A World of
Solutions: Summary
CARE is engaged in a broad-based attack on
poverty in the developing world. Our fundamental
mission is to help families acquire the skills
and resources they need to improve their lives.
As part of a comprehensive approach to
development, CARE integrates its programs --
including health, education, water and
sanitation, micro-enterprise development, and
agriculture -- to maximize benefits to families
and communities.
Reproductive health is a key component of
CARE's worldwide strategy for alleviating
poverty and promoting human dignity.
Reproductive health programs encompass family
planning, maternal health, newborn care,
preventing and treating HIV/AIDS and other
sexually transmitted infections, detecting and
treating cervical cancer, and preventing and
managing sexual and gender based violence in all
its forms.
The Calculus of
Poverty
 |
| Photo
by: Ellen Pieterse. All photos ©
CARE. |
All families face difficult choices, but the
dilemmas are amplified for poor families in
developing countries. Too often one basic need
must be weighed against another before a family
invests scarce resources into health care.
Families must decide: Do we pay for antibiotics
to treat an infection or pay for our daughter's
school fees? Should we sell one of the animals
to pay for obstetrical care? Even the slightest
miscalculation can have a devastating
consequence on a family's ability to meet its
basic needs.
How Women Factor
into the Equation
Of the more than 1
billion people in the developing world who live
on less than $1 a day, 70 percent are women.
Investing in women's health, education and
economic opportunities is critical to lowering
reproductive risk. Research demonstrates that
when given the opportunity, women overwhelmingly
invest in their families by improving the
nutrition, health and education of their
children. And it just builds from there. When
girls receive a primary school education, they
are more likely to marry later in life and to
have healthier children. Their lives typically
are more productive -- economically and
socially, and, they pass on these benefits to
the next generation.
Community Action:
Power through Numbers
 |
| Photo by: Billy Howard. All photos ©
CARE. |
Families do not exist in isolation; they are
part of communities that must engage in
collective action to advance public health. The
community norms, social structure and leadership
all influence a family's health behaviors.
Moreover, many health issues, such as the
availability and quality of health services,
must be addressed at the community level.
Community-level interventions include: community
health educators, community based distribution
of contraceptives, rapid transport of
obstetrical emergencies, blood donation,
ensuring access to essential drugs, support for
people living with AIDS, health education,
emergency health loan funds and equipping local
health facilities.
A Basic Equation
for Child Survival
Providing a mother
with access to contraception also helps her
children. Studies show that children spaced in
two-year intervals are healthier than siblings
born in rapid succession. Research by the
National Academy of Sciences affirms the role of
child spacing in reducing the high rates of
child mortality. In fact, experts consider
contraceptives as much a part of the public
health arsenal as vaccines or antibiotics.
Achievements in
Public Health
While the challenges to
reducing reproductive risk are formidable, the
other public health achievements of the past 50
years demonstrate that they are not
insurmountable. A few of the many -- often
overlooked -- gains in the developing world
include:
- In 1960, life expectancy in developing
nations was only 37. Today it is 63.
- In 1950, 28 percent of children died before
age 5 in developing countries. Today 90 percent
survive.
- In 1974, only 5 percent of children in
developing countries were immunized against
major childhood diseases. Today the figure is 80
percent, saving 3 million lives each year.
- In 1997, small pox was eliminated from the
planet, saving millions of lives and $1 billion
each year.
Achievements in
Reproductive Health
One of the key
successes in reproductive health is the number
of women worldwide who are now able to access
family planning -- a number that has doubled in
the last 20 years. Because more women are using
family planning services, a woman's lifetime
risk of dying from a complication of pregnancy
has decreased. Unfortunately, the risk a woman
in the developing world faces with each
pregnancy has not diminished over time.
