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National Essential Medicines lists (EMLs) indicate medicines that meet the priority health needs of the population and often guide a government’s purchasing and distribution decisions for public health facilities.

A key element of successful tuberculosis (TB) control programs is adherence to treatment, and this is a cornerstone of most international and national policies and guidelines. Non-adherence is often due to patient-related factors but can also be a result of provider issues, such as stock-outs of TB medicines.

Purpose: The Quality Assurance Manual can be used by national, state or local level health institutions to evaluate the quality of health services at service delivery sites, to determine whether they meet predetermined quality standards in order to be accredited.

The objective of this study was to implement a rapid assessment of the performance of four malaria control strategies (indoor spraying, insecticide-treated bed nets, timely diagnosis, and artemisinin-based combination therapy) using adequacy criteria. The assessment was carried out in five countries of the Amazon subregion (Bolivia, Colombia, Ecuador, Guyana, and Peru). Although ACT is the strategy with the better implementation in all countries, major gaps exist in implementation of the other three malaria control strategies in terms of technical criteria, coverage and quality desired. The countries must implement action plans to close the gaps in the various criteria and thereby improve the performance of the interventions. The assessment tools developed, based on adequacy criteria, are considered useful for a rapid assessment by malaria control authorities in the different countries.

Over the past two decades, Ethiopia has improved its delivery of primary health care services and begun to make great progress toward meeting the Millennium Development Goals, particularly with regard to maternal, newborn, and child health and the prevention and control of HIV and tuberculosis.

Final Report: Help Ethiopia Address Low TB Performance (HEAL TB) Project 2011–2016

A Review of SIAPS’ Activities in Eight Countries The USAID-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program has published the results of its activities in eight countries (Angola, Burundi, the Democratic Republic of the Congo (DRC), Ethiopia, Kenya, Guinea, Mali, and South Sudan) to control malaria.

Health Systems in Action: An eHandbook for Leaders and Managers is an electronic resource that provides managers of health programs or health services with both practical and theoretical information to help strengthen and align the building blocks of a health system.

The Human Resource Management (HRM) Rapid Assessment Tool offers a method for assessing an organization’s human resource management system and how well it functions. This tool helps users to develop strategies to improve the human resource management system and make it as effective as possible. It is designed to be used in public and private health organizations.

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.

The community-based health insurance (CBHI) scheme launched by the Government of Rwanda (GoR) reached 91% of the population in 2010, starting from 7% in 2003. Initially, all CBHI members paid the same fees, regardless of their personal income, and the poorest citizens faced challenges in paying premiums (almost US$1.50 per person). A mechanism was thus urgently needed to guarantee access to health care for the most vulnerable and promote equity among members. The GoR decided to introduce a stratification system based on the socioeconomic status of the population. Together with partners, including the Integrated Health Systems Strengthening Project (IHSSP), the GoR developed a national database that stratifies Rwandan citizens by income. To date, more than 10 million residents’ records, representing 96% of Rwanda’s population, have been entered into the database. This database helped identify the most vulnerable based on socioeconomic status (about 25% of the population). Identification of the poorest among the population has allowed an increase in CBHI funds due to identification of individuals who have a greater capacity to pay. The database thus improved the financial viability and management capacity of the CBHI scheme.

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

At the beginning of the HEAL TB project in 2011, culture and drug susceptibility testing (DST) using solid media was available to the program in two regions to detect drug-resistant tuberculosis (DR-TB) and for monitoring treatment response, which made identifying drug- resistance patterns possible and allowed health care workers to provide more appropriate drug treatment for DR-TB patients.

In Bangladesh tea and rubber garden workers and indigenous communities live in isolated areas with difficulties to access government health facilities. In addition, the level of poverty of some of these groups put them at risk of getting TB.

GeneXpert has revolutionized the diagnosis of tuberculosis (TB) and drug resistant TB (DR-TB) by effectively detecting M. tuberculosis in clinical specimens and RMP resistance in less than two hours without sophisticated laboratories. This enables patients to begin treatment for rifampicin resistant TB on the same day, rather than after several months of ineffective treatment.

Challenge TB was implemented in Ethiopia as part of Management Sciences for Health’s (MSH’s) Innovation Challenge Fund (INCH)2 initiative designed to encourage innovative interventions across MSH supported projects. MSH used the ExpandNet Framework3 to scale up the innovation.

Afghanistan faces a burden of tuberculosis (TB) among the highest in the world, according to the World Health Organization (WHO). An estimated 60,000 new cases arise yearly, with 110,000 Afghans now living with TB; 14,000 Afghans died from the disease in 2015. Only about two in three presumed patients are found, and the treatment success rate is only 49 percent on average in the country.

Together with Borena and Guji zonal health department and the Oromia Regional Health Bureau (RHB), MSH, through the HEAL TB project (December 2015-June 2016) and now through Challenge TB (December 2016-present), identified six districts within the mining areas. Six woreda coordinators were trained and deployed to coordinate case finding and treatment observation.

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.

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