Engenderhealth 70th Anniversary Impact Report
From the beginning, we championed women’s rights and contraceptive choice by putting the power of family planning into the hands of women and couples worldwide. We believed then and to this day that when a woman can choose the number of children she wants, not what her circumstances dictate, the possibilities for her future are infinite. We have transformed that passion into action—every day for 70 years.
The EngenderHealth story is all about passion. From the beginning, we championed women’s rights and contraceptive choice by putting the power of family planning into the hands of women and couples worldwide. We believed then and to this day that when a woman can choose the number of children she wants, not what her circumstances dictate, the possibilities for her future are infinite. We have transformed that passion into action— every day for 70 years. Our pioneering efforts to expand women’s access to family planning and reproductive health care have made a lasting impact. Together with our partners—governments, nongovernmental organizations, communities, and health care facilities— we have introduced and improved highquality family planning and reproductive health care, including long-acting and permanent methods of contraception, across more than 110 countries. As a result, more than 200 million women and men have been able to effectively choose their family sizes and shape their futures. EngenderHealth stands apart in our accomplishments to ensure that reproductive health services uphold women’s rights and are high-quality, woman-centered, and sustainable, today and for generations to come. These are fundamental values that were present from the very beginning and that remain very much alive today. We are proud of our role as a driving force behind the incredible progress that has been made by the international reproductive health field, and these successes would not have been possible without our longstanding partners and supporters. As we look ahead, we are as passionate and determined as ever to strive until every pregnancy is planned, every child is wanted, and every mother has the best chance at survival. Thank you for your invaluable partnership and support. Pamela W. Barnes President and CEO Our story EngenderHealthâ€™s 70-year history is one of innovation, commitment, and visionary leadership. We began as a small, local volunteer association in the United States, and have since evolved to become the leading international womenâ€™s health organization dedicated to expanding high-quality reproductive health services in more than 110 countries. We tackled tough issues that others shied away from, guided by optimism that when women are able to have the number of children they want, not the number their circumstances dictate, a better life is possible. The Right to Contraception and Quality Care Established in 1943, we spent our first 25 years helping women and men gain greater access to voluntary surgical contraception (tubal ligation and vasectomy) in the United States, at a time when most modern contraceptives did not exist. The centerpiece of our work then, and still today, is the deep-seated conviction that women have a fundamental right to choose the number and spacing of their children. We helped tear down the legal and institutional barriers to voluntary permanent methods of contraception, while at the same time advocating that services had to be high-quality and offered with full choice and information. Our efforts paved the way for women to have contraceptive options to fit their needs at various times throughout their lives, whether they were planning their first child or had completed their families. 4 Going Global During the 1970s, EngenderHealth began working globally to expand family planning services, particularly long-acting and permanent methods. We helped introduce simpler options, such as minilaparotomy under local anesthesia for women and no-scalpel vasectomy for men, thereby making surgical contraception more widely available in low-resource settings. Equally important was our role in establishing the fundamentals of quality care—informed choice, respect for women’s rights, and provision of safe services by well-trained health care providers around the globe. We forged close partnerships with governments, hospitals, and clinics, and we transferred knowledge and skills to ensure that family planning services were high-quality and sustainable. These are core values that continue today. Building on our roots as advocates, we became the world’s leading authority on voluntary permanent methods and on the counseling and informed consent needed to protect individuals’ rights and guarantee contraceptive choice. This set the stage for the introduction of new family planning methods, including the intrauterine device (IUD) and hormonal implants, in places where many would not have dreamed that such methods could be offered. Knowing that programs succeed when communities participate in designing services and when individuals are empowered to use them, we championed innovative approaches and best practices that are used throughout the world today. 