By Matthew Ziba
Many health facilities across Malawi don’t have enough trained pharmacy staff to adequately manage stock and dispense medicines. These tasks often fall on health care providers, who already have many other responsibilities, namely caring for patients. In some cases, even a ground laborer or a security guard—who may have no training in pharmacy management—must step in to help.
The chart above shows the good-news-bad-news scenario that is the decades-long fight against TB in Afghanistan. TB is still a crushing problem there; the country has among the world’s highest rates of the disease, which killed some 10,000 people in 2017. But if you glance at this chart and think that we haven’t made much progress, look again. We’re finding and treating more people with TB in Afghanistan than ever before. In 2001, we were missing three quarters of presumptive TB patients — that is a whopping 75% gap in case detection.
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.
"Work to lose your job. If you don't have that in mind, you shouldn't be working in development," says Hammouda Bellamine, Senior Technical Advisor for Capacity Building for the USAID-funded KJK (Keneya Jemu Kan) Project in Mali.
Hammouda and his team are modeling important leadership skills and building capacity for social marketing and behavior change communication activities among local NGOs and public and private organizations. This interview has been edited for length and clarity.
Hi Hammouda. Could you start by describing your role and responsibilities on the KJK Project?
Elimase Kamanga is a mother, a midwife for more than 15 years, and the Senior Technical Advisor for Maternal and Newborn Health for the USAID-funded Organized Network of Services for Everyone’s (ONSE) Health Activity, led by MSH. Chisomo Mdalla, ONSE’s Chief Communications and Knowledge Exchange Officer, talked with Kamanga about her work to improve the quality of care for mothers and newborns in Malawi. This interview was edited for length and clarity.
Elimase, can you tell us about how you got to where you are today?
Antimicrobial resistance (AMR) occurs when a microorganism becomes resistant to a drug that was originally effective for treating the infections it caused. It is one of the world’s most pressing global health threats and could erode progress made thus far in the treatment of HIV/AIDS, TB, malaria, and many other infectious diseases.
Management Sciences for Health’s (MSH) role in combatting AMR was recently featured in the peer-reviewed journal, Global Public Health.
Photos by Chisomo Mdalla, ONSE Health communications officer.
As the globe marks World Water Day on March 22, the Organized Network of Services for Everyone’s Health (ONSE) Activity has been supporting the Government of Malawi in responding to a months-long cholera epidemic.
The Systems for Improved Access to Pharmaceuticals and Services (SIAPS) program helped make sure that some of the world’s most vulnerable people have timely access to safe, affordable medicines and to quality services to improve their health. Funded by USAID, the program worked for six years in 46 countries to comprehensively strengthen pharmaceutical systems by addressing five interrelated functions, with a focus on medical products—governance, human resources, information, financing, and service delivery.
In the late 19th and early 20th centuries, Poliomyelitis, or polio, was a greatly feared scourge of the industrial world. It would paralyze hundreds of thousands of children every year. Once effective vaccines were introduced in the 1950s the number of cases of polio dropped dramatically and the virus was eliminated in many countries, but in some places, it still remains a real threat.
This post originally appeared on the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program blog as, "UHC Day 2016: Strong pharmaceutical management boosts access to essential medicines".
By Sherif Mowafy
Chantal, an HIV-positive woman, waits for her monthly supply of antiretroviral medication at the Hôpital Immaculée Conception in Haiti.Photo credit: Jean Jacques Augustin, SCMSAs the warm Haitian sun comes up, Chantal leaves her four children behind to get her HIV treatment, traveling for three hours in the back of a crowded jeep.
She bumps over unpaved roads to her monthly visit for antiretrovirals, one that she has been doing routinely for several years to keep her disease at bay.
When my daughter got sick, I took her to a clinic in my neighborhood. They gave her cough syrup for seven days.
I thought she was getting better, but it was apparent that she was still ill. After another examination, they referred her to St. Paul Hospital in Addis Ababa where they put her on oxygen and started taking blood sample after sample and injection after injection for a month. Her condition did not get better so they gave her another medicine. The doctors then decided to take blood from her back… only then did they know it was tuberculosis.
And a happy International Women’s Day to you too. Every year, on March 8, activists, organizations, and officials celebrate advancements in women’s rights; however, despite global advocacy and action, women continue to suffer a disproportionate burden of disease and death.
If health systems are expected to deliver responsive and high-quality health services that can end preventable child and maternal deaths, then governments, organizations, and leaders must first address women’s continued underrepresentation in health leadership, management, and governance.
“When we started our project in 2011, there was no system in place to identify multidrug-resistant tuberculosis (MDR-TB),” explained Muluken Melese, project director for the Help Ethiopia Address the Low Tuberculosis Performance (HEAL TB) project. However, since then, the five-year USAID-funded project, implemented by Management Sciences for Health (MSH), has expanded access to TB services to over half the population of Ethiopia and led a 15-fold increase in the number of MDR-TB patients on treatment.
Tuberculosis (TB) is now the leading infectious cause of death worldwide -- ahead of HIV. While major advances in the diagnosis and treatment of TB have been made since 1990, children suffering from this disease have remained neglected and vulnerable. An estimated 1 million children become ill with TB each year, and at least 200 children die each day from TB around the world.
This week, at the 46th Union World Conference on Lung Health (hashtag #WCLH2015), the US Agency for International Development (USAID)-funded and Management Sciences for Health (MSH)-led, Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program is launching a new tool to improve how the safety and effectiveness of medicines is monitored in low- and middle-income countries.
Despite improvements in child survival in recent decades, children in low- and middle-income countries still suffer from illnesses virtually nonexistent in the industrial world.
