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{Photo Credit: Carmen Urdaneta/MSH}Photo Credit: Carmen Urdaneta/MSH

Strong, well-functioning health systems need strong leadership, management, and governance. Over the next couple of weeks, leading up to conversations that MSH is hosting at the Global Symposium on Health Systems Research next month in Vancouver, we will be sharing stories and insights about the role of leadership, management and governance in health systems strengthening.

Over the last five years at the MSH-led, USAID-funded Leadership Management and Governance Project, our experience has underscored the importance of good governance, management and leadership to achieve service delivery outcomes in all health areas — from family planning to maternal, newborn and child health to HIV and AIDS.

The Leadership, Management and Governance Project's activities range from strengthening leadership and management skills of staff at the centralized level of Haiti's Ministry of Public Health and Population to supporting midwife managers to deliver high-quality family planning and reproductive health services in their communities at the decentralized level in Malawi.

Following our recent announcement of MSH’s involvement in Hurricane Matthew recovery efforts in Haiti, the Devex global development media platform interviewed MSH Chief Operating Officer Paul Auxila for an article about the rising threat of cholera in Haiti.

Mr. Auxila told Devex that cholera “needs to be a priority and approached differently than the international community did last time,” referring to the 2010 Haiti earthquake response.

He urged organizations to focus on “greatest impact” interventions, such as oral rehydration therapy. “Coordination is a big problem, just like it was after the earthquake,” he added. Interventions need to be more synergistic, working toward a “common goal” and not bypassing the Haitian government, he told Devex.

MSH is partnering with the Haitian government to rebuild the health system in the wake of Hurricane Matthew. At the government’s request, MSH has begun an assessment of the health system to make recommendations for ways to make it stronger. MSH will also assist in deployment of health workers to stem the cholera outbreak.

{Up to 50% of African patients now purchase their antimalarial medicines at private retailers, i.e. small pharmacies, patent drug stores, and general stores. This pharmacy in Kisumu, Lake Victoria region, Kenya, is well stocked with antimalarials. (Photo Credit: Novartis AG/CC BY-NC-ND)}Up to 50% of African patients now purchase their antimalarial medicines at private retailers, i.e. small pharmacies, patent drug stores, and general stores. This pharmacy in Kisumu, Lake Victoria region, Kenya, is well stocked with antimalarials. (Photo Credit: Novartis AG/CC BY-NC-ND)

This article was originally published on Devex as part of its series, Making Markets Work, on October 11, 2016.

At a session on defining the "next generation" of primary health care at the United Nations General Assembly, Tim Evans, senior director of health, population and nutrition at the World Bank Group, said the international development community is suffering from "pilotitis."

"We have an epidemic of startups, and we need an epidemic of scale-ups," he said.

Evans described a "systematic blind spot" in global health to understanding and implementing solutions to scaling that we — international nongovernmental organizations and companies — know can work, such as encouraging partnership between the public sector and private sector health systems; creating large-scale pilots in order to create the evidence and measurements needed to justify a primary care approach; and creating affordable models that promote health and prevent diseases, not just treat them.

Femi Oke, international journalist and emcee (L) and Dr. Jonathan D. Quick, president and CEO of MSH (R) toast to health systems heroes on September 20 in New York. (Photo credit: David Neff)

One year ago, the UN General Assembly adopted an ambitious new agenda, the Sustainable Development Goals (SDGs). Goal 3 of the SDGs requires a focus on health systems strengthening to meet targets for universal health coverage and primary care. MSH and partners hosted many lively discussions on stronger health systems for women and children, epidemic prevention, and prevention of chronic diseases during the 71st UN General Assembly week. Here are some highlights from New York.

A Toast to Health Systems Heroes

Left to right: Health Systems Hero Annette Widmann-Mauz, Parliamentary State Secretary, Germany; Presenter Dr. Marie-Paule Kieny, Assistant Director General, Health Systems and Innovation, WHO; Health Systems Hero Mr. Yasuhisa Shiozaki, Minister of Health, Labor, and Welfare, Japan; and Health Systems Hero Michael Myers, Managing Director, The Rockefeller Foundation, at "A Toast to Health Systems Heroes." (Photo Credit: David Neff)

{Malagasy CHV from Anjeva presenting family planning options to a young woman. (Photo Credit: Samy Rakotoniaina/MSH)}Malagasy CHV from Anjeva presenting family planning options to a young woman. (Photo Credit: Samy Rakotoniaina/MSH)

When it comes to contraceptives, having choices is key.

