day long, we participated in interactive and engaging round table discussions with some of the world’s most engaged and passionate people on the issues that I believe are vital to the United States. It was a pre-curser to the rest of our week in KL.

We are here to participate in the 2013 Women Deliver Global Conference. This is third international conference of its kind intended to bring world leaders and experts in the field together to discuss one aspect of our foreign assistance agenda. The Women Deliver conference builds on commitments, partnerships, and networks mobilized at the groundbreaking Women Deliver conferences in 2007 and 2010, fighting to end the deluge of preventable deaths that kill approximately 287,000 girls and women from pregnancy-related causes every year.

Many people back home wonder why the United States is engaged in funding activities like global health concerns and sometimes its hard to explain. But when you’re in a place like this, surrounded by people who address these concerns daily, it’s more than clear why.

Despite the fact that many people view foreign assistance as unnecessary – particularly in austere budgetary climates – I would argue that drastically reducing foreign assistance is not the answer to balancing the budget, nor is it our best interest as a nation.

To help frame the discussion, its important to note that sixty percent of people questioned in a CNN/ORC poll conducted early in 2012 said they’d like to put foreign aid on the budget chopping block; however, at the same time, the public grossly overestimated how much the U.S. is spending on foreign aid. Americans estimate that foreign aid takes up 10% of the federal budget, and one in five think it represents about 30% of the money the government spends. The reality is, it amounts to less than one percent of our budget and I contend, it may be one of the most important annual expenditures and investments we make.

We are a nation blessed with an abundance of wealth and opportunity and I firmly believe that we have a moral responsibility to invest in the world around us. For one percent of total federal spending, the United States is able to respond to humanitarian needs, promote a more secure world, help those most in need around the world, and spur economic development to improve people’s lives. But just as important as our moral responsibility in this arena is the fact that these precious taxpayer resources are an investment in America’s long-term national security.

No matter your political persuasion, it is a fact that the money we spend on global health and development is a cost effective investment. The threat of terrorism and extremism are two of this generation’s greatest challenges. Families all around the world want the same thing. A happy, healthy family, one that promotes and stabilizes the family unit, that leads to a strong village filled with hope and optimism for tomorrow, which leads to stable governments, stronger economies, more friends abroad, and ultimately, a peaceful world.

While it might sound naive, it is the truth….promoting peace and stability through effective foreign assistance ultimately means the promotion of healthy societies, which are often the best defense against extremism and protects our overall national security interests.

Today’s briefings and discussions focused more pointedly on women’s health and we had robust discussions with numerous groups working on the ground. We heard from advocates like Mandy Moore and Barbara Bush, plus numerous experts from the field. Funding programs that improve the health and lives of girls and women in the developing world is a smart investment for the United States. Every year of schooling for a girl increases her future earning potential between 10-20 percent. Simply ensuring skilled care during a delivery would reduce maternal deaths by 74%.

Women are important contributors to the global economy. They make up 40% of the global labor force and more than 60% of the workers in agriculture in sub-Saharan Africa. When women thrive, families flourish, communities do well, and nations grow.

The math is rather simple, investing in women pays dividends. I am looking forward to meeting experts from the field over the next few days and the dynamic conversations that will follow!

Recap: May 27 – Day 3, Monday

On Monday morning, the delegation visited the Ministry of Health, where they were briefed on the current investments in, and the successes of, the Malaysian healthcare system. The briefing identified how the Malaysian health system’s successes can be used as an example to achieve similar results in other countries and helps meet the Millennium Development Goals.

After the Ministry briefing, delegates visited the Putrajaya Health Clinic outside of Kuala Lumpur. There, they toured an integrated family health clinic with Malaysian government officials. Delegates gained an overview on the clinic’s holistic health services; saw the impact of family counseling, education, reproductive health, and family planning services; and gained a better understanding of health research and development, social marketing, and health promotion initiatives. The delegates also met directly with the women and children who are benefiting from the Putrajaya Health Clinic‘s services.

Full group at the Ministry of Health.

Full group at the Ministry of Health.

At the Putrajaya Family Clinic.

At the Putrajaya Health Clinic.