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A broken health system is a silent killer. It results in more illness and death despite the fact that the public health and medical knowledge exists to greatly reduce illness and save millions of lives every year, especially in developing countries. What is missing is the leadership capacity to ensure that the management systems are in place to apply and scale up this knowledge.

An Open Mind and a Hard Back: Conversations with African Women Leaders is a summary of interviews conducted with over a dozen women leaders from Burkina Faso, Democratic Republic of the Congo, Liberia, Mauritius, Nigeria, Rwanda, Senegal, Seychelles, Sierra Leone, Swaziland, Uganda, and Zambia.

This quarterly bulletin provides information on the activities of the Integrated Health Systems Strengthening Project (IHSSP). Funded by USAID and led by Management Sciences for Health, IHSPP combines evidence-based approaches, proven service delivery strategies, and extensive public health expertise to support the Rwandan Ministry of Health in building its health system. In this issue:

Drawing on their experience in a range of developing countries, including 20 years of long-term experience in Afghanistan, Cambodia, Indonesia, and the Philippines, Steve and Cathy Solter identify 10 important lessons about assisting ministries of health Pursuing true country ownership for effective programs requires a long-term approach involving persistence, patience, keen understanding of counterparts’ perspective, deference, building of trust, focus on priorities, technical competence, and sustained optimism.

The Multidrug Resistant Tuberculosis (MDR-TB) Cost Effectiveness Analysis Tool is a simple, user-friendly, generic tool that is allows countries to compare the cost-effectiveness of different MDR-TB diagnoses and treatment methods. The tool builds on previous studies about MDR-TB control cost-effectiveness and WHO guidelines on TB control costs and cost-effectiveness.

The themes emerging from this collection are straightforward and within our grasp. To be sure, there is an urgent need to strengthen earlier diagnosis of newborns to identify exposed and infected children and strategies for getting those children into HIV care and treatment services sooner than has been the norm.

Chronic diseases—including cancers, diabetes, cardiovascular diseases, and asthma—represent a rising health burden in developing countries. Of the 36-million annual chronic disease deaths, 80 percent occur in low- and middle-income countries. Eight million of these deaths are preventable through changes in lifestyle and access to quality, affordable health services.

The Ministry of Health’s Pharmacy Division and the Securing Ugandans’ Right to Essential Medicines (SURE) program developed the  Supervision, Performance Assessment, and Recognition Strategy (SPARS) to increase health workers’ ability to manage medicines through on- the-job training and support from a new cadre of Medicines Management Supervisors (MMS).

Ugandan daily newspaper, New Vision reports: Drug dealers and pharmacies have a two-year grace period to style up and meet the required good pharmaceutical practice or face closure.  This follows announcement by the health minister that all public sector pharmacies will be subjected to inspection just like the private sector.State minister for health in charge of general duties, Dr.

Prepared by the AIDSTAR-Two project, this technical brief presents the results of an extensive literature and tools review conducted in 2009 that identified critical needs in the area of capacity building, including improved monitoring and evaluation, increased focus on basing capacity building programs on assessment, and wider dissemination of tools and approaches.

Prepared by the USAID-funded AIDSTAR-Two project, this technical brief explores the types and causes of typical implementation challenges faced by local implementing organizations, and shares some promising practices and stories from the field that demonstrate the results of effective implementation of capacity building interventions by civil society organizations.

Prepared by the USAID-funded AIDSTAR-Two project, this technical brief discusses country ownership in the context of organizational capacity building in public institutions and civil society organizations in the health sector.

This technical brief developed by the AIDSTAR-Two project examines a specific cadre of health workers, child and youth care workers.

Santé pour le Développement et la Stabilité d’Haïti (SDSH) has helped over one million people receive HIV tests and learn their status. Every year SDSH made it possible for over 13,000 women to deliver their child with assistance from a facility- based, skilled provider, and has reached more than half a million children each year with nutrition services.

