Health Systems Strengthening

Health Systems Strengthening (HSS)

 {Photo Credit: Samy Rakotoniaina/MSH}A mother in Madagascar who has been sensitized on the use of bed nets.Photo Credit: Samy Rakotoniaina/MSH

World Malaria Day: A Conversation with Dr. Bernard Nahlen

[Dr. Bernard Nahlen]Dr. Bernard NahlenThe theme for World Malaria Day this year is MSH’s newest Board Member, Dr. Bernard Nahlen, recently spoke with Thomas Hall, MSH’s Senior Principal Technical Advisor for Malaria, about reducing the malaria burden in developing countries most affected by the disease. Dr. Nahlen, Director of the University of Notre Dame’s Eck Institute for Global Health, has decades of experience in research and disease elimination programs worldwide. Prior to his recent appointment at the Eck Institute, Dr. Nahlen served as Deputy Coordinator of the US President’s Malaria Initiative from 2007 to 2017. From 2005 to 2006, he was Senior Advisor, Monitoring and Evaluation, at the Global Fund to Fight AIDS, Tuberculosis and Malaria.  

Participants of the EPN-SPS AMR regional workshop in Moshi, Tanzania. Photo credit: EPN

Antimicrobial resistance (AMR) occurs when a microorganism becomes resistant to a drug that was originally effective for treating the infections it caused. It is one of the world’s most pressing global health threats and could erode progress made thus far in the treatment of HIV/AIDS, TB, malaria, and many other infectious diseases.

Management Sciences for Health’s (MSH) role in combatting AMR was recently featured in the peer-reviewed journal, Global Public Health.

The article describes an approach used by the USAID-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program and its predecessors to build and strengthen coalitions to defeat AMR. SIAPS was implemented by MSH.

 {Photo Credit: Erik Schouten}A cholera patient recovers at a treatment center in Lilongwe District, Malawi.Photo Credit: Erik Schouten

Photos by Chisomo Mdalla, ONSE Health communications officer.

As the globe marks World Water Day on March 22, the Organized Network of Services for Everyone’s Health (ONSE) Activity has been supporting the Government of Malawi in responding to a months-long cholera epidemic.

ONSE, funded by the United States Agency for International Development and led by Management Sciences for Health (MSH), works in Malawi to reduce maternal, newborn, and child morbidity and mortality by focusing on health system strengthening; family planning and reproductive health; maternal, newborn, and child health; malaria; and water, sanitation, and hygiene (WASH).

The first cases of cholera began appearing in Malawi in November 2017. As of March 20, a total of 827 cases had been reported in 13 of country’s 28 districts. Twenty-six deaths have been reported, according to the Epidemiology Unit of the Directorate of Preventive Health Services at the Ministry of Health. Cholera is an infectious bacterial disease that is often transmitted through poor hygiene and contaminated food and water.

Samuel Kasozi is Deputy Chief of Party with the TRACK-TB project.

We’re excited to bring you this month’s edition of Leading Voices, a series that features the incredible talent that makes up MSH.

Can you name the biggest achievement that the TRACK-TB project has made in Uganda?

The TRACK-TB project improved TB control indicators in Kampala and rapidly scaled up MDR-TB programs from 3 to 15 facilities by the end of 2017. Patient enrollment and TB treatment outcomes were greatly improved.

What drives you?

I am motivated by good results, availability of efficient work tools, and a conducive work environment.

What do you think makes MSH different?

Its sound capacity and experience in building health systems.

Finish this sentence: Health is a

right and must be.

Anything about yourself that you colleagues may not know about?

I love reading and touring.

 {Photo Credit: Diana Tumuhairwe}Mary Nkiinzi, a TRACK TB Community Linkage Facilitator for the Komamboga Health Centre in Uganda, checks on Nakawesi Harriet and her family during a home visit while Harriet and her mother complete treatment for multi-drug resistant TB (MDR-TB).Photo Credit: Diana Tumuhairwe

Tuberculosis remains the world’s leading infectious disease killer. Ending TB will require a comprehensive approach and targeted action, rapid innovation and proven interventions, bold leadership, and intensive community engagement.  