Pneumonia is the deadliest of these, responsible for the death of 900,000 children under five worldwide in 2013—more than any other infectious disease.
Breastfeeding is a human right, and critical for the health of both newborn and mother. Newborns benefit from early skin-to-skin contact and the antibodies in the mother’s first milk, plus factors that protect against later obesity and chronic diseases such as diabetes and asthma. Mothers benefit because early breastfeeding assists in uterine shrinkage and helps prevent postpartum bleeding. In addition, frequent, exclusive, breastfeeding reduces the likelihood of an immediate new pregnancy.
My home region of Tigray in northern Ethiopia has made great strides in ending preventable maternal mortality. Best estimates suggest that the maternal mortality ratio in our region dropped from approximately 653 maternal deaths per 100,000 live births in 1990, to 267 in 2014. However, while most pregnant women in Tigray attend at least one antenatal care visit, only 41 percent attend the recommended four visits, and less than 63 percent deliver with a skilled birth attendant.
Update, July 30, 2015:
Prior to 2002, the vast majority of health service delivery systems in Afghanistan were non-existent or informal. The Leadership, Management, and Governance (LMG)-Afghanistan project improved family planning, reproductive health, and maternal and child health using strategies to strengthen health leadership developed by Afghans, for Afghans.
See the Journey to Restoration on Exposure
The original post follows:
The following blog post is a web-formatted version of MSH's Global Health Impact newsletter (June 2015 edition), Good Governance Strengthens Health Systems. We welcome your questions and feedback in the comments. Get Global Health Impact in your inbox
by James A. Rice, PhD
We spoke with MSH’s Chryste D. Best, BS, product quality assurance manager, The Partnership for Supply Chain Management (PFSCM), about her selection as one of the top 300 women leaders in global health by the Global Health Programme of the Graduate Institute of International and Development Studies in Geneva. Best provides innovative quality assurance oversight for the global procurement of medicines and commodities by MSH and partners.
This week, African Strategies for Health (ASH)—a USAID-funded, MSH-led project that identifies public health best practices in sub-Saharan Africa and advocates for their adoption—has been attending the International Conference on Urban Health from May 24 through 27 in Dhaka, Bangladesh. At the conference, ASH has been sharing A Corridor of Contrasts, a report compiling photographs and stories of the people living along the West African Abidjan to Lagos transport corridor, which crosses Côte d'Ivoire, Ghana, Togo, Benin and Nigeria.
Antimicrobial resistance is a major threat to the long-term security of public health and has the potential to negatively impact our society. It is a serious and growing global health security risk, which needs to be prioritised at local and international levels.
Health workers throughout the developing world provide vital services and improve the lives of the people they serve, and yet they are often invisible. These men and women conduct community outreach, provide key prevention messages in the community, and deliver clinical care, treatment, and follow-up. In Uganda, the US Agency for International Development (USAID) TRACK TB project, led by Management Sciences for Health (MSH), supports 52 community linkage facilitators to help increase tuberculosis (TB) case detection and treatment success rates.
It’s nearly impossible to find someone who doesn’t own or have access to a mobile phone these days. According to International Telecommunication Union (ITU) 2014 estimates, there are nearly seven billion mobile subscriptions worldwide, five billion of which are in low- and middle-income countries.
With mobile technologies accessible to 95.5 percent of the world population, a new platform for promoting and delivering health services has emerged.
For five years, the USAID-funded, MSH-led Leadership, Management and Sustainability project in Haiti (LMS/Haiti) worked with the Ministry of Health and Population (MSPP) and local NGOs to ensure a steady supply of family planning commodities to nearly 300 facilities throughout the country amid bone-rattling roads, surging rivers, and rocky footpaths.
Said Dr. Georges Dubuche, General Director of the MSPP, at the project’s closing ceremony April 14: It is with real pride and great emotion that I salute LMS/Haiti.
Nearly three years ago, I blogged about a systems approach to improving access for a Maternal Health Task Force (MHTF) series on maternal health commodities: Increasing access to essential medicines and supplies for maternal health requires a systems approach that includes: improving governance of pharmaceutical systems, strengthening supply chain management, increasing the availability of information for decision-making, developing appropriate financing strategies and promoting rational use of medicines and supplies. It was an exciting year for maternal health.
Last month I represented Management Sciences for Health (MSH) at Oxfam India’s South Asia Consultation on Maternal Health in Kathmandu, Nepal. The purpose of the meeting was to discuss significant maternal health programming experiences in Afghanistan, Bangladesh, India, Nepal, Pakistan, and Sri Lanka, and to suggest strategic directions for Oxfam India’s future maternal health programming. More than 30 representatives from governments, national and international universities, and nongovernmental organizations attended.
When Mearege gets really sick, her husband leaves town. Bedridden and in the care of her parents, Mearege gets tested and learns she--and her daugther--are HIV-positive. Through the support of mother mentors, trained by the Ethiopia Network for HIV/AIDS Treatment, Care and Support Program (ENHAT-CS), Mearege finds solace, guidance, and healing -- and decides to have another child.
This post is part of MSH's Global Health Impact Blog series, Improving Health in Haiti: Remember, Rebuild. The post originally appeared on LMGforHealth.org, the blog of the US Agency for International Development (USAID)'s Leadership, Management & Governance (LMG) Project, led by Management Sciences for Health (MSH) and a consortium of partners.
The US Agency for International Development (USAID)-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program, led by Management Sciences for Health (MSH), in collaboration with the Stop TB Partnership Global Drug Facility, will host a technical conference titled, “Building the Post-2015 Agenda: Novel Approaches to Improving Access to TB Medicines and Pharmaceutical Services” from March 2-6, 2015 at the Conrad Bangkok Hotel in Bangkok, Thailand.
