Health Systems Strengthening

Health Systems Strengthening (HSS)
{Photo credit: Julius Kasujja}Photo credit: Julius Kasujja

This op-ed was originally published in The Hill.

Along with the Ebola outbreak that’s already infected more than 1,600 people, the Democratic Republic of the Congo (DRC) is fighting another battle: An epidemic of fear and mistrust. Community members are afraid to seek treatment, including a promising experimental vaccine.

Meet Hortense Kossou, Principal Technical Advisor for the USAID-funded Integrated Health Services Activity (IHSA) in Benin. Hortense previously served as the national malaria coordinator for the Ministry of Health in Benin and today leads IHSA’s malaria-related activities on the ground. In this issue of Leading Voices, she presents the challenges that the country faces in its fight against malaria and the actions being taken to combat it.

Malaria is the leading cause of mortality among children under five and morbidity among adults in Benin. How has the landscape changed since you first began working at the MOH in 1997?

There have been many changes between the 1990s and today. The Ministry of Health has implemented the newest technological innovations: for example, it has gone from providing untreated mosquito nets to providing long-lasting, insecticide-treated nets. Changes were also made to increase access to these products. Nets were first provided only to the most vulnerable groups, such as children under five; nowadays, there is broader coverage that includes all members of the population.

{Health Surveillance Assistant (Community Health Worker) recording data in health card at outreach clinic, Mulanje, Malawi, ONSE Health Activity} Health Surveillance Assistant (Community Health Worker) recording data in health card at outreach clinic, Mulanje, Malawi, ONSE Health Activity

This article was originally published by Global Health Now.

Paid or volunteer?

Community health workers are on the frontlines in many countries—and vital to achieving universal health coverage. Yet the public health community has not reached a consensus on which model is the best.

Consensus is urgently needed, both at the global and country levels, to inform future policies and strategies for strengthening health systems and delivering on UHC.

Based on our experiences in rural Peru and Ethiopia, it’s not either-or. It’s both.

Full-time, paid CHWs form the backbone of family- and community-based services, but there aren’t enough to reach all families. We envision teams of government-paid, full-time CHWs providing comprehensive services to a given population, with a primary health center hub as the base of operations. Each CHW, in turn, would lead a team of part-time community health volunteers providing limited health education and referral services—such as maternal and newborn health, nutrition, hygiene, tuberculosis, malaria, and HIV/AIDS—to a small number of neighboring families.

{Nurse Gabriella Oroma welcomes patients at Ngetta Health Centre in Uganda, where drug-resistant TB is treated. Photo credit: Sarah Lagot/MSH}Nurse Gabriella Oroma welcomes patients at Ngetta Health Centre in Uganda, where drug-resistant TB is treated. Photo credit: Sarah Lagot/MSH
By Dr. Ersin Topcuoglu
 
This op-ed was originally published in The Hill.
 
{Hawa Coulibaly Kone leads a workshop with partner NGO YA-G-TU to develop its strategic plan. Photo credit: MSH}Hawa Coulibaly Kone leads a workshop with partner NGO YA-G-TU to develop its strategic plan. Photo credit: MSH

Meet Hawa Coulibaly Kone, capacity building advisor and the representative on gender for the USAID-funded Keneya Jemu Kan (KJK) Project in Mali. Most recently, Hawa helped conduct a situational gender analysis of the KJK project and its partner organizations to assess the level of gender integration in the project design, implementation, and monitoring framework. The analysis found that KJK’s work with local partners across the country enabled the project to strengthen its institutional capacity in gender at the policy and programmatic levels and to respond to gender-related challenges.

We caught up with Hawa to learn more about how she and her team are working to break down barriers for women and build mutual trust among the project’s local partner organizations in Mali.

Tell us about your role and daily work on the KJK project in Mali

I joined the KJK project in August 2015. At first, it was a small team of two, myself and Hammouda, the senior technical advisor. I assisted in all activities, from developing plans and budgets to supporting activities for partners.

