Nigeria

 {Photo credit: Ghaffar Rabiu}Dr. Zipporah Kpamor, Country Director, MSH Nigeria, is interviewed at the 10th anniversary event.Photo credit: Ghaffar Rabiu

Management Sciences for Health (MSH) celebrated 10 Years of Improving the Health of Women and Children in Nigeria with 250 stakeholders and supporters at a special event in Abuja on March 31, 2016. Distinguished guests included the chairman of the Nigerian House of Representatives, director of the Federal Ministry of Health in Nigeria, high-level representatives from state governments and partner organizations, and more.

After a rousing rendition of “Arise, Oh Compatriots,” the Nigerian national anthem, Country Director, Dr. Zipporah Kpamor, welcomed participants and underscored the intention for the day’s two round-table panel discussions:

In Nigeria, 150 women and 2,300 children die every day from preventable causes. One in five children won’t live to see their fifth birthday. This event can help continue conversations on what we can do to end preventable deaths among women, children, and young people.

Currently, MSH’s partnerships for health system strengthening in Nigeria reach nearly 560,000 people through four projects.

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

Today, April 7, we celebrate World Health Day, started by the World Health Organization (WHO) to mark its founding in 1948.

Amid Ebola, Zika, maternal and child mortality, and other global health challenges, WHO chose diabetes, for the first time, as its World Health Day theme (“Stay super. Beat diabetes”).  To urge global action on the rising diabetes burden, WHO released a new global report yesterday, April 6, highlighting key global diabetes findings, country profiles, and recommendations to reach the Sustainable Development Goal (SDG) target 3.4, which calls on countries to reduce premature death from noncommunicable diseases (NCDs), including diabetes, by 30 percent by 2030. 

{Photo credit: Mark Tuschman}Photo credit: Mark Tuschman

Impact. Scale. Sustainability. As public health professionals, we are dedicated to high-impact and high-coverage interventions that significantly improve the health of large human populations. We also hope that the benefits become part of the timeless fabric of their families, communities, and the health system.

This triple expectation—impact, scale, and sustainability—has accompanied global health for decades and especially during the last  generation. In 1990, Dr. Thomas Bossert reported that, among five US government-funded health programs in Africa and Central America, a project’s capacity to show results was the most important factor to ensure the sustainability of its benefits.

 {Photo credit: MSH Nigeria}Some members of the Amdo Health Club in Billiri, Gombe StatePhoto credit: MSH Nigeria

It isn’t easy being a woman–or a girl–in Nigeria.

I grew up in a little village in the North where the tradition was very patriarchal. But my family was quite revolutionary. My father, right from the beginning, supported all of his children to go to school. When he got ill, he told my mother:  ‘You must promise me this: If I’m not around, and you are forced to choose between who to send to school, always choose the girl. The boy will inherit the land; he will always have a livelihood. The girl, she is not allowed to inherit anything; the girl child needs an education to find a livelihood for herself. '

It’s the opposite of what everyone thought! This is how I learned to lead.

 {Photo credit: MSH staff.}MSH staff at IAS2015 included: Dr. Ndulue Nwokedi, Deputy Project Director, Pro-ACT; Dr. Ginika Egesimba, Senior Clinical Advisor, TB/HIV, Pro-ACT; Emmanuel Nfor, Principal Technical Advisor, SIAPS; Dr. Andrew Etsetowaghan, Clinical Advisor, PMTCT, Pro-ACT.Photo credit: MSH staff.

Management Sciences for Health (MSH) presented seven abstracts at the 8th International Aids Society Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2015) in Vancouver, Canada, July 19-22, 2015.

{Photo credit: Andrew Esiebo/MSH Nigeria}Photo credit: Andrew Esiebo/MSH Nigeria

I am a woman. I am a Nigerian. I am a mother. I am a leader. And, I am a daughter. As the Nigerian country representative, I guide Management Sciences for Health (MSH)’s efforts to ensure the people of my country have access to quality health services. Indeed, I am many things. Before all else:

I am a woman of Nigeria.

The Girl Child in Nigeria

From the beginning, our girl children are at a disadvantage.

Our culture (like many are) is strongly patriarchal. The boy child is given higher status than the girl child. If a family has to choose, the boy child is the first to go to school. The girl child is the first to be dropped from school.

No matter how young she is, the girl child feels that it is her responsibility to care for her siblings. She is expected to take on added responsibilities and earn money to keep the other children. This pressure frequently leads to early sexual activity, transactional sex, and sex with older men-- increasing her risk of getting HIV and other sexually-transmitted infections.

Then Boko Haram came to the North East Zone of Nigeria. They take our girls away. They abuse them. They rape them. They marry them off to older men.

{Photo credit: Anteneh Tesfaye Lemma/MSH.}Photo credit: Anteneh Tesfaye Lemma/MSH.

Meeting my predecessor

There he was: Kenaw! I was seeing him in person for the first time. Kenaw is a friendly guy; we greeted like we’d known each other awhile. I hear from my Health for All: Campaign for Universal Health Coverage in Africa (Health for All) colleagues that he was wonderful to work with and got along with almost everyone in the office within a few weeks of arriving. Although I hadn't had the opportunity to work with him, I sprinted from the foundation he laid to further the campaign’s activities as I joined MSH and Health for All in January 2013.

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

Staff contributors at Management Sciences for Health (MSH), a founding member of the UHC Day coalition, are blogging this week about universal health coverage, including sharing fresh videos, photos, and analysis, inspired by the five reasons to support health for all. Each day we also include how you can take action right away to support health for all.

Today, we highlight reason two ("Because UHC is attainable") with video and stories from Ethiopia, Kenya, and Nigeria--countries working toward UHC.

Because Universal Health Coverage (UHC) is Attainable

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 {Photo credit: Ian Sliney/MSH.}"Let's prevent Ebola together" billboard in Liberia.Photo credit: Ian Sliney/MSH.

Management Sciences for Health (MSH) hosted an interactive, three-day, online seminar on the West African Ebola outbreak on LeaderNet.org, October 28-30, 2014. Edited summaries from seminar facilitators (MSH Global Technical Lead on Malaria and Communicable Diseases, A. Frederick Hartman, MD, MPH, Days One-Three, and co-authored by Independent Pandemic Planning Advisor, Lisa Stone, Day Two), appear below. You can access seminar archives, including resources for preparedness and response, by joining LeaderNet.org.

Day One (Oct. 28): Mobilizing community-based care

Many thanks to the 240 individuals from more than 50 countries who have signed on to participate in the LeaderNet Ebola seminar so far. I am very impressed with your interest and enthusiasm in discussing, and ultimately controlling, this massive Ebola outbreak.

L to R: MSH staffer Niniola Soleye and her aunt, Dr. Ameyo Adadevoh

My aunt, Dr. Ameyo Adadevoh, identified and contained the first case of Ebola in Nigeria.  She paid with her life because the health system was not ready to deal with Ebola.  The system has since caught up, and is today a model for other countries.  But the loss of such a gifted doctor and family anchor is incalculable.

Ebola arrived in Nigeria at a time when doctors at all federal government hospitals were on a labor strike (my aunt worked in a private hospital).  After ongoing negotiations with the government failed to meet their demands, the doctors – desperate to see significant changes in the health system and seeking improved salaries, positions, and titles – reached their breaking point.  So they went on an indefinite strike.

Patrick Sawyer – the index case – left quarantine in Liberia and collapsed at the airport in Lagos, Nigeria.  He was trying to travel to a meeting of the Economic Community of West African States (ECOWAS) in Calabar, Nigeria.

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