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October 2003 On the Ground in Sub-Saharan Africa Population Council president Linda G. Martin, Peter J. Donaldson, vice president and director of the Council’s International Programs Division, and Ayorinde Ajayi, regional director for sub-Saharan Africa, travelled together for three weeks in Africa this June, meeting with researchers and high-level government officials. Discussions focused on the Council’s efforts to provide the scientific basis for cost-effective policies and programs to improve the well-being and health of people in some of the poorest countries in the world. Given the daunting population issues facing Africa, the Council is working to ensure that its research, technical assistance, and capacity-building activities are helping policymakers and program managers make the best use of their limited resources.
The substance of the meeting focused on reporting to Mr. Kufuor about the group’s visit to Nkwanta in the Volta Region on the border with Togo. Nkwanta is a key site in the plan to replicate nationwide lessons learned from the Council’s decade-long research project in Navrongo in northern Ghana. That experiment, conducted in collaboration with the Ministry of Health’s Navrongo Health Research Centre, has demonstrated that child survival and reproductive health could be substantially improved by mobilizing community resources and by relocating government nurses from centralized clinics to local communities. Application of these concepts and interventions in Nkwanta has resulted in health services being provided by ten community health nurses to over 40 percent of the district’s more than 187,000 people—a population that previously had relied on one doctor and his staff at the district hospital.
While in Nkwanta, Council representatives met with district leaders, community health workers, and local residents whom the tribal chiefs and elders had brought together for a community durbar (a gathering convened for motivational speechmaking and entertainment). They were joined by representatives of WorldVision, a faith-based organization that works with the world’s poorest children and families, in dedicating the Azua Community Health Center—a modest structure built by members of the Azua community in which a government nurse will live and care for the community. WorldVision provided physical resources to build the health center; Council researchers were key partners in designing the package of services to improve health care. The next stop was South Africa, where Martin, Donaldson, and Ajayi met with colleagues at the University of Cape Town and the Medical University of Southern Africa (MEDUNSA) who helped conduct the Population Council’s expanded safety trials for Carraguard®, the Council’s candidate microbicide to prevent the sexual transmission of HIV. Both institutions are working with the Council on preparations for the large efficacy trial that the Council hopes to start in 2004, with support from USAID and the Bill and Melinda Gates Foundation, among others. Along with Nono Simelela, chief director of the HIV/AIDS Directorate of the National Department of Health, Martin dedicated a clinic in Soshanguve township near Pretoria, where MEDUNSA will conduct one arm of the Council’s microbicide clinical trial. Commenting on the ceremony, Martin said, “Most notable for me were public testimonials by a group of young people who are HIV-positive about how the epidemic has changed their lives and about the need to reduce the fear and denial, a topic of ongoing Population Council research." It is estimated that over one-fifth of the 15-to-49-year-old population in South Africa is HIV-positive. During the final stop in Kenya, the group had the opportunity to visit a project aimed at improving opportunities for young people to earn a decent living. In Kenya, 44 percent of the population is under the age of 15, and education and jobs are quite limited for most. The project, which focuses on girls and boys ages 16 to 22 in the Nairobi slum of Eastlands, is being implemented by K-Rep, the Kenyan micro-credit financing organization. Council researchers are evaluating whether the approach of combining small loans with training in business and life skills is a cost-effective way to provide a better future for the young people of Kenya and elsewhere.
The group also met with the Honorable Charity K. Ngilu, minister for health, who is part of the administration of President Emilio Mwai Kibaki, elected in December 2002. Ms. Ngilu thanked the Council for its research in Kenya and discussed ways in which the Council can continue to assist Kenya’s government and people. The Council has been active in Kenya since 1965 when a Council team helped the government prepare its first population policy. Of particular interest to Ngilu and her staff is the possibility of scaling up nationwide a pilot program to reduce maternal mortality through expanded access to antenatal services, attended deliveries, and obstetric referrals for pregnancy complications. Council researchers have been evaluating the pilot in western Kenya with support from the UK Department for International Development. Reflecting on the trip, Martin noted, "I was impressed by the extent to which the Population Council is helping answer tough questions about what works and what does not. It is a tribute to our multi-talented staff and their reputation for high-quality, objective, policy-relevant research that governments, nongovernmental organizations, and academia look to the Council for leadership in research and the development of cost-effective strategies to address some of the region's most intractable human development issues." See Also | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
