Ghana

{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: MSH}Photo credit: MSH

Management Sciences for Health (MSH) joined African civil society organizations (CSOs) at a side event  on July 2 of the Abuja +12 meeting of African heads of governments. The groups agreed that universal health coverage should be included in the post-2015 development agenda.

In April 2001, the Heads of State and Government of the African Union signed the Abuja Declaration after undertaking a critical review of the rapid spread of HIV and AIDS on the continent. The Declaration cited practical strategies to deal with the menace. It also urged governments of member states to increase funding for health to at least 15% of the national budget. 

The Nigerian government and the African Union (AU) will co-host the Abuja +12 Special Summit of the AU Heads of government from July 15 to July 19 to review the 2001 Abuja declaration. The Summit intends to focus on the unfinished work of the health-related Millennium Development Goals. It will serve as an avenue to review the progress made on the implementation of the Abuja Declaration on HIV/AIDS, Tuberculosis and Other Communicable Diseases. It will also propose a framework for post-2015 development agenda for Africa. 

Grace Tsawe owns a prayer camp in Ghana's Lower Manya Krobo District. She recovered from TB, and uses her experience to encourage others to be tested and treated medically for TB. {Photo credit: B. Adusei/MSH.}Photo credit: B. Adusei/MSH.

Tuberculosis (TB) control in Ghana is challenging: detection of TB cases is low, and TB mortality rates high. In many communities, like Lower Manya Krobo District, these challenges are compounded by the popular belief that TB is a spiritual disease. Many Ghanaians who contract TB seek healing in prayer camps and shrines, rather than going to health facilities for testing and treatment. By the time these patients seek medical care, it often is too late to recover and avert death.

Lower Manya Krobo District has over 93,000 residents, and a high incidence of TB (209 cases per 100,000 people in 2011). The district is also home to many of the nation’s mushrooming prayer camps, where local healers provide daily services for ill residents. There are 50 prayer camps in Lower Manya Krobo District---and only 18 health facilities.

Grace Tsawe owns a prayer camp in this district, and she usually sees over 100 patients on her main clinic day.

World TB Day celebration in Ghana (2012). {Photo credit: MSH.}Photo credit: MSH.

Sunday, March 24, 2013, is World TB Day, and MSH staff and partners are promoting global efforts to stop TB throughout the week.

Here are highlights from some of our activities around the world:

The Afghanistan TB CARE I team is working with the national TB program (NTP) to conduct celebration events at 290 health facilities and communities in 13 USAID-supported provinces. TB messages will be aired through local telephone companies to approximately one million people throughout the nation. TB CARE I is also identifying and publicly rewarding high-performing health workers.

The Bangladesh SIAPS TB team will participate in a national rally on March 24 with all TB partners and stakeholders within the NTP network, as well as in a press conference, workshop, and scientific session.

Richard Horton moderates a panel on post-2015 development goals. {Photo credit: HSR-Symposium.org}Photo credit: HSR-Symposium.org

Last month, I joined over 1,800 participants from more than 100 countries in Beijing at the Second Global Symposium on Health Systems Research. We've made some concrete steps forward since we last met in Montreux, Switzerland, two years ago, among them the launch of a new research society Health Systems Global. Central topics of this year's discussions included: “Inclusion and Innovation towards Universal Health Coverage” (UHC), the symposium theme, and monitoring and evaluation.

Health for All.Health for All.

The October edition of MSH's Global Health Impact newsletter (subscribe), features stories of people, communities, and countries on the road toward universal health coverage (UHC).

The vital role of the essential package for health impact

On the Road to Universal Health Coverage: The Vital Role of the Essential Package for Health Impact

A Rwandese woman shows her child's community-based health insurance card. {Photo credit: C. T. Ngoc/MSH.}Photo credit: C. T. Ngoc/MSH.

Eugénie, a widow in Rwanda, farms to provide for her children. In January 2012, she had surgery to remove a tumor, a procedure that would have devastated her family economically if she did not have insurance. Rwanda’s health insurance program is the most successful of its kind in sub-Saharan Africa: it supports the health of more than 90 percent of the population, including the most vulnerable, like Eugénie.

{Photo credit: deltaMike via FlickR.}Photo credit: deltaMike via FlickR.

Co-authored by Gina Lagomarsino, managing director for Results for Development Institute

Cross-posted on UHC Forward.

We welcome the United States Supreme Court decision to uphold President Obama’s sweeping health care overhaul. The Affordable Care Act (ACA) requires all Americans to have health insurance, which will dramatically increase both equitable access and the health of Americans.

It also adds the US to the growing list of countries on the path to universal health coverage.

US Affordable Care Act a good step forward

We have learned that countries must create systems that reflect their history and their current realities. In the US, this means improving upon a system dominated by private insurers that historically have been able to provide subjective and selective coverage – denying coverage or charging exorbitant premiums to those most in need.

To provide health care coverage for all in the US, it was critical that the ACA accomplish the following goals:

Ms. Apegnon Akpene, a family planning client and role model, in Diguegue. {Photo credit: Niagia Santuah/MSH.}Photo credit: Niagia Santuah/MSH.

Apegnon Akpene is a 20-year-old mother of three children: four-year-old Joseph, two-year-old Romance, and one-month-old Akou Jacqeline. Since attending USAID's Action for West Africa Region, Phase II (AWARE II)  community health worker training, she has become a client of family planning -- and a role model for family planning in her community.

Akpene is one of three community health workers in Diguegue, a small village of about 800 people in the hills of the southwestern forest separating Togo and Ghana. Distance and difficult terrain are major hindrances to accessing health care for the inhabitants of the village. Diguegue is 47 kilometers from the nearest health facility, a small clinic, in the Prefecture of Tchifama. The village is served by a 12-kilometer dirt road that winds through the thick forest.

Akpene attended school for eight years. When she became pregnant at age 16, she was forced to drop out. She gave birth to three children within four years.

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