Amy Weissman has worked in maternal, neonatal and child health (MNCH) and nutrition, HIV/AIDS, and sexual and reproductive programming for more than 20 years, with much of that time in South East Asia. She recently joined Save the Children Laos PDR as Chief of Party and Nutrition Advisor for a new USAID-funded integrated nutrition and water, sanitation and hygiene project. Prior to this, Amy served both as Associate Director, leading the infectious disease prevention portfolio for FHI 360 in Cambodia and Regional Advisor for the organization’s Alive & Thrive nutrition project. She has also worked with UNICEF in their regional Latin America and the Caribbean office, FHI 360 in Botswana, and Save the Children in Vietnam where she was the technical director. Prior to that, she oversaw Save the Children’s global adolescent health program. She has a Doctoral Degree from the University of North Carolina’s School of Public Health, Master’s Degrees in Public Health and in Natural Resource Policy and Behavior from the University of Michigan. Amy currently lives in Lao PDR with her husband, three sons, and their dog Soft.
You are the Chief of Party and Nutrition Advisor at Save the Children Laos. What are some of the biggest challenges facing child nutrition in Laos?
Amy Weissman: Lao PDR has some of the highest child malnutrition rates (35.6%) in South East Asia. A recent study shows that more than 1/3 of all children here are chronically malnourished. As a result, Lao children are sicker or die more often than they should. Malnourished children’s bodies and brains don’t develop well, which means these children do not reach their cognitive or economic potential. The Government of Lao PDR recognizes the importance of addressing malnutrition and is taking action. The project I work on with Save the Children, which is funded by the US Government, through the United States Agency for International Development (USAID), supports this effort.
Can you tell us more about some of your experiences with Save the Children and your most valuable takeaways about nutrition in Laos?
Amy Weissman: Save the Children established operations in Lao PDR in 1965. As a child rights organization, our efforts aim to ensure children’s rights to education, health, protection and participation are fulfilled. I was fortunate to join the team in Laos a year ago to lead Save the Children’s new nutrition project, called USAID Nurture.
USAID Nurture is an integrated nutrition and water, sanitation and hygiene project. We are implementing our activities in two provinces where dietary, health care, and sanitation practices are well below national rates. For instance, the World Health Organization recommends that all children be exclusively breastfed (EBF) for the first 6 months of life; the national EBF rate is only 40%, and the rate in the project provinces, Savannakhet and Khammouane, is much lower at 16% and 13% respectively. To address this situation, our project creates linkages within the health sector and communities to build capacity and mobilize action to improve nutrition. Communities assess, analyze, and address their own nutrition, water, sanitation and hygiene environment, while health staff and community volunteers share information house-to-house and through peer group support to mothers and children during the critical 1000 Days period (from pregnancy through the first two years of life). In addition, to encourage greater use of soap in the villages, women are trained to support their peers to adopt healthy practices, and to make and sell a natural soap product. This approach also places more power in the hands of women, promoting gender equity, and increasing women’s access to economic security and decision-making, all the while improving children’s health and growth.
Our organization also supports adolescent girls’ health and nutrition; keeping girls free of pregnancy until adulthood for their own and their future children’s health and well-being is critical. Lao PDR has one of the highest adolescent birth rates in the region – 94 per 1000 among 15-19 year olds. Children born to girls under the age of 17 are significantly more likely to die in the first year of life, and have an increased risk of stunting, diarrhea, and anemia. Adolescents who give birth are also more likely to be left nutritionally depleted than women who give birth at an older age. Save the Children will ensure that more activities target women and girls before they are pregnant, as a key strategy to break the intergenerational cycle of malnutrition.
The most important takeaway from our work in Laos is that early and integrated interventions focused on women and girls can make a significant impact for the entire village and improve nutritional outcomes for future generations.
You were also the Associate Director of FHI 360 in Cambodia and a Technical Advisor of FHI 360 in Botswana. What motivated you to join FHI 360 and what projects were you involved with in the organization?
Amy Weissman: Throughout my career, I have been motivated by the need to address the health and well-being of those who are most vulnerable to poor health outcomes or at risk of developing infectious diseases. In particular, I am passionate about tackling adverse gender roles and norms which significantly affect health (and other) behaviors and health care. Addressing these norms is critical to achieving public health impact and was a cornerstone of my work with FHI 360. In Botswana, I was part of an HIV Prevention project with youth. The project, Basha Lesedi, addressed alcohol use and abuse, intergenerational and transactional sex, gender-based violence, gender norms and expectations, and sexual activity among individuals with HIV through interpersonal communications, a radio drama, and community-level events. It also sought to strengthen the communication between parents and their children because children typically want their parents’ advice, and parental involvement protects children from risk.
