Blog

It’s common sense that a mother who is on treatment for AIDS, pregnant, has a sick child, and is accompanying a sister debilitated by Tuberculosis should not have to visit four separate service delivery points to receive care. Integrated health services not only make the world a healthier place, but also decrease the burden on health systems.

Integration is a comprehensive approach to service delivery. It is the transition from a vertical or horizontal approach to a diagonal, synergistic approach at all levels of a health system. Smart integration means coordinating disease specific programs (such as HIV and AIDS) with other health programs that have operated independently in the past (for example, family planning) to deliver services at the same time or, more importantly, with the same funding. Integration helps organizations maximize the impact of their health investments while allowing people, information, and funding to flow more easily among collaborating groups and stakeholders. Equally important, integration enables providers to treat the health needs of individuals and families more efficiently---regardless of the initial reason a person seeks care.

This is a guest post from Olive Mtema, Policy Advisor, from the Community Based Family Planning and HIV & AIDS Services project in Malawi. Olive is an employee of the Futures Group.

On March 12, 2011, Muslim Leaders gathered in Lilongwe, Malawi for a conference on Reaffirming Muslims' Positions on Family Planning and HIV & AIDS Issues. The conference was hosted by the USAID-funded Community Based Family Planning and HIV & AIDS Services project (CFPHS) in collaboration with the Malawi Ministry of Health, Reproductive Health Unit (RHU); Muslim Association of Malawi (MAM); and Quadria Muslim Association of Malawi (QMAM). CFPHS is led by MSH, with Futures Group and Population Services International as key implementing partners.

This is a guest blog post written by Derek Lee from Pathfinder International.

The donkey cart ambulances were built by local craftsman.

On October 15, 2010, dozens of Kenyan women in bright headscarves gathered beneath the acacia trees scattered outside Balambala sub-district hospital.  The area chief was in attendance, as were members of the local women’s livelihood groups.  Despite the oppressive heat, everyone was in jovial spirits because this sunny day marked a momentous occasion for their “Care for the Mother” project.

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.

Last week, the United Nations Commission on Population and Development (CPD) met in their 44th session to negotiate next steps on a resolution for fertility, reproductive health, and development.  The Commission helps inform the United Nations (UN) on their global efforts and provides crucial recommendations to form UN Resolutions.

MSH, with over 80 partners and advocacy organizations, sent an open letter to the delegates of the 44th session. Together, we called on the Commission on Population and Development to:

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.

Over the course of the past ten days, I have been fortunate to visit the Central, Eastern, and Western Regions of Uganda.  As part of these visits, I have traveled through and spent time in many of the districts in these regions. It is during these drives through the countryside that I have noticed the campaigns for family planning services over and over again. Though it is possible my eye is fine tuned to notice these signs, as I am here supporting STRIDES for Family Health (a MSH-led, USAID funded family planning, reproductive health, and child and maternal health project), it would be hard for anyone to miss the cheerful rainbows that are posted on signs outside many of the health centers and hospitals indicating that family planning services are provided in that facility.

Signs promoting available family planning services in Uganda, March 2011.

 

Pages

Printer Friendly VersionPDF