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Strong leadership and management skills are crucial to finding solutions to the human resource crisis in health. Health professionals and human resource (HR) managers worldwide who are in charge of addressing HR challenges in health systems often lack formal education in leadership and management. Management Sciences for Health (MSH) developed the Virtual Leadership Development Program (VLDP) with support from the United States Agency for International Development (USAID). The VLDP is a Web-based leadership development programme that combines face-to-face and distance-learning methodologies to strengthen the capacity of teams to identify and address health challenges and produce results. The USAID-funded Leadership, Management and Sustainability (LMS) Program adapted the VLDP for HR managers to help them identify and address HR challenges that ministries of health, other public-sector organizations and nongovernmental organizations are facing. Three examples illustrate the results of the VLDP for teams of HR managers: (1) the Uganda Protestant and Catholic Medical Bureaus; (2) the Christian Health Association of Malawi; and (3) the Developing Human Resources for Health Project in Uganda.

A presentation delivered at the Union World Conference on Lung Health 2012 in Kuala Lumpur, Malaysia.  Presentation Outline Background ChallengestoimplementingTBservices Interventionsapplied Results and lessons learned Recommendations Conclusion   

The aim of the present study was to indentify the epidemiological factors of drug-resistant (DR TB) patients in the northern part of Bangladesh. A cross-sectional study was conducted of registered DR TB patients at two chest diseases hospitals. The present study demonstrated that males (68.9%) were more affected by DR TB than females (31.8%).This study suggested that sex, age, type of treatment, residence, education and smoking status were important factors for getting MDR TB. It is expected that this study can help government to take activities for controlling and prevent MDR TB disease.

We assessed a participatory community and health system intervention to reduce the prevalence of disrespect and abuse during childbirth in Tanzania. After implementation of the combined intervention, the likelihood of women’s reports of disrespectful treatment during childbirth was substantially reduced. These results were observed nearly 1 year after the end of the project’s facilitation of implementation, indicating the potential for sustainability. The results indicate that a participatory community and health system intervention designed to tackle disrespect and abuse by changing the norms and standards of care is a potential strategy to improve the treatment of women during childbirth at health facilities.

TB data for 2015 were combined with cost data using a simple type of cost-benefit analysis in a decision tree model to show the economic burden under different scenarios. In Indonesia, there were an estimated 1, 017,378 new active TB cases in 2015, including multidrug-resistant TB. It is estimated that 417,976 of these cases would be treated and cured, 160,830 would be unsuccessfully treated and would die, 131,571 would be untreated and would achieve cure spontaneously, and 307,000 would be untreated and would die. The total economic burden related to treated and untreated cases would be approximately US$6.9 billion. Loss of productivity due to premature death would be by far the largest element, comprising US$6.0 billion (discounted), which represents 86.6% of the total cost. Loss of productivity due to illness would be US$700 million (10.1%), provider medical costs US$156 million (2.2%), and direct non-medical costs incurred by patients and their households US$74 million (1.1%). The economic burden of TB in Indonesia is extremely high. Detecting and treating more cases would result not only in major reductions in suffering but also in economic savings to society.

Launched in 1999, Community-Based Health Insurance (CBHI) in Rwanda has reached extensive coverage for health care services. CBHI was developed by the Government of Rwanda in response to a drop in the use of health services after the reintroduction of user fees in 1996.

A Toolkit for Using Evidence from the State of the World’s Midwifery 2014 Report to Create Policy Change at the Country Level

To determine if children presenting without complaints related to the Integrated Management of Childhood Illness (IMCI) are at greater risk for suboptimal screening for IMCI conditions, we randomly sampled and observed 3072 sick child visits in 33 provinces of Afghanistan. The study indicated that children with non-IMCI complaints are at greater risk of suboptimal screening compared to children with IMCI-related complaints. We concluded that facility and provider capacity needs to be improved, particularly during training, supervision and guideline dissemination, to ensure that all children receive routine screening for common IMCI conditions.

Purpose: To examine the effectiveness of stock monitoring and record-keeping practices in warehouses and help users identify suggestions for improvement.