During my tenure in Cambodia, I worked on HIV prevention and sexual health with commercial sex workers, men who have sex with men (MSM), transgender individuals, and drug users. One of the projects I’m proud to be associated with is called SMARTgirl. Have a look at this video, and you’ll see why. I was also part of the Alive & Thrive team, supporting Cambodia and Lao PDR to strengthen policies to support women and children’s health and nutrition, such as maternity and breastfeeding protections.
From your experiences, what have been some innovative technologies and organizational strategies to address health and nutrition?
Amy Weissman: In Cambodia, the creative use of media was transformational, allowing much wider access to an unreached audience. Our mobile health initiative (known as “mHealth”) was built on the project’s branded programs for at-risk populations: SMARTgirl for female commercial sex workers, MStyle for MSM, and Srey Sros for transgender women. The platform includes “My Community,” a set of interactive web sites and Facebook pages offering electronically-mapped service locations and downloadable referrals, HIV and related news and information, individual risk screening, and more. The second component, “Voice4U,” is an interactive voice response system that provides callers with on-line counseling, on-demand HIV and health-related information, and medication and appointment reminders.
Another critical innovation is in the area of HIV testing, which is the vital first step in addressing the global HIV epidemic and reaching those with HIV with critical health care and services. Many people who may be living with HIV are unaware of their status, yet due to a number of factors, such as HIV stigma and discrimination, have not gone for testing. The advent of HIV home testing is a game changer. It puts power in the hands of individuals, much like home pregnancy tests have done.
Finally, we know that the greater involvement of beneficiary communities in interventions, the more likely we will see positive change from our activities. To address the power inequities and a cultural gap between marginalized communities and health workers, which often affect treatment and service use, Save the Children developed an approach called Partnership Defined Quality (PDQ). This is a participatory approach involving community members in designing, implementing, and monitoring service improvements and encourages them to recognize and take responsibility for assuming their rights to information and services. PDQ has been shown to increase health service use in a variety of settings, such as Peru, and Nepal, and with different populations, including indigenous communities, youth, and sex workers.
In your opinion, what are some lesser known or overlooked issues related to maternal/child and sexual/reproductive health in South East Asia?
Amy Weissman: We know that when women have access to and control resources, they invest in health care, food, and education. This makes financial independence a key component for women’s – and their children’s – health. Yet, although there are relatively small scale loan and job development efforts, there are few opportunities for women entrepreneurs to scale businesses for larger impact and greater sustainability. In addition, basic access to quality health care, ensuring girls have equal access to quality education, increasing the value of women and girls, and reducing sexual and other forms of gender-based violence, though on the agenda, all need greater attention.
On a personal level, why does women’s empowerment matter to you?
Amy Weissman: Women’s empowerment matters to me because, like all women, I deserve equality in this world. Yet, on a more personal level, I can say it matters to me for several reasons. First, although I am extremely fortunate in my life, I have faced challenges simply because I am female, including sexual violence. Another reason is that, as my husband and I raise our three boys, what matters most is for them to live in a world where women are empowered, and that they perceive, treat, and respect women as equals. That they see me in a leadership role and addressing these issues every day is a regular source of encouragement and inspiration.
Can you talk about one woman who has impacted your life?
Amy Weissman: There are many women whom I admire and who have influenced me. You asked me why women’s empowerment matters to me. Perhaps another answer to this question is that every woman I have known has faced significant challenges, no matter her access to resources. There are women with few-to-no resources, such as our beloved nanny when we lived in Botswana; she is a single mother in southern Africa, who in the past two months lost her mother and learned that her 10-year-old daughter is HIV positive. And there is Khanh, the SMARTgirl in the video mentioned above who, given the right opportunity, has become a leader among her peers. As women, we all face challenges and have responded as best we can, but the person dearest to my heart is my sister who has faced many challenges in her and her family’s life: infertility, sexual abuse, addiction, and brain cancer. With each additional challenge, my sister upped her game. She not only supported her family through these times, but she also actively supports others facing similar issues. Most recently, she was a participant in Ohio Senator Sherrod Brown’s panel on the implications of repealing the Affordable Care Act (ACA). In front of Congresspeople and the media, she shared her personal story about how her family benefits from and depends on the ACA’s elimination of lifetime caps on insurance payouts. I deeply admire and am inspired by the depth of her strength, will, and passion to live a life that resonates and will make an impact on us all.
What are your favorite books, films, websites and resources about maternal and child health and nutrition?
Amy Weissman: I was greatly influenced by a number of female authors, including Gloria Steinem, Audre Lorde, Betty Friedan, Vandana Shiva, and Alice Walker. I recently read I Know Why the Caged Bird Sings by Maya Angelou to my kids and was reminded again of the power of her voice. When it comes to public health, culture, and ethics, I would highly recommend The Immortal Life of Henrietta Lacks, by Rebecca Skloot, and The Spirit Catches You and You Fall Down by Anne Fadiman. A few of my favorite resources are: The Girl Effect, Girl Rising, and the Pleasure Project. I’ve also been impressed with Teen Vogue reporting on the political situation in the US.