vaccines

World Hepatitis Day is commemorated July 28. {Photo credit: C. Urdaneta/MSH, Afghanistan.}Photo credit: C. Urdaneta/MSH, Afghanistan.

Hepatitis is a personal disease for me.  Some years ago, I spent two weeks leading training workshops for faculty at the University of Costa Rica in San Jose, Costa Rica. The work and the participants were delightful, as we worked together to improve medicine prescribing practices. Every day I ate lunch at a local seafood restaurant, often joined by a colleague. One Friday, two weeks after returning home, I felt exhausted—so tired that I could not continue working. By Sunday I was orange as a pumpkin, unable to walk or keep food down. I visited my physician and was diagnosed with acute, severe hepatitis A. I felt like I was dying. I lost 6 weeks of work and 25 pounds before I was able to return to normal functioning. I discovered that the colleague who had joined me for lunch developed hepatitis A with the same intensity and duration, and at the same time.  We traced this “point source outbreak” to some uncooked mussels that the restaurant used in a fish sauce that transmitted the hepatitis A virus to us both.

DRC. {Photo credit: Warren Zelman}Photo credit: Warren Zelman

Millions of girls in developing nations will avoid getting a deadly form of cancer---cervical cancer---due to a major drop in costs for two vaccines against cervical cancer. Merck and GlaxoSmithKline announced May 9 that costs for the vaccines against human papillomavirus (HPV) would be cut to below $5 per dose.

Over 275,000 women die from cervical cancer per year in poor countries.

Merck’s Gardasil vaccine will cost $4.50 per dose and GlaxoSmithKline’s Cervarix will cost $4.60 per dose. The costs were negotiated through the GAVI Alliance (see infographic).

This is welcome news, with cancers and other chronic diseases becoming one of global health’s biggest challenges, moving towards the post-Millennium Development Goals era.

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.

Three Afghan children. {Photo credit: MSH.}Photo credit: MSH.

About 7.6 million children under age five die each year of preventable causers; 3 million — 40 percent — are newborns (under 28 days old). Ninety-nine percent of these occur in developing countries; three-quarters are mainly due to preventable causes such as neonatal conditions, pneumonia, diarrhea, malaria, and measles. Many of these under-five deaths could be averted by known, affordable, low-technology interventions.

Any preventable child death is one too many.

Here are 10 important interventions for child survival --- a list that is by no means exhaustive:

  1. Exclusive breastfeeding

    Could keep 1.3 million infants from dying (including by preventing pneumonia)

  2. Long-lasting, insecticide-treated bednets

    Would save more than 500,000 children by preventing malaria

  3. Vaccines, such as PCV, Hib, and rotavirus

    Would help prevent common childhood illnesses, such as measles, and save children’s lives

  4. Micronutrient supplements, such as vitamin A and zinc

    Would fight malnutrition. (While not a direct cause of death, malnutrition contributes indirectly to more than one-third of these deaths.)

Nator Namunya, 6-months old, receives a vaccination in Kapoeta North County. Credit: Save the Children.

 

A version of this post originally appeared on the Save the Children website.

The healthcare system in South Sudan is struggling to get on to its feet after the devastation of over 20 years of war. The biggest killers of children in southern Sudan are malaria, diarrhea and respiratory infections. These preventable diseases can be easy to treat. But, on average, only one in four people in South Sudan are within reach of a health center. Only 3 percent of children under two in South Sudan are fully immunized against killer diseases and only 12 percent of families have a mosquito net in their home.

A child born in Ghana today will most likely receive a full schedule of immunizations, and her chances of surviving past the age of five are far better than they were a decade ago. Today Ghana boasts a coverage rate for infant vaccination of 90 percent and hasn’t seen an infant die of measles since 2003.

Ghana has been expanding primary health care by bringing services to people’s doorsteps since the 1980s, and since the early 2000s has done so in the context of a commitment to universal health coverage. The secret to its success in child immunization has been both integration and decentralization of health services: Government funding for all health activities is provided through a "common pot." District-level managers are responsible for local budgeting and service delivery. Local staff provide comprehensive rather than specialized care.

Ghana is one of a growing number of low- and middle-income countries demonstrating that strong performance in immunization can go hand-in-hand with the aspiration of universal health coverage, access for all to appropriate health services at an affordable cost.

One of many billboards erected in Juba, South Sudan, in anticipation of Independence day on July 9th, 2011 (Erin Polich/MSH)

MSH, leader of the the USAID-funded Sudan Health Transformation Project- II, is proud to congratulate South Sudan on their independence. The following blog post discusses the impact that independence will have on South Sudan’s health system and the challenges that still lie ahead.

It is 5:30 a.m. on a Thursday morning in the town of Mwene-Ditu, located in the Eastern Kasaï Province of the Democratic Republic of Congo. The skies are still dark as the crieur, the town crier, makes his rounds, calling out to the community that today is the start of the three-day national vaccination campaign against polio.

As the local residents begin their day, health workers are finalizing preparations for the massive door-to-door effort to immunize children under age five years old from this crippling disease. One such worker is Evariste Kalonji, a community mobilization specialist with the Integrated Health Project.

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