Young People Leading the Way to a Brighter Future Pathways Spring 2020

Raise Your Voice

Dear Pathfinders,

I am a woman's rights activist at heart. I see sexual and reproductive health and rights as the primary way to give women a choice and a chance to make their own decisions in life. I am proud to lead Pathfinder's programs in Pakistan. Every day, I see how Pathfinder offers women and girls more choices to succeed.

Naya Qadam, Pathfinder's largest program in Pakistan, seeks to give women and girls power over their reproduction by enabling them to access high-quality family planning services, especially after they have given birth. Post-pregnancy family planning allows women and girls to space or delay their next pregnancy as they wish.

Naya Qadam has a specific focus on reaching young women. Studies show that young women in Pakistan have the least power and the least authority to make decisions about their own lives. Naya Qadam offers young women sexual and reproductive health information and services— helping them, one by one, to gain autonomy and a voice

Over the past two years, Naya Qadam has made considerable progress in preparing the health system to offer gender-sensitive family planning services, especially during the postpartum period. To achieve the long-term sustainability of these services at scale, we remain responsive to the changing needs of the health system and communities we serve.

Today, this means continuing to provide women and girls with sexual and reproductive health care amid the global COVID-19 pandemic. Pakistan's health system has been inundated with an increasing number of COVID-19 cases. The Naya Qadam team is working day and night on solutions that will help to support continued sexual and reproductive health care during this emergency. This includes working toward the availability of essential commodities, communications campaigns that inform on both COVID-19 and post-pregnancy family planning simultaneously, and a policy framework for post-pregnancy family planning during public health emergencies.

I am moved every day by Naya Qadam's work, particularly our partnership with Pakistan's Lady Health Workers. During this difficult moment in time, I recall a fond memory—when we brought together 300 Lady Health Workers for a convention in November 2019. We joined the Lady Health Workers to recognize and celebrate them and to provide a safe space for them to share their stories.

Lady Health Workers are one of the most under-appreciated health cadres in our society. They struggle to make a living; travel long distances to reach remote households; and, often face salary delays, sexual harassment, and community backlash while doing their work. Yet these women are bringing about the social change to which our program aspires.

I was honored to shake hands with the 300 Lady Health Workers. One of the oldest Lady Health Workers at the convention, very frail— she held my hand and started crying. "This is the first time in a long period of time that someone has recognized me. I want to thank Pathfinder for bringing me here and honoring me."

We continue to work with the brave Lady Health Workers and midwives, ensuring their protection, and helping them to reach pregnant women in need of care. Today, humanity needs to respond in solidarity to this global pandemic and ensure that no one's needs are left behind.

As a physician, as an activist, as a Pathfinder— I am here to invest myself in that effort.

Tabinda Sarosh

Country Director, Pakistan

Pathfinder in Ethiopia

Act With Her: When Girls Say No to Early Marriage

Yeshimebet was just 12 years old when she heard rumors from the neighbors that she would soon be married. For many young girls in her Ethiopian village, this would be a natural evolution—but Yeshimebet wanted something different.

A participant in Pathfinder's Act With Her program, Yeshimebet had been attending weekly meetings with a mentor—a young woman who was teaching Yeshimebet and other local girls about issues of health, nutrition, education, gender, and economic empowerment.

Using the negotiation skills she learned in her weekly meetings, Yeshimebet discussed her concerns first with her mentor and then her parents, citing specific challenges she would face as a result of the marriage, including ending her education and the possible complications of pregnancy at her age.

“The negotiation skills that I acquired from Act With Her sessions helped me convince my parents to cancel my proposed marriage."

Yeshimebet also explained to her family her aspirations to become a teacher and the actions that she was taking to attain her goal. After a series of discussions and negotiations, her parents were convinced and agreed to cancel the marriage.

For a 12- year-old girl like Yeshimebet, the likelihood of complications is far more severe.

Empowering young Ethiopians

While child marriage is on the decline in Ethiopia and the government is solidly committed to ending it, the country is still home to 15 million child brides, 6 million of whom were married before age 18. In addition, young girls are vulnerable to female genital mutilation and sexual- and gender-based violence. And often, their voices are more limited than boys, due to social norms that put value on being a wife and a mother first.

The Act With Her program aims to improve gender equality in Ethiopia's Amhara, Oromia and Afar regions, empowering adolescent girls and boys with a wide range of knowledge and skills that will help them thrive later in life.

In 2019, more than 500 mentors worked with more than 13,000 adolescent girls and boys ages 10-13. Mentors range in age from 18-24 and hold curriculum-based group sessions every week for nearly a year. They also host a series of group discussions with the participants' parents. Unlike a typical family planning or health project which may deliver services to young people, Act With Her takes an upstream approach by shifting social norms and including not just girls— but also young boys, parents, and families— in ongoing conversations that encourage gender equality and empowerment of adolescent girls.