5 The Woman-Centered Approach We have always known that for women to achieve reproductive health, we had to look beyond family planning. Beginning in the 1990s, we began to focus on the full range of reproductive health needs, such as HIV and AIDS services and maternal health, including postabortion care, obstetric care, and cervical cancer. We also extended our reach beyond the clinic walls to make greater impact. In addition to training doctors and nurses, we partnered with communities to raise awareness of quality services and advocated for supportive policies. In the late 1990s, we began to engage men to proactively support women’s health, seek health services, and speak out against gender-based violence and HIV and AIDS. We knew from our experience on the ground that some harmful traditional ideas about gender place both women’s and men’s health at risk. For example, in some cultures, it is acceptable for men to refuse contraception, to forbid their female partners to use it, or to refuse to discuss family planning. These actions can lead to unwanted pregnancies, unsafe abortion, and maternal death or disability. We pioneered Men As Partners®, an awardwinning approach that proactively addresses gender norms to improve the health and well-being of both women and men, and we are globally recognized for having led this innovative work across 26 countries, including in the United States. We are proud to have been part of the tremendous progress that we see today: More women around the world are surviving pregnancy and childbirth than in previous decades. We have made incredible breakthroughs in HIV. And at the country level, in places as diverse as Tanzania and Azerbaijan, millions more women and men than ever before are exercising their fundamental rights in deciding when to have children and how many to have. The challenge ahead is to build on these important gains and accelerate momentum so that every pregnancy is planned, every child is wanted, and every mother has the best chance at survival. 6 Did You Know? For every $1 invested in family planning, up to $6 dollars is saved in other areas, such as housing, education, and other public services. $1 " $6 Addressing the unmet need for family planning could prevent newborn and infant deaths annually. 1.1 million Together with our partners, EngenderHealth has improved the lives of more than women and men in 110 countries. 200 million 7 Family Planning: The X Factor in Women’s Lives “ Family planning is the most important gift I have received. Now, I can send all of my children to school. My family is a lot happier, wealthier, and healthier—all because of family planning.”—Almaz Kibri, Ethiopia Family planning is one of the most important keys to unlocking opportunities for women and to alleviating poverty. When a woman is able to have the number of children she wants, transformative events happen: She goes further in school, she is more likely to invest money back into her family, and her family is more likely to prosper. For 70 years, EngenderHealth has been improving access to family planning and reproductive health care worldwide. Our global impact is unparalleled. We have led the way in ensuring informed choice, defining clinical and service delivery standards for training health care providers, and ensuring the quality of family planning and reproductive health services. In Bangladesh, our technical expertise in family planning and reproductive health has contributed to a 40% drop in maternal deaths during the past decade. In Tanzania, we helped expand access to the most effective contraceptives, which increased family planning use nationwide by 35% during the past five years. 8 Our Family Planning Impact in 2012 5 million Across countries as diverse as Bangladesh, Kenya, Mexico, Turkey, and the United States, we have helped millions access contraception, particularly long-acting reversible contraceptives and permanent methods. EngenderHealth was also one of the first advocates for integrating family planning with HIV and other health services as a key way to reduce missed opportunities for women and girls in particularâ€”as well as other vulnerable groupsâ€”to access HIV prevention, counseling and testing, treatment, and care and support services. These were needs clearly identified by women, and we responded so that highquality care was available for the community, by the community. women and men received high-quality family planning services at EngenderHealthsupported sites. 