fragile states

 {Photo credit: DRC-IHP/MSH.}A healthy, exclusively breastfed, five-month old Ataadji and mom, Thérèse. In two months, his weight increased from six to sixteen pounds.Photo credit: DRC-IHP/MSH.

This post is part of the  blog and event series on proven, impactful practices that are advancing maternal, newborn, and child survival. The series is sponsored by MSH, Jhpiego, and Save the Children.

At three months old, Thérèse’s baby boy Ataadji was malnourished and unhealthy, weighing in at only six pounds. Within two months, Ataadji had transformed into a thriving, healthy baby boy and his weight had nearly tripled. The keys to this success? An Infant and Young Child Feeding (IYCF) support group and exclusive breastfeeding.

{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.

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

This post originally appeared on the Maternal Health Task Force (MHTF) Blog as part of a series celebrating the one-year anniversary of The Lancet publishing “A Manifesto for Maternal Health post-2015,” co-authored by Ana Langer, Richard Horton, and Guerino Chalamilla.

In celebration of the one-year anniversary of the Manifesto for Maternal Health, Management Sciences for Health (MSH) congratulates our global community, including ministries of health, their partners, and the women we serve and work with, on the progress made toward creating a healthier world for mothers and their babies.

 {Photo credit: MSH/Filmona Hailemichael}Dr. Florence Guillaume, Minister of Health of Haiti.Photo credit: MSH/Filmona Hailemichael

On June 7, Management Sciences for Health (MSH) and partners hosted Dr. Florence Guillaume, the Minister of Health of Haiti, and panelists for a Capitol Hill luncheon on community health workers in fragile states. The day before, MSH hosted Guillaume in Cambridge, MA, for a town-hall style event on improving maternal and child health. Revisit the two events through a "Storify" story of photos, text, and tweets.

Trying to cross through a flooded section of road in South Sudan. {Photo credit: E. Polich/MSH.}Photo credit: E. Polich/MSH.

“We’re going to try to drive through that?”

After spending nearly two years working in South Sudan, I was on my way with two colleagues to one final meeting. The USAID-funded second phase of the Sudan Health Transformation Project (SHTP II), led by Management Sciences for Health (MSH), ended activities on July 31, 2012, and three of us needed to travel 360 kilometers (220 miles) to a results dissemination meeting. A flight booking mishap meant we had no choice but to drive --- during rainy season.

With a key bridge washed out.

And it rained --- down poured --- for over an hour the morning we left.

After passing several toppled trucks, overtaking pickups irrevocably mired in mud, and crossing through a river, we came across the point where I uttered the above quote (“We’re going to try to drive through that?”).

"Makasi" after two months of TB treatment. {Photo credit: A. Massimba/MSH.}Photo credit: A. Massimba/MSH.

Seven-year-old Makasi, an HIV-positive orphan in Tanzania, was diagnosed with advanced tuberculosis (TB) and started on curative treatment. Clinicians at a local health center used standardized TB guidelines to overcome the difficulty of identifying TB in children co-infected with other diseases. In Afghanistan, sixteen-year-old Hamida provides for her family while trying to complete school. Hamida was visited by a community health worker, who identified her TB symptoms, and helped her access appropriate diagnosis and treatment.

Steady Progress Against Daunting Challenges

Tuberculosis mortality has fallen by a third since 1990. Yet TB is still the second leading cause of death from infectious disease worldwide. The vast majority of new cases (8.8 million in 2010) and deaths (1.1 million in 2010) occur in poorer countries. TB’s effects are often most devastating among people in fragile circumstances. Poverty and conflict push people into crowded, unsanitary conditions without appropriate nutrition and health care.

Even more, TB is fast spreading, easy to misdiagnose, often co-morbid with other diseases, and, increasingly, highly drug-resistant.

President William Clinton at Closing Session of AIDS 2012. {Photo credit: © IAS/Steve Shapiro - Commercialimage.net.}Photo credit: © IAS/Steve Shapiro - Commercialimage.net.

It's been nearly two weeks since former President William J. Clinton closed the last session of the XIX International AIDS Conference (AIDS 2012) and delegates returned home.

This year's conference featured commitment and calls for an AIDS-free generation, a growing interest in Option B+, and new research towards a cure.  Here are some reflections from what we learned at AIDS 2012, where we truly started "turning the tide together".

Clinton calls for a blueprint toward an AIDS-free generation

Secretary Hilary Rodham Clinton announced significant funding towards preventing mother-to-child transmission (PMTCT) of HIV, South Africa’s plan for voluntary medical male circumcision, and money for “implementation research,” civil society, and country-led plans. Sec. Clinton also called on Ambassador Eric Goosby to provide a blueprint for achieving an AIDS-free generation during her plenary address. Numerous other stakeholders echoed her commitment. But, if we really want to achieve an AIDS-free generation, the $7 billion funding gap that stands between where we are now, and where we should be, will need to be erased

Ramatu Fullah now ekes out a decent living selling acheke; her two children stand by her side. {Photo credit: ACEPT staff/MSH.}Photo credit: ACEPT staff/MSH.

Ramatu Fullah is a 27-year-old woman in the Pujehun district of Sierra Leone.  She comes from a poor family and, for years, had to earn her living as a sex worker to take care of her two children. Recently, Ramatu learned skills that enabled her to change her trade through an awareness-raising campaign supported by the USAID West Africa Regional Health Office's Action for West Africa Region II (AWARE II) project, managed by Management Sciences for Health (MSH). Today, Ramatu sells acheke, a local delicacy, on the streets of Sierra Leone.

Women and HIV & AIDS in Sierra Leone

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