The African Evaluation Journal (AEJ), the official journal for the African Evaluation Association (AfrEA), is calling for articles and peer reviewers for the special AEJ edition “Health Evaluations in Africa.” This process presents an exciting opportunity to participate in Africa’s contribution to the internationally-declared 2015 Year of Evaluation.
The Supply Chain Management System (SCMS), established in 2005 under the US President’s Emergency Plan for AIDS Relief (PEPFAR) administered by the US Agency for International Development (USAID), supplies lifesaving medicines to HIV & AIDS programs around the world and is led by the Partnership for Supply Chain Management (PFSCM), a nonprofit organization established by Management Sciences for Health (MSH) and John Snow, Inc. SCMS first established a presence in Haiti in 2007. MSH manages SCMS operations in Haiti.
The first Lesotho National Conference on Vulnerable Children, December 8-11, 2014, was organized by the Government of Lesotho, with support from US Agency for International Development (USAID)/The US President's Emergency Plan for AIDS Relief (PEPFAR) through Management Sciences for Health’s Building Local Capacity for Delivery of HIV Services in Southern Africa Project, and in collaboration with UNICEF, UNAIDS, and other development partners.
People of Haiti: We remember your struggle. We applaud your success. We reaffirm our commitment to work, shoulder to shoulder, to support your efforts to improve health … This year marks the 5th anniversary of the catastrophic earthquake (January 12, 2010) that devastated Haiti’s already-fragile health system.
This post originally appeared on the Southern Africa HIV and AIDS Regional Exchange (SHARE) as "The role of the private sector in responding to OVC issues". As we travelled to the Mountain Kingdom of Lesotho, I had mixed emotions about the National Conference on Vulnerable Children I was going to attend. Issues of orphans and vulnerable children are very close to my heart, as I have first-hand experience of growing up with a cousin who is an orphan due to HIV and AIDS.
This post originally appeared on the Southern Africa HIV and AIDS Regional Exchange (SHARE) as "Meeting the needs of vulnerable children: where are we and where do we need to go?".
The first Lesotho National Conference on Vulnerable Children (LCVC), December 8-11, 2014, reflected upon the state of the response to vulnerable children and facilitated a systematic approach of generating and articulating evidence for future direction for an efficient, effective, and well-coordinated response within the region.
Post updated December 19, 2014.
This post originally appeared on the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program Blog. Funded by the US Agency for International Development (USAID) and implemented by Management Sciences for Health (MSH), SIAPS works to assure the availability of quality pharmaceutical products and effective pharmaceutical services to achieve desired health outcomes.
“MSH is like my mother,’’ said Yimenu, a young medical professional from East Gojam, a place about 600 kilometers from Ethiopia’s capital, Addis Ababa. “I have been suffering for five years and it was because of MSH that I started living all over again.”
Yimenu is the voice of thousands: the symbol of partnership that contributed significantly to the country’s increasingly strengthened health sector to save lives.
“I ask no more than an opportunity to help others,” said Yimenu looking at the crowd with complete joy.
A version of this post originally appeared on the Leadership, Management & Governance Project Blog.
Since 1992, the United Nations General Assembly has observed the International Day of Persons with Disabilities on December 3. The annual observance aims to promote an understanding of disability issues and mobilize support for the dignity, rights, and well being of persons with disabilities. It also seeks to increase awareness of gains to be derived from the integration of persons with disabilities in every aspect of political, social, economic and cultural life.
My name is Tiglu. I was born and raised in Bahir Dar. When I first learned that I am living with the [HIV] virus, my mind went blank. I was depressed. After that, I started taking antiretroviral treatment. Then they found TB in me... Meet Tiglu, a living example of how partnering for stronger health systems saves lives. In Ethiopia, about 790,000 people are living with HIV. Tiglu, a patient at the Bahir Dar Health Center in the Amhara Region of north-western Ethiopia, discovered he is HIV positive three years ago, and started on antiretroviral treatment (ART).
This post originally appeared on the Frontline Health Workers Coalition blog.
Ayelew Adinew was working as a pharmacist in a large public hospital in Addis Ababa, Ethiopia. He looked around and saw that the 100-year old pharmaceutical system was broken.
In 2013 diarrhea killed 578,000 children under the age of five, 9 percent of all deaths in this age group globally. The tragedy of these deaths is that they are avoidable at many levels. The risk of contracting diarrhea can be drastically decreased through basic hygiene measures, such as consistent and exclusive use of a latrine and washing one’s hands with soap. Once a child becomes ill with diarrhea, most cases can be managed with oral rehydration salts and zinc.
November is Prematurity Awareness Month in the US, and the 17th is World Prematurity Day. But I never need any reminders about the importance of access to medicines and services for premature babies. Every November, I celebrate the birthday of my own little preemie. On November 30, 1997, I went into labor just after reaching 32 weeks. I was terrified. I had had a healthy second pregnancy up to that point and my doctor did not believe me at first when I told her I was in labor.
This post originally appeared on Devex on November 14, World Diabetes Day (#WDD).
During her third pregnancy, Eden Bihon visited the Mekelle Health Center in Tigray, Ethiopia. Although a routine prenatal visit, it held great importance for Eden, as she had recently lost her second child, who died from unknown causes at the age of just one year.
Unknown to her at the time, this visit would have lasting implications for Eden and her baby. A 23-year-old mother, Eden, like most Ethiopian women, had concerns about her pregnancy and well-being. But gestational diabetes was not one of them.