650,000 unintended pregnancies were prevented. 100,000 16,000 unsafe abortions were prevented. health care professionals were trained to offer family planning. EngenderHealth received the prestigious United Nations Population Award for our leadership in family planning and reproductive health care. Did you know? Family planning services could reduce maternal deaths by 30%, simply by delaying pregnancy. 9 Ghana WHY I AM A FAMILY PLANNING CHAMPION… Every month, Florence found herself agonizing over the same question: Will I get my period? The thought of becoming pregnant again filled her with anxiety about what it would mean for her health, her job, and her finances. What also kept her awake at night was the thought of dying during pregnancy or childbirth, a tragic reality for some 4,000 Ghanaian women every year. With an infant son already, Florence simply couldn’t afford to become pregnant again—at least until she was ready. But one day, after discussing her worries with Juliana Atiso, Florence learned about family planning, a simple solution that had set Juliana free from the very same anxieties. Florence had heard of family planning but was always skeptical about its safety or effectiveness. But hearing firsthand from Juliana about how family planning changed her life, Florence decided to give it a try. “Like Florence, I used to be very conscious about my menstrual cycle,” said Juliana, a 41-year-old mother of two from Ghana’s Eastern region. “But with family planning, I knew that she could be free from worry and can focus on other things, like taking care of her child and having a job.” By profession, Juliana is a deft and experienced seamstress. She spends her days sewing intricate seams and transforming vibrant fabrics into beautiful dresses and scarves. But since 2011, Juliana has adapted 10 her talents toward mending a different kind of fabric—that of women’s lives, held together by the infinite interwoven threads of their hopes and dreams for the future. Trained by EngenderHealth, Juliana is one of dozens of women in Ghana who volunteer as “family planning champions,” sharing their personal experiences with others. “I feel compelled to encourage my friends and others to use family planning,” Juliana said, highlighting what motivated her to volunteer her time as a champion. “Family planning has been very good for me because it allowed me to work and earn an income before I had my second child. It’s what I am doing before we have a third child.” Since 1986, EngenderHealth has partnered with the government of Ghana and local communities to reach tens of thousands of women with contraceptives, so they can stay healthy and plan their futures. The current EngenderHealth-led project, Reducing Maternal Mortality and Morbidity (R3M), uses the power of peer testimonials to increase awareness within communities about the farreaching benefits of family planning. As a “champion” for the last three years, Juliana routinely dons her white T-shirt— with “I am a satisfied client” emblazoned across the back—to speak at public gatherings. She explains how her decision to use contraceptives was a life-changing one, not just for herself but for her family and their entire community. Juliana Atiso, a family planning champion in Ghana 11 Investing in Women around the World We take a holistic approach to meet a woman’s sexual and reproductive health needs throughout her life, including pregnancy and childbirth. For many women in the developing world, pregnancy marks their first contact with a health care provider, which provides an unmatched opportunity not only to help make pregnancy and delivery safe for both mother and child, but also to address broader aspects of women’s health, including family planning, HIV, and other sexually transmitted infections. We ensure that hospitals and clinics are equipped with well-trained staff and supplies to provide quality prenatal and obstetric care, comprehensive abortion care, fistula treatment, family planning, and HIV treatment and care, such as prevention of mother-to-child transmission of HIV. EngenderHealth’s work to improve women’s access to postabortion care was recognized as one of the “50 most inspiring ideas and solutions” by Women Deliver in 2012. “ Women are not dying because of diseases we cannot treat. They are dying because societies have yet to make the decision that their lives are worth saving.” —Mahmoud Fathalla, MD, PhD, former EngenderHealth Board member With generous support from the Bill & Melinda Gates Foundation, EngenderHealth launched the Maternal Health Task Force and mobilized a diverse expert community to work collectively toward improving maternal health worldwide. 