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IntraHealth International's East Africa regional director Ummuro Adano (right) talked health investments with Bill Gates (left) and Africa Health Business chair Amit Thakker (center left) at the high-level inaugural meeting on financing health care across Africa.

“Clearly, beyond the medium-term, African countries can’t rely on aid to fill their health spending gaps,” Adano says. “The global aid budget isn’t growing and fluctuates depending on the changing priorities in donor countries.” 

Read more: AU Leaders: Domestic Resource Mobilization, Smart Partnerships Form Bedrock of Universal Health Coverage

Last month, Tanzania’s Chief Medical Officer, Muhammad Bakari Kambi, paid a visit to a health facility in Katoro, Geita Region, to see how IntraHealth International is helping prevent new HIV infections in Tanzania through voluntary medical male circumcision (VMMC), which reduces men’s risk of acquiring HIV through heterosexual intercourse by 60%. The November 6 visit was the CMO’s first-ever trip to an IntraHealth-supported VMMC clinic. While he was there, he also visited the maternity/labor, reproductive health, and child health units, and assessed the status and quality of VMMC services, which have been provided to millions of men in Tanzania since 2010. 

VMMC provides a much-needed entry point for reaching men and boys with HIV services. As part of its plan to end AIDS by 2030, UNAIDS has set a number of ambitious targets that must be met by 2020 in order to reduce HIV incidence by 90%, including an additional 27 million circumcisions in the 14 PEPFAR priority countries, of which Tanzania is one. 

Program evaluation data have shown sharp increases in HIV case identification and treatment initiation in men when VMMC services are introduced, which demonstrates the potential of VMMC not only as a primary prevention service but also as a critical contributor to the UNAIDS 90-90-90 treatment goals, specifically for men.

This is crucial in Tanzania, where only 52.2% of all people living with HIV between the ages of 15 and 64 years know their HIV-positive status.

According to the Tanzania HIV Impact Survey, annual incidence of HIV among adults in this age range is 0.29%, which corresponds to approximately 81,000 new cases annually. Prevalence of HIV among adults in the country is 5%, meaning that approximately 1.4 million people in Tanzania are living with HIV. The highest rates (8.4%) are among men aged 40 to 44 years.

Since IntraHealth began supporting the country’s VMMC program in 2011, a total of 1,045,501 boys and men have been served with comprehensive VMMC services in Mwanza, Geita, Shinyanga, Mara, and Simiyu regions in Tanzania. Based on the VMMC impact model, our program has helped avert over 13,000 new infections.

A total of 941,763 men were counselled and tested for HIV and received their test results through IntraHealth’s comprehensive VMMC services outlets—this is about 90% of all VMMC clients served during this project period. Of all VMMC clients who were tested, 2,815 (~0.3%) were identified to be HIV-positive and linked to care and treatment services and more than 90% were confirmed to be enrolled into care and treatment services.  

Dr. Pastory Sekule, IntraHealth’s director of programs, says regional health management teams must take ownership of donor-funded projects by putting budget lines in their government funds and creating feedback systems that show the interventions’ impact.

During his visit to the clinic, Kambi recommended that by adapting the strategies used by VMMC projects in other types of health interventions, Tanzania could further improve the friendliness and quality of health services in the country’s public health facilities.

In its second year alone (2017/2018), IntraHealth’s ToharaPlus project provided circumcision services to 305,718 men, 33% of all PEPFAR-supported VMMC services that year—the highest of all implementing partners in the country. The project plans to reach 410,844 more in 2018/2019.

IntraHealth International leads the ToharaPlus project with funding from the US President’s Emergency Plan for AIDS Relief (PEPFAR) through the US Centers for Disease Control and Prevention (CDC).

Before he started his new job as a domestic worker in a house near Omuthiya, Namibia, Johnas had taken his antiretroviral (ARV) medications regularly ever since he learned his status just under a year ago. But he didn’t know this new boss very well yet. How would he react if he found out his new staff member was HIV-positive? Would he tell him to leave?

Outside of work, Johnas watched as his friends took their own ARVs, and it made him anxious. He started having trouble sleeping.

“When am I going to get to take my meds again?” he thought.

Meanwhile, his friends were becoming more and more concerned for his welfare. They urged him to get back on his treatment regimen, but he wouldn’t budge for fear of losing his job. Finally, out of desperation, Johnas’s friends told his boss what was going on.

