Engenderhealth 2014 Impact Report by EngenderHealth

EngenderHealth is a leading global women’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 nearly 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 available—today and for generations to come.

440 Ninth Avenue New York, NY 10001 www.engenderhealth.org

“ I am healthy… I am educated, my children have a better life…”

Alem, a 15-year-old student in Ethiopia, sharing her story about how she escaped an early marriage

Board of Directors

senior leadership Team

Robert D. Petty Chair

Pamela W. Barnes President and Chief Executive Officer

Francine Coeytaux Chair, Executive Committee

Yetnayet Asfaw, M.D. Vice President, Strategy & Impact

Rosemary Ellis Secretary

Kelly Culwell, M.D., M.P.H. Senior Medical Advisor

Mehret Mandefro, M.D., MSc Assistant Secretary

Daniel Doucette, M.S. Chief Operating Officer

Margaret Neuse, M.P.H., M.A. Assistant Secretary

Sara Kriksciun, M.I.A. Vice President, External Relations

Donald J. Abrams Treasurer

Paul Perchal, M.P.H. Vice President, Program Management

Clover Bergmann Mark Chataway, M.A. Mark Chiaviello, M.B.A. Denise Dunning, Ph.D., M.P.A., M.A. Teresa Edenholm, M.I.A., M.P.H. Joseph Hafey, M.P.A. Karen Koh Ben Lilienthal Michael McDermott, M.B.A., C.P.A. Linda Rosenstock, M.D., Ph.D. Marie Washington, M.B.A. Directors Emeriti Lyman B. Brainerd, Jr., M.B.A., Ed.D. Anne H. Howat

© 2015 EngenderHealth (CM0121) Photo credits: pp. 2–3: Zeleman Production/EngenderHealth; p. 4: M. Tuschman/EngenderHealth; p. 5: Staff/EngenderHealth; p. 6: Robin Wyatt/EngenderHealth; pp. 8–11: Robin Wyatt/EngenderHealth; S. Lewis/EngenderHealth; W. Gallagher/ EngenderHealth; M. Tuschman/EngenderHealth; p. 13: C. Ngongo/EngenderHealth; p. 15: Dominic Chavez/ United Nations Foundation

At the Heart of a healthy Family Is a healthy Woman From Amhara to Cebu, from Dhaka to Zanzibar, my travels throughout the past year inspired and connected me with unforgettable women and girls. Across all cultural lines and geographic coordinates, there was a similar refrain in my conversations: “I want… to be healthy, …to finish school, … to survive childbirth, …a better life for my children.” Yet too often, these dreams are out of reach. EngenderHealth is working to change this. Our woman-centered approach is making a lasting impact, so that women and girls can be healthy and thrive. When I was in Ethiopia, I saw this in real time with Alem—a young woman who shared her emotional story about how she became a student at Baso High School in the small city of Debre Birhan. In a sea of burgundy-colored uniforms, Alem’s brightly colored hair accessories and shy smile set her apart. Narrowly escaping a forced early marriage at the age of 12, Alem broke ties with her family and chose

an education instead of a wedding. She is now a member of the school’s Gender and Youth Club (supported by EngenderHealth), where she is learning what she needs to make informed decisions for her health and future. Through Alem’s eyes, I saw the tremendous progress we are making and her potential for the future. She feels it too. With your invaluable support, we are reaching more women and girls like Alem, who can access vital information and health services so they can better determine their futures. When women and girls are at the center of reproductive health priorities and programs, instead of wishes we will hear resounding affirmations: “I am healthy… I am educated... My children have a better life…” That’s what I call progress. Thank you for your continued partnership,