12 Our Maternal Health Impact in 2012 “ EngenderHealth’s Fistula Care project and its partners have played a vital role in expanding access to fistula treatment and prevention activities with USAID support.” —Hillary Rodham Clinton, former U.S. Secretary of State Every day, about 800 women die from pregnancy- or childbirth-related complications around the world. For every one of these women, another 25 to 50 survive but suffer devastating injuries, including obstetric fistula—an abnormal hole in the birthing canal that results in leakage of urine and/or feces. EngenderHealth leads the Fistula Care project, the largest U.S. government– funded effort focused on preventing and treating fistula and restoring women’s hope and dignity. We train fistula surgeons, educate communities about fistula, and help governments budget for maternal health services. With our partners, we have supported more than 26,000 repair surgeries across 14 countries and trained 33,500 doctors, nurses, and community health workers to date. 222,000 45,000 4,500 2,000 women reached with high-quality maternal health services at EngenderHealth-supported sites. women living with HIV gave birth to HIV-free babies. doctors, nurses, and community health workers trained to provide maternal health care and information. maternal deaths prevented. EngenderHealth cofounded the Postabortion Care Consortium to to address complications of unsafe abortion and miscarriage. Representing 60 organizations worldwide, the Consortium has played a crucial role in advocating for greater resources for postabortion care. 13 TANZANIA A SHINING LIGHT IN ONE COUPLE’S DARKEST HOURS On a warm day in January, 28-year-old Maimuna walked along a dirt road to a health center in the town where she lives in Tanzania. Nearing her due date, she was going for a final prenatal check-up. But during her visit, she received devastating news—she was HIV-positive. That day, Maimuna returned home in utter shock but was afraid to tell her husband, Jumanne. She had heard of many husbands reacting aggressively to such news, blaming their wives, refusing to accept the results, and in some cases abandoning their families. But perhaps most of all, Maimuna was worried about the health of her baby. A week later, Maimuna went into labor. In the midst of labor, Maimuna broke the news to Jumanne, whose heart sank. After getting tested himself, Jumanne learned that he too was HIV-positive. As they awaited the arrival of their baby, normally a moment of elation for parents, the two struggled to come to terms with their new status. But EngenderHealth-trained nurses at the clinic reassured Maimuna and Jumanne, explaining how they could help keep the baby healthy through a process known as the prevention of mother-to-child transmission of HIV (PMTCT). Two months later, the couple were ecstatic and relieved to learn that their baby was free of HIV. They were grateful to the nurses for their guidance, knowledge, and comfort in the darkest hours of their lives. Today, the parents continue to visit the clinic for HIV treatment and family planning services. Magugu Health Center is one of thousands of health care sites supported by EngenderHealth in Tanzania and around the world. Just three years ago, a couple like Maimuna and Jumanne who needed HIV treatment or PMTCT services would have had to travel far to reach Babati District Hospital, the nearest facility with the resources to help them. Following the delivery of their baby, the couple received counseling on family planning options. “We don’t plan to have any more children, because now we are fighting for our own lives,” Jumanne said. “Being able to plan my family puts me at ease, so I worry less about being able to provide for my children over the long term.” 14 Maimuma and Jumanne visiting the EngenderHealthsupported Magugu Health Center in Tanzania. Because of EngenderHealth, the health staff in Magugu today can meet the comprehensive reproductive health needs of women and menâ€”short- and long-acting family planning, basic obstetric care, PMTCT, and HIV care and treatmentâ€”all under one roof. Through our partnership with the Tanzanian Ministry of Health and Social Welfare, and with support from the U.S. Agency for International Development (USAID), EngenderHealth trains providers to offer quality reproductive health services, equips facilities with critical supplies and medicine, and supports physical renovations at the clinic to improve services. 