And it turned out that Johnas’s boss was upset—not because his staff member was living with HIV, but because Johnas was putting his own health in danger. So his boss offered to drive Johnas the 40 kilometers here, to the Omuthiya District Hospital’s HIV clinic.

Now Johnas is sitting with nurse Olivia Nandy, 68, who is one of 40 Namibian nurses who came out of retirement in 2016 to help fight the country’s HIV epidemic. Olivia asks him questions and speaks kindly to him.

Physically, he’s feeling fine, Johnas says. But he’s been so afraid.

When he finishes talking with Olivia, Johnas visits the clinic’s pharmacy to pick up his ARVs. Before he turns to leave, he says to Olivia and the other health workers:

“You are very good people. I thought maybe you would shout at me because I wasn’t taking my medication. But you are good people.”

Read more about IntraHealth’s work in Namibia .

IntraHealth is working with the government of Namibia to increase the number of health workers providing HIV services and provide the support and training they need to reach the country’s goal of an AIDS-free generation. IntraHealth’s  USAID HIV Clinical Services Technical Assistance Project in Namibia is funded by the US Agency for International Development (USAID) through the President’s Emergency Plan for AIDS Response (PEPFAR).

Aminata was forced to marry her 45-year old cousin when she 14 years old. Taken against her will, she lived in misery for a year-and-a-half before divorcing him. In her mind, life as she knew it had ended at 14. But then she heard about the Neema Project.

Already very active in her community and interested in the project’s sensitization sessions taking place in her neighborhood, Aminata was selected to become a youth community health worker, called “Dispensateur de soins à domicile” (DSDOM), which focus on providing care at the household level. 

This was the chance of a lifetime. The project provided her training on adolescent sexual and reproductive health and offered her the opportunity to support her peers so that what happened to her doesn’t happen to them.  

Since the training, Aminata goes to Dahiras (religious schools), schools, and associations in her neighborhood to discuss the negative consequences of child marriage and forced marriage. She even initiated an association of 25 boys and 16 girls to discuss the issue and build advocates. These activities give her a sense of vindication and USAID/Neema provides her with the tools to fight against these harmful practices.

This work is part of IntraHealth’s Integrated Services and Healthy Behaviors Adoption (ISD-HB) Neema project, which supports the efforts of the Government of Senegal to ensure that health services are improved in a sustainable manner and used effectively to reduce maternal, neonatal, and childhood morbidity and mortality and contribute to a generation free of AIDS. Photos and text courtesy of ChildFund.

In Namibia, teen clubs help provide adolescents who live with HIV a positive space to gather socially—and help health centers reach the growing number of HIV-positive teenagers who need emotional and psychological support in addition to medical treatment. Odibo Health Center established a teen club in 2013 to better meet the unique needs of adolescents living with HIV, increase their adherence to treatment, and achieve viral suppression in the Odibo district. The club meets once per month. 

Since its inception, the teen club has helped 60 HIV-positive adolescents improve antiretroviral treatment (ART) adherence and retention in care; 53 of these teens have achieved viral suppression.

Selma Immanuel* is a member of the St. Mary’s Health Center (Odibo) teen club. It played a significant role in her journey to adherence to ART. She’s hoping her story will help other HIV-positive adolescents who are struggling with adherence. These are her words: Although I was born with the virus, I only learned that I was HIV-positive in 2010 when I was 10 years old. I could not understand why I had to take a lot of pills and always accompany my granny to the hospital for check-ups. 

Then I asked her one day. She told me I was HIV-positive, but I didn’t understand the seriousness of taking my medication and the impact it could have on my life.  

Weather, transport, water, environment and health – all can be problematic and need to be tackled differently. Remote villages nestled in mountains must be reached so that basic services can be provided. People worry about the migration of young people and a changing climate.

But thanks to Anandi Devi, a dedicated Accredited Social Health Activist (ASHA), the people of Nali Bari don’t have to worry quite as much about their health.

We decided to spend a day with Anandi Devi, who visits people door-to-door, dispenses free advice, attends to pregnant women and newborn babies—to see how she brings efficient health care to the doorsteps of people in her village.

Nali Bari lies in the higher reaches of Kotdwar, Uttarakhand, and has a population of just 446 people. Even before she became an ASHA, Anandi was doing social work in rural areas as a “motivator.”

