HIV & AIDS

{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:

{Photo credit: MSH staff/Afghanistan}Photo credit: MSH staff/Afghanistan

“I started feeling this coughing… so I went to the health center and got tested. It was positive for TB,” says Grace*, a young Ugandan woman. She started on medicines, but after two months, she stopped adhering to treatment.

They told me to continue with the drugs for five more months, but I stopped.

I thought I was ok.

She started coughing again, went to the hospital, and was diagnosed with multidrug-resistant TB (MDR-TB). MDR-TB cannot be treated with two of the most powerful first-line treatment anti-TB drugs. Her treatment regimen? Six months of injections and two years of drugs.

{Photo credit: Andrew Esiebo/MSH Nigeria}Photo credit: Andrew Esiebo/MSH Nigeria

I am a woman. I am a Nigerian. I am a mother. I am a leader. And, I am a daughter. As the Nigerian country representative, I guide Management Sciences for Health (MSH)’s efforts to ensure the people of my country have access to quality health services. Indeed, I am many things. Before all else:

I am a woman of Nigeria.

The Girl Child in Nigeria

From the beginning, our girl children are at a disadvantage.

Our culture (like many are) is strongly patriarchal. The boy child is given higher status than the girl child. If a family has to choose, the boy child is the first to go to school. The girl child is the first to be dropped from school.

No matter how young she is, the girl child feels that it is her responsibility to care for her siblings. She is expected to take on added responsibilities and earn money to keep the other children. This pressure frequently leads to early sexual activity, transactional sex, and sex with older men-- increasing her risk of getting HIV and other sexually-transmitted infections.

Then Boko Haram came to the North East Zone of Nigeria. They take our girls away. They abuse them. They rape them. They marry them off to older men.

{Photo: Dominic Chavez}Photo: Dominic Chavez

The key element of any health system is the people who run it. Nowhere is this more true than in countries in the midst of, or recovering from, conflict. Indirect or direct threats faced by health workers exacerbate a population’s challenges in seeking and receiving health care.

In conflict settings, health workers may be forced to flee to safe havens as refugees, internally displaced people, or leave the country as migrants—if they have the means to do so. Some of the most capable are absorbed into international agencies. Those who remain frequently have insufficient resources to perform their jobs and must carry on as best as they can under daunting circumstances.

This situation has worsened in recent years with a growing number of direct attacks on health workers in fragile states, such as those against polio vaccinators in Pakistan and Nigeria. These blatant violations of the Geneva Conventions inhibit an already difficult environment for the delivery of health services and the recovery or development of the health system.

When Mearege gets really sick, her husband leaves town. Bedridden and in the care of her parents, Mearege gets tested and learns she--and her daugther--are HIV-positive. Through the support of mother mentors, trained by the Ethiopia Network for HIV/AIDS Treatment, Care and Support Program (ENHAT-CS), Mearege finds solace, guidance, and healing -- and decides to have another child.

Mearege is one of many HIV-positive women in Ethiopia whose lives have been transformed, with the support of ENHAT-CS. Says Mearege:

I was able to have a healthy child because I followed up with the mentor mothers and applied their teaching...

Presented by ENHAT-CS in partnership with the National Network of Positive Women Ethiopians, this video is made possible by the generous support of the US President's Emergency Plan for AIDS Relief (PEPFAR) through the US Agency for International Development (USAID).

Watch video

 {Photo credit: Julie O'Brien/MSH}Haiti.Photo credit: Julie O'Brien/MSH

This post is part of MSH's Global Health Impact Blog series, Improving Health in Haiti: Remember, Rebuild. The post originally appeared on LMGforHealth.org, the blog of the US Agency for International Development (USAID)'s Leadership, Management & Governance (LMG) Project, led by Management Sciences for Health (MSH) and a consortium of partners.

 {Photo credit: Dominic Chavez}Brissault Eunise (seated) watching over her daughter Kerwencia, after receiving breast feeding classes.Photo credit: Dominic Chavez

This post is part of MSH's Global Health Impact Blog series, Improving Health in Haiti: Remember, Rebuild.

As January 12, 2015 marked the fifth anniversary of the Haiti earthquake, Management Sciences for Health (MSH) and its partner organizations, including the Leadership, Management & Governance Project/Haiti, brought together Haitian and US government officials and key global health stakeholders for two days of meetings and events highlighting health progresses made in Haiti since 2010.

Update, April 14, 2015:

Watch video recordings of the summit


Original post continues:

Haitian health leaders meet on Capitol Hill

 {Photo credit: Todd Shapera}Gisenyi District Hospital, Rwanda.Photo credit: Todd Shapera

The African Evaluation Journal (AEJ), the official journal for the African Evaluation Association (AfrEA), is calling for articles and peer reviewers for the special AEJ edition “Health Evaluations in Africa.” This process presents an exciting opportunity to participate in Africa’s contribution to the internationally-declared 2015 Year of Evaluation

Articles must focus on evaluations of the health sector in Africa, have at least one author who is an African national or based in Africa, and be written in English or French. According to AEJ:

Priority will be given to health evaluations contributing to or involving: policy development or policy change, health system strengthening, and/or integration of the health sector with other sectors.

{Photo credt: Katy Doyle/MSH}Photo credt: Katy Doyle/MSH

For the third consecutive year, Management Sciences for Health (MSH) sponsored an internal storytelling contest, inviting staff to submit MSH's best examples of saving lives and improving health around the world.

Today, we share the top 12 stories of 2014, as selected by a cross-section of staff, in this special edition of our Global Health Impact Newsletter.

Click on each story to learn more about the people, projects, and partners who, together with MSH, make strong health systems happen. Visit 11 of the countries where we work and meet a few of the thousands of people whose lives have been transformed.

~ Dr. Jonathan D. Quick, MSH President & CEO

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