Improving health outcomes for women and their communities

March 8th, 2023 | Story


This year, International Women’s Day is focused on equity. At JSI, we support programs and policies that make health systems more equitable so that women can make informed decisions and access the health care they need, when and where they need it. We also strengthen the community health care workforce, which in many countries is powered by women, so it can provide high-quality services.


Adolescent girls and young women often have limited access to health care and education, which increases risk of HIV infection. USAID Controlling HIV Epidemic for Key and Underserved Populations (CHEKUP II) in Zambia provides age-appropriate services through the DREAMS program to help adolescent girls and young women access health care and economic opportunities. To date, USAID CHEKUP II has initiated 1,639 clients on pre-exposure prophylaxis (PrEP), 78 percent of whom were adolescent girls and young women, and helped more than 2,500 access family planning services. USAID CHEKUP II also helped create wellness centers for other under-resourced populations. To date, these centers have tested nearly 1,000 female sex workers for HIV. Of these, 267 accessed PrEP, and the 103 who tested positive linked to antiretroviral treatment. To read more about this work, see How A CHEKUP II Wellness Center Supports Key Populations in their Safety and Wellness Journey in Kabwe, Zambia.

The KP Wellness Center, established in Kabwe through the USAID CHEKUP II project
The KP Wellness Center, established in Kabwe through the USAID CHEKUP II project


Stigma has long deterred many people, especially those who are young, from HIV testing and treatment. In northern Uganda, where the HIV prevalence rate is higher than the national average, the USAID Regional Health Integration to Enhance Services-North, Lango’s Youth and Adolescent Peers (YAPs) program trains participants to provide certain HIV services and support to decrease stigma and discrimination so that their peers are comfortable getting tested and treated for HIV. Watch the following video to hear Sandra Akello, one of 89 YAPs trained by the project, talk about how she’s making a difference in her community.

Kyrgyz Republic

Stigma also keeps people from accessing tuberculosis (TB) care and treatment. The USAID Cure Tuberculosis project works closely with the Kyrgyz government to ensure that TB services are both high-quality and accessible, even to the most hard-to-reach citizens. The project provides training to health promotion unit and village health committee staff, who disseminate accurate information and reduce misconceptions about TB and support people to complete their treatment. Saadat Tamanbaeva works for the health promotion unit in her village and rallied her neighbors, friends, and village health committee to ensure one young man completed his TB treatment. Read more about Saadat’s commitment to changing attitudes toward TB in the Kyrgyz Republic in One Young Woman’s TB Advocacy Inspires a Village.

Two women sit behind a desk talking.
Saadat Tamanbaeva (right) visits a TB doctor's office. Photo: Ksenia Basova for JSI


In Pakistan, COVID-19 vaccination services are readily available in cities and major hospitals, but less so for people, especially women and children, who live in rural areas. The USAID Integrated Health Systems Strengthening and Service Delivery Activity (IHSS-SD) worked with the provincial governments of Khyber Pakhtunkhwa and Sindh to help 25 districts dispel misinformation and reach more people with COVID-19 vaccination services. Outreach teams meet women in their homes and communities so they can make informed vaccination decisions for themselves and their families. To date, USAID IHSS-SD has helped the Government of Pakistan vaccinate more than 8.9 million eligible adults against COVID-19. Hear more about this work from Riffat Hafeez, a social mobilizer, and Khushnuma Bibi, a vaccinator, who are bringing COVID-19 vaccination services to other women in rural Pakistan. Watch their videos below.


The Behavioral Science Center at Kathmandu University School of Medical Sciences, JSI, and UNICEF Nepal conducted a rapid inquiry to understand the behavioral and social factors that limit or prevent vaccine uptake among under-immunized and zero-dose communities in Kathmandu. The research team found that women caregivers, particularly in low-income and migrant families, lacked decision-making power, leaving them simultaneously responsible for childcare but unable to decide if or when to vaccinate children. Additionally, the team found that caregivers, who are primarily women, experienced discrimination from health workers and were unaware of immunization clinic locations and service hours. The inquiry were shared with local health officials, health workers, and community members who participated in a co-creation workshop to design solutions to increase vaccine uptake.

Female Community Health Volunteer accompanies a mother and her neonate for immunization to the health facility in Nuwakot District Hospital Nepal 2017.

Jakarta, India, Nigeria, Mozambique, Kenya

The USAID-funded MOMENTUM Routine Immunization Transformation and Equity project works in a number of countries to identify and overcome gender-related barriers to reach zero-dose and under-immunized children, individuals, and communities with the full range of vaccines. To make COVID-19 vaccination services more accessible, the project organized a special vaccination camp for pregnant and lactating mothers in Jharkhand, India, and in Nigeria, the project brought vaccinations right to people at a busy market, most of whom are women. For more on how the project is helping stop the spread of COVID-19, see International Women’s Day: Women Working Together to Combat COVID-19 in the DRC. In Mozambique, to help change the belief that women are solely responsible for getting children vaccinated, the project convenes community health committee meetings with men and women to discuss how men can support routine immunization. Read more about the project’s work at the community level in Health Workers and Community Volunteers Work Together To Improve Routine Immunization Rates in Western Kenya.

A Nigerian woman holds a vaccination certificate.
A Nigerian woman holds her vaccination card.


Few women in Yemen have the resources to travel to distant health facilities for essential maternal, child, and reproductive care. To improve accessibility of high-quality health care services and information, the USAID Systems, Health and Resiliency Project (SHARP) project trained more than 200 community midwives, who have provided skilled care to around 140,000 women. In the following video, hear from Hanan, one of the midwives who are increasing access to life-saving maternal and child health care in Yemen.


The Ethiopia eCHIS Scale-up for HEP Improvement Project, funded by the Children’s Investment Fund Foundation, aims to scale up the electronic community health information system (eCHIS) and transform the Health Extension Program to improve health outcomes for mothers, children, and adolescents. Health extension workers, primarily women, provide health care services at the community level. Digital tools like eCHIS help them do their jobs more effectively and efficiently, which means that communities have access to better care. To date, in woredas where eCHIS is used, more women are receiving their first antenatal and postnatal care visits, which are essential to keeping mothers and their babies safe and healthy before and after delivery.

A women sits on a stool in a dark room speaking to other women who are seated on the floor.
Fozia Hayredin, a Health Extension Workers at Demala Health Post, together with her health development army (HDA) member, facilitates a family conversation in the home of an eight month pregnant woman. They discuss birth preparedness. Photo: Robin Hammond.

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