“I used to meet up with people and encourage them to take up good farming and animal husbandry practices, like caring for the cattle and feeding them better.” Anandi worked as a motivator for nearly five years, and when the opportunity presented itself in 2007, she became a health worker.

Looking back, she says, working as a frontline health worker is much more satisfying. Being an ASHA is being knowledgeable—and she finds that her work with women is really making a difference in their lives. “It is now that I have actually come to know about health,” says a confident Anandi. During the implementation of mSakhi, the mHealth application developed by IntraHealth, she went through a series of trainings on the use of a smart phone, running the app, and improving her knowledge of maternal, neo-natal and child health. After this, Anandi felt a surge of confidence.

It’s not just Anandi. Over 136 frontline health workers like her access smart phones and mSakhi. For ASHAs, this changed their mode of communicating and interacting with people. Anandi now lets her mSakhi-enabled mobile phone do the talking. Her smart phone ‘speaks’ with communities, telling mothers about taking vitamins, the importance of the colostrum, eating a balanced diet and reminding them about vaccinations. With the app’s help, she does not miss her appointments with pregnant mothers, remembers every single important date for vaccinations, and schedules visits to the health center on important days. Anandi goes to meet 25-year-old Ritu Devi, who is eight months pregnant. This is Ritu’s first pregnancy and because of Anandi’s regular visits, she is informed about pregnancy care. Anandi often encourages Ritu’s mother-in-law to join them for counseling. The next visit is Vinita, who recently had her second baby. Both Vinita and her husband are farmers. Their son Samardeep is now four months old. Here, Anandi’s counseling role changes completely. She is now talking about breastfeeding, vaccinations and the right diet for little Samardeep.

The mSakhi intervention impacts a population of nearly 130,000 in Kotdwar. This has led to increased antenatal care (ANC) coverage, with the percentage of pregnant women delivering without ANC visits dropping from almost 70% to just over 3%. At the same time, the percentage of pregnant women who were provided all four ANC visits prior to delivery rose from 21.7% to 55.3%. The use of mSakhi has also led to better tracking of high-risk pregnancies. Though Nali Bari is a small village, Anandi must keep walking up and down narrow, hilly tracts. But she ensures women have access to health information. She accompanies pregnant women to local health centers. She informs mothers about pending vaccinations for their children. And through persistent follow-up, she ensures that mother and child reach the health center on time. Toward the end of our visit she says: “Work has become easier using the mSakhi app.”

Dr. Tedros Adhanom Ghebreyesus visited IntraHealth’s booth at the Access Challenge High-Level Conference on Universal Health Care, along with H.E Mrs. Toyin Saraki, founder and president of the Wellbeing Foundation Africa and WHO special advisor.

The conference included four forums focusing on the critical areas of maternal health, child health and malaria, noncommunicable diseases, and neglected tropical diseases in Africa. IntraHealth’s CEO and president, Pape Gaye, spoke on the maternal health panel, and highlighted the importance of having a team of health professionals trained and available to provide maternal care—not just obstetricians and gynecologists but community health workers, nurses, and midwives providing a whole range of essential services for mothers. He also stressed we need to focus on settings with the least access to trained and supported health workers to improve maternal health. Dr. Tedros called on heads of states to mobilize tangible actions to achieve UHC.

IntraHealth’s booth showcased our efforts in all four of these key areas and gave us the platform to share how we’re working to make health workers count for advancing UHC and advocating for increased and more strategic investment in health workers.

We’re excited that we were able to share our work with Dr. Tedros during the cocktail hour!

Health care is an investment and one the best investments you can make, said Gaye today at the third annual African Health Business Symposium in Johannesburg. The African continent is healthier than it was just years ago, he said, but as we acknowledge the 40th anniversary of the Declaration of Alma-Ata on primary health care, we must also acknowledge that it’s not acceptable to take 50 years to simply get where we already are today.

If you are still wringing your hands over whether the private and public sectors should work together to achieve universal health coverage or whether they can trust each other, he said, the train has left the building.

We can’t think of health care as just an expenditure or cost. Poor-quality health systems result in more than 9 million deaths annually in low- and middle-income countries, amounting to economic welfare losses of $6 trillion.

He shared that 91% of health employment potential exists in lower-middle and low-income countries in Africa and Asia, where jobs would boost inclusive economic growth and contribute to achieving full employment. And each new job in the health sector can result in 2.3 additional new jobs in non-health occupations within the broader community, according to the ILO.

