child health

Women and child in Tambura, South Sudan. {Photo credit: MSH.}Photo credit: MSH.

Nearly 50 countries, including Afghanistan, Democratic Republic of the Congo, Haiti, Liberia and South Sudan, are considered a fragile or conflict-affected state -- a state that is in conflict, recovering from conflict or crisis, or a state that has collapsed or has a strong and repressive government. Over nearly 40 years of working in fragile states, Management Sciences for Health (MSH) has identified best practices, lessons learned, and appropriate interventions for a myriad of situations in fragile states.

MSH takes an integrated approach to building high-impact sustainable public health programs that address critical challenges in leadership, health systems management, health service delivery, human resources, and medicines. Wherever our partnerships succeed, the positive impact of good health has a ripple effect, contributing to the building of healthy nations.

MSH works collaboratively with health care policymakers, managers, providers, and the private sector to increase the efficacy, efficiency, and sustainability of health services by improving management systems, promoting access to services, and influencing public policy.

Godgift and his caregiver receiving educational supplies from the Executive Director of Synergycare Initiative. {Photo credit: Anayo Chike Charles/MSH.}Photo credit: Anayo Chike Charles/MSH.

Early one morning Mrs. Fred woke up and found a boy outside her house. Alarmed and curious, she asked him why he was there. Godgift, as he identified himself, told her that the continuous appearance of a snake where he lived forced him to abandon the place he called home, after numerous futile attempts to frighten it off with pepper. Highly disturbed, she arranged for him to eat in a nearby restaurant whenever he showed up by her house.

The boy, Godgift Henshaw, is 13 years old. Godgift's mother took him along when she left her husband and eloped with another man. When the burden of care got too heavy, she left Godgift with her mother in Agbia community, Bayelsa State, Nigeria. Godgift’s grandmother beat and neglected him. Most of the time he went without food and often slept outside the house. Finally, she labeled him a wizard and abandoned him, fleeing from their home.

The landlord evicted Godgift when there was no one to pay the rent. He took refuge in an uncompleted building in a nearby bush, completely at the mercy of the elements. Abandoned and stigmatized (following his identification as a wizard), he fed himself by doing odd jobs.

Alice Gune with her son who was treated successfully for neonatal sepsis at the SHTP II-supported Kuda PHCC in South Sudan. Credit: MSH.

Shortly after delivering her baby boy at home, Alice Gune grew nervous for his health. Her baby had a high fever and was obviously uncomfortable and unhappy.

She took him to see Rose Kujang, the Maternal and Child Health Worker, during a community outreach program orchestrated by Kuda Primary Health Care Center (PHCC). Rose examined Alice’s baby and, recognizing the danger signs he presented, immediately referred her to Kuda PHCC for further diagnosing and treatment.

Three decades ago, life in the lakeside village of Zambo was calm.

A child born in Ghana today will most likely receive a full schedule of immunizations, and her chances of surviving past the age of five are far better than they were a decade ago. Today Ghana boasts a coverage rate for infant vaccination of 90 percent and hasn’t seen an infant die of measles since 2003.

Ghana has been expanding primary health care by bringing services to people’s doorsteps since the 1980s, and since the early 2000s has done so in the context of a commitment to universal health coverage. The secret to its success in child immunization has been both integration and decentralization of health services: Government funding for all health activities is provided through a "common pot." District-level managers are responsible for local budgeting and service delivery. Local staff provide comprehensive rather than specialized care.

Ghana is one of a growing number of low- and middle-income countries demonstrating that strong performance in immunization can go hand-in-hand with the aspiration of universal health coverage, access for all to appropriate health services at an affordable cost.

Mother and children, Salima, Malawi, April 2011

Malawi leads the developing world as the first to propose an approach to prevention of mother to child transmission (PMTCT) of HIV that addresses the health of the mother. Recently my MSH colleague Erik Schouten and his colleagues in Malawi wrote a commentary in the Lancet about Malawi’s innovative, public health approach to PMTCT. Malawi calls its model “B+” because it complements the World Health Organization’s (WHO) B option, whereby a mother’s CD4 cell count, a measure of the volume of HIV circulating in her blood, determines her eligibility for lifelong antiretroviral therapy (ART).

I’d like to call attention to an important set of articles in the recent HIV/AIDS themed issue of The Lancet. Erik Schouten of Malawi Basic Support for Institutionalizing Child Survival (BASICS) has published a commentary (free registration required) about Malawi’s push to be the first country to implement a “B+” approach to reducing mother to child transmission.

Discovering MSH blog series graphicOver the next couple of months, as MSH celebrates it's 40th anniversary, reporter John Donnelly and photographer Dominic Chavez will be traveling to several countries to report on MSH’s work in the field. The stories will go into a book due out in the fall on MSH’s 40 years in global health. This blog entry is a post from the road, to give a flavor of their experiences with MSH staff.LILONGWE, Malawi – The problem with writing about improvements in Malawi’s health system is focus. There are multiple directions to explore: extending family planning into rural communities, training HIV counselors, the rapid scale-up of HIV treatment, integrating TB services more into the mainstream of health care. At the US Agency for International Development (USAID) mission here, Dr.

It is 5:30 a.m. on a Thursday morning in the town of Mwene-Ditu, located in the Eastern Kasaï Province of the Democratic Republic of Congo. The skies are still dark as the crieur, the town crier, makes his rounds, calling out to the community that today is the start of the three-day national vaccination campaign against polio.

As the local residents begin their day, health workers are finalizing preparations for the massive door-to-door effort to immunize children under age five years old from this crippling disease. One such worker is Evariste Kalonji, a community mobilization specialist with the Integrated Health Project.

Orou Assoumanou describing the work within his community to Dr. Lola Gandaho, of BASICS Benin.

 

Living in the rural village of Kpagnaroung, Benin, Orou Assoumanou is a dedicated health worker who promoted vaccinations and distributed ivermectin (a medicine used to treat roundworm) within his community before receiving training by the MSH-led, USAID BASICS (Basic Support for Institutionalizing Child Survival) project in community-case management. The comprehensive BASICS training improved his ability to offer care and enabled him to treat children within his community.

With the arrival of a trained community health worker able to prescribe medications, members of his community no longer have to travel long distances to seek medical care for their children. In fact, Orou says that crowds would form at his door to receive care.

 

 

 

 

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