This post originally appeared on SIAPSProgram.org. Accounting for more than one million under-five deaths each year, pneumonia is the leading killer of children under the age of five worldwide, claiming more lives than AIDS, malaria, and tuberculosis combined. This year’s World Pneumonia Day (WPD) theme is “universal access to pneumonia prevention and care”. In commemoration of WPD, child health advocates are calling for pneumonia control through proven interventions that protect against, prevent, and treat pneumonia.
Every year, pneumonia kills approximately 936,000 children under the age of five, accounting for 15 percent of all deaths within this age group. One of the worst affected countries is the Democratic Republic of the Congo (DRC), where pneumonia took the lives of nearly 50,000 children in 2013, including almost 7,000 newborns.
For the sixth year, people around the global are bringing awareness to this critical—and solvable—problem by commemorating World Pneumonia Day today, November 12th. This year’s theme is: “Universal access to pneumonia prevention and care”.
Guaranteeing that patients have uninterrupted access to anti-tuberculosis (TB) treatment begins with national TB programs (NTP) making complex calculations about how many cases to expect in the future. Vigilant stock management, accurate number of cases started on each type of treatment along with forecasting the expected number of patients that will be enrolled on treatment, are vital to ensure that medicines are available to all patients who need them.
The unprecedented outbreak and spread of the Ebola virus in three West African countries (Guinea, Liberia, and Sierra Leone) continues to wreak havoc on the lives, economy, and already-strained health systems of the region. The outbreak is particularly high in Liberia with 2,413 people killed by the disease to date.
This post originally appeared on the Community of Practice on Scale-up and Gender, Policy, and Measurement and US Agency for International Development (USAID)'s Leadership, Management & Governance (LMG) Project Blog. Management Sciences for Health (MSH) leads the USAID-funded LMG project with a consortium of partners.
This post originally appeared on LeaderNet.org.
Have you ever wondered what happens after a project activity ends? We are always deeply committed to local ownership and sustainability, yet, we rarely have the opportunity to do long term follow up or reflection. I recently had the extraordinary opportunity to discover for myself the long term impact of the Leadership Development Program (LDP) in Nepal.
To sum it up in one word: Wow!
In years to come we will look back on the summer of 2014 and recall the US Agency for International Development (USAID)’s Acting on the Call: Ending Preventable Child and Maternal Deaths campaign as a turning point in our struggle to reduce maternal, newborn, and child mortality and morbidity. USAID announced this summer that it is realigning $2.9 billion of the Agency’s resources to refocus on high-impact programs with proven track records to save women, newborns, and children under five.
Expanding access to essential maternal health medicines saves mothers’ lives. Access to life-saving maternal medicines requires an effective supply chain that delivers the right medicines to the right people at the right times. In many countries, weak pharmaceutical management systems are unable to meet the challenges of providing access to these essential medicines.
This post originally appeared on the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) program blog.
Does antimicrobial resistance mean the end of modern medicine as we know it? Not quite yet. However, in a report recently released on global surveillance of antimicrobial resistance (AMR), the World Health Organization (WHO) warned that "a post-antibiotic era–in which common infections and minor injuries can kill–is a very real possibility for the 21st century."
MSH is one of 52 finalists in USAID's Grand Challenge to pitch an idea that will accelerate substantial and sustainable progress against maternal and newborn deaths and stillbirths at the community level.
The idea: Piloting a model that uses mobile phone decision-support tools by small accredited drug dispensing outlets (ADDOs) in Tanzania to
counsel and provide needed medicines to pregnant women
identify and rapidly refer at-risk pregnant and postpartum women and their newborns to health facilities
provide family planning counseling, dispensing, and referral
On the eve of the 20th International AIDS Conference (AIDS 2014), Rachel Hassinger, editor of MSH’s Global Health Impact Blog, spoke with Dr. Scott Kellerman, global technical lead on HIV & AIDS, to discuss his latest research on prevention of mother-to-child transmission (PMTCT) of HIV and pediatric HIV & AIDS. Kellerman and colleagues will be attending AIDS 2014, July 20-25, in Melbourne, Australia. (Read more about the conference.)
The US Agency for International Development (@USAIDGH) and partners are hosting a #MomandBaby Twitter relay today, June 24, from 9 am to 5 pm ET as part of the "20 Days of Action for #MomAndBaby" campaign.
We (@MSHHealthImpact) are leading the conversation, from 12:30 to 1:00 pm ET, on "All levels, all functions, all places: Building local capacity for stronger health systems".
Follow or join us with hashtag #MomandBaby!
View the Twitter relay schedule
This post originally appeared on the Health Communication Capacity Collaborative (HC3) blog.
In my role as a capacity building advisor, I design a lot of learning programs. Time and again, I find myself asking: How can I present technical content in a way that will best enable my audience to apply new knowledge and skills in their work environment?
Should I use a mobile phone app?
What about some on-the-job-learning?
The Building Local Capacity for Delivery of HIV Services in Southern Africa (BLC) Project, funded by the US Agency for International Development (USAID) and led by Management Sciences for Health (MSH), provided a grant to The Luke Commission (TLC) to deliver safe medical male circumcision to men and boys in Swaziland. The BLC Project also provides organizational capacity building support to TLC. A version of this post originally appeared on the Southern Africa HIV and AIDS Regional Exchange (SHARE) blog.
Editor's note, June 24, 2014: Chat with us (@MSHHealthImpact) from 12:30-1:00 pm ET today, about building local capacity to strengthen health systems and end preventable child and maternal deaths, even in the most remote, rural, and fragile areas. Follow or join the Twitter relay today, led by @USAIDGH and partners, with hashtag #MomandBaby. The goal of ending preventable child and maternal deaths is within reach.
