HIV & AIDS

 {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: Associated Press/Aurelie Marrier d’Unienvil}Women celebrate as their country is declared Ebola free in the city of Freetown, Sierra Leone, Saturday, Nov. 7, 2015.Photo credit: Associated Press/Aurelie Marrier d’Unienvil

When 18-year-old Ianka Barbosa was 7 months pregnant, an ultrasound showed the baby had an abnormally small head, a dreaded sign of microcephaly due to Zika infection.  Upon hearing the news, Ianka’s husband fled. In her poor neighborhood of Campina Grande, Brazil, Ianka soon became a young mother alone.

As Ianka’s baby Sophia grows, she may never walk, or talk. She could develop seizures before she reaches six months.  By the end of the year there may be a staggering 3,000 Sophias in Brazil – mostly in the poorest places.

Epidemics erase the gains women have achieved.

The world has suffered a series of “Zikas”—virtually unknown diseases that seemed to come from nowhere and explode with devastating consequences for families and entire countries – before Zika, Ebola, SARS, AIDS, and others.

Epidemics don’t just leave behind a death toll.  They can demolish the gains women have made in maternal, newborn, child, adolescent, and reproductive health—gains that have been propelled by women’s rights and empowerment. 

SCMS supported local partners in 25 countries to build country ownership of supply chain management. Read more about SCMS’s impact in its report: 10 Years of Supporting PEPFAR through Stronger Public Health Supply Chains

By Sherif Mowafy

[Chantal, an HIV-positive woman, waits for her monthly supply of antiretroviral medication at the Hôpital Immaculée Conception in Haiti.] {Photo credit: Jean Jacques Augustin, SCMS}Chantal, an HIV-positive woman, waits for her monthly supply of antiretroviral medication at the Hôpital Immaculée Conception in Haiti.Photo credit: Jean Jacques Augustin, SCMSAs the warm Haitian sun comes up, Chantal leaves her four children behind to get her HIV treatment, traveling for three hours in the back of a crowded jeep.

She bumps over unpaved roads to her monthly visit for antiretrovirals, one that she has been doing routinely for several years to keep her disease at bay.

Her children don’t know that she is HIV positive, and she doesn’t want to tell them. She makes this long trip over rough and ragged terrain to preserve her privacy and escape the possibility of stigma, still prevalent in Haitian society.

 {Photo credit: Rebecca Weaver/MSH}A community health worker in Democratic Republic of the Congo.Photo credit: Rebecca Weaver/MSH

This Global Health Impact issue highlights community health and community health workers, and presents a glimpse of MSH's work at the community level, in partnership with national ministries of health, civil society organizations, the private sector, and more.

The community is the center of the health system in developing countries.

Throughout sub-Saharan Africa, community health workers, often volunteers, represent the foundation of the health system, addressing priority health areas ranging from maternal and newborn health to family planning and infection prevention. The community health worker (known by different names in different countries) is the fundamental frontline promoter, provider of services and medicines (through integrated community case management), and the one who refers and links beneficiaries with more complex health needs to facilities. Not only do community health workers extend access to health services for the underserved and those living in hard-to-reach or conflict-ridden areas, they help countries accelerate certain health outcomes and achieve the Sustainable Development Goals and related targets for universal health coverage.

 {Photo credit: Katy Doyle/MSH}A health worker in Togo counsels a woman on reproductive health.Photo credit: Katy Doyle/MSH

Many years ago I began my public health career in Ciudad Nezahualcoyotl, then a squatter settlement of 1.8 million people, bordering Mexico City in the State of Mexico. Lack of land and unaffordable rents forced poor migrants, streaming in from the country side in search of employment and a better life in the city, to settle in the surrounding peri-urban areas. This large municipality, with few paved streets, was difficult to navigate in the rainy season. During the dry season, the wind would kick up dust storms that made it hard to see a block ahead. Nezahualcoyotl means hungry coyote in the Nahuatl language  and too many families in Neza, as people sometimes called it, were poor and hungry.

 {Photo credit: Ghaffar Rabiu}Dr. Zipporah Kpamor, Country Director, MSH Nigeria, is interviewed at the 10th anniversary event.Photo credit: Ghaffar Rabiu

Management Sciences for Health (MSH) celebrated 10 Years of Improving the Health of Women and Children in Nigeria with 250 stakeholders and supporters at a special event in Abuja on March 31, 2016. Distinguished guests included the chairman of the Nigerian House of Representatives, director of the Federal Ministry of Health in Nigeria, high-level representatives from state governments and partner organizations, and more.

After a rousing rendition of “Arise, Oh Compatriots,” the Nigerian national anthem, Country Director, Dr. Zipporah Kpamor, welcomed participants and underscored the intention for the day’s two round-table panel discussions:

In Nigeria, 150 women and 2,300 children die every day from preventable causes. One in five children won’t live to see their fifth birthday. This event can help continue conversations on what we can do to end preventable deaths among women, children, and young people.

Currently, MSH’s partnerships for health system strengthening in Nigeria reach nearly 560,000 people through four projects.

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

Today, April 7, we celebrate World Health Day, started by the World Health Organization (WHO) to mark its founding in 1948.

Amid Ebola, Zika, maternal and child mortality, and other global health challenges, WHO chose diabetes, for the first time, as its World Health Day theme (“Stay super. Beat diabetes”).  To urge global action on the rising diabetes burden, WHO released a new global report yesterday, April 6, highlighting key global diabetes findings, country profiles, and recommendations to reach the Sustainable Development Goal (SDG) target 3.4, which calls on countries to reduce premature death from noncommunicable diseases (NCDs), including diabetes, by 30 percent by 2030. 

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

"Medicines are a key component of treatments to save lives"

~ Kwesi Eghan, trained Ghanian pharmacist and MSH portfolio manager for the US Agency for International Development (USAID)-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) program in South Sudan and Afghanistan

A child in Tanzania has a fever for three days. A pregnant woman in Namibia is taking antiretroviral therapy (ART) to treat HIV and prevent transmission of HIV to her baby. A man in Swaziland suffers from drug-resistant TB and struggles to adhere to treatment.

Who helps ensure they take the right drug, at the right time, and for the right reason?

A pharmacist.

In many developing countries, pharmacists are primarily responsible for medicines selection, procurement, distribution, and explaining rational use of these medicines to their patients. But, many low- and middle-income countries suffer shortages of trained pharmacists. MSH and partners are helping countries and communities ensure that pharmacists and related health workers are equipped with the skills, systems, and support to provide quality services every day.

{Photo credit: Mark Tuschman}Photo credit: Mark Tuschman

A woman. A newborn. A child. In many countries, their basic health and rights are tenuous. These women, newborns, and children are the health system.

A woman is ostracized: abandoned by her husband, her family, and her community. She suffered a fistula after giving birth to her son. After 20-plus years, an operation repairs her fistula; now, she is teaching again, and a part of the community.

{Photo credit: Mark Tuschman}Photo credit: Mark Tuschman

Impact. Scale. Sustainability. As public health professionals, we are dedicated to high-impact and high-coverage interventions that significantly improve the health of large human populations. We also hope that the benefits become part of the timeless fabric of their families, communities, and the health system.

This triple expectation—impact, scale, and sustainability—has accompanied global health for decades and especially during the last  generation. In 1990, Dr. Thomas Bossert reported that, among five US government-funded health programs in Africa and Central America, a project’s capacity to show results was the most important factor to ensure the sustainability of its benefits.

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