Health Systems Strengthening

Health Systems Strengthening (HSS)

{Photo credit: Todd Shapera}Photo credit: Todd Shapera

In the Geita District in Tanzania’s Lake Zone, some 10 kilometers from the nearest health facility, a one-year-old girl child wakes up crying with a severe fever. “We used to walk more than 10 kilometers to present our sick children to Geita Regional Hospital,” says Joyce Bahati, the girl’s mother.

Access to proper diagnosis and medicine is critical when a child develops a severe fever. A long journey can delay treatment, or for some, discourage seeking care altogether. In rural sub-Saharan Africa, where the nearest fully-functional health facility may be, at best, a three-hour journey on foot, women and children often turn first to community-based caregivers and medicines sellers or small health dispensaries as first providers of primary health care, including severe fever.

 {Photo credit: Rachel Hassinger/MSH}L to R: Dr. Jonathan D. Quick, Stefanie Friedhoff, Dr. Peter PiotPhoto credit: Rachel Hassinger/MSH

On March 27, 2015, Dr. Peter Piot of the London School of Tropical Medicine and Hygiene and Dr. Jonathan D. Quick, MSH President and CEO, sat down at the Boston Public Library with Stefanie Friedhoff of The Boston Globe to discuss Ebola, epidemic preparedness and rebuilding public health systems. 

Watch the video of the whole program:

Here are some excerpts from their conversation:

Stefanie Friedhoff: What did countries do that worked well in the Ebola fight?

Jonathan Quick: There were 6 things that worked well in three of the rim countries of Nigeria, Mali and Senegal.

  1. Leadership: Ministers of Health were on top of the first cases and declared national emergencies.
  2. Preparedness of public health systems.
  3. Rapid action in getting the index case identified and case detection system for subsequent cases.
  4. Good communications campaigns.
  5. Mobilizing the community.
  6. Heroism of local health workers.

SF: Why was the international response so slow? What should be done?

{Photo credit: C. Gilmartin/MSH}Photo credit: C. Gilmartin/MSH

For five years, the USAID-funded, MSH-led Leadership, Management and Sustainability project in Haiti (LMS/Haiti) worked with the Ministry of Health and Population (MSPP) and local NGOs to ensure a steady supply of family planning commodities to nearly 300 facilities throughout the country amid bone-rattling roads, surging rivers, and rocky footpaths.

Said Dr. Georges Dubuche, General Director of the MSPP, at the project’s closing ceremony April 14:

It is with real pride and great emotion that I salute LMS/Haiti.

LMS/Haiti’s greatest success, as everyone present can attest, was to guarantee the availability of family planning commodities at all times to ministry sites, with zero stock-out.

[ Dr. Georges Dubuche, General Director of the MSPP.] {Photo: MSH staff} Dr. Georges Dubuche, General Director of the MSPP.Photo: MSH staff

MSH President & CEO Jonathan D. Quick says: "Let this be a loud call to action for greater investment in strong local health systems and global networks..." in today's The New York Times.

"Let this be a loud call to action for greater investment in strong local health systems and global networks to prevent, detect and respond to public health threats. We know how to prevent the next local outbreak from becoming the world’s next major epidemic," says MSH President & CEO Jonathan D. Quick in a Letter to the Editor, published today in The New York Times.

Dr. Quick responds to “Yes, We Were Warned About Ebola,” an April 7 opinion editorial by Bernice Dahn, Vera Mussah, and Cameron Nutt, saying:

Dr. Dahn, the chief medical officer of Liberia’s Ministry of Health, and her colleagues express dismay that missed information from 1982 contributed to the gravely flawed conventional wisdom that Ebola was absent in West Africa. An even greater error of conventional wisdom was the longstanding misjudgment by experts that Ebola was a “dead-end event,” killing its human host too quickly to spread out of control.

World Health Worker Week (April 6-10, 2015) is an opportunity to mobilize communities, partners, and policymakers in support of health workers in your community and around the world. It is a time to celebrate, raise awareness, and renew commitments to health workers having the training, supplies and support they need to do their jobs safely and effectively.

Meet some of the health worker heroes among us!

Muhamed Mulongo, acting district health officer, Uganda

[Dr. Muhamed Mulongo] {Photo credit: Cindy Shiner/MSH}Dr. Muhamed MulongoPhoto credit: Cindy Shiner/MSH

Muhamed Mulongo decided when he was a boy to become a doctor after accompanying his sister to the hospital in the middle of the night during difficult labor. The baby died.

I said to myself, 'I should be a doctor I think'.

Now he is the only surgical doctor in the eastern Ugandan district of Bulambuli.

You work here only when you love your job.

You always have to improvise. You have no choice -- you have to save people in the process.

On behalf of our 2,200-plus worldwide staff, we wish you, your family, and communities, a happy World Health Day!

This World Health Day, we celebrate the heroes among us: health workers. We envision a world where everyone has the opportunity for a healthy life. Says a nursing officer from Kenya:

My vision is to have the best maternal services in this community.

Watch video

For more than 40 years, MSH has expanded access to quality maternal, neonatal, and child health services by strengthening all levels of the health system.

We support health workers at all levels -- ministries of health, community volunteers, midwives, medicine shop owners, nursing officers, and more -- so that every woman and newborn, even in the most remote areas, has the opportunity for a healthy life.

Envision a world where everyone has the opportunity for a healthy life!

 {Photo credit: Bright Phiri/MSH}Delegates learn about pharmaceutical management from Systems for Improving Access to Pharmaceuticals and Services (SIAPS) Program staff while visiting Mokopane Hospital in Limpopo Province, South Africa.Photo credit: Bright Phiri/MSH

Management Sciences for Health (MSH) sponsored a Congressional Staff Study Tour to South Africa and Zambia in February 2015 to examine the local impact of US funded health capacity strengthening in Southern Africa. During the trip, site visits and meetings highlighted the impact of local health capacity building efforts in pharmaceutical management of essential medicines and HIV & AIDS drugs and technical and managerial development opportunities for community workers.  

Unpublished
{Photo credit: Warren Zelman.}Photo credit: Warren Zelman.

Nearly three years ago, I blogged about a systems approach to improving access for a Maternal Health Task Force (MHTF) series on maternal health commodities:

Increasing access to essential medicines and supplies for maternal health requires a systems approach that includes: improving governance of pharmaceutical systems, strengthening supply chain management, increasing the availability of information for decision-making, developing appropriate financing strategies and promoting rational use of medicines and supplies.

 {Photo credit: Emily Phillips/MSH Afghanistan}A postnatal woman with her newborn and mother-in-law.Photo credit: Emily Phillips/MSH Afghanistan

Last month I represented Management Sciences for Health (MSH) at Oxfam India’s South Asia Consultation on Maternal Health in Kathmandu, Nepal. The purpose of the meeting was to discuss significant maternal health programming experiences in Afghanistan, Bangladesh, India, Nepal, Pakistan, and Sri Lanka, and to suggest strategic directions for Oxfam India’s future maternal health programming. More than 30 representatives from governments, national and international universities, and nongovernmental organizations attended.

Three elements of improving maternal health outcomes stood out in my mind from discussions at the meeting:

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