Health Systems Strengthening

Health Systems Strengthening (HSS)

{Photo: MSH staff/Tanzania}Photo: MSH staff/Tanzania

Invest in teenage girls. Change the world.

Sylvia, age 16, knew little about HIV & AIDS or reproductive health when she started primary school. Now, she says: “I am not scared by the pressure from boys and other girls to engage in early sex, I know my rights and am determined to fulfill my vision of completing my education.” Sylvia is one of 485 girls in 6 eastern Ugandan schools who received integrated sexual and reproductive health and HIV information.

Today, July 11, we commemorate World Population Day 2016 and the midpoint toward reaching the Family Planning 2020 (FP2020) goal to ensure the right of 120 million additional women and girls to access contraception. More than half of the 7 billion people on earth are under the age of 30. Most of the FP2020 focus countries are in the very regions of the world where we find (a) the highest population of youth and (b) more marginalized and disenfranchised young people. In many of the world's poorest countries, people aged 15 to 29 will continue to comprise about half of the population for the next four decades.

 {Photo credit: Cindy Shiner/MSH}A mother waits for the nurse to vaccinate her baby during an immunization clinic at Phebe Hospital in central Liberia.Photo credit: Cindy Shiner/MSH

Stronger health systems are critical to preventing outbreaks from becoming epidemics. In fragile states, systems already weakened by conflict, disaster, or instability can crumble under the weight of an outbreak -- devastating access, availability, and quality of basic health for women and their families.

 {Photo credit: Warren Zelman Photography}A pharmacy/clinic window in Democratic Republic of the Congo.Photo credit: Warren Zelman Photography

Strong health systems are necessary to help prevent and mitigate epidemics, including the oft-overlooked epidemic of antimicrobial resistance.

This is the third post in a new series on improving the health of the poorest and most vulnerable women, girls, families, and communities by prioritizing prevention and preparing health systems for epidemics (see also: Part 1 and Part 2). Join the conversation online with hashtag .

 {Photo credit: MSH staff}Irene Koek of USAID’s Global Health Bureau gives closing remarks at the health security side event in Geneva.Photo credit: MSH staff

This is the second in a new series on improving the health of the poorest and most vulnerable women, girls, families, and communities by prioritizing prevention and preparing health systems for epidemics (read Part 1). Join the conversation online with hashtag .

World Health Assembly and Beyond: Advancing the Global Health Security Agenda

Outbreaks are inevitable. Epidemics are preventable.

Last month, the No More Epidemics campaign convened a high-level, multi-sectoral panel on the Global Health Security Agenda during the 69th World Health Assembly (WHA69) in Geneva, Switzerland.

{Photos: Warren Zelman (left); Associated Press/Aurelie Marrier d’Unienvil (right)}Photos: Warren Zelman (left); Associated Press/Aurelie Marrier d’Unienvil (right)

This is the first in a new series on improving the health of the poorest and most vulnerable women, girls, families, and communities by prioritizing prevention and preparing health systems for epidemics. Join the conversation online with hashtag .

Prioritizing prevention of regional epidemics and global pandemics

{Photo: Warren Zelman}Photo: Warren Zelman

Last month, MSH President & CEO, Jonathan D. Quick, MD, MPH, urged G7 leaders (Huffington Post Impact) meeting in Ise-Shima, Japan, to prioritize pandemic prevention:

 {Photo credit: Matthew Martin/MSH}Mark R. Dybul, executive director of The Global Fund to Fight AIDS, Tuberculosis and Malaria, expressed enthusiastic support for strategies combating epidemics in his keynote address.Photo credit: Matthew Martin/MSH

The No More Epidemics campaign convened a multi-sectoral panel on “Advancing the Global Health Security Agenda” at the 69th World Health Assembly in Geneva, Switzerland on May 25, 2016. Keynote speaker, Mark Dybul, MD, Executive Director of The Global Fund to Fight AIDS, Tuberculosis and Malaria, expressed enthusiastic support for strategies combating epidemics. Dybul emphasized the importance of community level engagement in infectious disease preparedness and response, stressing that interventions cannot end at a health clinic, they must continue on to the “last mile”.