15 Beyond the Clinic Walls Our success comes with a deep understanding that many factors affect a woman’s health and well-being— beyond the clinic walls. That is why EngenderHealth always proactively engages communities and advocates for supportive policies to ensure that quality reproductive health services last, today and for years to come. EngenderHealth was one of the first organizations to recognize the pivotal role that men and gender norms can play in reproductive health, including choices about contraception, HIV, sexually transmitted infections, maternal health, and gender-based violence. Our approach to engaging men and promoting gender equality is rooted in our renowned Men As Partners® program, which activates men to support women’s health, seek out health services, and speak out against gender-based violence and HIV and AIDS. We have extensive experience in working with men and boys in 26 countries, and we are applying our knowledge to prevent teenage pregnancy in the United States through our awardwinning Gender Matters initiative. Pam Barnes (far right) with actress Salma Hayek Pinault (second from left), Avon CEO Sheri McCoy (center), and other awardees at the United Nations. Our CHAMPION Project won the 2013 Avon Global Communication Award for exemplary work with our partners to combat violence against women in Tanzania. Our Gender Matters project won the 2013 Healthy Teen Network Outstanding Emerging Innovation Award for teen parenting and teen pregnancy prevention. EngenderHealth is a founding member of MenEngage, a global alliance of organizations and United Nations agencies working with boys and men to promote gender equity and to prevent HIV and genderbased violence. EngenderHealth is a winner of the prestigious United Nations Red Ribbon Award for our work in South Africa. 17 Ethiopia Knowledge is power One evening in Addis Ababa, Ethiopia, Mesfin Beyene, 36, was assisting a young woman in labor at Kirkos Health Center, where he works. In the middle of the delivery, the power at the facility went out, an all-too-frequent occurrence. Just a year ago, staff would have had to deliver the baby by flashlight or refer the woman to another clinic. But today, they simply paused while the facility guards switched on an emergency generator that he helped to procure just months earlier. With the assistance of the medical staff, the woman gave birth to a healthy baby. As Medical Director of Kirkos Health Center in Addis Ababa, Mesfin felt thrilled and, in fact, proud. It was through EngenderHealthâ€™s training of the health center staff that Mesfin learned how to mobilize his staff to identify and overcome the many challenges at the clinic. These skills have empowered him to improve the quality of health care for Ethiopian women through simple, but impactful, ways. As part of EngenderHealthâ€™s Access to Better Reproductive Health Initiative, which is funded by a private donor, we work with health care providers, community partners, and Ethiopian government officials to increase access to family planning and comprehensive safe abortion. Having spent years as a midwife/nurse across the Amhara Region of Ethiopia (and later as head of health centers), Mesfin is well acquainted with the many operational challenges of running a health center with limited resources. For example, without an ultrasound machine on-site, health care providers had to refer women to a private facility, a costly and cumbersome step that many simply could not afford to take. Without an efficient client appointment 18 “ Ideas and will alone are not enough, unless you couple them with knowledge and skill. Knowledge is power, and EngenderHealth gave me that power.”—Mesfin Beyene system, dozens of women would arrive at the clinic at once, overwhelming staff and forcing women to wait hours for their medical records. Mesfin was determined to fix the problems he saw around him. “I had so many ideas and the will to fix problems, but ideas and will alone are not enough, unless you couple them with knowledge and skill,” said Mesfin, who is further motivated to improve women’s health because of his wife and 1-year-old daughter. After being promoted to Medical Director, Mesfin received training from EngenderHealth, along with other members of Kirkos staff. Spurred by his immense energy and motivation, Mesfin applied his newly acquired skills and inspired his staff to make the changes he always dreamed to make—improving health care for women. Under Mesfin’s leadership, the staff tirelessly and successfully advocated among district officials for a generator and an on-site ultrasound machine to save money for women, as well as a shaded waiting area. The staff also set up an innovative appointment system; women now call the clinic one day before arrival to have their records ready for them. This creative solution has reduced waiting times and improved both the clients’ experience and providers’ working conditions. Mesfin Beyene is Medical Director of Kirkos Health Center, a health care facility in Ethiopia. 