Blog

 {Photo Credit: Aubrey Clark}A technician tests a child for malaria at a health center in Kinshasa, DRC.Photo Credit: Aubrey Clark

(Cross-posted on the Global Health Council website).

Between 2000 and 2015, great strides have been made in fighting malaria. Globally, malaria case incidences declined by 41% and mortality rates by 62%. However, approximately 212 million people were infected and 429,000 people died in 2015, with the majority being children under the age of 5 in sub-Saharan Africa. Malaria also places a great financial burden on individuals and health systems. In sub-Saharan Africa alone, the annual cost of case management related to malaria is estimated at USD 300 million.

Much has been done since 2000 to eliminate this disease, and ensuring improved access to and appropriate use of quality-assured malaria medicines is necessary to sustain these gains.

The USAID-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program recently published the results of its activities in eight countries (Angola, Burundi, the Democratic Republic of the Congo, Ethiopia, Kenya, Guinea, Mali, and South Sudan) to control malaria.

{Photo credit: MSH}Members of government and civil society from Myanmar, Cambodia, Laos, Vietnam, and Philippines work together on priority challenges related to ensuring persons with disabilities in their countries can access the rehabilitation services they need.Photo credit: MSH

A recent increase in political commitment and global cooperation has led many countries to adopt Universal Health Coverage (UHC) strategies—such as establishing packages of essential health services and implementing health financing reforms—in an effort to ensure their citizens have access to basic health care services. Health is increasingly being embraced as the driver of human welfare and sustained economic and social development, but I wonder: If persons with disabilities are not deliberately included in the design of UHC strategies and reforms, will they be left behind? What do we, as a development community, stand to gain if we prioritize disability inclusion?

UHC is for everyone

Persons with disabilities are the world’s largest minority group. One in seven people around the world—15 percent of the world’s population, accounting for more than one billion individuals—live with some form of disability. Yet, they are rarely at the table when health policies and programs are being designed, governed, or evaluated. The majority of these persons live in the developing world. Disability disproportionately affects the key populations who already face development inequities, such as women, the elderly, people living in poverty, indigenous populations, ethnic minorities, and LGBT persons.

 {Photo credit: Julius Kasujja}Team of doctors and nurses at the Joint Clinical Research Centre in Uganda Photo credit: Julius Kasujja

What it takes for health systems to provide lifelong antiretrovirals

Soon after her husband’s death in 1991, Bahati Shellinah tested positive for HIV, but antiretroviral drugs (ARVs) were not yet available. In 2004 she fell ill, but, luckily, this time ARVs were available. Bahati visited the Joint Clinical Research Centre (JCRC) outside of Kampala, Uganda, and she began taking ARVs for the first time

Thankfully for Bahati, a local service provider was able to start her on treatment, but that is not the case for many people living with HIV, who often find themselves facing long waiting times, overwhelmed staff, medicine stock outs, stigma, and discrimination. No organization is immune to these challenges, and although JCRC was prepared when Bahati returned, they, too, grappled with organizational challenges as they scaled up services between 2003 and 2010. The gaps in management systems put JCRC's eligibility for donor funding at risk, which would mean patients like Bahati would lose access to their essential medicines. 

 {Photo Credit: Gwenn Dubourthournieu}HIV education is a crucial aspect of family planning services.Photo Credit: Gwenn Dubourthournieu

This year’s World Population Day coincides with the Family Planning Summit—a global moment where intentions and commitments to the right to health for all are revitalized. An essential component of HIV prevention and treatment, family planning must be prioritized in global and national agendas. Here are four reasons why: 

  1. Family planning is essential to maintaining progress on HIV goals: Meeting the needs of young people, particularly in developing countries, is critical to maintaining progress and momentum in controlling the HIV and AIDS epidemic. In Sub-Saharan Africa, where the youth population has nearly doubled since the beginning of the epidemic, millions more young people are entering a stage in life where they may be at increased risk of exposure to HIV. With the world’s highest fertility rates and the lowest use of modern contraception, family planning services are urgently needed to help young people protect themselves and prevent new infections.

