October 2016

{Up to 50% of African patients now purchase their antimalarial medicines at private retailers, i.e. small pharmacies, patent drug stores, and general stores. This pharmacy in Kisumu, Lake Victoria region, Kenya, is well stocked with antimalarials. (Photo Credit: Novartis AG/CC BY-NC-ND)}Up to 50% of African patients now purchase their antimalarial medicines at private retailers, i.e. small pharmacies, patent drug stores, and general stores. This pharmacy in Kisumu, Lake Victoria region, Kenya, is well stocked with antimalarials. (Photo Credit: Novartis AG/CC BY-NC-ND)

This article was originally published on Devex as part of its series, Making Markets Work, on October 11, 2016.

At a session on defining the "next generation" of primary health care at the United Nations General Assembly, Tim Evans, senior director of health, population and nutrition at the World Bank Group, said the international development community is suffering from "pilotitis."

"We have an epidemic of startups, and we need an epidemic of scale-ups," he said.

Evans described a "systematic blind spot" in global health to understanding and implementing solutions to scaling that we — international nongovernmental organizations and companies — know can work, such as encouraging partnership between the public sector and private sector health systems; creating large-scale pilots in order to create the evidence and measurements needed to justify a primary care approach; and creating affordable models that promote health and prevent diseases, not just treat them.

Following our recent announcement of MSH’s involvement in Hurricane Matthew recovery efforts in Haiti, the Devex global development media platform interviewed MSH Chief Operating Officer Paul Auxila for an article about the rising threat of cholera in Haiti.

Mr. Auxila told Devex that cholera “needs to be a priority and approached differently than the international community did last time,” referring to the 2010 Haiti earthquake response.

He urged organizations to focus on “greatest impact” interventions, such as oral rehydration therapy. “Coordination is a big problem, just like it was after the earthquake,” he added. Interventions need to be more synergistic, working toward a “common goal” and not bypassing the Haitian government, he told Devex.

MSH is partnering with the Haitian government to rebuild the health system in the wake of Hurricane Matthew. At the government’s request, MSH has begun an assessment of the health system to make recommendations for ways to make it stronger. MSH will also assist in deployment of health workers to stem the cholera outbreak.

{Photo Credit: Carmen Urdaneta/MSH}Photo Credit: Carmen Urdaneta/MSH

Strong, well-functioning health systems need strong leadership, management, and governance. Over the next couple of weeks, leading up to conversations that MSH is hosting at the Global Symposium on Health Systems Research next month in Vancouver, we will be sharing stories and insights about the role of leadership, management and governance in health systems strengthening.

Over the last five years at the MSH-led, USAID-funded Leadership Management and Governance Project, our experience has underscored the importance of good governance, management and leadership to achieve service delivery outcomes in all health areas — from family planning to maternal, newborn and child health to HIV and AIDS.

The Leadership, Management and Governance Project's activities range from strengthening leadership and management skills of staff at the centralized level of Haiti's Ministry of Public Health and Population to supporting midwife managers to deliver high-quality family planning and reproductive health services in their communities at the decentralized level in Malawi.

{Baby Anika, from northern Bangladesh, was diagnosed with TB at 22 months and was cured after 6 months of directly observed treatment. (Photo Credit: Francies Hajong/MSH)}Baby Anika, from northern Bangladesh, was diagnosed with TB at 22 months and was cured after 6 months of directly observed treatment. (Photo Credit: Francies Hajong/MSH)

This article was originally published on Devex on October 26, 2016

I was exposed to the plight of children with tuberculosis early in my 32 years of experience as a physician. I was a medical intern in a provincial hospital in Peru's jungle region. I noticed Adrian, a severely malnourished 3-year-old child in the corner of the ward, feverish and breathing with great difficulty. His condition didn't respond to pneumonia treatment, and a chest X-ray revealed liquid surrounding the right lung. My attending physician concluded that Adrian had severe malnutrition and pneumonia and decided to continue his antibiotic treatment.

Adrian died on the third day of my watch. An autopsy revealed the little boy had been afflicted with TB. That was likely why he died, not malnutrition or pneumonia. We later found out that Adrian was living with an uncle who had recently died "coughing blood." My attending physician confessed that he had been so focused on managing the presumed pneumonia that he didn't think about TB as an alternative diagnosis.

{Photo Credit: Rui Pires}Photo Credit: Rui Pires

Strong, well-functioning health systems need strong leadership, management, and governance. Over the next couple of weeks, leading up to conversations that MSH is hosting at the Global Symposium on Health Systems Research next month in Vancouver, we will be sharing stories and insights about the role of leadership, management and governance in health systems strengthening. This is the second in a series of four blog posts on this topic. See part one.

Linvell Nkhoma is a midwife manager at Mitundu Community Hospital in northern Lilongwe, Malawi. She lives on the hospital premises so she can be on call 24 hours a day for emergencies or complicated cases that less experienced midwives don't know how to manage.

"We have limited space, only three delivery beds for 400 deliveries a month," Linvell said.

Linvell and her colleagues were concerned about overcrowding, and more importantly, the high rates at which mothers and babies were dying during deliveries.

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