By Pickett Slater Harrington
A conversation with Diana Nambatya Nsubuga, 2016 American Express NGen Leadership Award Winner
Our world is changing. In a way it is becoming larger and smaller all at once. The impact of technology now allows us to connect instantly with others around the globe expanding our network and magnifying our reach while simultaneously economic, environmental, and socio-political realities are deepening our interdependence and interconnectedness with every person on the planet.
As global challenges like poverty, disease, and environmental degradation cross geographic boundaries, next generation nonprofit and philanthropic leaders must also be willing to cross those same geographic boundaries to learn new ideas and approaches, forge partnerships and work with their global counterparts to address the intractable issues that face our world.
ISQ sat down with Diana Nambatya Nsubuga, Uganda country manager for Global Health Corps and the 2016 American Express NGen Leadership Awardee to see what lessons her work might hold for other next generation nonprofit and philanthropic leaders working in the United States and around the world.
Diana, please describe your work to improve the health of women and families in Uganda?
Over the past ten years, I have worked directly with women, young people, and the community to dialogue on issues of reproductive health and family planning. Through my personal and professional work, I have helped women, men, and young people clearly understand sexuality and overcome barriers such as inadequate information that could otherwise lead to poor decision-making.
Beyond my work at Global Health Corps and Partners in Population and Development’s Africa regional office, I have done this on my farm where I train women, men, and young people on farming in small spaces. During my training sessions I include sessions on reproductive health including family planning.
One of the reasons that women give for not going for skilled attendance at birth is poverty. I have had trainings for several women and men on my farm and at health centers on how they can do farming and earn money. As an added session I teach about birth preparedness which includes the benefits in having skilled attendance at birth. With these sessions women are able to do farming, earn an additional income, and hence be able to buy all hospital necessities and have skilled attendance at birth.
How have you engaged women, families, and your community in developing collaborative and comprehensive solutions to the challenges they face?
In my country, skilled attendance at birth is 34 percent and this explains the high maternal deaths of 438 per 100,000 women. I held lobby meetings with our council leaders to pass a bylaw that calls on all women to have skilled attendance at birth versus giving birth at home or with a traditional birth attendant. As a result a bylaw was passed and this has led to a six times increase in the skilled attendance at birth.
Since I am in a developing country, I take advantage of low cost technologies which impact a large population but which are inexpensive for children, these include immunization, bed nets for malaria, and exclusive breastfeeding for the first six months. I mobilize my community for these low cost effective technologies. During the trainings I hold I have a session on these and even when I get some of these from partners I distribute these to the community members with first priority to pregnant women and breastfeeding mothers.
I also introduced the Kangaroo Mother Care (KMC) where women who deliver premature babies put them close to their chests (like kangaroos) to keep them warm as soon as they are born because the biggest killer of such babies is hypothermia (low temperature in the baby) This has been extremely effective in saving lives in my community. What does it cost? Nothing! I have worked with women to popularize low cost interventions such as use of family planning to space children and benefit both mother and child etc. In addition, the use of tablet (misoprostol) which a woman can keep with her and if she over bleeds after delivery, she can swallow it even if she is on her own in rural remote area.
In the future, what challenges/issues do you foresee facing the next generation of leaders who are addressing issues of poverty, health, and education and how would you engage with leaders around those issues?
What started as a financial issue of the U.S. and Europe is now clearly a global crisis that will continue to hit Africa hard over the years to come. It is already affecting our progress toward reducing poverty. Uganda and other developing countries are negatively impacted in the economic crisis because of our reliance on remittances from family overseas and official development aid for national budget support.
Investing in family planning and reproductive health services not only is good for women’s health and rights, it makes economic sense—each $1 invested in contraceptive services will avoid between $1.7 and $4 in expenditures on maternal and newborn health, in addition to cost-savings in education, water sanitation, and immunization. Investing in family planning services reduces maternal mortality, improves child survival, promotes women’s empowerment and contributes to poverty reduction.
Over the past 20 years, we have seen investments in health and education for women and girls leading to increases in productivity, agricultural yields, and national incomes in developing countries.
Every year, 265,000 mothers in sub-Saharan Africa die in childbirth from preventable causes. In Uganda alone, approximately 6,000 women die every year due to pregnancy complications. Women bleed to death, they do not have access to antibiotics to prevent simple infections; they often do not have the option of a caesarean section when it is necessary. We can prevent these tragedies by providing women with prenatal care, skilled attendance at births, and emergency obstetric care.
Engaging with future leaders through targeted advocacy using tools such as the SMART/SPITFIRE Approach would be a game-changer. We have a blueprint for what we need to do, in Uganda and globally—we must fund and implement the “Uganda Family Planning Costed Implementation Plan.”
This aligns with global frameworks and agreements such as the global commitment to universal access to reproductive health services by 2015 and FP2020. We have the shared-knowledge to implement effective, low-cost strategies such as family planning to improve the health of mothers and children. What we now need is the commitment of community and political leaders to support health programs that work and to fund the policies and commitments they have made.
About Global Health Corps
Global Health Corps is a leadership development organization focused on health equity. Its mission is to build a global community of diverse young leaders changing the face of global health. Barbara Bush is CEO and co-founder.
Pickett Slater Harrington is the manager of leadership development and effectiveness at Independent Sector.