{Photo Credit: Fabrice Duhal}Photo Credit: Fabrice Duhal

How health workers use technology to combat illness

Treatments for diseases like tuberculosis (TB) and HIV are lengthy and complex. Medications need to be taken regularly and for extended periods. Interruptions come at a high cost for patients, their families, and the health systems that treat them. 

Over the past several years, professionals across a range of disciplines have focused on creating solutions at all levels of the health system. From a tool that helps governments calculate the economic cost of medicine stock-outs to a piece of software that allows doctors across Ukraine to follow a patient’s complex TB treatment, technology can play a critical role in bringing solutions to scale and making significant progress in the age-old fight against deadly diseases. 

Here are two examples of how MSH is helping health workers use computers to fight back.

 {Photo: Kate Ramsey/MSH}Women examine cards depicting health information during a pregnancy club session in eastern Uganda.Photo: Kate Ramsey/MSH

Improving the quality of care that women experience during pregnancy, childbirth, and the postpartum period has become a major global priority. Achieving good quality care requires not only clinical improvements, but also a person-centered approach that takes into account women’s and health workers’ needs and perspectives.

In 2016, the World Health Organization (WHO) updated its antenatal care guidelines, calling for a positive pregnancy experience through holistic, person-centered antenatal services that provide pregnant women with emotional support and advice in addition to the standard clinical assessments.

 {Photo credit: Kate Ramsey/MSH}A midwife in Uganda leads a group antenatal care session, an approach that can transform how quality care is delivered and experienced.Photo credit: Kate Ramsey/MSH

For many people living in poor and underserved regions – whether rural communities or growing cities – midwives are the health system.

Midwives play a vital role for women during pregnancy and childbirth, but their care expands much more than that. Midwives provide solutions that ensure girls and women have access to a comprehensive range of services promoting their right to physical and mental health. They provide family planning and reproductive health services and care for newborns and young children not only at health facilities but also in communities. They deliver the respectful and excellent quality of care that can prevent more than 80 percent of all maternal deaths, stillbirths, and newborn deaths worldwide.

Related

Reaching Women in Uganda Through Pregnancy Clubs

 {Photo credit: Gashaw Shiferaw/SIAPS}SIAPS technical advisor Alan George (standing left) conducts an inventory management exercise.Photo credit: Gashaw Shiferaw/SIAPS

Some 13.5 million people desperately require humanitarian assistance in Syria, which includes access to essential medicines and other pharmaceutical products. Managing a sound supply chain is challenging in the best of circumstances—and in a crisis like this, there are many potential pitfalls and little room for error.

That becomes clear when health workers from relief organizations talk about their work in the country. The large number of displaced persons fleeing the conflict and the unstable, dangerous conditions in Syria require a tight strategy and concerted international effort to deliver vaccines, medical products and devices, and medicines. 

First, there are the painstaking tasks of procuring supplies, including negotiating prices, estimating consumption rates, and quantifying stock—all against the backdrop of a situation in flux. Items shipped across the border require a specific type of sealing and more than a year of shelf life. Stock needs to be transported and stored in temperature-controlled trucks.

{Photo credit: © 2013 Alfredo L Fort, Courtesy of Photoshare}A strong pharmaceutical system with a skilled health workforce translates into savings in health service costs.Photo credit: © 2013 Alfredo L Fort, Courtesy of Photoshare

You can’t put a price tag on health, but we do have budgets that determine what we can spend to help countries improve their health. At Systems for Improved Access to Pharmaceuticals and Services (SIAPS)-- a USAID-funded, MSH-led program--  that means we need to look closely at the impact each dollar we spend has on achieving our goal: strengthening the management of essential medicines and supplies so they reach the people who need them and are used rationally. Here are some of the evidence-driven activities SIAPS has been pursuing, with their results.

Increasing global health security

As Bill Gates recently noted, foreign aid keeps people safe and makes the world more stable. The three countries most affected by the Ebola epidemic—Guinea, Sierra Leone, and Liberia—had weak health systems that provided little or no warning of the impending epidemic and few resources with which to fight quickly.

Pages

Printer Friendly Version