Pamela W. Barnes President and CEO

At the Nexus of Care For more than 70 years, EngenderHealth has helped millions of women and couples access high-quality reproductive health and family planning services in communities where the need is greatest. Our woman-centered approach arises from our belief that services must meet womenâ&#x20AC;&#x2122;s diverse health needs throughout their lives and that for the impact to be sustainable, lasting change must take place both within and beyond the clinic walls. In addition to training health care professionals, EngenderHealth advocates for positive policies that ensure rights are respected, women have contraceptive choices, and men become champions against gender-based violence and HIVâ&#x20AC;&#x201D;promoting better health for themselves and their families. It is this future EngenderHealth envisions and works toward every day: one where every pregnancy is planned, every child is wanted, and every mother has the best chance at survival.

profile of A champion EngenderHealth’s Vice President of Strategy & Impact, Dr. Yetanyet Asfaw, grew up in a world where young girls are told more often what they cannot do than what they can. Growing up in Addis Ababa, Dr. Yet was the eldest of 10 children; from a young age, her heart was set on becoming a physician. Initially, her extended family and community members were amused. They told Dr. Yet she could only be a nurse, because she was a girl. Fortunately, Dr. Yet had parents who believed in and encouraged her to pursue her dreams. Dr. Yet’s mother had the foresight to tell her that times were changing and that she needed to change with them. The only help she could provide her daughter was an education, but this

“ When a woman gets counseled on family planning, you can see the smile on her face, the spark of enlightenment in her eye; you see hope for the future.” —Dr. Yetnayet Asfaw

investment ultimately unlocked a cycle of benefits that helped not only Dr. Yet and her family, but also her community. After a few years of practicing medicine, Dr. Yet earned a public health degree and began directing programs focused on improving access to quality reproductive health programs in Ethiopia. Today, Dr. Yet oversees EngenderHealth’s global and technical programs in nearly 20 countries from her new office in Washington, D.C., bringing the same determination and passion to work every day.

The Exponential Power of Contraception A woman’s ability to decide if, when, and how many children to have is one of the most important factors for determining the course of her future and that of her family. She is healthier, goes further in school, and is more likely to invest money back into her family, and her family is more likely to prosper. Today, more than 225 million women who want to delay or postpone pregnancy still lack access to modern contraception. If this unmet need were satisfied, nearly one-third of maternal deaths could be prevented every year, among other benefits.

Leading the Way in Promoting Rights and Contraceptive Choice EngenderHealth is a trusted global leader in advocating for family planning programs that are designed, implemented, and monitored in a way that protects and fulfills human rights and puts women’s needs, desires, and preferences at the center. Last year, we produced new tools and resources to assist governments, local organizations, and advocates to ensure informed choice, women’s rights, and safe services. We co-organized events with health and rights experts in India, Kenya, Uganda, and the United States, to discuss human rights–based family planning efforts, and we brought the dialogue to a global audience. We also created a blog focused on this topic, called Champions for Choice (www.champions4choice.org).

The RESPOND Legacy EngenderHealth celebrated the completion of its globally recognized RESPOND Project, which was funded by the U.S. Agency for International Development (USAID). The project generated important knowledge from 23 countries, enhanced “data for decision making” with innovative tools like Reality Check, and played a central role in bringing a rights-based approach to family planning programs. With our partners, EngenderHealth convened 72 technical consultations and developed more than 230 journal articles, project briefs, advocacy and training materials, videos, and country profiles that will advance global knowledge and influence family planning programs for years to come. To learn more, visit www.respond-project.org/archive.

EngenderHealth launched the Where’s the Family Planning?! (WTFP?!) campaign to raise awareness of the need for family planning around the globe. We partnered with Academy Award–winning actress Mira Sorvino. The response to date has been phenomenal. Our video “History’s Worst Contraceptives” was viewed more than 410,000 times on YouTube, and we received mentions in TIME, Glamour, Cosmopolitan, Upworthy, BuzzFeed, RH Reality Check, Jezebel, and The Huffington Post. We also received the Best Nonprofit Video Award from PR News. Our campaign is attracting a new generation of supporters to the organization and inspiring American women to take action in support of the 225 million women worldwide who want but cannot get modern contraception. To learn more, visit www.wheresthefp.org.