On this World TB Day, the global health community is calling for “Leaders for a TB-Free World” to work together, make history, and end TB once and for all.

{Photo Credit: Warren Zelman}Photo Credit: Warren Zelman

The Systems for Improved Access to Pharmaceuticals and Services (SIAPS) program helped make sure that some of the world’s most vulnerable people have timely access to safe, affordable medicines and to quality services to improve their health. Funded by USAID, the program worked for six years in 46 countries to comprehensively strengthen pharmaceutical systems by addressing five interrelated functions, with a focus on medical products—governance, human resources, information, financing, and service delivery. 

Each level of progress in pharmaceutical systems strengthening (PSS) sets the stage for further advances. Which areas need focused attention going forward so that progress continues? 

After more than 15 years working on women’s health and development issues, I feel hopeful as the growing movement for women’s rights brings us closer to a breakthrough. Everyday, more women around the world -- from Madagascar to Mexico -- are emerging as leaders. They are organizing and demanding justice, equality, and the full realization of their fundamental human rights. In the halls of the United Nations, at the policymaking tables of country ministries, and in the local health clinics, women and girls are calling for health policies and services that meet their needs, and those of their families and communities.

On International Women’s Day, Management Sciences for Health (MSH) joins women worldwide to press for progress. Our work is grounded in the fundamental view that safeguarding women’s, children’s, and adolescents’ health is a core health system function. It is time we listen to all women and girls, because they are the health system.  

{Photo Credit: Samy Rakotoniaina}Photo Credit: Samy Rakotoniaina

In the late 19th and early 20th centuries, Poliomyelitis, or polio, was a greatly feared scourge of the industrial world. It would paralyze hundreds of thousands of children every year. Once effective vaccines were introduced in the 1950s the number of cases of polio dropped dramatically and the virus was eliminated in many countries, but in some places, it still remains a real threat.

Polio is an infectious viral disease that is transmitted from person to person and can lead to paralysis, respiratory failure, even death. The polio virus easily spreads in areas with poor sanitation. Vaccination is the most reliable way to prevent polio and to protect children under five, who are the most vulnerable.

The virus was wiped out in Madagascar 2005 but reappeared in 2014. Since then, Madagascar’s government and health partners, including the World Health Organization, United Nations Children's Fund, and the United States Agency for International Development, have held multiple vaccination campaigns across the country.

We’re excited to bring you this month’s edition of Leading Voices, a series that features the incredible talent that makes up MSH.

We’re chatting with Maura Brown, a Technical Advisor with the USAID-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program. Maura spent her early career in Antigua Guatemala, where she was first exposed to pharmaceutical management work. Today, she works on the development of the Pharmaceutical Systems Strengthening (PSS) Insight tool, a web-based platform and data management system to measure the impact of PSS. The tool has been piloted in Bangladesh and Namibia, and will be available on March 15 from pssinsight.org.

What are you most proud of in your work?

I’m proud of the cross-cutting nature of my work. I have been able to work with many of the teams within SIAPS and PHT, and gain a working understanding of most of the types of work that we do.

Members of the Bangladesh study tour visit an ADDO in Tanzania. Photo Credit: Jafary LianaMembers of the Bangladesh study tour visit an ADDO in Tanzania. Photo Credit: Jafary Liana

In recent years, global health stakeholders have begun to recognize the profound potential that drug shops have to advance public health goals, such as those related to malaria diagnosis and treatment, child health, and family planning. These outlets, for reasons of convenience and cost, are the first choice of care for millions of people - and until recently, they have largely been ignored.

“Drug shops and pharmacies are important sources of health care, particularly in rural areas or urban slums with few public clinics. They are often the first stop for women and men who seek FP information or services.”  - World Health Organization

This is why, in 2003, Management Sciences for Health (MSH) helped launch the Accredited Drug Dispensing Outlet (ADDO) Program in Tanzania to address the important role of these informal drug sellers by creating certain standards that, when met, increase the quality of medicines and services in the community. Tanzania’s successful ADDO Program provides a model that other countries in Africa—and now Asia—have adapted and made their own.

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