In a health clinic outside Nairobi, Kenya, Janet* waits to see a doctor. Janet is a 32-year-old widow and mother of four from Kibera, a neighborhood of Nairobi. Her 11-year-old daughter, Jane*, isn’t feeling well. Both mother and daughter are HIV-positive.
This blog post, cross-posted with permission from The Leadership, Managment, and Governance (LMG) project blog on LMGforHealth.org, is part of our Global Health Impact series on the 67th World Health Assembly in Geneva, May 18-24, 2014. MSH is co-hosting three side events focusing on the role of universal health coverage (May 20), chronic diseases (May 20), and governance for health (May 21) in the post-2015 framework. This year, six MSH representatives are attending WHA as part of the 60-plus-person Global Health Council (GHC) delegation.
Good governance is like a large elephant, Ahmed Adamu, Chairperson of the Commonwealth Youth Council, said. One person can touch the trunk, one the stomach, and one the tail, and they have had very different experiences with the elephant. Around the world, everyone has different experiences and different perceptions of good governance. With this anecdote, Adamu, a speaker at the plenary, “Achieving Good Governance and Accountability” at the 2014 World Conference on Youth, captures the challenges of defining good governance often cited in more academic terms. Though the concept of good governance is up for interpretation, there is consensus across countries, generations, and sectors that it is sorely needed. According to a consultation by Restless Development with young people in 12 countries , overall, governance is their most important issue that should be addressed in the post-2015 dialogue. And while good governance might be their most pressing concern, according to Subinay Nandy, Sri Lanka’s Resident Coordinator to the United Nations, it is young people themselves who are the most important tool international agencies can use to guarantee good governance.
The World Conference on Youth (WCY2014) is bringing together over 1,500 youth delegates, ages 18 to 29, from May 6-10, 2014, in Colombo, Sri Lanka, for thematic policy roundtables to create an outcome document ("Colombo Action Plan") that will state the position of mainstreaming youth in the post-2015 development agenda.
The availability of new and essential medicines and other health technologies to treat life-threatening illnesses have helped millions of people lead long and productive lives. However, global availability does not necessarily mean access by the end-consumer to these lifesaving health products in low-and middle-income countries. Effective supply chains are needed to deliver these health products in hard-to-reach, resource-constrained settings that often times are inhospitable to collaborative, high-performing supply chain systems.
So how do we get safe, quality, essential medicines and commodities to the people who need them, at the right time and in the right quantities?
This blog post is part of a series leading up to the 67th World Health Assembly (WHA) in Geneva, Switzerland from May 19 – 24, 2014. In conjunction with the WHA, the Leadership, Management & Governance (LMG) Project will host a side session with global health leaders titled, “Governance for Health: Priorities for Post-2015 and Beyond”. This blog series will offer insight on how good governance in the health system can result in stronger health impact as we move beyond the Millennium Development Goals. This post originally appeared on the LMGforHealth Blog.
Four Ethiopian HIV-positive mothers received 2014 REAL Awards for their outstanding contributions to the fight against HIV, particularly prevention of mother-to-child transmission of HIV (PMTCT), at a ceremony in Addis Ababa, Ethiopia, on April 10, 2014. Created by Save the Children and the Frontline Health Workers Coalition, the REAL Awards are designed to develop greater respect and appreciation for health workers and the lifesaving care they provide globally, as well as in the United States.
Meet Tsegay, Haile, Alemayehu, and Derebrew
Pablos-Méndez Applauds and Encourages MSH Representatives and Partners at DC Country Health Impact Fair
Representatives from 13 MSH countries—Afghanistan, Angola, Cote d’Ivoire, DRC, Ethiopia, Ghana, Haiti, Kenya, Nigeria, Rwanda, South Africa, Tanzania, and Uganda—shared stories and materials about the lives saved and health impact of MSH’s work, in partnership with US Agency for International Development (USAID) and others, at the MSH Country Health Impact Fair at the Ronald Reagan Building in Washington, DC, last week. Country ownership and health impact were common themes at the fair. Ariel Pablos-Méndez (MD, MPH), assistant administrator for global health at the US Agency for International Development (USAID), addressed participants and attendees.
MSH extends our thanks to Ariel Pablos-Méndez (MD, MPH), assistant administrator for global health at the US Agency for International Development (USAID), for addressing the MSH Country Health Impact Fair participants and attendees on Wednesday, April 9, at the Ronald Reagan Building in Washington, DC.
Successfully combating the tuberculosis (TB) epidemic requires that national TB programs (NTPs) prevent new infections and ensure that current patients are cured. Although the treatment for drug-sensitive TB is very effective, curing the disease requires that patients adhere to a strict daily regimen of multiple pills for six to nine months. Adding to the challenge is the fact that treatment for drug-resistant TB is longer, more toxic, and less effective.
The highest rate of multi-drug resistant (M) and extensively drug-resistant (XDR) cases of tuberculosis (TB) is found in the World Health Organization (WHO) European Region. The Consolidated Action Plan to Prevent and Combat M/XDR-TB in the WHO European Region specifies that, by the end of 2013, all member states assure provision of an interrupted supply of quality first- and second-line medicines for treatment of all TB and M/XDR-TB patients.
This post originally appeared on the Maternal Health Task Force (MHTF) Blog as part of a series celebrating the one-year anniversary of The Lancet publishing “A Manifesto for Maternal Health post-2015,” co-authored by Ana Langer, Richard Horton, and Guerino Chalamilla.