19 The Power of Partnerships EngenderHealth is proud to have played an integral role in the global family planning and reproductive health movement over the last 70 years. The progress we see today is a result of our innovation, commitment, and most importantly, partnershipsâ€”at every levelâ€” from ministries of health, nongovernmental organizations, and communities to health care professionals. To mark our 70th anniversary, we honor our partners and celebrate our collective achievements. We are grateful to our national and local government partners for entrusting us to help strengthen family planning and reproductive health services in places as diverse as Bangladesh, Ethiopia, Ghana, Mexico, and Turkey. 20 EngenderHealth recognizes in particular those partners who have supported us at the leadership gift level, including but not limited to: Bloomberg Philanthropies, the Canadian International Development Agency, the Estate of Helen W. Edey, the Bill & Melinda Gates Foundation, Enid and Martin Gleich, the William and Flora Hewlett Foundation, the F.M. Kirby Foundation, the John D. & Catherine T. MacArthur Foundation, the Andrew W. Mellon Foundation, the David and Lucile Packard Foundation, Thomas M. and JaMel S. Perkins, the Lydia & Rob Petty Family Foundation, the Scherman Foundation, Inc., the Swedish International Development Cooperation Agency, the UK Department for International Development (DFID), the United Nations Population Fund (UNFPA), the United States Agency for International Development (USAID), and the United States Department of Health and Human Services (DHHS). We have the deepest gratitude to our longstanding individual and institutional supporters for believing wholeheartedly in the value and impact of our work. EngenderHealth began its work out of a passionate belief that continues to drive our organization today. It is one based on a simple truth: When a woman is empowered to choose the number of children she wants, the possibilities for her future are infinite. Looking ahead, we remain steadfast in our efforts to continue to make this right a reality for women everywhere. Thank you for standing with us to realize this vision for women everywhere. 21 Bangladesh Meeting women where they are: The community-Based approach to saving Lives Rashida Begum, the wife of a fisherman, was overjoyed when she became pregnant for the first time at age 19. But following a difficult childbirth, she bled profusely and nearly died. Fortunately, Rashida’s family was able to get her treatment from the village doctor in the Cox’s Bazar District in Bangladesh, where she lives. Over the next 11 years, Rashida had four more children, giving birth at home and with untrained birth attendants. Following each delivery, Rashida experienced postpartum hemorrhage, which left her weak, in need of medical attention, and unable to care for her newborn. As the leading cause of maternal death, postpartum hemorrhage kills many new mothers because to an untrained eye, it is difficult to tell the difference between normal and excessive bleeding before it is too late. In 2009, Rashida became pregnant once more, for the sixth time. But this time, everything was different—and not just because she was carrying twins. Rashida was visited by UmaShree Pal, a government health worker trained by EngenderHealth through our partnership with the Bangladesh Ministry of Health and Family Welfare, and with support from USAID. Uma-Shree counseled Rashida, as well as her mother-in-law and birth attendant, on the proper use of misoprostol, a 50-cent pill that prevents excessive postdelivery bleeding. Rashida was told that she should take the two tablets immediately after the delivery of the baby, and before the delivery of the placenta. Most importantly, Rashida was not to take the tablets before childbirth. Uma-Shree also gave them a leaflet, from which Rashida’s husband learned of the benefits of misoprostol. All of this information created a supportive environment for Rashida as the childbirth approached. Immediately following delivery of her twins, Rashida began to bleed. She swallowed the misoprostol tablets as instructed by UmaShree, and the bleeding gradually subsided. “This time, I had almost no bleeding [compared with] that of any of my previous deliveries,” Rashida said. “I didn’t have any problems using the tablets—they were so easy to take. I felt good and strong after the birth, which allowed me to focus on caring for my new twin babies.” Uma-Shree Pal (right) with Rashida Begum, who survived after giving birth, because of misoprostol. 