The panel was comprised of H.E. Kesetebirhan Admasu, MD, Minister of Health, Ethiopia; H.E. Aníbal Velasquez Valdivia, MD, Minister of Health, Peru; H.E. Elioda Tumwesigye, MD, Minister of Health, Uganda; as well as David Barash, MD, Chief Medical Officer, GE Foundation; and Minister Renne Klinge, Deputy Permanent Representative, Permanent Mission of Finland to Geneva.

The discussion, moderated by MSH President and CEO, Jonathan D. Quick, MD, MPH, highlighted the need to ensure that epidemic prevention, preparedness and response capabilities are sustainable under the Global Health Security Agenda (GHSA).

 {Photo: Joey O'Loughlin}Women Deliver attendees celebrate the launch of the FCI Program of MSHPhoto: Joey O'Loughlin

The FCI Program of MSH will maintain and strengthen the spirit and vision of FCI...
–Dr. Jonathan D. Quick, MSH

MSH hosted a lively reception at the close of the Women Deliver conference in Copenhagen, Denmark. More than 150 guests joined us to celebrate the recently-launched FCI Program of MSH, an advocacy and accountability program drawing upon the staff and projects of Family Care International (FCI). The work of the FCI Program of MSH builds on FCI’s 30-year history of effective advocacy for improved maternal, newborn, and adolescent health and for sexual and reproductive health and rights. Women Deliver began in 2007 as a program of FCI, so this 4th and largest-ever Women Deliver conference was an especially appropriate place to honor FCI’s legacy and celebrate the FCI Program’s future within MSH.

 {Photo credit: Rebecca Weaver/MSH} bit.ly/msh_May2016Photo credit: Rebecca Weaver/MSH

MSH is a worldwide leader in strengthening health care financing systems toward universal health coverage (UHC). Stronger systems. Stronger women and children.

MSH has made tremendous impact on health care financing and UHC in the last two decades.

Performance-based financing

In 1999, MSH pioneered performance-based financing in Haiti, and has continued to adapt and improve upon it since. We contributed to and supported Rwanda to design, implement, and achieve UHC through community-based health insurance and performance-based financing; drastically reduce maternal and child mortality; and meet all of its health Millennium Development Goals.

In Democratic Republic of the Congo, we contributed to drastic reductions in child mortality and some of the greatest results-based financing outcomes in two decades.

Altogether, we've designed and/or implemented performance-based financing interventions in 14 countries across 3 continents (sub-Saharan Africa, Latin America, and South-East Asia).

{Photo credit: Warren Zelman}Photo credit: Warren Zelman

This post appears in its entirety on HuffPost Impact.

Pandemics are back on the agenda for the 2016 G7 Summit, which convenes this week in Ise-Shima, Japan. The Group of Seven is expected to further its commitments to global health security.

Look what has happened in less than one year since the G7 last met (June 2015), just after the Ebola crisis peaked at over 26,300 cases, 10,900 deaths.

{Photo credit: Warren Zelman}Photo credit: Warren Zelman

There are no magic bullets in life. For fixing a healthcare system, though, there is one approach that comes close: results-based financing. Management Sciences for Health (MSH) pioneered results-based financing in Haiti in 1999, and has been adapting and improving it ever since in sub-Saharan Africa, Latin America, and South-East Asia, including in fragile states.

In my 20-plus years in global health, I’ve seen what happens without results-based financing: A major donor sends millions of dollars’ worth of equipment and supplies to a developing country—and the quality of health services delivered doesn’t improve—or worse, it declines. Why?

Health providers are human, like all of us—sensitive to incentives, motivation, and demotivation. Say a hospital improves and now is well stocked: the community realizes this and the utilization rate doubles. Suddenly, a nurse may be facing 40 patients a day instead of 20, but without any added pay or assistance. It’s only natural he or she might work less under the crushing workload.

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