Health Systems Strengthening

Health Systems Strengthening (HSS)

Three Afghan children. {Photo credit: MSH.}Photo credit: MSH.

About 7.6 million children under age five die each year of preventable causers; 3 million — 40 percent — are newborns (under 28 days old). Ninety-nine percent of these occur in developing countries; three-quarters are mainly due to preventable causes such as neonatal conditions, pneumonia, diarrhea, malaria, and measles. Many of these under-five deaths could be averted by known, affordable, low-technology interventions.

Any preventable child death is one too many.

Here are 10 important interventions for child survival --- a list that is by no means exhaustive:

  1. Exclusive breastfeeding

    Could keep 1.3 million infants from dying (including by preventing pneumonia)

  2. Long-lasting, insecticide-treated bednets

    Would save more than 500,000 children by preventing malaria

  3. Vaccines, such as PCV, Hib, and rotavirus

    Would help prevent common childhood illnesses, such as measles, and save children’s lives

  4. Micronutrient supplements, such as vitamin A and zinc

    Would fight malnutrition. (While not a direct cause of death, malnutrition contributes indirectly to more than one-third of these deaths.)

Sophia is now the go-to person for family planning and reproductive health services at Rwesande health center IV in western Uganda. {Photo credit: M. Hartley/MSH.}Photo credit: M. Hartley/MSH.

Sophia is a humble woman. She has been working as a nurse for 10 years, and is currently one of five nurses posted at Rwesande health center IV in the hills of western Uganda.

When I arrived I was impressed by the number of services the health center offers, and the general appreciation felt around the compound. Rwesande health center IV has a maternity ward to safely deliver babies; counseling areas for family planning, reproductive health, and HIV; a general ward, a surgery theater, and health education space.

Family planning counseling and services now available

As Sophia shows me her meticulously-kept record books I can see the pride she takes in her work. She explained how women are now coming and asking for family planning services.

Not too long ago clients were not coming, and the nurses didn’t have proper training on methods to offer clients.

The NCD Alliance announced today that delegates at the 65th World Health Assembly are likely to pass a historic target on chronic non-communicable diseases (NCDs) tomorrow, May 26.

The NCD Alliance, a network of over 2,000 civil society organizations, including Management Sciences for Health, urged delegates to "support comprehensive Global Monitoring Framework and Targets; support the establishment of a Global Coordinating Platform on NCDs; and put NCDs at the heart of the post-2015 development agenda."

Three women gather outside a Tanzanian health center. {Photo credit: M. Paydos/MSH.}Photo credit: M. Paydos/MSH.

The 65th World Health Assembly is convening this week in Geneva, beginning May 21. For six days, the Assembly will focus the world’s attention on chronic non-communicable diseases (NCDs), universal health coverage, mental disorders, nutrition and adolescent pregnancy, among other health issues.

This is the second time in less than a year that chronic NCDs --- such as cancer, cardiovascular disease, diabetes and lung diseases --- are in the international spotlight. Last fall, the High Level Summit on Non-Communicable Diseases convened in New York, when, for only the second time in the history of the United Nations, a high level summit focused on a global health concern.

Ms. Apegnon Akpene, a family planning client and role model, in Diguegue. {Photo credit: Niagia Santuah/MSH.}Photo credit: Niagia Santuah/MSH.

Apegnon Akpene is a 20-year-old mother of three children: four-year-old Joseph, two-year-old Romance, and one-month-old Akou Jacqeline. Since attending USAID's Action for West Africa Region, Phase II (AWARE II)  community health worker training, she has become a client of family planning -- and a role model for family planning in her community.

Akpene is one of three community health workers in Diguegue, a small village of about 800 people in the hills of the southwestern forest separating Togo and Ghana. Distance and difficult terrain are major hindrances to accessing health care for the inhabitants of the village. Diguegue is 47 kilometers from the nearest health facility, a small clinic, in the Prefecture of Tchifama. The village is served by a 12-kilometer dirt road that winds through the thick forest.

Akpene attended school for eight years. When she became pregnant at age 16, she was forced to drop out. She gave birth to three children within four years.