CARE implements more than 70 reproductive
health programs in more than 30 countries. In
1999-2000, CARE provided reproductive health
services and education to approximately 4.3
million people. Examples of this work include:
Bangladesh
Through
the Dinajpur Safe Mother Initiative, CARE is
reducing maternal death and illness among women
and teenage girls. In Bangladesh, 28,000 women
die each year, many from complications
surrounding childbirth. In addition, 14 percent
of maternal deaths are linked to domestic
violence. CARE's project, in partnership with
the government of Bangladesh and UNICEF,
provides women with increased access to
emergency obstetric care. It also empowers them
to take charge of their lives and combat
domestic violence through education and
community support.
Guatemala
In
Guatemala, CARE works in Mayan communities in
remote rural communities of the Alta and Baja
Verapaz regions to reduce death rates for
mothers and babies by increasing the
availability of high quality, culturally
acceptable reproductive health services. The
project is reaching 13,000 women and 3,000 men
of reproductive age. CARE trains community
members as family planning educators and
distributors of contraceptives and also is
responsible for the training and supervision of
health personnel as well as the provision of
basic medical equipment and supplies to these
communities.
Haiti
CARE's
Riches 2000-Grande Anse project is improving
child survival by decreasing maternal death in
remote communities in Haiti. In conjunction with
local health institutions, the project provides
women and with education about family planning,
the importance of maternal health care, and
HIV/AIDS education. An estimated 60,000
individuals will be reached through this
project.
Honduras
While
Honduras accounts for only 17 percent of Central
America's population, it has 60 percent of the
region's AIDS cases. Working in partnership
with, local interest groups and two
corporations, Chiquita Brands and Cargill, CARE
provides HIV/AIDS information, counseling, and
training for peer educators within these
corporations.
India
The
Integrated Nutrition and Health Program is
improving the health and nutritional status of
an estimated 6.6 million women of
childbearingage and children under 2. CARE
teaches mothers what they can do to safeguard
their families' health, such as practicing good
hygiene and nutrition, and making use of the
services offered at rural health centers. These
services include: immunizations; growth
monitoring; distribution of nutritious food and
Vitamin A and iron supplements; pre-natal care;
family planning; and health and nutrition
education.
Lesotho
SAFE II
is decreasing the incidence of HIV/AIDS and STDs
among young adults through a role-model program
using popular football (soccer) players. CARE is
working with the organized football league in
Lesotho to educate players about AIDS risks and
prevention. The football players in turn
participate in a "Football Players Against AIDS"
media and educational campaign. Using an
innovative approach whereby peer education is
facilitated at sporting tournaments across the
country, 50,000 youth will be reached.
Somalia
In
Somalia, CARE has partnered with six maternal
health care centers to reduce maternal and child
mortality. The Safe Motherhood Project is
providing family planning and medical care
during all phases of pregnancy. CARE workers
organize and conduct educational activities to
educate women about the risks associated with
childbirth. CARE helps to provide assisted
childbirth, distributes folic acid and iron
tablets to pregnant women, and educates mothers
about the importance of spacing pregnancies.
Thailand
Integrated
Community-Based Care fosters community
initiatives that support HIV/AIDS-affected
families. Information outlets providing
information on how to seek support from
government and non-profit programs are set at
the village level. Training courses are held for
child day-care workers of community-preschool
nurseries on caring for children from HIV/AIDS
affected families. A volunteer network has
enabled CARE to cover a large number of villages
using only a small number of project staff.
Zambia
In Zambia,
the Community Family Planning Project increases
people's access to high-quality reproductive
health care by improving community and clinic
services. At the community level, the project
has established a network of 400 trained health
educators who provide information, counseling
and medical referrals. The project further
promotes a supportive environment for behavior
change through 40 local support groups where
adolescents, women and men meet each month to
discuss reproductive health issues. The project
also works with 172 clinical service provider to
ensure quality to and access of reproductive
health services. The delivery of family planning
has been strengthened through provider training,
institution of quality care monitoring and the
provision of basic supplies and equipment.
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