Private sector collaborations in the health sector can lead to both improved public health and improved economic conditions.

He went on to share two examples of successful public-private collaborations:

The Afya Elimu Fund in Kenya is a mechanism that offers students low-interest loans to complete their health training programs.

Better Hearts Better Cities is an initiative of the Novartis Foundation led by IntraHealth in Dakar, Senegal. It works with the public and private sectors to improve access to prevention and treatment services for hypertension.

Gaye was speaking as part of a panel with Freddy Kgongwana, CEO of the Dr. George Mukhari Academic Hospital; Dr. Sanele Madela, Founder and CEO of Expectra Health Solution; Dr. Kate Tulenko, CEO of Corvus Health; and Dr. Ademola Olajide, resident representative, UNFPA Kenya.

At a United Nations General Assembly side session in New York City last week, IntraHealth International joined Novartis Foundation and others to discuss how the private sector can team up with governments and development partners to improve access to high-quality primary health care services and make faster progress toward universal health coverage. 

Vince Blaser (above left), senior advocacy and policy advisor at IntraHealth and director of the Frontline Health Workers Coalition (FHWC), called on participants to join FHWC in collectively advocating for three distinct points:

Engage private-sector companies to bring their expertise to address the most acute gaps in access to high-quality primary health services

Create and prioritize country-led investment frameworks with private-sector components that focus on delivering primary health services to communities with the least access

Encourage and amplify the voices of frontline health workers to enable greater and more strategic investments in the health workforce.

Rosaura Polanco (above right), a promotora (community health worker) with Grameen PrimaCare in The Bronx in New York City, then shared her experience as a provider for immigrant women in her community and as an advocate for increased investment in frontline health workers around the world. IntraHealth partnered with Medtronic Foundation last year to train Rosaura and other health workers around the world in storytelling for advocacy. Rosaura has since shared her story about delivering primary services in her underserved area to hundreds of global health policy-makers and influencers. 

Rosaura’s presence—and her story—at this UNGA event further amplified the voice of the health worker and illustrated the power of advocacy and partnerships.

You can join FHWC in this call to action by following @FHWCoalition on Twitter and retweeting the call, which looks like this: 

During the Fistula Mali end-of-project event on October 4, IntraHealth International’s Mali team gathered with friends and colleagues from the government of Mali, the US Agency for International Development, the Orange Foundation, the International Association for Maternal and Neonatal Health, the Medical Alliance Against Malaria, the Women Action Research, Study, and Training Group, and other local partners to look back on the results and advances brought about by this USAID-funded project over the last decade.

The IntraHealth team.

In the past five years alone, the project has trained 25 local surgeons, 1,067 community health workers, and health workers at all levels of the health system to provide high-quality, comprehensive screening and care for women with obstetric fistula—a devastating childbirth injury that affects more than 2 million women in Asia and sub-Saharan Africa. Together we’ve provided over 1,140 surgeries for women in Mali, three-quarters of whom are now completely healed.

Read more about the project and the people who are working to end obstetric fistula in Mali:

Meet the Feminists of Western Mali

Women on the Rise in Global Health: Q&A with a Malian Trailblazer

Let’s End Obstetric Fistula

After Fifty Long Years with Obstetric Fistula, Two Women Reclaim Their Dignity

A Special Delivery for Women in Mali

And more

Gaye presented early results from IntraHealth’s partnership with Novartis Foundation on the Better Hearts Better Cities initiative in Dakar, Senegal, during a United Nations General Assembly side session called Innovative Partnerships to Advance Universal Health Coverage in Cities. 

In Senegal, uncontrolled hypertension—the most common noncommunicable disease—is now the fifth leading cause of death. Around 30% of Senegalese 18 to 69 years old have hypertension, yet only 28% of those men and women are aware of their condition and have their blood pressure under control. 

The work of Better Hearts Better Cities Dakar contributes to improved cardiovascular health outcomes among the urban population by addressing hypertension at all levels of the continuum of care, from primary prevention through treatment at referral health centers. Gaye highlighted how IntraHealth successfully advocated for a national policy shift to enable community health workers to provide hypertension services, expanding access to care. Now nurses and community health district supervisors in Dakar are collaborating to train and equip community health workers to conduct blood pressure screening and referrals. 

