Our mission is to empower people and communities in situations of poverty, illiteracy, disease and social injustice. Our interventions aim to achieve large scale, positive changes through economic and social programs that enable men and women to realize their potential.
Mar 12, 2013

Inside a Birthing Hut with Deborah Roberts

Susan Davis and Deborah Roberts
Susan Davis and Deborah Roberts

The following post was written by ABC News Correspondent Deborah Roberts on the Million Moms Challenge blog about her recent trip to Bangladesh to see BRAC’s programs working to save the lives of mothers and children.

When I went into labor with my first child 13 years ago, I expected, like many moms- to-be, smooth sailing. It wasn’t. After 18 intense hours, my labor had not progressed much. So my skilled and trusted obstetrician ordered a cesarean section. My disappointment over having major surgery soon gave way to joy over my beautiful daughter. Three years later, I had a second C-section with my son. I healed well and didn’t think much about the medical intervention surrounding my birthing experiences, until last month.

As I prepared for a story on maternal mortality, I realized that what happened to me could have been life-threatening if I lived in another part of the world. The statistics are stunning: Every 90 seconds a woman dies during pregnancy or childbirth. That’s 1,000 girls and women a day… more than half a million women every year. And experts say more than 80% of these deaths are preventable.

And I made another shocking discovery. The United States, a country which spends nearly $3 trillion annually on healthcare has an astoundingly high maternal mortality rate. One international group ranks us 50th in the world, behind countries like Albania and South Korea. Two women in this country die each day due to pregnancy-related problems. And for black women the number is four times higher for reasons that are unclear.

My birth state of Georgia has one of the highest maternal mortality rates in the country. I visited the Atlanta Medical Center where Dr. Bradley Bootstaylor offered a stunning, and controversial theory: that we may be leaving women vulnerable to complications by turning childbirth into a medical event instead of allowing it to happen more naturally. He worries about the routine reliance on ultrasounds, epidurals and C-sections. His hospital is now taking a low tech approach to childbirth. They have eight midwives on staff who discourage painkillers and offer alternatives like massage, walking during contractions and warm tubs of water to allow women to get through the birth experience more naturally. While there are no published studies to suggest that medical intervention leads to maternal deaths, there is no arguing that maternal mortality is a problem in the U.S.

Some countries, however, are making extraordinary progress. Believe it or not, one of them is in the developing world. Bangladesh, one of the most densely populated countries on the planet – nearly 150-million people in an area the size of Iowa – is somehow creating a miracle. Over the last decade the deaths of new mothers has dropped dramatically – by 40 percent! Today Bangladesh is one of just 16 countries on the path to achieve the United Nations’ Millennium Development Goals – including cutting maternal deaths by 75% by the year 2015.

I traveled 8,000 miles to the capital city of Dhaka to see what was happening. There I met Dr. Kaosar Afsana. She’s an academic working with BRAC, an international aid group, which has had a major role in saving the lives of Bangladeshi women. In a country where close to 80 percent of women give birth at home, BRAC has discovered that the lack of skilled medical care during childbirth is at the heart of the problem.

Afsana took me by boat to a local slum called Korail. As we wound our way through narrow alleyways I met young mother after young mother. Afsana explained how women, often teens, really, die at alarming rates in Bangladesh due to hemorrhaging, obstructed labor, infections, poor nutrition and lack of knowledge about childbirth. And worse, most don’t trust the medical system to help them. So BRAC decided that the key to change is in delivering medical attention to the doorstep of expectant women.

We visited a birthing hut where eight pregnant women, wrapped in colorful saris, were being instructed on the basics of what to expect during delivery and how to recognize a possible complication before it’s too late. I asked how many of them planned to come back to the hut to deliver, and all raised their hands. The hut was clean and had a warm feeling. Then, we got word of a birth happening in a hut nearby. We raced through the litter strewn streets to another birth center to find a bright-eyed, beautiful baby boy who was just delivered by 25-year old Rina. Both mother and child, surrounded by four skilled female birth attendants, were doing fine. A nice safe birth. Six hours later, Rina was on her way home. She was escorted by two women who helped with the birth and possibly spared her life threatening complications. We could call them Rina’s guardian angels.

On the last day of my visit, I met with Richard Greene, an official with United States Agency for International Development (USAID), the U.S. government’s humanitarian aid arm. A Virginia resident now living in Dhaka, Greene is one of the architects for a new cell phone program that has enormous promise to improve health outcomes for pregnant women and new moms. Its success makes sense: more than half the population carries a cell phone

The plan is to text or call pregnant women to give them critical alerts about their pregnancies timed to their due date. They get reminders to take vitamins, see a health worker or eat healthy food (poor nutrition is a big problem in Bangladesh). Once the baby is born, they get text messages about breastfeeding and potential problems to look out for. Health workers also carry cell phones, and with a few keystrokes can upload data on specific patients to a server so doctors can monitor a pregnant woman health throughout the pregnancy.
The pilot program, called MAMA, is still in its infancy. It’s an idea that’s catching on. When I returned home I learned of a similar texting program in the U.S.