Purpose: To allow effective, rapid, inexpensive, large-scale, decentralized implementation of health programs and projects. Intended Users: Ministry of Health (MOH) at central, provincial, and district level, non-government organizations (NGOs), hospitals, and any organizations or groups responsible for program implementation within a decentralized health care system. Description:

The International Medical Products Price Guide (formerly International Drug Price Indicator Guide) contains a spectrum of prices from pharmaceutical suppliers, international development organizations, and government agencies.

We implemented a group randomized controlled trial in 24 reproductive and child health clinics in eight districts in Mbeya region. Three months pre-intervention, we identified 1924 and 1226 patients established on antiretroviral therapy for six months or more in intervention and control clinics, respectively, of whom 83.4% and 86.9% had one or more post-intervention visits. The unadjusted rate of missed visits declined from 36.5% to 34.4% in intervention clinics and increased from 38.9% to 45.5% in control clinics following the intervention. Interrupted time series analyses demonstrated a net decrease of 13.7% (95% CI [-15.4,-12.1]) for missed visits at six months post-intervention. Similar differential changes were observed for visits missed by 3, 7, 15, or 60 days. Appointment-tracking and community outreach significantly improved appointment-keeping for women on antiretroviral therapy. The facility staff controlled their workload better, identified missing patients rapidly, and worked with existing community organizations. There is now enough evidence to scale up this approach to all antiretroviral therapy and Option B+ reproductive and child health clinics in Tanzania as well as to evaluate the intervention in medical clinics that treat other chronic health conditions.

Uganda’s Ministry of Health in 2012 implemented a comprehensive strategy (SPARS) to build medicines management capacity in public sector health facilities. The approach includes supportive supervision. This structured observational study assesses supportive supervision competency among medicines management supervisors (MMS). The study used structured observations of two groups of five purposely selected MMS—one group supervising facilities with greater medicines management improvement during one year of SPARS and one group with less improvement, based on quantitative metrics. Our results suggest that MMS’ supportive supervision competency is positively related to the SPARS effectiveness scores of the facilities they supervise. We recommend strategies to strengthen supportive supervision behaviors and skills.

MSH authors have published a number of journal articles describing the accredited drug seller implementation experience and lessons learned in Tanzania—home of the flagship ADDO program. A new compendium reviews highlights ranging from robust multi-method quantitative to informative qualitative research. 

Managing Drug Supply (MDS) is the leading reference on how to manage essential medicines in developing countries. MDS was originally published in 1982. It was revised in 1997 with over 10,000 copies distributed in over 60 countries worldwide.

The Management of Medicines Benefit Programs in Low- and Middle-Income Settings manual serves as a primer for managers, government officials, or consultants who are tasked by a government, health insurance plan, or other institution with designing or implementing a medicines benefit program.

Lessons From a Quality Improvement Approach in Uganda

Due to its link to various complications during and after pregnancy, the prevention of malaria among pregnant women is regarded as an important strategy for reducing mortality and adverse maternal and neonatal health outcomes, such as maternal anemia, low birth weight, and perinatal deaths. 

Reducing the burden of malaria in Uganda is a priority for The National Malaria Control Program. While significant strides have been made, some components have not progressed to the same extent, including addressing malaria in pregnancy. This assessment was undertaken by the ASH project to examine facility-based factors that influence the coverage of IPTp among pregnant women.

Due to its link to various complications during and after pregnancy, the prevention of malaria among pregnant women is an important strategy for reducing mortality and adverse maternal and neonatal health outcomes, such as anemia, low birth weight, and newborn death.  

The Leadership Development Program Plus (LDP+) is the enhanced version of the Leadership Development Program (LDP) first delivered by Management Sciences for Health (MSH) in 2002.

A Conference on Epidemic Preparedness November 13, 2017 The Joseph B. Martin Conference Center I Harvard Medical School

Several recent studies have attempted to measure the prevalence of disrespect and abuse (D&A) of women during childbirth in health facilities. Variations in reported prevalence may be associated with differences in study instruments and data collection methods. This systematic review and comparative analysis of methods aims to aggregate and present lessons learned from published studies that quantified the prevalence of D&A during childbirth.

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