22 EngenderHealth is saving mothers’ lives in Bangladesh, where 85% of births occur at home, without skilled birth attendants. We train community health workers to distribute misoprostol, a lowcost, lifesaving drug to prevent postpartum hemorrhage, a leading cause of maternal death. The “ Seeing the smile of a woman government of Bangladesh who has just given birth gives asked EngenderHealth to help me such great happiness. I consider expand the misoprostol intervention nationally. that smile a priceless reward for my hard work.”—Uma-Shree Pal In addition to training, Uma-Shree also received flipcharts, leaflets, and stickers, which strengthened her ability to counsel women in her catchment area. “EngenderHealth’s training was very effective and comprehensive,” Uma-Shree said. “It gave me the information I needed to communicate effectively and demonstrate how a simple pill, when taken properly, can save the lives of the daughters, wives and women of the community.” During the project’s first phase, Uma-Shree and other fieldworkers distributed misoprostol to nearly 13,000 pregnant women, at or after 32 weeks of pregnancy. More than 90% of these women used the tablets as directed, demonstrating the effectiveness of using community-level fieldworkers from the government and nongovernmental organizations to distribute misoprostol and ensure its appropriate use. All of the women took the tablets as instructed, and they all survived. In collaboration with our partners, EngenderHealth has since expanded the community-based misoprostol program to six districts. As a result of its success to date, the government of Bangladesh has asked EngenderHealth to help expand the misoprostol intervention nationally as a means of preventing postpartum hemorrhage, to reach as many pregnant women as possible to save lives. 23 EngenderHealth Around the World Countries where we work today: Angola Bangladesh Burkina Faso Burundi Côte d’Ivoire Democratic Republic of the Congo Ethiopia Ghana Guinea India Kenya Mali Mauritania Niger Nigeria Philippines Rwanda Sierra Leone South Africa Tanzania Togo Uganda United States Countries where we have worked Last year, EngenderHealth reached... 14 million people with health messages. 24 5.3 million women and men with family planning, maternal health, and HIV services. 22,700 health care providers with training on family planning and reproductive health services. 6,500 hospitals and clinics to deliver better care in 22 countries. 25 Board of Directors Robert D. Petty Chair Francine Coeytaux, M.P.H. Chair, Executive Committee Cecily C. Williams, J.D. Secretary Mehret Mandefro, M.D., M.Sc. Assistant Secretary Margaret A. Neuse, M.P.H., M.A. Assistant Secretary Donald J. Abrams, M.B.A. Treasurer Clover Bergmann, M.B.A., M.A. Mark Chataway Mark Chiaviello, M.B.A. Teresa Edenholm, M.P.H., M.I.A. Rosemary Ellis Joseph Hafey, M.P.A. Michael McDermott, M.B.A., C.P.A. Jeffrey Oâ€™Malley, M.A. Linda Rosenstock, M.D.,M.P.H. Sara Seims, Ph.D Marie Washington, M.B.A. Wendy L. Wysong, J.D. Directors Emeriti Lyman B. Brainerd, Jr., M.B.A., Ed.D. Anne H. Howat senior leadership Team Pamela W. Barnes, M.B.A. President and Chief Executive Officer Karen Beattie, M.A. Associate Vice President, Strategy & Impact, and Project Director, Fistula Care Kelly Culwell, M.D., M.P.H. Senior Medical Advisor Daniel Doucette, M.S. Chief Operating Officer Sara Kriksciun, M.I.A. Vice President, External Relations Paul Perchal, M.P.H. Vice President, Program Management Harriet Stanley, Ph.D. Vice President, Strategy & Impact, and Project Director, RESPOND For an online version of our financials, visit www.engenderhealth.org/financials. 26 © 2013 EngenderHealth. “Men As Partners” is a registered trademark of EngenderHealth. (CM0074) Photo credits: p. 2: G.Hecker/EngenderHealth; A. Jackson/EngenderHealth; R. Raj Kumar/EngenderHealth; p. 3: K. Beattie/ EngenderHealth; p. 5: A. Jackson; p. 7: M. Tuschman/EngenderHealth; pp. 8–9: Emily Hsu Pfeiffer/EngenderHealth; p. 13: State Department photo/Public Domain; pp. 15–16: S. Lewis/EngenderHealth; p. 19: Staff/ABRI; p. 20: R. Raj Kumar/EngenderHealth; M. Tuschman/EngenderHealth; p. 21: S. Lewis/EngenderHealth; R. Raj Kumar/EngenderHealth; N.K. Acquah/EngenderHealth; p. 22: Staff/EngenderHealth; p. 23: C. Ngongo/EngenderHealth; p. 26: S. Lewis/EngenderHealth; p. 27: W. Gallagher/EngenderHealth; For an online version of our visit www.engenderhealth.org/financials. A. Jackson/EngenderHealth, C. financials, Ngongo/EngenderHealth. 27 EngenderHealth is a leading global womenâ€™s health organization committed to ensuring that every pregnancy is planned, every child is wanted, and every mother has the best chance at survival. In 20 countries around the world, we train health care professionals and partner with governments and communities to make high-quality family planning and sexual and reproductive health services availableâ€”today and for generations to come. 440 Ninth Avenue New York, NY 10001 www.engenderhealth.org