Keep an eye out for more results and news on this public-private partnership!

Ms. Ouba Somé is responsible for the financial management of Ouagadougou’s contributions to The Challenge Initiative in the capital city. She proudly showed us the bank account statement showing a contribution of 8 million CFA, which represents the first cash financial contribution of the city. They have pledged a total of 52 million CFA, which is in a budget line item and can only be transferred to this bank account as funds are spent.

It becomes even more difficult when volunteering in rural areas where the populace is often unaware about the latest information in maintaining good health. 

Frontline health workers in India have the onerous responsibility of encouraging people to inculcate healthy practices and are often the only link between people and quality health care. But even before they can carry out their work in communities and gain confidence, they must build their own strength and knowledge about health. 

This is where IntraHealth International comes in. Over the last two years, IntraHealth has been training and building the capacity of dozens of women in Uttarakhand state so they can deliver health care right to people’s homes. These women have the information capacity, modern tools, and confidence they need to be able to strike up a conversation with people within their communities about following healthy practices. IntraHealth has provided mHealth technology and conducted numerous training programs to update health worker knowledge and provide them with tools to make them more efficient. It would not be an exaggeration to say that frontline health workers in Uttarakhand have become experts on maternal and child health within their communities. They share information, visit households in their areas, and persuade the families to adopt healthy practices.    One such frontline health worker, Anita Ghidiyal, works in village Padampur Sukhro in Kotdwar, Uttarakhand. She lives in a modest home with her two children, husband, and mother-in-law, and has been working as a health worker since 2007. She tells us how the IntraHealth application mSakhi has made her a more confident health worker. Anita is now using a smart phone and the mSakhi app to schedule her visits, communicate better with people, and record health data about the people that she meets. We accompany Anita as she leaves her home in village Padampur Sukhro to visit some of the households that she has been counseling. She tells us that that gaining the respect of people in her village has been a long journey, but the use of mSakhi and sharing health information over the smart phone changed things for her. Anita says that over time, things have changed to an extent that people come visiting her to seek advice on health issues other than those related to maternal and child health.

Anita opens up the gate to the house of Beera Devi, a young mother who had an unexpectedly difficult delivery. She has been spending considerable time with Beera Devi and her family, counseling them about diet and nutrition.

At Beera Devi’s home, Anita takes a good look at the baby and inquiries about his diet and other behaviors. She once again reinforces messages like the importance of breast-feeding and immunization using the mSakhi app.

Beera had to spend extra time in the hospital as she was nervous during delivery. It was here that Anita played an important role supporting her through her difficult days. “Even though the delivery was normal, Beera faced problems because this was her first pregnancy. Beera's hemoglobin level was as low as 6 mg/dl when she was three months pregnant, which eventually rose to 10 mg/dl by the time of her delivery,” Anita says.

Anita not only counselled a pregnant Beera, but also her husband and in-laws about the importance of proper nutrition and adequate food intake for both the newborn and his mother.

IntraHealth holds the secretariat of the Frontline Health Workers Coalition (FHWC), and organized visits to US representatives’ offices. This “Hill day” advocacy event on August 16 aimed to encourage representatives to co-sponsor House Resolution 342, which recognizes the “essential contributions of frontline health workers to strengthening the United States’ national security and economic prosperity, sustaining and expanding progress on global health, and saving the lives of millions of women, men, and children around the world.”  

Introduced by Representatives Nita Lowey (D-N.Y.) and Mario Diaz-Balart (R-Fla.), this bipartisan resolution calls for an action plan to maximize the impact of existing U.S. global health investments in the frontline health workforce. U.S. leadership has been critical to fostering frontline health workers’ central role in driving enormous progress in global health in recent years. That’s why IntraHealth, through its leadership of the Frontline Health Workers Coalition, focuses much of our advocacy work on educating members on the outsize impact of this leadership and the tiny sliver of the federal budget invested in these programs.

IntraHealth’s advocacy team, including Vince Blaser, Sarah Kashef (above left), and Jessica Turner, were joined by Katie Coester from Elizabeth Glaser Pediatric AIDS Foundation, Aarin Palomares from FHI360, and Victoria Rodriguez (above right) from Global Health Council. They conducted 12 meetings with offices of representatives, which gave much verbal support for this resolution. Over the next few weeks, the team will follow up with offices and encourage other representatives to support the resolution.

