governance

 {Photo credit: Rachel Lieber/MSH.}ADDO owners and dispensers in Mafia Island, Tanzania, learn to use the mobile applications developed by SDSI. The applications allow ADDO personnel to access an SMS-based Pharmacy Council helpline, send service utilization reports to the Pharmacy Council, and to pay annual licensing fees via mobile money.Photo credit: Rachel Lieber/MSH.

Cross-posted with permission from mHealthKnowledge.org.

In the private sector, Tanzania has more than 1,000 pharmacies, 2,500 pharmaceutical personnel, 6,000 accredited drug dispensing outlets (ADDOs), and more than 18,000 ADDO dispensers. The Pharmacy Council of Tanzania has overseen these facilities and personnel since 2011, but lacked a comprehensive system to manage regulatory information. Without such a system, basic facility and personnel information was inaccessible, the locations of rural ADDO facilities were unclear, and tracking business and professional licensing status, including fees collection, was difficult. Furthermore, the Pharmacy Council had no way to efficiently communicate directly with the outlets.

 {Photo credit: Brooke Huskey/MSH.}Mother and baby in the pediatric ward at Shinyanga Regional Hospital, Tanzania.Photo credit: Brooke Huskey/MSH.

The most recent edition of the MSH Global Health Impact Newsletter (May 2014, Issue 5) highlights MSH and global efforts moving toward universal health coverage (UHC) in the post-2015 development framework. This issue includes: MSH President & CEO Dr. Jonathan D.

 {Photo credit: MSH}H.E. Dr. Suraya Dalil, Minister of Public Health, AfghanistanPhoto credit: MSH

This post, cross-posted with permission from The Leadership, Managment, and Governance (LMG) project blog on LMGforHealth.org, is part of our Global Health Impact series on the 67th World Health Assembly in Geneva, May 18-24, 2014. MSH is co-hosting three side events focusing on the role of universal health coverage (May 20), chronic diseases (May 20), and governance for health (May 21) in the post-2015 framework. This year, six MSH representatives are attending WHA as part of the 60-plus-person Global Health Council (GHC) delegation.

 {Photo credit: Sarah Lindsay/MSH.}Youth delegates at the World Conference on Youth in Hambantota, Sri Lanka.Photo credit: Sarah Lindsay/MSH.

Good governance is like a large elephant, Ahmed Adamu, Chairperson of the Commonwealth Youth Council, said. One person can touch the trunk, one the stomach, and one the tail, and they have had very different experiences with the elephant. Around the world, everyone has different experiences and different perceptions of good governance. With this anecdote, Adamu, a speaker at the plenary, “Achieving Good Governance and Accountability” at the 2014 World Conference on Youth, captures the challenges of defining good governance often cited in more academic terms. Though the concept of good governance is up for interpretation, there is consensus across countries, generations, and sectors that it is sorely needed. According to a consultation by Restless Development with young people in 12 countries , overall, governance is their most important issue that should be addressed in the post-2015 dialogue. And while good governance might be their most pressing concern, according to Subinay Nandy, Sri Lanka’s Resident Coordinator to the United Nations, it is young people themselves who are the most important tool international agencies can use to guarantee good governance.

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

This blog 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 the 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 blog 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. This post originally appeared on the LMGforHealth Blog.

While substantial progress in the Millennium Development Goals will have been achieved in many countries by 2015, reductions in preventable maternal and infant deaths lags, and the persistent struggle of disease burdens from communicable and non-communicable diseases is worrying.

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

Co-authored with Elly Mugumya, director of the LMG/IPPF partnership, this post originally appeared on the LMGforHealth.org Blog.

Hearing the perspectives of women leaders is an effective way of amplifying the collective voices of women to bring about change. Women often do not have a platform to tell their stories. These stories are personal and resonate with those of other women who aspire to leadership positions. The USAID-funded Leadership, Management & Governance (LMG) Project has captured some of these stories in a new publication, An Open Mind and a Hard Back: Conversations with African Women Leaders.

 {Photo credit: Rui Peres}Children in Uganda, one of many LMICs where good governance at all levels of the health system is key.Photo credit: Rui Peres

This post originally appeared on the LMGforHealth.org Blog. USAID's Leadership, Management and Governance (LMG) Project, led by Management Sciences for Health (MSH), hosted the Governance for Health (G4H) in Low- and Middle-Income Countries Roundtable 2013 (G4H2013) at Georgetown University in August.

The overwhelming consensus of G4H2013? Governance matters.

Health sector leaders gathered in Washington, D.C. in August for the second roundtable on enhanced governance for the health sectors of low- and middle-income countries (LMICs). Governance involves decisionmaking by diverse stakeholders that set the strategic direction for public and private organizations; assembling and allocating resources needed to implement the strategic plan; monitoring the progress of champions; and protecting the mission of the organization.

{Photo credit: MSH staff}Photo credit: MSH staff

Cross-posted with permission from UHC Forward.

I walked into a pediatric unit of a teaching hospital in Nigeria a few years ago to review a patient. On the first bed was a lifeless child. He was brought in dead a few minutes earlier by his parents. His mother, "Bisi", wept uncontrollably. While in tears, she recounted how difficult it was for them to borrow money to get to the hospital. Although they got some money from a chief in the community, the two-year-old baby died before they got to the hospital.

Kunle’s story touched me deeply. Kunle’s case typifies the plight of many poor people in Nigeria and the rest of sub-Saharan Africa: The financial burden of illness makes many families poorer. People are afraid to go to hospitals because they may not be able to afford the cost of the health services they need. They prefer to buy drugs over the counter, or visit a local herbalist, who will charge little or nothing to provide poor health service.

 {Photo credit: MSH/Paula Champagne}Participants of "Medicines as Part of UHC: Starting a Dialogue".Photo credit: MSH/Paula Champagne

What do medicines, financing, governance, and management have in common?

They are all essential pieces of the puzzle that must come together in order to make universal health coverage (UHC) a realizable goal.

From June 2-4, 2013, Management Sciences for Health (MSH), in collaboration with the Rockefeller Foundation and Harvard Medical School’s Department of Population Medicine, and additional support from the Pan American Health Organization (PAHO) and the US Agency for International Development (USAID), brought representatives of countries working towards UHC, private insurance schemes, and medicines and financing experts from across the globe to start a dialogue around medicines coverage under UHC.

Dr. Jonathan Quick, MSH’s President and CEO opened the event: “UHC is about filling the tragic gaps that exist in health systems around the world: gaps in access, in affordability, and health needs that go unanswered.”

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

Modern medicines, vaccines, and other health technologies have revolutionized health care. Yet these products haven’t improved lives everywhere, often because health systems haven’t made them accessible and affordable. In many developing countries, where health systems still rely heavily on out-of-pocket expenditure, patients face high costs at the point of service. Some people forgo necessary care; others endure financial hardship or even impoverishment. A majority of out-of-pocket spending goes towards medicines.

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