Azmara Ashenafi, a 35-year-old woman from the Amhara region of Ethiopia, was diagnosed with tuberculosis (TB) and placed on treatment. She was fortunate. Many people with TB are missed by health systems altogether. But Azmara’a treatment wasn’t helping. Despite taking medicine for months, her symptoms persisted and became more severe.
In many places, her story would have a sad ending—TB is one of the top three leading causes of death for women 15 to 44 in low- and middle-income countries.
"At the Duka" tells the story of a Systems for Improved Access to Pharmaceuticals and Services Program (SIAPS) project to increase early detection of tuberculosis in Tanzania.
SIAPS partnered with the Tanzanian National Tuberculosis and Leprosy Program to train drug dispensers on the symptoms of TB, so that they could refer clients with these symptoms to TB diagnostic and treatment centers for follow up.
MSH staff are commemorating World TB Day through awareness-raising activities around the globe, including in Afghanistan, Cambodia, Ethiopia, Ghana, Indonesia, and Nigeria. Here are photos (some from 2013) with activities this year.
Afghanistan - TB CARE I
Have you ever thought about water? I mean, really thought about the quality of the water you drink or use for your personal hygiene? Clean water is something many of us take for granted, but billions of people around the world lack access to a dependable source of fresh water and acceptable sanitation facilities.
As a government we cannot work alone. However, it is important that those contributing to achieving the government’s vision of a healthy Kenya be guided by standards that encourage them to provide a certain level of quality that is acceptable and desirable. These were the words of Dr.
In Kenya, cancer is ranked third as a cause of mortality and morbidity after communicable and cardiovascular diseases.
The Ministry of Health, supported by the USAID-funded, Management Sciences for Health (MSH)-led, Health Commodities and Services Management (MSH/HCSM) Program, led the development and launch of the First National Guidelines for Cancer Management in Kenya, in collaboration with World Health Organization (WHO), Africa Cancer Foundation, and other stakeholders.
Knowledge is power, so the saying goes.
No one understands that more than Teberih Tsegay, Almaz Haile, Jember Alemayehu, and Yeshi Derebew, of Korem Town, Ethiopia, who have used their knowledge to save the lives of babies in their community. "Some years back there was no one to teach us, so we gave birth to HIV-positive children. But now we can teach others so no child will be born with the virus," said Jember.
This post originally appeared on the LMGforHealth Blog.
In discussions around the importance of country ownership of health-related activities and initiatives, both Management Sciences for Health (MSH) and the Leadership, Management, and Governance (LMG) Project are committed to making sure that the role of civil society is taken into consideration and promoted, in line with USAID Forward’s drive to engage and strengthen local capacity.
Every year, billions of US dollars’ worth of medicines are purchased by or through international procurement agencies, NGOS–such as UNICEF, UNITAID, The Global Fund, Médecins Sans Frontières (MSF)–and governments for use in developing countries. The World Health Organization’s (WHO's) PreQualification of Medicines Programme (PQP) helps ensure that these medicines meet acceptable standards of quality, safety and efficacy.
SCMS and MSH at the forefront of efforts to remove supply chain barriers to the scale up of HIV/AIDS treatment programs For many of us in the developed world, it is easy to overlook the critical role that well-functioning supply chains play in effective healthcare. When supply chains are operating as they should, we take for granted that the medicines we need will be in stock and available.
Last month, I had the honor of welcoming United States Agency for International Development (USAID) Administrator Rajiv Shah to Democratic Republic of the Congo (DRC) during a visit that took place December 15-18, 2013.
This post originally appeared on USAID’s IMPACT blog. USAID is observing World AIDS Day this year by celebrating ten years of HIV and AIDS work under PEPFAR.
More than 85,000 infants in Nigeria are at risk of HIV transmission from their mothers every year. While the number of HIV-positive pregnant women who receive antiretroviral treatment (ART) is increasing, robust efforts to improve coverage are needed if national targets (PDF) for prevention of mother-to-child transmission of HIV (PMTCT) are to be met in 2015.
November 14 is World Diabetes Day. This year’s theme, “Protect our future,” emphasizes the importance of engaging and inspiring local communities to promote awareness and education on the effects of diabetes and its preventable risk factors.
This post originally appeared on the LMGforHealth.org Blog. USAID's Leadership, Management and Governance (LMG) Project, led by Management Sciences for Health (MSH), hosted the Governance for Health (G4H) in Low- and Middle-Income Countries Roundtable 2013 (G4H2013) at Georgetown University in August.
The overwhelming consensus of G4H2013? Governance matters.
On July 4, 2013, 26-year-old Elina Jean-Baptiste of Cazale, Haiti began experiencing painful contractions as she prepared to deliver her child. Realizing she was going into labor, Elina walked to the Cazale health center and with the help of trained nurses and a doctor, delivered a healthy baby girl named Dadeline. “The labor and delivery were very painful, but as soon as I arrived at Cazale, I knew I was in good hands,” she said.
Strengthening health systems at all levels is the core of MSH’s response to the HIV epidemic. We build organizational capacity to implement innovative HIV, prevention, care, and treatment interventions in over 35 countries---from Côte d'Ivoire to Ethiopia to Vietnam.
Today, as we celebrate International Youth Day and the theme of “Youth Migration: Moving Development Forward,” we are reminded of difficult situations millions of young people experience every day—and of the power young people have to create change in their lives when they connect with their peers.
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.
In 2005, "Chima" abandoned "Sinachi" and their four children to marry another woman. Heartbroken and unemployed, Sinachi returned to her home village and became a farmer. Although she worked hard, Sinachi’s children often went hungry and did not attend school for three years because she was unable to pay the fees.
A version of this post originally appeared on the SIAPS program blog.
