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In Nigeria, tuberculosis (TB) is a major public health problem and low case finding remains a challenge to its eradication. The USAID-funded Challenge TB project supports GeneXpert sites across the country. However sub-optimal GeneXpert utilization due to modular failures, power supply issues, and inadequate samples has contributed to low TB case finding.

Antimicrobial resistance (AMR) is one of the world’s most pressing and urgent global health threats —one that could erode gains against tuberculosis (TB), malaria, HIV/AIDS, and many other infectious diseases. While AMR has emerged as a critical issue at the global level, current efforts to address AMR are insufficient to curb its spread.

We are pleased to share this booklet that summarizes 10 of the best stories we’ve collected from the field. These narratives are a legacy to Madagascar’s health system and for future public health interventions in the country.

Tuberculosis (TB) remains a major public health problem in the regions of East, Central, and Southern Africa (ECSA). Because TB is an airborne disease, its transmission is facilitated by the movement of people across internal and national borders.

The primary goal of the Challenge TB (CTB) project in Afghanistan is to assist the NTP to reach its strategic objective of increasing TB case notifications by at least 8% annually through comprehensive TB care and prevention activities.

In high TB- and HIV-burden settings, the two diseases reinforce each other and share common risk factors. Single, categorical services provided to persons with multiple, related risk factors miss opportunities to diagnose, treat, and prevent TB and/or HIV.

Bangladesh is one of the world’s high tuberculosis (TB) burden countries. According to World Health Organization’s 2017 Global TB Report, 38% of drug-sensitive and approximately 84% of drug-resistant patients are undiagnosed or unreported. The most infectious TB patients are these missing cases.

Ethiopia is one of the most populous countries in Africa with a high TB burden across a wide geography. The national TB program has reached hundreds of thousands of cases and successfully treated them. However, health authorities believe that a third of cases have been missed in the community, development corridors, industries, and crowded settings, such as universities.

The Technical Support Services Project (TSSP) worked with the Tanzania Ministry of Health, Community Development, Gender, the Elderly, and Children (MoHCDGEC) to support and strengthen the Star Rating Assessment (SRA) Tool system. The project integrated HIV/AIDS indicators into the tool to create more comprehensive assessments of the country’s health care facilities. 

In collaboration with the USAID-funded Rwanda Health Systems Strengthening Project and partners, Rwanda’s Ministry of Health introduced the Workload Indicator of Staffing Needs (WISN) tool in all public district and provincial hospitals in the country.

A key challenge identified by a study on health sector staff retention, conducted by the USAID-funded Rwanda Health Systems Strengthening Project in 2017, was the lack of access to credit at a reasonable interest rate from commercial banks for building a home, purchasing essential items or meeting emergency expenses.

In collaboration with the Ministry of Health and other health sector stakeholders, the USAID-funded Rwanda Health Systems Strengthening Project conducted many interventions aimed at improving the performance of the health system at all levels.

In Rwanda, the Ministry of Health has committed to providing universal access to health services and improving the quality of care. An important factor that impacts quality and access to care is the amount of time patients wait to see providers at health facilities.

Launched and administered with support from the USAID Rwanda Health Systems Strengthening Project, the District Operational Research Challenge Fund aims to build and grow the capacity of MOH’s district hospital staff and young health researchers to conduct research and implement sustainable public health programs.

In 2000, the Government of Rwanda decentralized health and other services to the district level. After nearly two decades of progressively taking on responsibilities for the health sector, district leaders are demonstrating stronger ownership of health initiatives.

One of the most successful interventions designed to provide universal health coverage to the citizens of Rwanda has been the establishment of the Community Based Health Insurance (CBHI) Scheme. This provides a basic package of primary care and referral services through a wide network public and some private health facilities at an affordable cost for those who can pay.

The Rwanda Medical Procedure Coding (RMPC) system was developed by Rwanda’s Ministry of Health, with technical assistance from the USAID-funded Rwanda Health Systems Strengthening Project, to harmonize procedure coding with an international standard.

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