October 2010

In mid-June the United States Government continued to show its commitment to global health by announcing the first Global Health Initiative (GHI) Plus countries: Bangladesh, Ethiopia, Guatemala, Kenya, Malawi, Mali, Nepal, and Rwanda. The GHI is a six-year, $63 billion initiative to help partner countries improve measurable health outcomes by strengthening health systems and building upon proven results. The GHI focuses on women, newborns, and children using an integrated approach including programs that address HIV & AIDS, malaria, tuberculosis, maternal and child health, nutrition, family planning and reproductive health, and neglected tropical diseases. These initial countries will receive additional technical and management resources to quickly implement GHI’s approach.  They will be used as “learning labs” – using best practices and lessons learned when implementing programs in other countries. MSH works in seven of the eight countries, so we asked our country experts: What’s working? Please stay tuned for a continuing series.

Blog post originally appeared on Global Health Magazine.

Six years ago the Malawi health system was on the verge of collapse due to severe shortages of health workers. Every year the College of Medicine would train 20 doctors and every year, half of them would leave the country. Nurses were overwhelmed by the demand for services.

Yesterday the Direction of Civil Protection and Disaster in Haiti confirmed a cholera outbreak in two departments (districts) of the country resulting in 1,498 cases managed in health facilities and 135 cholera related deaths.

The USAID-funded, MSH-led Santé pour le Développement et la Stabilité d’Haíïti (SDSH) project is working closely with Haiti’s Ministry of Health and other local and international partners to coordinate a community-level response to the cholera outbreak.

SDSH is mobilizing its established network of over 4,000 community-based health workers to reach Haiti’s largely rural population. The project is working with local and international vendors to procure oral rehydration solutions, a critical component of first aid for diarrheal disease.

For more details reported by SDSH on the ground, see our press release from earlier today.

On Saturday, October 23, a four-member group from the Santé pour le Développement et la Stabilité (SDSH) project, led by MSH’s Dr. Patrick Dimanche, conducted an initial on-the-ground assessment and provided support for five local NGO partners---Service and Development Agency (SADA) in Mattheux/West Department, Saint-Paul Health Center in Montrouis/West Department, Pierre Payen Health Center in Pierre Payen/Lower Artibonite Department, Hospital Albert Schweitzer/Lower Artibonite Department, and Claire Heureuse Community Hospital/Upper Artibonite Department---that have cared for over a third of the 2,364 cases reported thus far. Ninety-eight of the reported 208 deaths have occurred in four of these five health facilities.

The three USAID-funded projects managed by MSH in Haiti---SDSH, Leadership, Management, and Sustainability (LMS), and the Supply Chain Management System (SCMS) project---are working together to deliver emergency commodities including bed sheets, towels, adult diapers, disposable gloves, oral rehydration salts, IV solution, water treatment tablets, and soap.

The Management Sciences for Health Haiti staff continues to work tirelessly alongside local partners to mitigate the cholera outbreak. A sample of today’s work is outlined below.

The Health Minister’s Conference for member countries of The East, Central and Southern Africa Health Community (ECSA HC) was opened by the Minister of Health, Zimbabwe in Harare on October 25. The theme, "Moving from Knowledge to Action: Harnessing Evidence to Transform Healthcare" is very relevant to the mission of Management Sciences for Health (MSH).

I’ll highlight two sessions from the first day that support the evolving global health field and the work of MSH.

The Santé pour le Développement et la Stabilité d’Haíïti (SDSH) project Chief of Party, Agma Prins, and Dr. Serge Conille are in the Artibonite department to support the MSH response to the cholera outbreak. They continue to coordinate with the Ministry of Health and other international and local partners. MSH is working with Pure Water for the World to educate communities about hygiene and provide access to clean water through bio-sand filters.

Additionally, MSH Sr. Technical Advisor, Dr. Georges Dubuche, is working with Direct Relief International to coordinate an air freight shipment of supplies including IV fluids. IV catheters, oral rehydration salt tablets, Pedialyte solution, tetracycline or doxycycline, exam gloves, soap, and IV equipment stands.

The MSH/SDSH project is funded by the USAID.

This blog was originally posted on Global Health Council’s Blog 4 Global Health. This is a guest blog written by Aaron Emmel, government affairs officer at PATH, one of the sponsors of the event.

Almost 80 people packed the Global Health Council’s conference room last week, with 63 more listening in online, to learn about new initiatives to strengthen maternal, newborn, and child health by improving nutrition. The briefing was held in conjunction with World Food Day on Oct. 16.

Officials from the State Department and the U.S. Agency for International Development (USAID) described the intersecting nutrition goals of the U.S. government’s Feed the Future and Global Health Initiatives, while representatives of two global health organizations spoke about how new approaches to reducing malnutrition and under-nutrition are being carried out on the ground.

Fragile states such as Afghanistan, the Democratic Republic of Congo, Haiti, Liberia, and Southern Sudan have among the worst health statistics – especially for women and children.  For political, economic, security and other reasons they can be extremely challenging work environments. Despite this, I have been deeply inspired to see what local health leaders have achieved when they have created strong partnerships among government, donors,  non-governmental organizations and where possible the private sector.  The charismatic former minister of health from Afghanistan, the  medical director of an urban clinic in northern Haiti, and the director of Torit hospital in Southern Sudan stand out as examples of local leadership in action under circumstances that would immobilize many of us.

In fragile states, constraints on governments often prevent them from simultaneously building their stewardship role and immediately expanding service delivery. Supporting the Ministry of Health to establish a basic package of health services, train local organizations to implement those services, and provide incentives (such as through performance-based financing) is critical to success. Additionally, the goal should be to move from many plans and actors across districts to one health plan with committed partners.