It’s called Text4Baby, and it’s a free messaging service. All a mother has to do is text 511411 and put in the word BABY or BEBE (for Spanish service), along with her due date or her child’s birthday, and she’ll receive three personalized, health-related text messages a week through her entire pregnancy and the first year of her baby’s life.

There’s an old African proverb: to be pregnant is to have one foot in the grave. The hope among those engaged in the fight against maternal mortality is that those ancient words will soon be forgotten.

Mar 1, 2013

Engaging Youth - Going Beyond Skills

STAR Program
STAR Program

In Bangladesh, close to two million young people join the workforce annually. Many of the opportunities that are currently on the market are not in the formal sector, but rather are entrepreneurial opportunities in the growing informal service sectors.

BRAC caters to hundred of thousands of youths and offers a range of empowering programs and services, including many dedicated to livelihood development and income generation. Last year, BRAC's Social Innovation Lab explored how BRAC's programs are working to support entrepreneurship and where there are opportunities to do more. We learned the most in speaking with current members of BRAC's programs, such as the Adolescent Development Program and listening to their stories.

Contrary to what you may expect (and to our experience in adolescent programs outside of Bangladesh), the adolescents who we spoke to showed a keen interest in job-seeking rather than entrepreneurship. In Dhamrai, Dhaka, we met a Rabeya, a 16-year-old member of ADP. Rabeya is a very bright student and is consistently at the top of her class. She plans to complete higher studies and pursue a career in the job market, but when we asked about applying her talent to become an entrepreneur, she is afraid to even consider it as an option. The risk and stigma associated with entrepreneurial ventures has her choosing the security the formal employment sector over the potential of establishing a thriving business.

In Chittagong, we met Halima, an ambitious15-year-old girl who is receiving training from another BRAC program--STAR or Skills Training for Advancing Resources, to become a tailor. STAR is currently providing vocational training to 1,000 school dropouts, drastically increasing their chances for job placement through training in growing market sectors. Halima is ambitious and displays the characteristics of a natural entrepreneur as she dreams of one day having her own shop. However, she doesn't equate that goal with that of being an entrepreneur. Difficulty in accessing financial resources and knowledge on basic business practices hampers her confidence in pursuing her dream.

This feedback from our participants helps us to understand that drastic improvements are needed at all levels of society to cultivate the entrepreneurial mindsets of young people. Successful entrepreneurs need to be celebrated and their stories and knowledge shared with creative and aspiring youths in Bangladesh.

But just a change of mindset still won't be enough. At the "Investing in Youth" workshop held by the Social Innovation Lab in April 2012, we met Sabila, a young energetic tech entrepreneur running her own company and has great potential for success. Unfortunately, a lack of societal support for her venture and the ventures of other emerging young entrepreneurs like herself is hindering their success in a highly competitive market.

With your support of BRAC's Adolescent Program, we are able to continue identifying opportunities to improve our programs and find new ways to empower these bright young entrepreneurs, cultivate interest in market innovation and break down stubborn taboos that hinder the entrepreneurial spirit of young people in Bangladesh.

Learn more about Sabila, the progress of young entrepreneurs, and much more in: BeyondSkills: Supporting Youth to Become Successful Entrepreneurs in Bangladesh.

Feb 14, 2013

The Economic Gain of Investing in Girls

What is the price of excluding girls from productive employment? The cost, according to a recent World Bank working paper, “Measuring the Economic Gain of Investing in Girls”, is in the billions of dollars!
The authors of the study, Judy Chaaban and Wendy Cummingham, explored the linkages between investing in girls and the potential increases in national income by examining three aspects of adolescent girls’ lives: school dropout, teenage pregnancy, and joblessness. Here is a summary of their findings:
Investing in girls so that they would complete the next level of education would lead to a lifetime earnings of today’s cohort of girls that is equivalent to up to 68 percent of annual gross domestic product. When adjusting for ability bias and labor demand elasticities, this figure falls to 54 percent, or 1.5 percent per year. Closing the inactivity rate between girls and boys would increase gross domestic product by up to 5.4 percent, but when accounting for students, male-female wage gaps and labor demand elasticities, the joblessness gap between girls and their male counterparts yields an increase in gross domestic product of up to 1.2 percent in a single year. The cost of adolescent pregnancy as a share of gross domestic product could be as high as 30 percent or as low as 1 percent over a girl’s lifetime.

The World Bank study demonstrates how investing in girls will lead to significant economic growth and points to the need for policymakers to create more robust programs that engage girls in the mainstream economy. 

Since inception, BRAC has made girls central to its approach toward poverty alleviation. Our Empowerment and Livelihood for Adolescents (ELA) and Social and Financial Empowerment for Adolescents (SoFEA)

 Programs seek to make girls productive and self-supporting members of society by providing livelihood and life-skills training, combined with credit facilities. To date, ELA has reached over 800,000 girls between the ages of 14 and 25 in Bangladesh, Afghanistan, South Sudan, Tanzania, and Uganda.

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