News Maternity and Birthing

Increased Investment in Midwifery Services Can Save 3.6 Million Lives Annually

Brenda Zulu

Thirty-eight of 58 countries surveyed may fail to meet their target of 95 percent coverage by skilled attendants by 2015 unless an additional 120,000 midwives are trained, deployed and retained. A new report also indicates that upgrading midwifery services could save more than 3.6 million lives each year by 2015.

“I lost my baby because of the neglect of a midwife who attended to me. I was told to go the toilet and gave birth in the toilet,” said Christine Kabwe (not her real name). 

When a woman is pregnant in Africa, it is assumed she has one foot in the grave and that her chances of being alive after birth are very slim.

Many mothers fear giving birth at a health facility, said Madame Callista Mutharika, first lady of Malawi, in her keynote address at the International Confederation of Midwives (ICM) 29th Triennial Congress, taking place in Durban South Africa.

Cultural traditions, a lack of sensitivity and poor treatment by midwives discourage women from accessing health services, she said, even where they are available. She reminded all midwives to remember the oath each one of them took when they started their job.

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“The State of the World’s Midwifery 2011: Delivering Health, Saving Lives,” a major report released at the Congress, says that women have cited a variety of abusive behaviours at clinics and hospitals as reasons for choosing the more perilous route of home birth. In some cases the provider does not speak the local language, or female providers may not be available when wanted.

In his forward to the report, Secretary General of the United Nations Ban Ki-moon wrote that there is need to ensure that every woman and her newborn have access to quality midwifery services which demands taking care of bold steps to build on what has been achieved so far across communities, countries, regions and the world..

“Our responsibility is clear we must safeguard each woman and child so they may live to their full potential,” said Ban Ki-moon.

One of the most important investments a country can make to reduce high rates of maternal and infant mortality is in human resources to ensure women have access to skilled care, particularly midwives, during labour and delivery.

“The report points to an urgent need to train more health workers with midwifery skills and ensure equitable access to their life saving services in communities to improve the health of women and children,” said Dr Babatunde Osotimehin, Executive Director United Nations Population Fund (UNFPA).

According to the report, 38 of 58 countries surveyed might not meet their target to achieve 95 percent coverage of births by skilled attendants by 2015, as required by Millennium Development Goal (MDG) 5 on maternal health, unless an additional 120, 000 midwives are trained, deployed and retained in supportive environments.

The new report also indicates that upgrading midwifery services could save more than 3.6 million lives each year by 2015 in the 58 developing countries surveyed.

“Each year, 358,000 women die while pregnant or giving birth, some 2 million newborns die within the first 24 hours of life and there are 2.6 million still births, all because of inadequate or insufficient health care,” says the report.

“There has never been a report like this,” said Bridget Lynch, president of ICM, noting that it had been supported by more than 30 agencies whose collective aim is to strengthen midwifery practices to prevent maternal death and disability and improve the health of newborns, families and the entire communities.

“The biggest challenge however remains the shortage of midwives,” said Lennie Kamwendo, chair of the board of trustees of the White Ribbon Alliance for Safe Motherhood in Malawi.

Meanwhile, Dr Joy Lawn, director of global evidence and policy with Save the Children, asked midwives to use the data in the report for advocacy. She said increasing women’s access to high quality midwifery services has become a focus of global efforts to realize the right of every woman to best possible health care.

The report makes a series of recommendations to governments, regulatory bodies, educational institutions, professional associations and international organizations that would help remedy these problems and reinforce the status of midwifery in the countries surveyed.  

News Health Systems

Texas Anti-Choice Group Gets $1.6 Million Windfall From State

Teddy Wilson

“Healthy Texas Women funding should be going directly to medical providers who have experience providing family planning and preventive care services, not anti-abortion organizations that have never provided those services," Heather Busby, executive director of NARAL Pro-Choice Texas, said in a statement.

A Texas anti-choice organization will receive more than $1.6 million in state funds from a reproductive health-care program designed by legislators to exclude Planned Parenthood

The Heidi Group was awarded the second largest grant ever provided for services through the Healthy Texas Women program, according to the Associated Press.

Carol Everett, the founder and CEO of the group and a prominent anti-choice activist and speaker, told the AP her organization’s contract with the state “is about filling gaps, not about ideology.”

