rural

{Photo credit: Warren Zelman, Democratic Republic of the Congo}Photo credit: Warren Zelman, Democratic Republic of the Congo

This post originally appeared on the Frontline Health Workers Coalition blog.

I grew up in a village in northwestern Democratic Republic of the Congo (DRC), and although I’m now a doctor and live in Kinshasa, I remember those days well.

I know what it’s like to live 23 kilometers from the nearest health center and to navigate forests and floods to get there. I know how a lack of something simple like antibiotics can cause a quick death. I’ve lost many peers from the village over the years and a lot of family members.

In fact, that’s why I became a physician.

 {Photo credit: MSH}A woman and her child consult with an ADDO dispenser in Tanzania.Photo credit: MSH

Cross-posted with permission from the Bill & Melinda Gates Foundation Blog, Impatient Optimists.

Primary health care has many different definitions, but can be defined simply as the first place where people seek care. Within this definition, private sector providers constitute an important source of primary health care in many parts of the world.

Private providers of primary health

Private providers can run the spectrum–from private hospitals, pharmacies, and non-profit clinics, to informal providers such as faith-based healers and drug shops. A 2013 review suggests that informal providers account for as much as two-thirds of health care visits in Bangladesh and Thailand, and a substantial percentage of visits in Nigeria and Kenya as well.[1]

 {Photo Credit: Abel Helebo/MSH.}Silenat with her three-year-old child, her husband Yirga, and Tadele, a TB focal person at the Keraniyo Health Center.Photo Credit: Abel Helebo/MSH.

Silenat Yihune, a 40-year-old woman, mother, and housewife, lives in a remote region of Huletejuenesie District, Ethiopia, which is approximately 20 kilometers from the closest health facility. For nine months Silenat suffered from a cough, chest pain, fever, and weight loss, but was unable to receive treatment. As is common among Ethiopian families, Silenat was economically dependent upon her husband. He refused to pay for her travel to the distant health facility. Several months later, Silenat’s husband, Yirga, started to show similar symptoms and visited the Keraniyo Health Center, where he was diagnosed with tuberculosis (TB).

Keraniyo Health Center is one of the health facilities in Huletejunesie district supported by the PEPFAR-funded, USAID project, Help Ethiopia Address Low TB Performance (HEAL TB), led by Management Sciences for Health (MSH).

A community-based distribution agent discusses family planning options with a family in the DRC health zone of Ndekesha. {Photo credit: MSH.}Photo credit: MSH.

Cross-posted from Frontline Health Workers Coalition.

Evidence of the need to scale up the number of frontline health workers in developing countries abounds throughout sub-Saharan Africa, as described in a recent post on the Frontline Health Workers Coalition blog by Avril Ogrodnick of Abt Associates. Yet training new health workers is not sufficient, in itself, to sustainably address the crisis: governments must also invest in providing management support to harvest the full value of these trainings.

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