Boys who support girls

Including boys has already paid dividends. In one community, 13-year old Bishaw, a member of an adolescent boys' group, learned about early marriage and how it would likely impact his sister's education and future. Advocating to his parents on her behalf, he was able to prevent her wedding at age 15, while also learning how to bolster his own independence through a financial savings program.

By 2022, the Act With Her program seeks to reach 50,000 adolescent Ethiopian girls and boys with its powerful end goal: to transform the lives of adolescents by advancing gender equality, empowering girls, and ensuring they can make healthy and happy transitions to adulthood. With help from young women like Yeshimebet, Pathfinder and its partners are well on our way to reaching that goal.

Pathfinder implements Act With Her in collaboration with the Government of Ethiopia, in partnership with CARE International, and with funding from the Bill & Melinda Gates Foundation. A randomized impact evaluation of the program is being conducted by the UK Department of International Development-funded Gender & Adolescence: Global Evidence research consortium.

Pathfinder in Pakistan

A Youth Champion of Women's Rights in Pakistan

Naya Qadam, our largest program in Pakistan, seeks to increase access to family planning, particularly post-pregnancy family planning, among young women ages 15-24 in six districts of Pakistan's Sindh and Punjab provinces. The program has trained more than 7,000 Lady Health Workers to provide post-pregnancy counseling and more than 1,200 public and private providers to offer postpartum and post-abortion family planning services.

Zubaria was 22 years old when she stepped outside of her home alone for the first time.

She had just been recruited by Pathfinder's Naya Qadam program to be a youth champion and mobilize communities in support of young women using contraception. As part of her training to become an effective youth champion, Pathfinder sponsored Zubaria's participation in the annual Young Leaders Conference in Pakistan.

"This project gave me the opportunity to step outside my house for the first time and interact with the outside world," said Zubaria. "Not only has it increased my self-confidence but also provided me the goals I need to work towards in life."

Although her family forbade her from working as a youth champion, Zubaria was excited by the prospect of doing something meaningful in her community.

"Initially my mother was hesitant, but eventually she allowed me to go to the Naya Qadam training," said Zubaria. "However, my brother stopped talking to me and refused to eat or drink anything which I have touched."

Zubaria's brother did not approve of her being outside of her home without a male companion. In the area of Pakistan's Sindh Province where Zubaria is living, women are largely forbidden from moving around independently.

But Zubaria remained courageous. Summoning courage is familiar to Zubaria.

Before she had even grown into an adult, Zubaria had married, divorced and given birth to a son.

After divorcing her abusive husband at 17, her ex-husband took custody of her son. Without the financial means to go to court or the support of her family to fight for keeping her son, Zubaria went alone to live with her parents.

Without much hope and stigmatized for being a divorcee in Pakistan, a society where divorce, especially for women, is a social taboo, Zubaria became depressed.

"I stopped taking part in any family and social events and went completely quiet. I had no purpose in life," said Zubaria

The depression began to lift when staff from a local organization partnering with Naya Qadam approached Zubaria to encourage her to participate in the program. And her journey of becoming a youth champion began.

Zubaria, now age 23, mobilizes communities to support young women using contraception and reaches out to young women like herself to teach them about their bodies and their right to health care. She lets them know where to go for family planning and reproductive health services.

Naya Qadam gives youth champions like Zubaria the skills to be effective mobilizers, teaching them about gender issues, adolescent and youth sexual and reproductive health, and postpartum family planning, and giving them theater training so that they can lead interactive dialogues in their communities. Naya Qadam has trained 215 youth champions in Sindh and Punjab provinces.

Zubaria has worked with Naya Qadam for almost six months, providing more than 50 referrals to young mothers who want to use the postpartum IUD to space or prevent another pregnancy. Beyond family planning, Zubaria said she now considers herself a "woman's rights advocate" in her community.

"I stress the importance for girls and women to receive proper care and attention when their health deteriorates," she said. "In our town, women are not provided with adequate health care, and they are subject to conventional methods and procedures* carried out at home which are harmful."

She even acts as a champion in her own home. "I had to advocate to my family for my sister, as she wanted to work, and they weren't allowing her. It took me a while to convince them, but I think my Naya Qadam training helped me the most to convince them with logic and reason."

"Slowly and gradually my brother and I are getting on good terms as well."

