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Drug Therapeutic Committee training course in Kampala, Uganda.

As we celebrate World Health Day on April 7, 2011, the global health community is focusing on an increasingly dangerous health challenge---drug resistance. Antimicrobial resistance (AMR)---defined by the World Health Organization (WHO) as the resistance of a microorganism to an antimicrobial medicine to which it was previously sensitive---is a global public health threat that is rapidly wiping out the effectiveness of many first-line treatments. It undermines major public health achievements in treating infectious diseases such as HIV & AIDS, tuberculosis, malaria, and sexually transmitted infections. Not only is AMR a complex, cross-cutting problem affecting a wide variety of sectors, but it has crossed all national, geographical, and ethnic boundaries and is spreading globally.

Strong leadership, governance, and management are the cornerstones of successful global, national, and local efforts to save lives and achieve the  maximum impact from health investments. Yet effective leadership, management, and governance skills and practices too often are the vital missing elements in public, civil society and even private health organizations. Fortunately, these skills can be developed. They are best developed working in teams, in one’s own setting, over time, while facing real challenges.

With our partners, MSH works to build capacity at all levels within public and private organizations to improve leadership and management practices. Improved capacity ensures sound governance policies, creates a work climate that supports staff motivation, increases flexibility, and realigns staff to focus on common, achievable objectives.

(This blog post was originally posted on Global Health Council's Global Health Magazine blog.)

How do we set a gold standard for monitoring and evaluating capacity building?

Last week I attended the inaugural HIV Capacity Building Partners Summit in Nairobi from March 16-18, 2011. The Summit provided a timely opportunity to reflect on capacity building achievements in the region thus far, and use the lessons learned to rethink, gather momentum and repackage HIV capacity building in ways that ensure achievement of universal access and the targets set in the Millennium Development Goals 4, 5 and 6.

News from the HIV Capacity Building Partners Summit in Nairobi, Kenya

On the second day of the first ever Regional HIV Capacity Building Partners Summit in Nairobi, Kenya, one of the key issues that continued to dominate the conversations in various sessions was sustainability.

Many speakers noted that despite a mild increase in organizational capacity building efforts by donors, governments, and nongovernmental organizations in the Eastern and Southern Africa region, the documentation and dissemination of these efforts and their effects on HIV & AIDS programs and other health programs and systems remains limited. Apparently, several factors have contributed to this situation.

First, the group noted that evaluative research for questions of program sustainability were primarily based on the objectives, work plans, timeframes and measures of sustainability that had been developed by individual projects. In most cases, these projects were donor funded and had their own agenda and hence did not take an organizational-wide approach in their approach to measuring sustainability. They just focused on the project deliverables.

As Haitians continue to struggle against many obstacles in improving and developing their country, cholera and sanitation remain challenges to many development efforts.

Since the cholera epidemic started in October, there have been a total of 252,640 confirmed cases. MSH integrated its response, where appropriate, with the national response that was coordinated by the Ministry of Health. Following the earthquake, MSH’s USAID-funded Santé pour le Développement et la Stabilité d’Haíïti (SDSH) Project found that provision of basic health care through mobile kiosks in the settlement camp tents were an effective way to provide services and messages. Educational messages and oral rehydration solution (ORS) therapy are now being delivered via these kiosks. In addition, SDSH distributed cots, buckets, bleach, bottled water, and ORS to combat the disease.

News from the HIV Capacity Building Partners Summit in Nairobi, Kenya

Sub Saharan Africa still remains the unenviable epicenter of the global HIV and AIDS epidemic. Over the years, the region has witnessed intensified emergency efforts to expand access to HIV treatment, prevention, care and support. These efforts now call for renewed commitment to strengthen the requisite organizational capacity to plan, implement and sustain effective interventions.

This week, 225 government, donor, academic, civil society representatives, and People Living with HIV/AIDS, coming from 22 countries in Eastern, Central, and Southern Africa, are meeting in Nairobi to take stock of progress, achievements and lessons in HIV capacity building, share best practices and innovations, and also plan for future efforts to strengthen the organizational capacity of local implementers.

Tukuls in the process of construction which will house midwives and PHCC staff, as viewed from Muni PHCC, (Muni Payam, Terekeka County, Southern Sudan)

Terekeka, a growing county and town just 60 miles north of Juba, translates as “The Forgotten” in the local dialect.  Just five years ago, this area was awash in violence, poised close to the frontlines of a civil war which resulted in the death and displacement of millions. Villagers and returnees began repopulating the area after the signing of the Comprehensive Peace Agreement in 2005, which heavily increased demand for health services. Today, Terekeka is heavily populated by southern returnees seeking refuge, land, and jobs, as well as internally displaced persons escaping nearby tribal violence.

I recently visited Haiti and had the opportunity to meet with some local Haitian non-governmental organizations supported by MSH’s Santé pour le Développement et la Stabilité d’Haíïti (SDSH) project, as well as the central Ministry of Health, and departmental Ministry of Health offices. I was searching for information in an effort to learn more about how Performance-Based Financing (PBF) has affected service delivery in Haiti. The SDSH-supported facilities produce monthly service utilization reports that capture the important information, but I’ve been working to obtain comparable information on other facilities. My first thought was the Health Information System (HIS) Unit at the Ministry of Health (MoH).

Every day people are dying in the developing world because they cannot access affordable, quality medicines. Modern pharmaceuticals have revolutionized health care, but weak health systems prevent many people from accessing basic life-saving medicines. The health of men, women, and children can be dramatically improved throughout the world by enhancing access to and improving the use of essential medicines and other health care technologies.

Gaps in the management and availability of essential medicines and health commodities have been a constant weakness for developing countries. These gaps hamper the ability to access and distribute the pharmaceutical and medical supplies needed to treat infectious diseases. We have seen particular success in addressing pharmaceutical management challenges when interventions include: increasing access to products and services, improving the use of those products and services, promoting rational pharmaceutical use, developing public-private partnerships, providing thorough assessments and trainings, and improving procurement processes.

Aberu Hailu and her HIV-Negative son.

 

Aberu Hailu is a 31 year old, mother of four living in Hidmo, Ethiopia a rural community 8 kilometers south east of Adigodum town in Tigray. Two years ago, she visited the Adigodum Health Center to be tested for HIV, a disease she had learned about through community health education. She discovered she was HIV-positive and informed her husband that he should be tested, but he refused.

Two months later, Aberu became pregnant and found herself in despair. She thought she would pass the virus on to her baby and she feared the stigma and discrimination she knew often came with a positive HIV status.

Aberu returned to the Adigodum Health Center and the HIV/AIDS Care and Support Program (HCSP), a USAID-funded MSH-led health project, for help. Aberu learned that her baby could be protected from the virus with prevention of mother to child transmission services.

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