"Health care is not about what doctors and nurses do in hospitals," said Dr. Sania Nishtar. "There are a range of different stakeholders that need to play their parts."
Cross-posted with permission from the Southern Africa HIV and AIDS Regional Exchange (SHARE).I used to smile at the sentimental nickname for Lesotho, “The Mountain Kingdom.” Following a few visits to the capital Maseru, I had the opportunity to travel to the district of Mokhotlong, in the east of the country. Here I discovered that this term is more literal than symbolic, and no laughing matter. Narrow gravel roads with incredible switchback turns had me engaging in lively discussion in the car to avoid thinking about how close I was to the edge.
On June 7, Management Sciences for Health (MSH) and partners hosted Dr. Florence Guillaume, the Minister of Health of Haiti, and panelists for a Capitol Hill luncheon on community health workers in fragile states. The day before, MSH hosted Guillaume in Cambridge, MA, for a town-hall style event on improving maternal and child health. Revisit the two events through a "Storify" story of photos, text, and tweets.
[View the story "From Capitol Hill to Cambridge: Learning from Haiti and Other Fragile States on Importance of Community Health..." on Storify]
Cross-posted with permission from the LMGforHealth.org blog.
I had the pleasure and privilege of moderating a stimulating discussion, hosted by the USAID-funded AIDSTAR-Two project entitled, "Organizational Capacity Development: How Do We Measure Impact?".
The Supply Chain Management Subgroup of the Community Case Management (CCM) Taskforce is organizing a webinar series, beginning May 15, 2013.Hosted by the CORE Group, the May 15 webinar will "provide an overview of the common pitfalls and bottlenecks of the CCM supply chain and potential solutions to these challenges."Jane Briggs, principal technical advisor for USAID's Systems for Improved Access to Pharmaceuticals and Services (SIAPS) at MSH, and Sarah Andersson, a country technical advisor for the Bill & Melinda Gates Foundation's Supply Chain for Community Case Management (SC4CCM) at J
This post originally appeared on the Southern Africa HIV and AIDS Regional Exchange (SHARE) blog."All the people we need to make a difference in HIV globally are sitting in this room," said Paul Waibale, deputy director of the Building Local Capacity Project (BLC) for the Delivery of HIV Services in Southern Africa, during the opening of the Southern African Development Community (SADC) HIV prevention workshop, "New evidence, new thinking."With funding from USAID, the week-long workshop on enhancing national and regional approaches to HIV prevention kicked off April 8, 2013, with 32 of Swazila
Cross-posted with permission from the Global Health Knowledge Collaborative.“What is important to you about KM [knowledge management] and why?” was the first question that some 40 small groups discussed, sitting at paper-covered tables with colored markers that invited participants to doodle out loud.
Maintaining state-of-the-art skills and knowledge is crucial for physicians. But in most developing countries, the lack of structured or ongoing educational activities has pushed medical doctors to travel abroad to benefit from the most recent expertise.
To solve that problem---and improve Rwanda's health system---the Rwanda Medical Council (RMC) launched the continuing professional development program in 2011. The continuing professional development sustains practitioners' knowledge through workshops, seminars, practical sessions, and research.
Cross-posted with permission from the K4Health blog. K4Health is a USAID project, led by Johns Hopkins Bloomberg School of Public Health’s Center for Communication Programs (JHU-CCP), with partners FHI-360 and Management Sciences for Health (MSH).When Yahoo rescinded their work from home policy a couple weeks ago they revitalized the debate over the future of office work.
Mildred Fernando lives and works in the Philippines for the USAID-funded, MSH-led, Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program. Mildred spoke at several World TB Day events in Washington, DC, including at a senate briefing and an event honoring TB survivors and advocates (watch video). The interview below first appeared on the SIAPS blog.It all began in November 2001 for Mildred Fernando when she was diagnosed with tuberculosis (TB), a preventable and curable disease which caused the death of 1.4 million people in 2011.
After South Sudan gained independence from Sudan in 2011, disagreements over oil-sharing between the two nations caused fighting and high economic inflation in certain regions. Desperate for security, over 110,000 Sudanese refugees escaped to South Sudan and now reside in camps in Maban County.
Bounj Hospital: Diagnosing and treating residents and refugees
These refugees, and the county’s 40,000 residents, are served by Bounj Hospital, the only TB diagnostic and treatment center in the district. This hospital is currently treating 75 patients for TB, 56 of whom are refugees.
Tuberculosis (TB) is a leading cause of death in Democratic Republic of the Congo (DRC), partly due to a low case detection rate within the health system, compounded by little knowledge or awareness among patients of the disease’s symptoms. In the province of Sud Kivu, where people have relied on traditional healers for generations, those who were suffering from the persistent, painful coughing that is one symptom of TB were advised by traditional healers that they had been poisoned, and they were not referred to health centers.
The state of tuberculosis (TB) is in a tug-of-war as current challenges threaten to undo past successes. One of the primary hurdles currently facing TB prevention and cure is the emergence of strains that are resistant to at least two of the most effective medicines (rifampicin and isoniazid).So-called drug-resistant (DR)-TB arises when patients are unable to complete a full-course of appropriate, high quality anti-TB medicines.
Tuberculosis (TB) control in Ghana is challenging: detection of TB cases is low, and TB mortality rates high. In many communities, like Lower Manya Krobo District, these challenges are compounded by the popular belief that TB is a spiritual disease. Many Ghanaians who contract TB seek healing in prayer camps and shrines, rather than going to health facilities for testing and treatment. By the time these patients seek medical care, it often is too late to recover and avert death.
Stop TB in my lifetime.