Through engagement and training of youth champions like Zubaria, male allies, Lady Health Workers, and public and private health providers, Naya Qadam seeks to reach 100,000 women and girls in Pakistan with post-pregnancy family planning services by the end of 2020. To learn more about Naya Qadam click here. To learn how Naya Qadam is adapting to the challenges brought on by the COVID-19 pandemic, click here

*What Zubaria refers to here is women who do not know about safe abortion services at clinics. To induce their own abortions, they will take homemade detergents or insert certain herbs into the uterus.

Change You've Made Possible

Chelsea Toler-Hoffman

Chelsea Toler-Hoffman, 27, is embarking on a new journey this year: launching her own family foundation and inspiring young people like herself to become next-generation philanthropists.

The loss of Chelsea's grandmother inspired her journey.

"When my grandmother died she left me the resources to start the foundation," said Chelsea. "The foundation is a way to honor our matriarch."

Chelsea's Keep Families Giving Foundation, in Austin, Texas, focuses on nurturing a new generation of philanthropy. The foundation's next-generation (next-gen) advisory board helps to make funding decisions and nominate nonprofits to receive support.

"70 percent of family foundations will be failing in the next three generations," said Chelsea. "At some point, the next generation will be involved in the foundations, but they really haven't taken the time to know what they do and how to own their legacy. I think we can start to turn things around through next-gen engagement and family alignment on issues they care about."

Chelsea has looked to Pathfinder's legacy giving through multiple generations of the Gamble family* and Acacia Circle as a model for next-generation giving. The Acacia Circle is recruiting young philanthropists and change-makers "under age 40" as donors and supporters through a genuine connection to the work that Pathfinder does. Members are asked to make a small annual membership contribution.

"Pathfinder's model works really well for next-gen giving," said Chelsea. "When I first started, I wasn't sure of communities or organizations out there taking this new direction and saying, 'we don't care what your giving level is yet, we want to form a community of young people that really cares about this issue and give them an active way of doing that."

Chelsea was introduced to Pathfinder through Nexus—a global group of philanthropists.

"I fell in love with Pathfinder's mission around women and health, and I got involved," said Chelsea.

Chelsea is now a member of the Acacia Circle, and her family foundation invited Pathfinder and a member of the Gamble family to deliver the keynote at the Intergen Philanthropy Summit in Austin.

"The Acacia Circle and Pathfinder's recruitment of a next-gen engagement officer is really next level," said Chelsea.

For more information about the Acacia Circle, please contact Shaylyn Stanley at sstanley@pathfinder.org

*Sarah and Clarence Gamble are the founders of Pathfinder international.

Dear Pathfinders,

We are living through an unprecedented moment in history.

As I write this, Pathfinders around the world are responding to COVID-19, and I assure you that as this crisis unfolds, the safety and well-being of the entire Pathfinder community is our priority. This includes the individuals and families we serve, our dedicated staff, and you— our supporters who continue to stand by us in moments of great uncertainty.

Much remains unknown about COVID-19, commonly known as the coronavirus. However, I can assure you that Pathfinder is closely monitoring this pandemic and remains relentlessly committed to those we serve.

We have implemented safety measures for our entire team around the globe-- ensuring that our work bringing sexual and reproductive health care to vulnerable women continues unabated. For the women, men, and children we serve across 17 nations, the continuity of services is a matter of life and death.

A dedicated, global team of Pathfinders is charged with monitoring the spread and trajectory of COVID-19 and implementing rapid response plans to keep our staff and the individuals we serve safe. The virus is present in all of the nations where we work. Vulnerable populations are ultimately the ones who are most at risk in any outbreak, and we must be prepared to take measures that increase their resilience.

We don't yet know all potential transmission routes for COVID-19, and the specific risks to pregnant women also remain unclear.

Here's what we do know: Those we serve could potentially face shortages of HIV medication, complications during pregnancy, and other supply shortfalls. Health care is many places where Pathfinder works could face significant interruptions with dire impacts, especially for people who live in remote, impoverished communities.

Please know we are planning for all contingencies and remain steadfast in our commitment to new mothers in Mozambique, to Rohingya refugees in Bangladesh, to young women in Burundi... and to every person who relies on our work.

It is of utmost importance to us that we protect not only the people we serve around the world, but that we uphold our values internally and prioritize the health of our staff and partners.

I'll be thinking of you and your families and hope you remain healthy and safe. It means everything to know you're with us.

Thank you for standing at our side.

With gratitude,

Lois Quam, Chief Executive Officer

Pathfinder International

President & CEO: Lois Quam
Board Chair: Roslyn Watson
Editor: Laurel Lundstrom
Contributers: Ali Asghar, Rayna Bagchi, Sarah Peck, Tyler Kalogeros-Treschuck, Sarah Heft