The strengthening of health systems in low and middle income countries is central to the global effort to promote economic and social development through universal health coverage, reduce mortality, and improve health and sustainability of health care over the next 15 to 25 years. ("Health Systems Strengthening: 2015 and Beyond [6]")

MSH has released a new information brief, "Health Systems Strengthening: 2015 and Beyond [6]." The brief looks at lessons learned from working at all levels of the health system for over 40 years, outlines problems that must still be addressed and identifies specific ways to address them.

What do the next 500 days mean for global health?

The looming deadline of the Millennium Development Goals (MDGs) will prompt a final push to achieve the health targets that have helped guide the global community since 2000: to reduce maternal and child mortality, provide contraception and curb the HIV, TB and malaria epidemics. Undoubtedly, many people will benefit from vital health services in the next 500 days.    

But many others won’t, and they’re likely to be the people who are already most vulnerable and least served. For example, as maternal deaths have dropped in developing countries, deaths are more concentrated in poor regions [9]; the HIV epidemic still rages in marginalized populations like sex workers and people who use drugs. A key lesson of the MDG era is that nothing contributes to illness more than poverty and exclusion.

In the next 500 days, therefore, many voices will be calling for a new approach to global health in the post-2015 development framework. It’s a dramatic reinvention around a simple idea: that everyone, everywhere, should have affordable access to the health services they need.

Management Sciences for Health (MSH) joined African civil society organizations (CSOs) at a side event  on July 2 of the Abuja +12 meeting of African heads of governments. The groups agreed that universal health coverage should be included in the post-2015 development agenda.

In April 2001, the Heads of State and Government of the African Union signed the Abuja Declaration after undertaking a critical review of the rapid spread of HIV and AIDS on the continent. The Declaration cited practical strategies to deal with the menace. It also urged governments of member states to increase funding for health to at least 15% of the national budget. 

The Nigerian government and the African Union (AU) will co-host the Abuja +12 Special Summit of the AU Heads of government from July 15 to July 19 to review the 2001 Abuja declaration. The Summit intends to focus on the unfinished work of the health-related Millennium Development Goals. It will serve as an avenue to review the progress made on the implementation of the Abuja Declaration on HIV/AIDS, Tuberculosis and Other Communicable Diseases. It will also propose a framework for post-2015 development agenda for Africa. 

With less than 1000 days until the Millennium Development Goals expire, the process for setting post-2015 goals [19] continues to ramp up.  We take this opportunity to reflect on the current state of community health systems in low- and middle-income countries and consider how the post-2015 agenda could reshape them—perhaps dramatically.

Community health systems today

Integration moves ahead

Poor and rural communities in low- and middle-income countries are leaving behind the “one clinic, one service” approach. So-called vertical programs, which organized resources according to single health conditions, created a patchwork of health services at the community level. You could get HIV care from one provider, but would have to go down the hall, down the street, or often much farther to get maternal health care or malaria care.

Last week, the 67th United Nations General Assembly adopted a historic resolution [22] that emphasizes universal health coverage (UHC) in the global health and foreign policy work of the UN and Member States in the coming year.

Eugénie [26], a widow in Rwanda, farms to provide for her children. In January 2012, she had surgery to remove a tumor, a procedure that would have devastated her family economically if she did not have insurance. Rwanda’s health insurance program is the most successful of its kind in sub-Saharan Africa: it supports the health of more than 90 percent of the population, including the most vulnerable, like Eugénie.

Crossposted on Maternal Health Taskforce's mhtfblog [29] as part of the Maternal Health Commodities Blog Series [30].

Despite a decade of significant progress reducing maternal mortality rates, very few countries are on target to meet Millennium Development Goal #5a [31] of reducing the maternal mortality ratio by three-quarters by 2015.

The World Health Statistics 2012 [34] report released this year reveals a mixed bag of amazing progress and underachievement.

The report --- the World Health Organization [35]'s (WHO) annual compilation of health-related data for its 194 Member States --- includes a summary of the progress made towards achieving the health-related Millennium Development Goals [36] (MDGs) and associated targets.

Countries have achieved amazing success in some areas and little or no progress in others. Here are some highlights:

(This blog post was originally posted on Global Health Council's Global Health Magazine blog [40].)

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

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.