EngenderHealth around the world

Countries where we work today Bangladesh Burkina Faso Burundi Côte d’Ivoire Democratic Republic of the Congo Ethiopia Guinea Countries where India we have workeD* Kenya * For over 70 years, we have worked in more than 110 countries to ensure Malawi that our government and community partners have the capacity, resources, Mauritania and commitment to offer quality Niger sexual and reproductive health care for women, men, and families, today Nigeria and for generations to come. When we have achieved our vision of success, Philippines EngenderHealth moves on to work in countries where the need is greatest South Africa and where our expertise will have the most impact. Tanzania Togo Uganda United States

COuntry HIGHLIGHTS United States Through our Gender Matters project in Texas (which has one of the highest teenage pregnancy rates in the country), we work with young people (ages 14–16) who are at a higher risk of becoming teen parents. The program teaches teenage girls and boys to challenge harmful gender stereotypes that drive unhealthy behavior. It also encourages boys and girls to think about and discuss issues together—like how to decide if and when to have sex and use contraceptives— using a mix of workshops, social media strategies, and youth-generated video messages.

Tanzania In addition to supporting the national family planning program, EngenderHealth engages men to promote healthy behaviors and to speak out against gender-based violence and take greater responsibility for preventing HIV and unintended pregnancies. In Tanzania, approximately 44% of women have experienced physical or sexual violence by their partners in their lifetime. More than 345,000 people in Tanzania received HIV and reproductive health interventions, and through the CHAMPION Project over 260,000 individuals were reached with activities to reduce gender-based violence.

West Africa In much of the region, the need for family planning outweighs access to and use of contraceptives. EngenderHealth launched a new program that is expanding access to family planning in Burkina Faso, Côte d’Ivoire, Mauritania, Niger, and Togo, where unmet need is the greatest. In addition to training health care providers in gendersensitive and youth-friendly services, we are leveraging mobile technology and reducing financial barriers through partnerships with ministries of health and local organizations to improve access to health services. We are also working to prevent and treat fistula in Guinea and Niger through Fistula Care Plus.

Burundi EngenderHealth is preventing and responding to sexual and genderbased violence through training, advocacy, and collaboration with local organizations. We are working to improve the quality and range of available services, in partnership with the Ministry of Gender and Burundi’s newly formed national Gender-Based Violence Technical Working Group.

India We are improving women’s access to wider contraceptive options, ensuring quality of care, and promoting rights-based family planning programs. We are also bringing vital information and health services to adolescents. For example, our TARUNYA Adolescent Reproductive and Sexual Health project trains health care professionals on adolescent health needs, educates young people about sexual and reproductive health, and advocates for policies to ensure a safe environment for young people accessing health services.

healthy mothers, Stronger communities Ugo’s Story Ugo was almost without hope at the time that she developed obstetric fistula: Caused by obstructed labor, this devastating but preventable childbirth injury causes a woman to leak urine and/or feces continuously. Two of her five children had died, and her parents had passed away. When Ugo was ready to deliver for the sixth time, her husband, Okoude, was away, looking for work as a driver. After the labor pains began, she locked herself inside her house and labored alone for days. Ugo finally delivered a baby, but the pressure from the baby’s head during Ugo’s prolonged labor caused a fistula.

Ugo and Okoude live in Ebonyi State in southeastern Nigeria. While Ugo was silently struggling with fistula, the wife of the Ebonyi State governor began to advocate for surgical fistula repair services to be made available. The First Lady launched a governmental initiative, constructed a fistula repair center, and brought together partners, including EngenderHealth, to support the costs of providing surgeries. EngenderHealth trained surgeons, anesthetists, nurses, and other staff and participated in research designed to improve the quality of care. When all was ready, she organized screening

EngenderHealth leads Fistula Care Plus—the largest U.S. government–funded effort focused on fistula prevention and treatment. With support from USAID, we train fistula surgeons, anesthetists, and nursing staff, educate communities, and work to expand fistula treatment, prevention, and reintegration in Bangladesh, the Democratic

Republic of the Congo, Niger, Nigeria, and Uganda. We also work in Guinea with support from the Islamic Development Bank, Fistula Foundation, Alcoa Foundation, Donner Foundation, and other donors. Since we began this work in 2002, EngenderHealth, in partnership with institutions and medical teams, has supported more than 27,000 surgeries in 14 countries to date.

campaigns to identify women living with fistula and to let them know that their condition could be repaired. Okoude heard that the screening was happening, and he and Ugo rushed to be included. Hundreds of women were there, and Ugo says she was lucky to be screened. Her recto-vaginal fistula could be repaired.