More than 220 million women around the world want to avoid pregnancy but are not using modern methods of contraception.

Reasons for this vary, from family disapproval, to fear of side effects, to infrequent sex. Increasing access to multiple contraceptive options can allay some of these barriers.

Without multiple options, a woman who is dissatisfied with her current method may stop using contraception completely. With more choices, she can switch to another method and have the support she needs to avoid an unwanted pregnancy.

Family planning is important not only for women’s health and empowerment, but it also helps reduce pervasive poverty and environmental degradation, and contributes to our goal of an AIDS-free generation. According to the World Health Organization, family planning has the potential to reduce maternal deaths by one-third and reduce newborn, infant, and child deaths by 10 percent.  

 {Photo by the Spanish Cooperation (AECID)}An expert and advocate for persons with disabilities attends a strategy meeting to discuss the new WE DECIDE initiative.Photo by the Spanish Cooperation (AECID)

Violence against women, including forced or coerced sex, is an epidemic that persists all over the world. But women with disabilities, often marginalized and denied their sexual and reproductive health rights, are particularly vulnerable to such abuse.

In June, UNFPA launched WE DECIDE, a global initiative to promote gender equality and social inclusion of young persons with disabilities and advocate for the end of sexual violence.

The FCI Program of MSH worked with UNFPA and a broad range of partners in the field of disabilities to build consensus for the framework of the four-year initiative and to develop communications materials for the initiative, including a video and an infographic that conveys key messages and data on the status of persons with disabilities and gender-based violence.

Alime, a patient featured in MSH's Medicine Movers

by Devex's Noa Gutterman and Management Sciences for Health

This summer, Devex partnered with Management Sciences for Health (MSH) to host Access to Medicines (), a conversation that has analyzed and amplified the discussion on global access to medicines.

Over the last three weeks,  has examined major questions including: 

 Cynthia (left) cares for her grandson, Alime, orphaned to AIDS and living with HIV, in East London, South Africa.

This post is an excerpt from "Medicine Movers," written by Daphne Northrop, and videos by Emily Judem

EAST LONDON, South Africa -- Nine-month-old Alime and his grandmother Cynthia sit at a table piled with pill bottles, cardboard cartons, and syringes. There are 19 items in all. 

The squiggly Alime, who traveled that morning on his grandmother’s back to the hospital, happily munches on a cookie while the pharmacist counsels his grandmother on when he should take each of his medicines and how much to give him. It’s hard to believe such a tiny boy needs so many pills to survive.

Alime has been HIV-positive since birth. His treatment seems to be working. His weight has doubled, and as he smiles and gurgles quietly in Cynthia’s arms, he looks like a healthy toddler. He rarely takes his eyes off his grandmother, and he reaches out to touch her face as she talks.

Medicine Movers: South Africa from Management Sciences for Health on Vimeo.

{Photo credit: Michael Paydos/MSH}Photo credit: Michael Paydos/MSH

This week, Devex and Management Sciences for Health (MSH) are discussing innovations for access to medicines in low- and middle-income countries. Public-private partnerships are key to ensuring innovations help medicines affordably reach the people who need them most.

From communities to global policy: Innovations to access to medicines underway

Devex reporter Andrew Green writes:

In Tanzania in 2002, MSH realized the medicines needed for basic treatment are in the government system, but not available to patients -- either because health facilities ran out of stock or were too far away.

Instead, patients turn to private dispensaries in high numbers. MSH reports that 82 percent of people in sub-Saharan Africa seek health care and medicines from retail drug shops -- even though the people staffing them often have little knowledge or training.

In Tanzania, MSH decided to try to change that, conceptualizing a program in 2002 to set government standards for the accredited drug dispensing outlets, or ADDOs, and upping the knowledge of the people running them. ...

Saving lives and improving health continues long after diagnosing disease or delivering medicines.

(Watch Faith tell her story)

Faith had been ill for months. She was 31 and had two daughters. She didn’t know what was wrong. A friend urged her to get an HIV test; it came back positive.

Faith started on antiretroviral treatment.

But, in 2013, one of her antiretroviral medicines started to work against her, causing misshapen fat deposits to develop on her body.

When she finally mustered the courage to speak up one year later, her doctor knew just what to do and shifted her to a different medicine.

(Medicine Movers: Kenya from Management Sciences for Health on Vimeo)

Faith didn’t know it, but her report to the doctor became part of a nationwide database that tracks adverse drug reactions, and poor quality or expired medicines.

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