{Hospital pharmacy in Antananarivo, Madagascar. Photo Credit: Warren Zelman}Hospital pharmacy in Antananarivo, Madagascar. Photo Credit: Warren Zelman

This op-ed was originally published by Devex

Multidrug-resistant germs are spreading. A number of antibiotics and other antimicrobials already don’t work as they should, and as many as 700,000 people die each year because of it.

If we don’t act to contain antimicrobial resistance, it may kill up to 10 million more people yearly by 2050 and cumulatively cost patients and health systems across the globe up to $100 trillion. This crisis may start to seem insurmountable, like a vague scientific problem with no apparent solution. Many of us have contributed to it, and each of us will need to collaborate — as nations, organizations, and individuals — to solve it.

“Without tackling wasteful, inefficient, and irrational use of antimicrobials, we cannot contain AMR.” — Mohan Joshi, a principal technical adviser for Management Sciences for Health 

Photos by: Samy Rakotoniaina/MSH

In Malawi, over 80% of people live in rural areas. For many (10%), the nearest health center is more than 8 kilometers (5 miles) away, making it difficult to access health care regularly. The USAID-funded Organized Network of Services for Everyone’s (ONSE) Health Activity, led by Management Sciences for Health, works to improve quality and access to care in rural communities.

“Before we had a village clinic, we were struggling. For every little sickness, we had to rush to the hospital, especially with our small children.” – Assan Symon, Mitawa village health committee chairperson

Stanley Liyaya, a heath surveillance assistant (HSA), is one of 3,500 community health workers trained to manage childhood illnesses in rural communities. HSAs have improved access to care and treatment of childhood illness to help Malawi reduce the under-five child mortality rate by 73% between 1990 and 2015, achieving Millennium Development Goal 4. Malawi’s vision is that by 2021, all young children will be treated for common illnesses promptly in their own communities.

Pfizer Global Health Fellow, Jay Shetty, at the MSH office in Dar es Salaam, Tanzania. Photo Credit: Jonx Pillemer/Pfizer

Meet Jay Shetty, Analytics and Reporting Senior Manager in Pfizer’s New York office—and one of two amazing Global Health Fellows (GHFs) to have worked with MSH in Tanzania this year.

The Pfizer Global Health Fellows Program pairs colleagues with partner organizations like MSH for volunteer skills-sharing assignments. Over his six-month fellowship with MSH, Jay generously lent his professional experience and technical skills to the Tanzania Technical Support Services Project (TSSP) in Dar es Salaam. With TSSP, Jay focused on a health information system initiative, aimed at improving client management and health service delivery. Through the project, MSH is providing assistance to the Tanzania Ministry of Health in key technical areas to help control the HIV epidemic and sustain HIV-related health systems and services.

Could you tell me a bit about your background and what inspired you to pursue the Pfizer fellowship?

Yes, I've been working with Pfizer for the last 23 years, beginning as a consultant for almost 14 years in the business technology, project management area, then as a colleague since 2010. Currently, I work in the analytics and compliance reporting area, supporting business areas like clinical trials, publications teams.

 {Photo credit: Greg Olson/MSH}David Collins, Senior Health Finance Advisor at MSH, demonstrates how an open source community health planning and costing tool, developed with UNICEF, can be used to cost health services and prepare investment cases for community health interventions.Photo credit: Greg Olson/MSH

 

This week, at the 5th Health System Research (HSR) Symposium in Liverpool, MSH shared some of our important work in health care financing. A common theme was using simple cost models to calculate the resources needed to provide good quality health services. This type of work is crucial to helping countries improve quality of care and access to key services as they move toward achieving universal health coverage (UHC).

MSH’s health financing presentations at HSR

  • The challenges of transitioning humanitarian health services to health systems: Experience from northern Syria

  • Scaling up community health: Prioritization and costing of the health service packages in Madagascar and South Sudan

  • A cost-effectiveness and cost savings analysis of community-based, seasonal malaria chemoprevention in seven countries in the Sahel region of Africa

  • The cost of implementing UHC in fragile states: Study results from Afghanistan and Syria

Unpublished

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