“I did not see quality health care offered to women in rural areas,” Everett said.

Heather Busby, executive director of NARAL Pro-Choice Texas, said in a statement that it was “inappropriate” for the state to award a contract to an organization for services that it has never performed.

“The Heidi Group is an anti-abortion organization, it is not a healthcare provider,” Busby said.

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State lawmakers in 2011 sought to exclude Planned Parenthood from the Texas Women’s Health Program, which was jointly funded through federal and state dollars. Texas launched a state-funded version in 2013, and this year lawmakers announced the Healthy Texas Women program.

Healthy Texas Women is designed help women between the ages of 18 and 44 with a household income at or below 200 percent of the federal poverty level, and includes $285 million in funding and 5,000 providers across the state.

Bubsy said the contract to the Heidi Group was “especially troubling” in light of claims made by Everett in response to a recent policy requiring abortion providers to cremate or bury fetal remains. Everett has argued that methods of disposal of fetal remains could contaminate the water supply.

“There’s several health concerns. What if the woman had HIV? What if she had a sexually transmitted disease? What if those germs went through and got into our water supply,” Everett told an Austin Fox News affiliate.

The transmission of HIV or other sexually transmitted infections through water systems or similar means is not supported by scientific evidence.

“The state has no business contracting with an entity, or an individual, that perpetuates such absurd, inaccurate claims,” Busby said. “Healthy Texas Women funding should be going directly to medical providers who have experience providing family planning and preventive care services, not anti-abortion organizations that have never provided those services.”

According to a previous iteration of the Heidi Group’s website, the organization worked to help “girls and women in unplanned pregnancies make positive, life-affirming choices.”

Texas Health and Human Services Commission spokesperson Bryan Black told the Texas Tribune that the Heidi Group had “changed its focus.”

The Heidi Group “will now be providing women’s health and family planning services required by Healthy Texas Women, including birth control, STI screening and treatment, plus cancer screenings to women across Texas,” Black said in an email to the Tribune.

Its current site reads: “The Heidi Group exists to ensure that all Texas women have access to quality health care by coordinating services in a statewide network of full-service medical providers.”

Everett told the American-Statesman the organization will distribute the state funds to 25 clinics and physicians across the state, but she has yet to disclose which clinics or physicians will receive the funds or what its selection process will entail.

She also disputed the criticism that her opposition to abortion would affect how her organization would distribute the state funds.

“As a woman, I am never going to tell another woman what to tell to do,” Everett said. “Our goal is to find out what she wants to do. We want her to have fully informed decision on what she wants to do.”

“I want to find health care for that woman who can’t afford it. She is the one in my thoughts,” she continued.

The address listed on the Heidi Group’s award is the same as an anti-choice clinic, commonly referred to as a crisis pregnancy center, in San Antonio, the Texas Observer reported.

Life Choices Medical Clinic offers services including pregnancy testing, ultrasounds, and well-woman exams. However, the clinic does not provide abortion referrals or any contraception, birth control, or family planning services.

The organization’s mission is to “save the lives of unborn children, minister to women and men facing decisions involving pregnancy and sexual health, and touch each life with the love of Christ.”

News Economic Justice

Wage Theft on Capitol Hill: Cafeteria Workers to Receive $1 Million in Back Pay

Michelle D. Anderson

“Most struggle to afford life’s basic expenses and pay their bills; they shouldn’t have to deal with paychecks that don’t accurately reflect their hard work and the wages to which they are legally entitled,” said David Weil of the U.S. Department of Labor.

Hundreds of people who work in cafeterias that serve U.S. senators and their legislative staffers on Capitol Hill will reportedly receive $1 million in back pay in connection to a United States Department of Labor wage theft investigation.

According to a Washington Post report, 674 food service workers will receive their owed compensation. The back wages break down to about $1,500 per worker.

Officials from the department’s Wage and Hour Division last week said an investigation had revealed the workers were denied prevailing wages that contractor Restaurant Associates and subcontractor, Personnel Plus, were obligated to pay under federal labor law.

Architect of the Capitol, the federal agency that runs the United States Capitol Complex, had contracted the employers.

