Barbara Jones, Caitlin Heising, Cristina Ljungberg, English Sall | Maverick Collective | 27 January 2018
Several members of The Philanthropy Workshop network are founding members of Maverick Collective, an initiative of Population Services International (PSI) in partnership with the Bill & Melinda Gates Foundation. Each of the members has partnered with PSI to conceptualize and fund a health project in the developing world.
Maverick Collective members bring their intellectual and financial capital to address challenging issues for girls and women worldwide. Through questioning and learning, Maverick members become strong allies of the communities with whom they partner to support effective and sustainable services as well as advocate externally on behalf of those communities to leverage additional funding and support.
Here is a snapshot of projects that TPW members are working on with Maverick Collective:
Barbara Jones (TPW 2011–2012): Breaking the Silence
In Myanmar, a major barrier to understanding violence and the needs of survivors was a lack of standardized data. There was little data available on the prevalence of gender-based violence (GBV), so questions were asked to better understand the scope of violence and how to approach the problem.
Discussions with local healthcare providers and advocacy organizations helped inform the program design for Breaking the Silence. From this understanding of the context of violence in Myanmar, PSI conducted training of doctors for identifying and responding to violence. PSI has over 300 Sun Island franchise health clinics in Myanmar. Although the training were needed and well received, as activities progressed, the Sun Clinic healthcare providers struggled to support survivors and document violence incidence.
The team asked more questions—questions that uncovered a need for clinical guidance. In response to this need, PSI sought partnership with UNFPA and the Ministry of Health in Myanmar to redirect program support to the development of national guidelines for clinical response to violence. The team’s willingness to continually ask questions and reassess program activities as necessary led to an important health policy activity.
In addition to providing training and clinical guidance to the doctors, PSI also conducted a media campaign on Facebook educating audiences on GBV and the services that were available for victims. PSI also partnered with a local woman’s organization, Akhaya, to strengthen their psychosocial, financial, and legal services to support GBV victims.
Caitlin Heising (TPW 2014–2015): Teen Mothers in Nicaragua
Globally, 16 million girls ages 15-19 give birth every year, along with one million girls under the age of 15. Adolescent pregnancy is strongly associated with poverty, low education levels, and gender inequality, and is the second leading cause of death for girls ages 15-19. Despite this significant need, family planning programs that target youth often neglect to take into account the unique needs of young mothers.
Two years ago, I joined Maverick Collective to expand access to contraception among adolescent mothers in Nicaragua, which has one of the highest adolescent fertility rates in the world. The PSI team and I envisioned a world in which girls are empowered to plan their futures and choose the timing and number of their children—one in which they’re afforded knowledge, access, and rights to comprehensive family planning counseling, products, and services.
To help achieve this vision, we set out to create adolescent-friendly environments among health providers and communities to increase adolescents’ access to comprehensive reproductive health services, including long-acting reversible contraception methods such as IUDs and implants, particularly among adolescent mothers.
We opened a model clinic in central Managua that offers high-quality, accessible primary, reproductive and sexual healthcare. Clinic staff has deep expertise in serving adolescents, and in addition to seeing clients, staff train other healthcare providers in best practices for serving adolescents. In order to create the most open, friendly environment for young people—who are often stigmatized or turned away when seeking sexual and reproductive healthcare—we engaged youth in the process by using human-centered design, resulting in a colorful community space where young mothers and their children feel welcome and safe.
The clinic is the anchor of a social franchise, which we are now working to scale throughout Central America via the private sector. By leveraging the model and evidence we’ve gained, we will partner with other healthcare providers and entrepreneurs to expand sexual and reproductive health access for adolescents, without relying on traditional development funding and philanthropy.
Cristina Ljungberg (TPW 2012–2013): Improving Sexual, Reproductive, and Menstrual Health for Teen Girls in Nepal
Menstrual health is one of the most overlooked components when talking about girls’ sexual and reproductive health. In Nepal, like in many countries, teen girls don’t understand the changes in their bodies when they enter puberty. The taboo around menstruation combined with a lack of product accessibility, disposal options, privacy, and clean water creates a situation where girls lack knowledge, comfort, and ways of managing the bleeding. These situations can lead to negative and shameful experiences, social exclusion, and health problems.
Before we look for solutions, we have to understand the problems girls face. By using Human Centered Design (HCD), this project sets out to understand the situation for girls in Nepal and to let them come up with ideas of how best to solve their problems.
Our implementing partners have developed four studies with the aim to understand the barriers preventing teen girls from accessing products for, and education on, their reproductive health, including menstrual health. Using the findings from these studies, we will work to create girl-centered solutions. These solutions can target everyone from healthcare providers to parents, teachers, and peers. This project is about learning first and then prototyping, with the hope of finding scalable models that can be adopted in Nepal and throughout the world.
The team in Nepal is now 18 months into the process, and it’s exciting to see the output from synthesizing the research studies. Our team has visited four times and is planning to visit again in February 2018 to learn more about the findings and process.
After the four research studies are complete, we look forward to seeing the girls’ prototype solutions—be it an educational programme, a product, or a campaign. We hope it will lead to improvement for adolescent sexual, reproductive, and menstrual health.
Entering a process using HCD is an open learning experience where one must be willing to listen without an agenda or bias. Even if the journey can feel scary for many donors, we deeply believe it will lead to scalable projects and long-term solutions and impact.
English Sall (TPW 2018–2019): Transforming Community Health Systems to Improve Health Outcomes in Zimbabwe
Universal Health Care Coverage is one of the most talked about and debated topics of our generation. Community Health Workers (CHWs) are key drivers in achieving Universal Health Care Coverage in our lifetime. In the rural Makoni district of Zimbabwe, we are taking a small step in this direction by embarking on a project that will strengthen community health systems and put CHWs at the forefront of quality care for HIV and AIDS patients.
This project will design and implement an electronic health information tool that provides patients with information about their health, enables community health workers to provide continuous care, and informs healthcare facilities staff and policymakers of the overall picture of health in their community.
Existing health information management systems tend to be fragmented and incomplete. This results in clients’ information being held in multiple silos but with no one system providing a holistic overview. This leaves room for misdiagnosis, mismeasurement, inefficient use of resources, and an overall lack of oversight of community health.
At the New Africa House clinic in Harare Zimbabwe, we are already piloting a new Electronic Medical Record (EMR) system that is addressing much of the problem of siloed data collection. We will soon be piloting in Makoni through the process of distributing HIV self-test kits, which will be able to bring care to the doorstep of patients, enable CHWs through training and technology, and pilot an electronic foundation that will better equip both CHWs and patients to build and participate in a health system that works for them.
The connectivity that can take place through this system will build a bridge of information between the client, CHW, clinic, and ministry. Our goal is to create a community health system that utilizes all of the tools in our toolbox in order to create a positive, high-quality healthcare experience and put data-driven information in the hands of healthcare providers, decision makers, and the patients themselves.