Ethiopia

{Photo credit: Mark Tuschman, Kenya.}Photo credit: Mark Tuschman, Kenya.

On the eve of the 20th International AIDS Conference (AIDS 2014), Rachel Hassinger, editor of MSH’s Global Health Impact Blog, spoke with Dr. Scott Kellerman, global technical lead on HIV & AIDS, to discuss his latest research on prevention of mother-to-child transmission (PMTCT) of HIV and pediatric HIV & AIDS. Kellerman and colleagues will be attending AIDS 2014, July 20-25, in Melbourne, Australia. (Read more about the conference.)

RH: What is the state of HIV & AIDS globally?

[Scott Kellerman]Scott KellermanSK: We are at the threshold of a sea change. In the beginning, our HIV prevention tool box was sparse. We could offer extended counseling and condoms, and impart information, but not much else. Behavioral change was the cornerstone of tackling the epidemic. It worked sometimes, but, not consistently.

Now biomedical advances are propelling treatment as prevention—even what I call “treatment IS prevention”.

 {Photo credit: Anteneh Tesfaye/MSH.}(from left) Dereje Haile and Tsedenia Gebremarkos during the filming of a health insurance themed episode of the popular ETV show, Question and Answer Competition.Photo credit: Anteneh Tesfaye/MSH.

We will sprint in the last round like our athletes. That is the Ethiopian style.

So says the famous Ethiopian comedian Dereje Haile. His team is lagging behind in the first round of the popular Ethiopian Television (ETV) game show, Question and Answer Competition.

Haile is the source of constant laughter since before the filming of the show, when he performed a quick physical exercise, as if about to enter into a boxing ring. His teammate, Kora Music Award winner and pop star, Tsedenya Gebremarkos, confirms Haile’s words, and promises the audience they will do better in the second round.

On the other side of the stage stand the other two contestants: the well-known Ethiopian poet, Tagel Seifu, and the famous journalist and actress, Haregewoyn Assefa.

They look confident, leading in the first round.

 {Photo: Todd Shapera}Dr. Apolline Uwayitu, country director of MSH Rwanda.Photo: Todd Shapera

Cross-posted from LMGforHealth.org, this blog post post is part of a series leading up to the 67th World Health Assembly (WHA) in Geneva, Switzerland from May 19–24, 2014. In conjunction with WHA, the Leadership, Management & Governance (LMG) Project will host a side session with global health leaders titled, “Governance for Health: Priorities for Post-2015 and Beyond.” This series will offer insight on how good governance in the health system can result in stronger health impact as we move beyond the Millennium Development Goals.

Governing bodies of health systems and health institutions around the world are dominated by men. The lack of female leaders within these governance structures creates an unbalanced approach to how best to create meaningful health outcomes and why institutions are not being gender-responsive. Gender-responsive governance in practice, means ensuring that governance decision-makers respond to the different needs of their internal and external clients, based on gender.

 {Photo credit: Genaye Eshetu/MSH}Almaz Haile, Yeshi Derebew, Jember Alemayehu, and Teberih Tsegay receive 2014 REAL AWARDS.Photo credit: Genaye Eshetu/MSH

Four Ethiopian HIV-positive mothers received 2014 REAL Awards for their outstanding contributions to the fight against HIV, particularly prevention of mother-to-child transmission of HIV (PMTCT), at a ceremony in Addis Ababa, Ethiopia, on April 10, 2014. Created by Save the Children and the Frontline Health Workers Coalition, the REAL Awards are designed to develop greater respect and appreciation for health workers and the lifesaving care they provide globally, as well as in the United States. 

Meet Tsegay, Haile, Alemayehu, and Derebrew

After breaking their silence and confronting the stigma faced by people living with HIV in Ethiopia, and envisioning that no child be born with HIV from their town, the four mothers—Teberih Tsegay, Almaz Haile, Jember Alemayehu, and Yeshi Derebew—received training on PMTCT and began working in late 2010 as mother mentors at Korem Town’s health center of Tigray Region.

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

Azmara Ashenafi, a 35-year-old woman from the Amhara region of Ethiopia, was diagnosed with tuberculosis (TB) and placed on treatment. She was fortunate. Many people with TB are missed by health systems altogether. But Azmara’a treatment wasn’t helping. Despite taking medicine for months, her symptoms persisted and became more severe.

In many places, her story would have a sad ending—TB is one of the top three leading causes of death for women 15 to 44 in low- and middle-income countries.