The Gender in Health Governance Tool is a simple survey that governance decision-makers should read prior to making a substantive decision. After the decision has been made, you can then use the tool to test how gender-responsive you were in your decision making process.  

This resource was designed to help Kenyan civil society organizations (CSOs) working in the health sector to become more effective, efficient, results oriented, and sustainable.

This report documents the lessons learned from the regional meeting on “Using Mobile Technology to Improve Family Planning and Health Programs” held in Dar es Salaam, Tanzania from November 12-16, 2012.

All medicines carry some risk of adverse events; although certain risks are identified when medicines are tested during clinical trials, others aren’t recognized until after the medicine is on the market and has been used in “real world” settings.

According to the World Health Organization (WHO), cancer is one of the leading causes of death worldwide; in 2008, it accounted for approximately 7.6 million deaths (13 percent of all causes of death). More than 70 percent of all cancer deaths occurred in low- and middle- income countries (LMICs).

To be better leaders, we must be better people, take actions that bring us closer to our communities, and use the best management tools and strategies available. The Guide for Training Community Leaders to Improve Leadership and Management Practices is designed for individuals, teams of managers, or institutions from the public health sector and other sectors of civil society that work a

A major strategy for preventing transmission of HIV and other STIs is the consistent use of condoms during sexual intercourse. Condom use among youths is particularly important to reduce the number of new cases and the national prevalence. Although a number of studies have established an association between condom use at one’s sexual debut and future condom use, few studies have explored this association over time, and whether the results are generalizable across multiple locations. This multi time point, multi district study assesses the relationship between sexual debut and condom use and consistent use of condoms thereafter. Uganda has used Lot Quality Assurance Sampling surveys since 2003 to monitor district level HIV programs and improve access to HIV health services. This study includes 4518 sexually active youths interviewed at five time points (2003–2010) in up to 23 districts located across Uganda. Using logistic regression, we measured the association of condom use at first sexual intercourse on recent condom usage, controlling for several factors including: age, sex, education, marital status, age at first intercourse, geographical location, and survey year. The odds of condom use at last intercourse, using a condom at last intercourse with a non-regular partner, and consistently using a condom are, respectively, 9.63 (95%WaldCI = 8.03–11.56), 3.48 (95%WaldCI = 2.27–5.33), and 11.12 (95%WaldCI = 8.95–13.81) times more likely for those individuals using condoms during their sexual debut. The results suggest that HIV prevention programs should encourage condom use among youth during sexual debut. Success with this outcome may have a lasting influence on preventing HIV and other STIs later in life.

Abstract The Philippines is one of the highest tuberculosis (TB) burden countries in the world with nationwide coverage of directly observed treatment, short-course (DOTS) achieved in 2003. This study reports on the National TB Control Programme (NTP) surveillance data for the period 2003 to 2011.

South Sudan has borne the brunt of years of chronic warfare and probably has the highest malaria burden in sub-Saharan Africa. Malaria is the leading cause of morbidity and mortality in the country. This nationally representative survey aimed to provide data on malaria indicators at household level across the country. The observed high malaria prevalence could be due to low levels of coverage and utilization of interventions coupled with low knowledge levels. Therefore, access and utilization of malaria control tools should be increased through scaling up coverage and improving behaviour change communication.

Effective surveillance systems are required to track malaria testing and treatment practices. A 26-week study “SMS for Life” was piloted in five rural districts of Kenya to examine whether SMS reported surveillance data could ensure real-time visibility of accurate data and their use by district managers to impact on malaria case-management. The study demonstrated the feasibility of using simple mobile phone text messages to transmit timely surveillance data from peripheral health facilities to higher levels. However, accuracy of data reported was suboptimal. Future work should focus on improving quality of SMS reported surveillance data.

Abstract An increasing number of countries are exploring the introduction or expansion of autonomous hospitals as one of the numerous health reforms they are introducing to their health system. Hospital autonomy is one of the forms of decentralization that is focused on a specific institution rather than on a political unit.

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