The speech commemorated the launch of the 2018 Family Planning Social and Behavior Change Mass Communication Microplan.

TCI is a three-year urban reproductive health program funded by the Bill & Melinda Gates Foundation. It is aligned with and will contribute to the Cote d’Ivoire’s achievement of its family planning objectives.

“There is no longer any doubt today that family planning contributes to the improved sexual and reproductive health of adolescents and youth, men, and women of reproductive age,” Minister of Health and Public Hygiene Aouélé Eugène Aka said.

Minister Aka is committed to increasing the availability of contraceptives and the contraceptive commodity budget in Cote d’Ivoire, while making youth-friendly family planning and reproductive health services more widely available and improving the country’s contraceptive supply chain.

“My greetings to our elected officials,” Minister Aka said, “the mayors who understand the impact of family planning on the development of their communities, and who are financially engaged alongside the ministry through the implementation of the TCI project.”

Find out more about IntraHealth’s work with The Challenge Initiative here.

It was her first child after ten years of marriage. From the beginning of her pregnancy, Rahimova planned to feed the baby only formula.

"I've always seen TV ads that show beautiful children eating different formulas. They look plump and healthy. I thought that if there are no ads about breastmilk, then it's useless. I always thought if I ever have a baby, I will not spare any money to buy formula for her," she says.

The other women in Rahimova’s household, her sisters-in-law, also fed their babies formula, and none of the older women in her life taught her about breastfeeding.

Rahimova’s mother-in-law, Rajabmoh Rahmatulloeva, says, "All seven of my grandchildren grew up on different formulas. When my first daughter-in-law gave birth, in 2005, the child was often sick and could not gain weight. The doctors told us her breastmilk was infected and harmful for the baby. At that point, breastfeeding lost its value for us. However, now we have turned around completely.”

The Feed the Future Tajikistan Health and Nutrition Activity has helped change similar attitudes about breastfeeding in many families. The project empowers over 1,300 volunteer community health promoters to work in Feed the Future’s target districts in southwestern Tajikistan. They educate their communities on a variety of health issues, including pregnancy nutrition, breastfeeding, and complementary feeding for young children.

Rahmatulloeva is a teacher, and she has become one of the volunteers in her village. When her granddaughter was born, Rahmatulloeva persuaded Rahimova to feed her daughter exclusively with breastmilk.

Soon, many women in their village began discussing the value of breastmilk. After delivery, another community health promoter gave Rahimova specific advice on how to properly apply the baby to the breast, the frequency and duration of each feeding, how to recognize the baby’s early hunger signs, the health benefits of breastfeeding for both mother and baby, and even the financial benefits of breastfeeding.

"Our family is grateful to Feed the Future not only for teaching us that breastmilk is an indispensable food for the baby during the first six months, but also for preserving our family budget," says Rahimova. "My husband does not have a permanent job and earns money on construction sites. The purchase of expensive formula could cost us dearly."

One pack of baby formula in Tajikistan costs 60 to100 somoni ($8-10). One pack lasts for three to seven days, depending on child’s age. Over six months, Rahimova’s family has saved approximately $550. (In March 2018, the average salary in Tajikistan was reported to be $139 per month.)

Over the past three years, the Feed the Future Tajikistan Health and Nutrition Activity has trained more than 3,000 volunteers to conduct educational activities in 500 villages in target districts. The project has also established a successful collaboration between volunteers and health care providers. So far in 2018, the project has hosted over 400 educational events for the population.

Most importantly, Rahimova's daughter recently turned seven months old and is happy and healthy.

Participants in The Village People microlab engaged in an immersive experience as they worked collectively to develop aspects of an ideal village. This lab  featured numerous speakers' innovations and involved groups of participants working together to solve challenges many communities face. 

SwitchPoint-goers brainstormed solutions to challenges in education, health care, sustainable energy, women’s empowerment and income generation, and access to water. 

Microlab leaders included Hawa Diallo of The Orange Foundation; Cheick Touré, Jeanne Tessougué, Mariam Zouboye, Demba Traoré, and Moctar Diallo of IntraHealth; Chef Pierre Thiam of Yolélé Foods; Neha Misra and Fatma Muzo of Solar Sister; Heidi Breeze-Harris and Kimberly Calkins of PRONTO International; and Fekadu Moreda of RTI.