Ugo with her son, Martin

Ugo waited three months before she received a phone call that surgeons were available to repair her fistula. She was fully repaired, and Ugo later had a healthy baby named Martin, after the governor. Ugo prays daily for the First Lady, grateful for her repair surgery and hopeful for the future.

our GLobal Impact In nearly 20 countries, we are responding to womenâ&#x20AC;&#x2122;s needs for family planning, maternal health, and HIV services. With your partnership and support, EngenderHealth reached:*

7 million

37,600

people with health messages

people with training on family planning and reproductive health information and services

6 million

8,000

women and men with family planning, maternal health, and HIV services

hospitals and health centers to deliver better care

These activities will prevent an estimated:**

3.3 million

71,000

unintended pregnancies

child deaths (as a result of improved access to family planning)

7,200 maternal deaths

397,000

$251 million will also be saved in direct health care costs (by avoiding adverse events related to pregnancy, death, and disability)

unsafe abortions

*EngenderHealth trains health care providers and supports hospitals and clinics in partnership with governments and local organizations to offer high-quality reproductive health services. The EngenderHealth-supported sites provided health care services that will reduce preventable deaths and disability and result in cost savings. The data cover FY2012â&#x20AC;&#x201C;2013. ** Estimated using Marie Stopes Internationalâ&#x20AC;&#x2122;s Impact 2 Model.

Meet Nurse Enidyjoyâ&#x20AC;&#x201D;a petite, graceful woman who stands tall as the head nurse at a rural clinic in Tanzania. She is one of 37,600 people trained by EngenderHealth last year to provide information and services on family planning and reproductive health. Any other provider might be daunted by the sheer number of clients waiting every

day, but not Enidyjoy: She exudes compassion and a lively energy, which stem from her belief that women can lead better lives if they can plan their families. To date, Enidyjoy has helped thousands of people build brighter futures. There is no doubt that she has saved many lives in the process. Enidyjoy is living proof of the progress we are making.

STATEMENT OF ACTIVITIES Operating revenue U.S. Agency for International Development

$ 38,622,194

Individual and institutional contributions

$ 19,914,262

Total operating revenue

$ 58,536,456

Operating expenses Program services: Reproductive health services

$ 40,843,572

Total program services

$ 40,843,572

Support services: Administration

$ 10,796,995

Fundraising

$ 1,219,107

Total support services

$ 12,016,102

Total operating expenses

$ 52,859,674

Nonoperating revenue Investment return

959,010

Change in value of split-interest agreements

19,139

Pension-related changes other than net periodic pension costs

(153,534)

Total Nonoperating Change in assets $

824,615

Increase in net assets Increase in net assets before nonoperating revenue

$ 5,676,782

Total nonoperating change in assets

Total Increase in net assets

$ 6,501,397

Net assets, beginning of year

$ 23,739,093

Net assets, end of year

$ 30,240,490

We are grateful to our longstanding individual and institutional supporters for your steadfast commitment to EngenderHealth and our work. It is through our partnerships with our national and local government partners, nongovernmental organizations, communities, and health professionals that we are able to realize our shared vision for a world where every pregnancy is planned, every child is wanted, and every mother has the best chance at survival. In 2014, EngenderHealthâ&#x20AC;&#x2122;s total income was $58.5 million, made possible through the generosity of thousands of caring individuals, foundations, corporations, the U.S. Agency for International Development, and other bilateral, multilateral, and technical agencies. We deeply appreciate this vital support.