But Azmara went to the Muja Health Center—one of over 1,600 supported by USAID's Help Ethiopia Address Low TB Performance (HEAL TB) program, and where MSH has been training health workers to screen patients for multidrug-resistant TB (MDR-TB).

MDR-TB cannot be treated with the two most potent first line anti-TB drugs and infects 6,000 Ethiopians each year. To help curb the spread of the disease, health workers learn how to screen people in close contact with MDR-TB patients. All of Azmara’s family members were tested and both she and her three year old son Feseha were found to have MDR-TB.

 {Photo credit: MSH staff.}Dr. Jamie Tonsing, TB CARE I Project Director, preparing to release of balloons with the TB health education messages during 2013 WTD celebrations in Phnom Penh, Cambodia.Photo credit: MSH staff.

MSH staff are commemorating World TB Day through awareness-raising activities around the globe, including in Afghanistan, Cambodia, Ethiopia, Ghana, Indonesia, and Nigeria. Here are photos (some from 2013) with activities this year.

Afghanistan - TB CARE I

During this year’s World Tuberculosis Day (WTD) celebration in Afghanistan, MSH’s TB CARE I project team will reach more than 21,000 individuals with tuberculosis (TB) advocacy and awareness activities. The project staff plans to distribute over 8,530 banners, notebooks, and posters on TB control to politicians, health workers, and community members. Additionally, the TB CARE I Afghanistan team will travel to the 13 project-supported provinces to help field-based staff plan and facilitate WTD celebrations at health centers in their communities. The project staff will also support staff from the National TB Program (NTP) and other stakeholders in planning and participating in WTD celebrations at 26 schools and 600 and communities.

{Photo credit: Todd Shapera.}Photo credit: Todd Shapera.

This post originally appeared on The Lancet Global Health Blog.

A strong civil society is essential for realizing the lofty goal of achieving universal health coverage (UHC). While the ongoing global discussions around UHC have largely focused on the role of government and development partners in designing and implementing risk pooling mechanisms that have the potential to improve access to essential health services, there has been little discussion on the key role that local civil society organizations (CSOs) play to ensure various communities support UHC and hold governments accountable.

{Photo credit: Rui Pires.}Photo credit: Rui Pires.

We do a lot of things in the name of culture. From our hair to our food to our ceremonies, culture informs our identity, our very understanding of who we are, and how we fit into this world.

In countries where female genital cutting is widely practiced, “culture/tradition/religion” feature prominently among the reasons why the practice began, and why it is perpetuated. In fact, there is no religious reason for this practice, also known as female genital mutilation, FGM, or FGM/C. Yet, those who support the continuation of FGM/C often invoke the name of their culture, or tradition, or religion as dictating their actions.

Culture viewed from this perspective is oppressive—denigrated into a static phenomenon, unchanging, and uninformed by new knowledge. It is only when we accept culture as a dynamic force–one which is ever changing and evolving–that we proudly can identify with, and derive our identities from it.

Culture can be a powerful positive force in our lives if we dare to challenge it.

{Photo credit: Rui Pires.}Photo credit: Rui Pires.

This special January 2014 edition of the Global Health Impact Newsletter (subscribe) features 12 stories from 2013 highlighting how MSH is saving lives by strengthening health systems at all levels--from the household to the community to the health facility to national authorities. The stories were selected through an internal storytelling contest (available in print soon).

We are also pleased to share a post from President and CEO Jonathan D. Quick outlining our vision for 2014.

A Note from Dr. Jonathan D. Quick

Vision 2014: UHC and the Opportunity for a Healthy Life

 {Photo credit: Anteneh Tesfaye Lemma/MSH.}Producing a TV spot on social health insurance in Ethiopia.Photo credit: Anteneh Tesfaye Lemma/MSH.

It was sudden and unexpected. It was also funny: the ball exploded and deflated right under Teferi's foot. But everybody started to worry when the director screamed: “We can’t shoot the next scene without the football! Somebody get me a new one!”

I looked at the young boy actor. Tears were about to wash his gloomy face as the ball changed into a useless piece of flat plastic right before his cloudy eyes. "This is bad!" I said to myself. "The kid might not be willing to act anymore; we might be forced to start the production all over again!"

We were shooting one of the scenes for a TV public service announcement. Producing the TV spot is one of the major activities for the Health for All Campaign–the campaign supporting the popularization of Ethiopia’s New Health Insurance Scheme.

It was ironic: the TV spot promotes preparing for unforeseen emergencies. Yet, once the ball became useless, we realized that we were not ready for an emergency ourselves.

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