malaria

Nator Namunya, 6-months old, receives a vaccination in Kapoeta North County. Credit: Save the Children.

 

A version of this post originally appeared on the Save the Children website.

The healthcare system in South Sudan is struggling to get on to its feet after the devastation of over 20 years of war. The biggest killers of children in southern Sudan are malaria, diarrhea and respiratory infections. These preventable diseases can be easy to treat. But, on average, only one in four people in South Sudan are within reach of a health center. Only 3 percent of children under two in South Sudan are fully immunized against killer diseases and only 12 percent of families have a mosquito net in their home.

Cross-posted from the K4Health Blog.

As the mHealth Summit gets underway this week in the Washington D.C. area amid thousands of mHealth projects taking shape around the world, one particular mobile activity is saving lives by helping to ensure that the contents of medicines match their labels.

The Problem:

According to a  2010 World Health Organization Fact Sheet, it is difficult to estimate the percentage of counterfeit medicines in circulation—WHO cites estimates in industrialized countries at about 1%, and adds that “many African countries, and in parts of Asia, Latin America, and countries in transition, a much higher percentage” of the medicines on sale may be falsely labeled or counterfeit.

If you grow up in places like Kasungu district in rural Malawi, you learn that when your wife is pregnant, you should not have sex outside marriage---because you will lose the “expected gift” through miscarriage. Male promiscuity during a partner's pregnancy is a taboo that many believe will bring a curse on the family.

Patricia Patrick says that after she miscarried in November 2008 “People talked in the village, and people talked within the household. My relatives asked me suspicious questions.” They wondered whether sexual misbehavior by her husband caused the tragedy. She remembers her husband telling his side of the story to prove his innocence, but nobody believed him.

It was an exciting and insightful week of discussions at this month’s Global Health Council meeting on how to address the drastically growing burden of non-communicable diseases (NCDs), such as cancers, diabetes, and heart and lung disease, in advance of the UN High Level Summit on NCDs in September. Speakers made a strong case for including NCDs as a priority on the global health agenda. The intertwining of these diseases with communicable diseases such as HIV, TB and malaria are striking. Julio Frenk, MD, MPH, Dean of the Harvard School of Public Health described the commonalities:

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.

 

 

 

 

Children in Southern Sudan

Malaria is preventable and curable, yet every year it kills more than a million people throughout the world and tens of thousands in Southern Sudan alone.  Malaria infection remains the highest cause of morbidity and mortality in Southern Sudan. Every year, thousands in Southern Sudan die unnecessarily due to lack of access to appropriate prevention and treatment. In the wake of nearly 50 years of civil war, the country is hastening towards independence and a future with unlimited potential. Yet, every death brought about by malaria steals another life from contributing to the nation’s future.

The US Agency for International Aid (USAID)-funded, Management Sciences for Health (MSH)-led Sudan Health Transformation Project, Phase 2 (SHTP II) is working to combat this scourge. Through 165 health facilities in 14 counties and 10 states, SHTP II is providing vital services to prevent and treat malaria. 

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.

Mobilizing communities in rural Benin to improve health.

The West African nation of Benin faces many challenges in achieving Millennium Development Goal 4---reducing child mortality. In the rural communities in Benin (91% of the population live in rural areas), access to health care and treatment is inadequate in relation to the vast need. Very few people have the appropriate skills and capacity to deliver care in these areas. The US Agency for International Development's (USAID) BASICS Benin project is increasing the capability of villages as far as 50 km away from health centers by training Community Health Workers (CHWs) to perform community case management of children five years-old and under.

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