Responding to the Changing Needs of Women and Families Worldwide
Since its founding in 1974, Jhpiego has been innovating to save the lives of women and families worldwide. From the first day, Jhpiego has been asking the question: How can we make lifesaving services available and accessible to the people who need them—all over the world?
Dr. Theodore M. King, an early innovator and champion for women’s health, was the moving force behind the founding of Jhpiego, an affiliate of Johns Hopkins University. In the early 1970s, King recognized the need to make physicians, nurses and administrators from developing countries aware of reproductive health breakthroughs, such as laparoscopy (a procedure used to inspect internal reproductive organs for infertility or to provide contraception by closing off the fallopian tubes) and modern contraceptives. Originally known as the Johns Hopkins Program for International Education in Gynecology and Obstetrics, the organization was funded through the United States Agency for International Development (USAID). Under King’s leadership, as a founder, trustee and later president of Jhpiego for 14 years, the organization conducted a steady stream of programs throughout the developing world.
How Did We Get from There to Here?
Early on, Jhpiego established itself as a leader in reproductive health training. Beginning in 1974, Jhpiego held training sessions on family planning/reproductive health for doctors and nurses in the USA In 1979, Jhpiego started its first in-country training programs in Tunisia, Brazil, Kenya, Nigeria, Thailand and the Philippines. From 1987 through 2004, Jhpiego conducted three global Training in Reproductive Health Projects, funded by USAID. Beginning in 1993, Jhpiego published learning materials on long-acting family planning methods.
Over the years—to respond more effectively to the needs of individual countries—Jhpiego became increasingly field-based and established its first field office in Kenya in 1993. Today, Jhpiego has field offices in more than 30 countries worldwide. Similarly, Jhpiego’s programming areas have expanded to meet changing needs in the field. In addition to family planning and reproductive health, Jhpiego now has expertise in maternal and child health, infection prevention and control, HIV/AIDS and infectious diseases.
Jhpiego’s work has also expanded to address reproductive health policy and guidelines and to support health systems strengthening. For example, in 1996 in Brazil, Jhpiego launched a performance and quality improvement approach, now known as Standards-Based Management and Recognition (SBM-R), which has since been implemented in 30 countries. SBM-R empowers health workers and facilities to improve the performance and quality of their services by providing them with the tools and methods they need to make decisions, solve problems and innovate at the local level.
Innovations in Training Methods and Technologies
In 1986, Jhpiego pioneered a competency-based training (CBT) approach that emphasizes learning by doing. CBT focuses on how the participant performs and promotes the trainer’s ability to encourage learning. Jhpiego also introduced the use of anatomic models for “humanistic training.” To minimize risk to clients, learners first practice on models until they achieve competency. In 1995, a clinical training skills manual—the cornerstone of Jhpiego’s training approach—was published. Using a systematic “training of trainers” approach, Jhpiego has created a global network of qualified physician, nurse and midwife trainers.
As early as 1984, Jhpiego collaborated with the University of the West Indies to deliver reproductive health courses, via satellite, to six islands in the Caribbean. In 1987, Jhpiego sponsored a global meeting on reproductive health education and technology with the World Health Organization (WHO) and introduced computer-assisted instruction to simulate clinical situations in several of its US-based courses. In 1995, ReproLine, an online source for reproductive health information, was launched. Today, Jhpiego continues to explore new learning technologies: mobile phones in Afghanistan, a computer-based learning management system in Ethiopia, computer-based training in Ghana, a distance learning program in Zambia.
Practical Solutions for Low-Resource Settings
Since the 1992 publication of its international reference standard Infection Prevention for Family Planning Service Programs, Jhpiego has been at the forefront in promoting evidence-based practices that can protect health care professionals, staff and clients from potentially life-threatening infections. To this end, Jhpiego has tested and introduced practical, low-cost infection prevention procedures that can be implemented effectively in settings with limited resources.
In developing countries, cervical cancer remains the leading cause of cancer deaths among women. In 1995, Jhpiego began research with the University of Zimbabwe to find a low-cost alternative to the Pap test that could make cervical cancer prevention a reality in low-resource settings. Based on the results of this research, Jhpiego helped form the Alliance for Cervical Cancer Prevention in 1999 and received funding from the Bill & Melinda Gates Foundation to expand its cervical cancer program. Since that time, Jhpiego has developed and piloted the single visit approach in which women are screened and treated during the same visit.
In 1995, Jhpiego began addressing HIV/AIDS and its integration with family planning services. Six years later, Jhpiego began work in HIV voluntary counseling and testing with a USAID-funded project in Jamaica. In 2002, Jhpiego received its first funding from the U.S. Centers for Disease Control and Prevention (CDC) for work in HIV/AIDS and, the following year, developed a global learning package on prevention of mother-to-child transmission of HIV—with CDC, WHO and university partners—to enable global scale-up. Also in 2003, Jhpiego began work on male circumcision for HIV prevention in Zambia. In 2008, Jhpiego developed a global learning package on male circumcision for HIV prevention with WHO and UNAIDS.
The Way Forward
Jhpiego’s role in maternal and child health has expanded dramatically over the years, increasing its emphasis on nurses and midwives as primary care providers. From 1998 through the present, Jhpiego has led three of USAID’s global flagship programs: the MNH Program, followed by the ACCESS Program—both of which focused on maternal and newborn health—and currently the Maternal and Child Health Integrated Program (MCHIP), an expanded program that focuses on maternal, newborn and child health.
Jhpiego’s dedicated teams of technical experts—in the areas of global learning; family planning/reproductive health/cervical cancer; maternal, newborn and child health; monitoring, evaluation and research; health systems strengthening; HIV/AIDS and infectious diseases; publications; and knowledge management—are renewing their efforts to pursue and disseminate practical, low-cost innovations that can make significant contributions to the health of women and their families.
As Jhpiego moves forward, its staff will continue to respond to changing needs in the field, and they will continue to ask: How can we save more lives?