health information

 {Photo credit: Niranjan Konduri/MSH}While the transition to digital case management might seem to be simple, health workers in low- and middle-income countries, like Ukraine, are challenged by a lack of basic technologies.Photo credit: Niranjan Konduri/MSH

[Niranjan Konduri]Niranjan KonduriMotivated frontline health workers play a key role achieving global strategies to fight tuberculosis (TB), writes MSH Principal Technical Advisor Niranjan Konduri, of USAID's Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program, for The Lancet Global Health Blog. Using the story of Irina Chaban, a Ukrainian TB doctor, as an example, Konduri highlights the challenges health workers in low- and middle-income countries must overcome while working to eradicate TB.

"While the transition to digital case management might seem to be a simple solution, [health workers like Chaban] are challenged by a lack of basic technologies that are taken for granted in higher-income countries," Konduri says.

 {Photo by: <a href="https://www.flickr.com/photos/nyayahealth/7157522726/">Possible</a> <a href="https://creativecommons.org/licenses/by/2.0/">CC BY</a>}A female health volunteer surveys women to gather data in Nepal. Better health information is vital to achieving health goals.Photo by: Possible CC BY

In many developing countries, true life-and-death decisions hinge on information that’s old, unreliable or both.

Without strong national capacity for data collection, health officials are left in the dark when monitoring outbreaks of diseases like Ebola or trying to improve care for cancer patients. Many countries are unable to produce an accurate picture of their progress toward universal health coverage (UHC) or even assess their starting point.

Meanwhile, the global health community has rallied behind ambitious sustainable development goals for the post-2015 era, an agenda that adopts new priorities like achieving UHC and addressing noncommunicable diseases alongside updated targets for the health-related Millennium Development Goals. Delivering on the Sustainable Development Goals (SDGs) for health foresees countries’ taking increased ownership over health priority-setting and program implementation.

 {Photo credit: MSH/Paula Champagne}Participants of "Medicines as Part of UHC: Starting a Dialogue".Photo credit: MSH/Paula Champagne

What do medicines, financing, governance, and management have in common?

They are all essential pieces of the puzzle that must come together in order to make universal health coverage (UHC) a realizable goal.

From June 2-4, 2013, Management Sciences for Health (MSH), in collaboration with the Rockefeller Foundation and Harvard Medical School’s Department of Population Medicine, and additional support from the Pan American Health Organization (PAHO) and the US Agency for International Development (USAID), brought representatives of countries working towards UHC, private insurance schemes, and medicines and financing experts from across the globe to start a dialogue around medicines coverage under UHC.

Dr. Jonathan Quick, MSH’s President and CEO opened the event: “UHC is about filling the tragic gaps that exist in health systems around the world: gaps in access, in affordability, and health needs that go unanswered.”

{Photo credit: KNCV/TB CARE I}Photo credit: KNCV/TB CARE I

TB CARE I Indonesia, The Global Fund to Fight AIDS, Tuberculosis and Malaria, and Indonesia’s National TB Program (NTP) organized a mass-mobilization World TB Day event on March 24, 2013, called "Run 4 TB".

This 5K race drew thousands of runners, bikers, walkers, and observers.

(Photo credits: KNCV/TB CARE I)

Dr. Jonathan Quick, President and CEO of MSH, tours with Dr. Christian Nzitimira, director of Kibagabaga Hospital in Rwanda. {Photo credit: Jon Jay/MSH.}Photo credit: Jon Jay/MSH.

In a postoperative ward of Kibagabaga Hospital, the district hospital serving Rwanda’s capital city of Kigali, Eric Bizimana sits up in bed. Bizimana, 25, had sought care after severe pain in his right leg forced him to stop work as a barber. He was diagnosed with a bone infection called osteomyelitis. Antibiotics alone couldn’t clear the infection. Without an operation to remove the diseased bone, Eric faced the possibility of losing his leg.

Eric was one of the 40 patients who enter Kibagabaga for surgery every day. In Rwanda’s tiered healthcare delivery system, patients are referred from local health centers up to the district hospital when their conditions require more complex care. Most babies are delivered at health centers, for example, but a woman suffering complications or who was expected to need a C-section would be referred to the district level.

A group of young men in Mwene Ditu discuss using a cell phone to access health information. {Photo credit: Overseas Strategic Consulting, Ltd.}Photo credit: Overseas Strategic Consulting, Ltd.

Mobile phones are being used increasingly throughout Africa to improve health. The USAID-funded Democratic Republic of Congo-Integrated Health Project (DRC-IHP) is using mobile phone technology to increase the number of people referred to health centers in the project’s 80 targeted health zones. In Mwene Ditu, project staff observed that low numbers of referrals to health centers would be improved by increasing communication—within the community, between the community and health service providers, and among provincial health officials.

Lisa Peterson, Deputy Chief of Mission, US Embassy, Yaoundé, Cameroon. {Photo courtesy of US Embassy Yaoundé.}Photo courtesy of US Embassy Yaoundé.

Formally launched in 2012 in Cameroon, the USAID-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program, led by Management Sciences for Health, has been working on strengthening the overall pharmaceutical management system, specifically to ensure the people of Cameroon have access to safe and affordable medicines at the central and peripheral levels.

In a new podcast, US Deputy Chief of Mission in Cameroon Lisa Peterson discussed SIAPS’ important work in the country and how it will impact the local population.

"The program will help, I believe, bring people to clinics. It will help definitely ensure that when people get to a clinic, they are able to access medicines and medical supplies that they need," Ms. Peterson said.

Trying to cross through a flooded section of road in South Sudan. {Photo credit: E. Polich/MSH.}Photo credit: E. Polich/MSH.

“We’re going to try to drive through that?”

After spending nearly two years working in South Sudan, I was on my way with two colleagues to one final meeting. The USAID-funded second phase of the Sudan Health Transformation Project (SHTP II), led by Management Sciences for Health (MSH), ended activities on July 31, 2012, and three of us needed to travel 360 kilometers (220 miles) to a results dissemination meeting. A flight booking mishap meant we had no choice but to drive --- during rainy season.

With a key bridge washed out.

And it rained --- down poured --- for over an hour the morning we left.

After passing several toppled trucks, overtaking pickups irrevocably mired in mud, and crossing through a river, we came across the point where I uttered the above quote (“We’re going to try to drive through that?”).

K4Health Knowledge Management/Health Systems Strengthening Conceptual Framework. {Image credit: MSH.}Image credit: MSH.

Cross-posted from the K4Health blog

No matter which health system building block you are trying to improve, you need specific data, information, and knowledge to inform your decision-making process—this is where good knowledge management comes in handy.

The Intersection of Knowledge Management and Health Systems Strengthening: Implications from the Malawi Knowledge for Health Demonstration Project” provides an interesting case study of the connection between improved knowledge management and health systems strengthening.

Senegal {Photo credit: Galdos/MSH.}Photo credit: Galdos/MSH.

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

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

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