Health Systems Strengthening

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.

 

 

 

 

This blog post originally appeared on the US Agency for International Development's IMPACT blog.

Yodit Assefa (center) and procurement colleagues from PEPFAR’s Supply Chain Management System (SCMS). Photo credit: SCMS

As a procurement specialist with PEPFAR’s SCMS (the Supply Chain Management System) project, I am one of a growing number of women working in supply chain management in Ethiopia. I manage procurements of HIV/AIDS commodities---including the complex procurement of specialized medical equipment used to treat HIV/AIDS---as well as the vehicles that distribute those commodities.

Well planned, strategic procurement is a smart investment. Our team helps save money by minimizing costly unplanned and emergency procurements and buying low-value and bulky products locally.

My recent field visit has given me a great perspective on one of MSH’s major activities - the costing of health services. MSH has extensive costing experience in East Asia & Pacific, Latin America & the Caribbean, Southern Africa, and West Africa.

MSH developed and has helped manage multiple applications of the CORE Plus (Cost and Revenue Analysis Tool Plus). CORE Plus is a tool that helps managers and planners estimate the costs of individual services and packages of services in primary health care facilities as well as total costs for the facilities. The cost estimates are based on norms and can be used to determine the funding needs for services and can be compared with actual costs to measure efficiency.

Costing of health care services is a powerful exercise whose data and results can be used for a number of things. When the cost of a package of services is determined, the analysis can be used for practical purposes, such as planning and prioritization or allocation of funds based on known cost figures. Results from a costing study can also be used to set appropriate user fees or other prices linked to provision of services. Finally, results of a costing study can be used as an advocacy tool to ensure that appropriate funds are allocated for the package of services.

Malawi has some of the worst health statistics in the world, ranking 166 out of 177 countries. This is the result of HIV & AIDS, food insecurity, weak governance, and many human resources challenges. Health care vacancies range anywhere from 30-80%, and Malawi only has 252 doctors in the entire country. The health system is regularly plagued with stock outs of key medicines and supplies, as a result of poor procurement and distribution practices. Malawi has one of the highest HIV prevalence rates in the world; the average prevalence for sub-Saharan Africa is 7.5%, Malawi has 12% prevalence in the adult population.

More than 50% of Malawi’s population lives further than 5 km from a health center.  Health care workers in the community, who are capable of providing essential health care services to those living in ‘hard to reach areas,’ are essential.  Meet the HSAs – Health Surveillance Assistants.

In March 2011, the CSIS Global Health Policy Center asked bloggers around the world: What should the key priority of the upcoming UN High Level Meeting on Non-Communicable Diseases be and why? We had a number of great submissions.  Dr. Jonathan D. Quick was one of our four finalists.  Read his entry below and look out in the days and weeks ahead for other finalist's blogs and another blog contest on NCDs. 

This was originally posted on smartglobalhealth.org.

The most common NCDs are diabetes, heart disease, cancers, and chronic lung diseases. According to the World Health Organization, about 36 million people die each year due to NCDs, and a quarter of NCD deaths are of people aged under 60; 9 in 10 of these people are from developing countries. Breast cancer kills over 270,000 women in the developing world each year.

Political and social momentum has been building, as the United Nations High Level Meeting on NCDs approaches, for a change from emergency, disease specific responses to an integrated systems-strengthening response.

Strong leadership, governance, and management are the cornerstones of successful global, national, and local efforts to save lives and achieve the  maximum impact from health investments. Yet effective leadership, management, and governance skills and practices too often are the vital missing elements in public, civil society and even private health organizations. Fortunately, these skills can be developed. They are best developed working in teams, in one’s own setting, over time, while facing real challenges.

With our partners, MSH works to build capacity at all levels within public and private organizations to improve leadership and management practices. Improved capacity ensures sound governance policies, creates a work climate that supports staff motivation, increases flexibility, and realigns staff to focus on common, achievable objectives.

Tukuls in the process of construction which will house midwives and PHCC staff, as viewed from Muni PHCC, (Muni Payam, Terekeka County, Southern Sudan)

Terekeka, a growing county and town just 60 miles north of Juba, translates as “The Forgotten” in the local dialect.  Just five years ago, this area was awash in violence, poised close to the frontlines of a civil war which resulted in the death and displacement of millions. Villagers and returnees began repopulating the area after the signing of the Comprehensive Peace Agreement in 2005, which heavily increased demand for health services. Today, Terekeka is heavily populated by southern returnees seeking refuge, land, and jobs, as well as internally displaced persons escaping nearby tribal violence.

I recently visited Haiti and had the opportunity to meet with some local Haitian non-governmental organizations supported by MSH’s Santé pour le Développement et la Stabilité d’Haíïti (SDSH) project, as well as the central Ministry of Health, and departmental Ministry of Health offices. I was searching for information in an effort to learn more about how Performance-Based Financing (PBF) has affected service delivery in Haiti. The SDSH-supported facilities produce monthly service utilization reports that capture the important information, but I’ve been working to obtain comparable information on other facilities. My first thought was the Health Information System (HIS) Unit at the Ministry of Health (MoH).

Every day people are dying in the developing world because they cannot access affordable, quality medicines. Modern pharmaceuticals have revolutionized health care, but weak health systems prevent many people from accessing basic life-saving medicines. The health of men, women, and children can be dramatically improved throughout the world by enhancing access to and improving the use of essential medicines and other health care technologies.

Gaps in the management and availability of essential medicines and health commodities have been a constant weakness for developing countries. These gaps hamper the ability to access and distribute the pharmaceutical and medical supplies needed to treat infectious diseases. We have seen particular success in addressing pharmaceutical management challenges when interventions include: increasing access to products and services, improving the use of those products and services, promoting rational pharmaceutical use, developing public-private partnerships, providing thorough assessments and trainings, and improving procurement processes.

Dr. Belkis Giorgis, MSH's Gender Expert 

One hundred years ago on March 8, a handful of countries celebrated the first International Women’s Day. Today it is celebrated around the world as an opportunity to look back on women’s accomplishments and look forward to the realization of their full economic, political, and social rights. The United Nations theme for International Women’s Day 2011 is centered on women’s access to education, technology, and decent work.

For 40 years, MSH has promoted equal access to health care for women by strengthening health systems and building the capacity of women as leaders and managers, technical experts, clinicians, and community health workers. We interviewed Dr. Belkis Giorgis, our NGO Capacity Building/Gender Advisor in Ethiopia about women and development.

Why is International Women’s Day important?

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