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The Labor Department said Restaurant Associates and Personnel Plus violated by the McNamara-O’Hara Service Contract Act (SCA) and the Fair Labor Standards Act (FLSA) by improperly classifying workers so that they could be paid wages for lower-paying jobs and by requiring employees to work prior to their scheduled starting times.

One cafeteria worker told the Washington Post in January that his hourly wage dropped to $13.80 an hour from $17.45 after his job title changed from “cook” to “food service worker.”

The employer also failed to pay required health and welfare benefits and violated SCA, which applies to every U.S. government contract valued in excess of $2,500, by failing to adhere to the law’s record keeping requirements.

David Weil, the department’s Wage and Hour Division administrator, said in a statement last week that restaurant industry workers are among the lowest-paid workers in the U.S. economy.

“Most struggle to afford life’s basic expenses and pay their bills; they shouldn’t have to deal with paychecks that don’t accurately reflect their hard work and the wages to which they are legally entitled,” Weil said.

The division is reviewing its findings to determine whether it will keep the Restaurant Associates from securing any more contracts with the federal government.

Labor Department spokesperson Joanna Hawkins told Rewire that the case is still open. She said SCA requires contractors guilty of this violation to be debarred unless the Labor Department’s Wage and Hour Division recommends otherwise “because of unusual circumstances.”

Restaurant Associates spokesman Sam Souccar told Rewire in an emailed statement that the misclassifications were largely attributable to “administrative technicalities related to our Associates’ evolving day-to-day work responsibilities, which in some cases crossed multiple job categories.”

Souccar said the company has since corrected the problem and was “100 percent committed to ensuring classifications [were] accurate going forward.” He also said Restaurants Associates valued its contract with the Architect of the Capitol and implied that the company wanted to continue working with the federal government.

Robert Guiney, president of Personnel Plus and Just Temps Staffing, disagreed with the Labor Department’s assessment. He denied any wrongdoing.

“Restaurant Associates admitted responsibility for the whole thing and they pay our employees,” Guiney said in a phone interview with Rewire. He declined to comment further.

Guiney said the Labor Department had given his company, Personnel Plus, a “clean bill of health,” according to a Courthouse News Service report.

Hawkins said Restaurant Associates is the prime contractor on the government contract in question. She said it was the company’s responsibility to formally advise subcontractor Personnel Plus of the SCA requirements.

“In this case, Restaurant Associates failed to do so. Restaurant Associates took responsibility for that and agreed to pay the back wages owed to the employees of Personnel Plus. Nonetheless, Personnel Plus also failed to pay all of its workers for all hours worked which resulted in additional back wages,” Hawkins said.

Paco Fabián, a spokes for Good Jobs Nation, an advocacy project of the Change to Win labor coalition that focuses organizing federal contract workers who work for low wages, told Rewire via phone interview that policy changes will help prevent wage theft violations.

He cited three labor-related executive actions signed by President Barack Obama, including one that raised the minimum wage to $10.10 an hour.

“It sort of kicked off an increase in minimum wage across the country because he led by example,” said Fabián, who noted that the cafeteria workers remain without union representation.

Fabián said policy changes should aim to create a system in which the most ethical bidder, rather than the lowest bidder, will be awarded a government contractor. Lowest bidders are more likely to engage in wage theft violations, Fabián said. “We want to create a system that gives preferences to companies that provide living wages and benefits and to freedom to form unions without retaliation,” he said.

Joseph Geevarghese, director of Good Jobs Nation, said in an emailed statement the recent $1 million award was the result of activism. In recent years, U.S contract workers and allies have gone on strike and filed legal multiple complaints.

“This shows that when workers act, workers can win,” Geevarghese said.

Last year, for example, more than two dozen Senate aides brought their own lunches to work and boycotted meals being served on Capitol Hill during a union drive among the cafeteria employees. Sen. Sherrod Brown (D-OH) was among those to join the boycott, according to Al Jazeera.

Sens. Brian Schatz (D-HI) and Harry Reid (D-NV) are among lawmakers who have shown support for reform on behalf of the food workers. Reid has said the federal government should stop working with the Restaurant Associates, according to an Associated Press report.

Geevarghese urged Obama to sign the Model Employer Executive Order that was recently added to the Democratic Party platform.

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