Health Systems Strengthening

Health Systems Strengthening (HSS)

Permanent Secretary of the Ministry of Medical Services, Ms. Mary Ngari, (Right), hands over the new Governance Guidelines to HMC Board Member and Deputy Provincial Commissioner of Central Province, Francis Sila, while USAID/Kenya HRH Specialist Peter Waithaka, LMS/Kenya Project Director Karen Caldwell, and Central Province Provincial Director of Medical Services Gichaiya M’Riara, look on. (Photo courtesy of Hosea Kunithia.)

 

Kenya’s new constitution, promulgated on August 4, 2010, mandates significant transformations in the health sector. Hospital reforms are a key part of these transformations. For MSH’s Leadership, Management and Sustainability Program in Kenya (LMS/Kenya), the opportunity to work closely with health sector partners, including the Ministry of Medical Services, to support the hospital reform agenda is an exciting and rewarding experience.

Discovering MSH blog series graphicOver the next couple of months, as MSH celebrates it's 40th anniversary, reporter John Donnelly and photographer Dominic Chavez will be traveling to several countries to report on MSH’s work in the field. The stories will go into a book due out in the fall on MSH’s 40 years in global health. This blog entry is a post from the road, to give a flavor of their experiences with MSH staff.

Lucy Sakala at the Salima District Hospital in Salima, Malawi (© Dominic Chavez)

 

It is 5:30 a.m. on a Thursday morning in the town of Mwene-Ditu, located in the Eastern Kasaï Province of the Democratic Republic of Congo. The skies are still dark as the crieur, the town crier, makes his rounds, calling out to the community that today is the start of the three-day national vaccination campaign against polio.

As the local residents begin their day, health workers are finalizing preparations for the massive door-to-door effort to immunize children under age five years old from this crippling disease. One such worker is Evariste Kalonji, a community mobilization specialist with the Integrated Health Project.

Today, the Center for Strategic and International Studies (CSIS) released a new video: “Spotlighting the NCD Problem.” This video explains the challenge the world is facing with non-communicable diseases. According to the World Health Organization, about 36 million people die each year due to NCDs, and a quarter of NCD deaths are of people aged under 60; 9 in 10 of these people are from developing countries.

MSH President and CEO Jonathan D. Quick, MD, MPH, recently called on UN member states to take a heath systems strengthening approach to NCDs.

Orou Assoumanou describing the work within his community to Dr. Lola Gandaho, of BASICS Benin.

 

Living in the rural village of Kpagnaroung, Benin, Orou Assoumanou is a dedicated health worker who promoted vaccinations and distributed ivermectin (a medicine used to treat roundworm) within his community before receiving training by the MSH-led, USAID BASICS (Basic Support for Institutionalizing Child Survival) project in community-case management. The comprehensive BASICS training improved his ability to offer care and enabled him to treat children within his community.

With the arrival of a trained community health worker able to prescribe medications, members of his community no longer have to travel long distances to seek medical care for their children. In fact, Orou says that crowds would form at his door to receive care.

 

 

 

 

Discovering MSH blog series graphicOver the next couple of months, as MSH celebrates it's 40th anniversary, reporter John Donnelly and photographer Dominic Chavez will be traveling to several countries to report on MSH’s work in the field. The stories will go into a book due out in the fall on MSH’s 40 years in global health. This blog entry is a post from the road, to give a flavor of their experiences with MSH staff.

Dr. John P. Rumunu, MSH’s Chief of Party in South Sudan. © Dominic Chavez

 

Discovering MSH blog series graphicOver the next couple of months, as MSH celebrates it's 40th anniversary, reporter John Donnelly and photographer Dominic Chavez will be traveling to several countries to report on MSH’s work in the field. The stories will go into a book due out in the fall on MSH’s 40 years in global health. This blog entry is a post from the road, to give a flavor of their experiences with MSH staff.

Dr. Ronald O'Connor, Founder of MSH, and Marcia Herrera, Director of Talent Management at MSH, co-authored this blog post.

Dr. David Sencer died on Monday, May 2, 2011 in Atlanta, Georgia at age 86. He died at Emory University Hospital, due to complications of heart disease.

Dr. Sencer, one of the major twentieth century public health thought leaders, was also one of the rarest: a warm-hearted, modest man of great accomplishments and lifelong dedication to Management Sciences for Health's mission of closing the gap between what is known and what is done to solve important public health problems around the world.

From 1986 until his retirement in 1993, Dr. Sencer was a valued MSH colleague and advisor; he served in the roles of Chief Operating Officer and Senior Fellow. Dr. Sencer led by empowering others; he believed that more could and would be done when leaders put the action, and often the visibility, in the hands of those most directly on the front lines of practical public health action.

Indeed, Dr. Sencer was doing it long before MSH was conceived, in a career that spanned many personal and professional challenges: Dr. Sencer overcame tuberculosis as a young physician and went on to lead many important health initiatives and institutions.

It’s common sense that a mother who is on treatment for AIDS, pregnant, has a sick child, and is accompanying a sister debilitated by Tuberculosis should not have to visit four separate service delivery points to receive care. Integrated health services not only make the world a healthier place, but also decrease the burden on health systems.

Integration is a comprehensive approach to service delivery. It is the transition from a vertical or horizontal approach to a diagonal, synergistic approach at all levels of a health system. Smart integration means coordinating disease specific programs (such as HIV and AIDS) with other health programs that have operated independently in the past (for example, family planning) to deliver services at the same time or, more importantly, with the same funding. Integration helps organizations maximize the impact of their health investments while allowing people, information, and funding to flow more easily among collaborating groups and stakeholders. Equally important, integration enables providers to treat the health needs of individuals and families more efficiently---regardless of the initial reason a person seeks care.

My recent field visit has given me a great perspective on one of MSH’s major activities - the costing of health services. MSH has extensive costing experience in East Asia & Pacific, Latin America & the Caribbean, Southern Africa, and West Africa.

MSH developed and has helped manage multiple applications of the CORE Plus (Cost and Revenue Analysis Tool Plus). CORE Plus is a tool that helps managers and planners estimate the costs of individual services and packages of services in primary health care facilities as well as total costs for the facilities. The cost estimates are based on norms and can be used to determine the funding needs for services and can be compared with actual costs to measure efficiency.

Costing of health care services is a powerful exercise whose data and results can be used for a number of things. When the cost of a package of services is determined, the analysis can be used for practical purposes, such as planning and prioritization or allocation of funds based on known cost figures. Results from a costing study can also be used to set appropriate user fees or other prices linked to provision of services. Finally, results of a costing study can be used as an advocacy tool to ensure that appropriate funds are allocated for the package of services.

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