Honor your mother, support healthy moms, and help kids reach their 5th birthdays: click the image to donate {Photo credit: MSH.}Photo credit: MSH.

Improving Child Health in Communities and at Home, the April/May 2012 edition of MSH's Global Health Impact newsletter (subscribe), features personal stories about child survival and child health in developing countries.

"Prevention, treatment and care close to the home are keys to saving children's lives," says Dr. Jonathan D. Quick, MSH president & chief executive officer, who blogs about saving children's lives through interventions closer to home, shares his 5th birthday picture, and encourages us to support USAID's 5th Birthday Campaign.

Stories about child survival and child health

The newsletter highlights a number of compelling stories from the Democratic Republic of the Congo, Uganda, Nigeria, and Lesotho.

MSH President Jonathan D. Quick, age 5. {Photo courtesy of Dr. Quick.}Photo courtesy of Dr. Quick.

Cross-posted on USAID's IMPACT blog

My most vivid early childhood memory is waking up to excruciating pain in my throat, and seeing the goldfish swimming in the aquarium of the pediatric surgical ward. Although penicillin had been discovered 30 years earlier, doctors had not learned yet that treating "strep throats” with penicillin was better than operating. I didn't need the tonsillectomy. But, I was lucky to receive quality care in a health facility, close to my home.

Millions of children today are not so lucky. Over 7 million children under the age of 5 die each year; 70 percent of child deaths occur in sub-Saharan Africa and South-East Asia. The vast majority -- over two-thirds -- are entirely avoidable with existing safe, effective, low-cost prevention and treatment.

Chinaecherem Nwodo {Photo credit: MSH.}Photo credit: MSH.

Stigmatized, isolated, and conditioned to undertake hard labor, 14 year-old Chinaecherem Nwodo shows that one can overcome the most dire circumstances. Chinaecherem was despised and accused of witchcraft in her community, the Onu-Orie-Obuno-Akpugo village in Nkano West Local Government, Enugu State, Nigeria. Her abusive treatment by community members reflected the challenges facing some children in rural areas of Nigeria.

The community blamed her for her mother’s death and father’s insanity. She was barely two years old when her mother died, and she was abandoned to the care of her sixty-three year-old maternal grandmother. As a teenager, she was traumatized and suffered intense malnourishment. To this day she looks like a 6 year-old girl, though her health has improved.

Nine female orphans and vulnerable children and two CIL staff members. {Photo credit: MSH.}Photo credit: MSH.

Early in the morning of January 31, 2012, caregivers, support group members, village leaders, and the local council secretary gathered to say goodbye to 9 girls and 11 boys, orphaned youth ranging in age from 15 to 17. From 10 different villages in the Mohale’s Hoek district of Lesotho, these teens were headed for new horizons.

The adults wished the youth well, encouraged them to try their very best, and waved them off as they boarded the bus. The early morning air was full of jubilant traditional celebration songs sung in beautiful voices by the community members, and these adventurous youth carried these songs with them during their journey. Although the bus broke down three times on its way to the final destination (approximately 130 kilometers on mountainous, pothole-filled roads), the singing continued; the enthusiasm and excitement of the youth never waned despite the hot sticky weather and the heavy rains.

Ezekiel Kyasesa, village health team coordinator in western Uganda. {Photo credit: Margaret Hartley/MSH.}Photo credit: Margaret Hartley/MSH.

Ezekiel Kyasesa is a village health team coordinator and supervisor in Kasese District, western Uganda. He supports 11 villages, 90 parishes, and 2 health centers.

Ezekiel has been working in community health for a few years, but only on a small scale. A year ago, he was selected to attend a training provided by STRIDES for Family Health to learn new family planning, child survival, and reproductive health information and the skills to become a village health team member. He was then nominated by his peers to become the coordinator and supervisor.

Now Ezekiel is educated and has the skills to go out to the communities and talk to people about the benefits of going to the health center for a range of services. The village health teams are a crucial link to sharing knowledge and information between the clinics and the communities.

Ezekiel and his village health team visit 10 households two days each week (20 visits per team member each week). He explained that they discuss with the mothers --- the key person to a healthy family --- four topics:

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