This global call to action---the Stop TB Partnership's theme for March 24, World TB Day 2013---is as relevant now as it was over a hundred years ago.
Progress toward reducing the global burden of tuberculosis (TB) has been impressive in recent years: TB mortality has fallen by 41 percent since 1990.
Yet, TB remains one of the world’s leading causes of death, killing more than 1.4 million people per year, including 70,000 children. In 2011, 600,000 people died of TB in Africa alone---including many people with HIV.
Sunday, March 24, 2013, is World TB Day, and MSH staff and partners are promoting global efforts to stop TB throughout the week.Here are highlights from some of our activities around the world:The Afghanistan TB CARE I team is working with the national TB program (NTP) to conduct celebration events at 290 health facilities and communities in 13 USAID-supported provinces. TB messages will be aired through local telephone companies to approximately one million people throughout the nation.
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.
For most of my life, women in Uganda---as in most countries---were treated as inferior to men. Girls were less likely to be educated than their brothers, and had little control over the direction of their lives. Many girls grew up being told how to act, eat, and talk; many women were regarded as little more than domestic caregivers. However, in 1986 the ruling government radically changed the dynamics of Ugandan women in global development and their participation in decision-making at all levels of government.
Integrating the Leadership Development Program into Guyana's national nursing school training (watch video): Guyana HIV/AIDS Reduction and Prevention, phase two (GHARP II), a PEPFAR-funded and USAID-supported project.Developing Strong Health Leaders Saves Lives, the newest edition of MSH's Global Health Impact e-newsletter (subscribe), features:a conversation with Jonathan Quick and Sylvia Vriesendorp on strong women health leaders;an interview with Xavier Alterescu on the next horizons of leadership: gender, decentralized governance, and building organizational capacity for networking;a blog
In my 35 years working in international health, I've attended hundreds of conferences. Conferences are opportunities to exchange ideas and form connections. They’re often fascinating. But once in a while a conference itself can be a pivotal moment.
Private sector companies, like McDonald's and General Electric, have successfully been using internal universities or academies for decades. So how can programming for health service managers be better, more cost effective and more sustainable? Embed programming within special “Leadership Academies” based in ministries of health.
Cross-posted with permission from the K4Health blog. With social media being a relatively new channel in the world of global health and development as a tool to share information, to advocate, as a marketing mechanism, or as a public health intervention tool, measurement is always a struggle when the path has not been set ahead of you.
The Improving Performance of Nurses (IPN) project in Upper Egypt celebrated the first Arabic publication of Management Sciences for Health's (MSH)'s “Managers Who Lead” handbook with an event last November.
After a very busy week scurrying around behind the scenes at Kenya’s First National Conference on Health Leadership, Management and Governance, the staff of the USAID-funded Leadership, Management and Sustainability project in Kenya (LMS/Kenya) gathered on Friday morning before the start of the fourth and final day. Generally, the last day of a conference is filled with summaries and closing-day formalities. But this time, Project Director Karen Caldwell informed us that we still had one essential task ahead.
A new report from the USAID-funded Afghan Sustainable Water Supply and Sanitation (SWSS) Project, led by Tetra Tech ARD, describes the methodology and results from the Sustainable Health Outcomes component, led by Management Sciences for Health (MSH). The SWSS project worked to improve the health and infrastructure of rural Afghans, with an emphasis on providing water supply and sanitation facilities and improving community hygiene behaviors (read stories).
Cross-posted from the SIAPS website.
“Respectful maternal care was said to be more than just a means to an end, and can be framed as several issues: human rights, quality of care, equity and public health,” Jocalyn Clark, senior editor of PLoS Medicine, noted about the final day of the 2013 Global Maternal Health Conference (GMHC).
Shelly has always been very athletic. She competed in both her high school track events and in community races in her hometown of Essequibo, Guyana. In 2010, she was ecstatic after winning a cash prize for placing first in an annual regional championship. However, her life took a turn one year later.Shelly became pregnant and, during an antenatal care appointment, tested positive for HIV. The news devastated her, as she believed that an HIV diagnosis meant her athletic career was over.
http://www.youtube.com/watch?v=I2Y7y-EfIHM&feature=youtu.beUSAID Administrator Rajiv Shah welcomes attendees to the African Leadership on Child Survival meeting in Ethiopia via this video.RelatedUSAID IMPACT blog: Ethiopia Hosts African Leaders to Accelerate Gains in Child SurvivalUNICEF: Ethiopia hosts African Ministers of Health and world experts to spur gains in child survival10 Steps Toward Child Survival
Management Sciences for Health (MSH) staff presenting at the Global Maternal Health Conference in Arusha, Tanzania, January 15-17, 2013. (Photo credits: C. Lander & J. Briggs / MSH)RelatedSecond Global Maternal Health Conference: Will it Set Itself Apart? Off to an Excellent StartJoin MSH at the Global Maternal Health Conference 2013
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.
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.
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.
In recent years, Haiti has endured some of the greatest misfortunes in its history, including hurricanes, floods, the devastating 2010 earthquake, and the cholera epidemic that followed. These natural disasters and public health crises have added to the harm already caused by the country’s widespread poverty, social and political unrest, and under-resourced health system.
Global health leaders, advocates, experts and practitioner gathered to increase awareness following this year's London Summit on Family Planning and to seek ways to carry forward the promises made during the event.
I got a call from the resident doctor to come to exam room 6. As soon as I entered the room, I prepared myself. The little girl, 7- or maybe 8-years-old, didn't look well; she was “floppy,” combative, and not entirely aware of where she was or what we were doing to her. She was HIV-positive, and my colleague needed to get an IV line in her arm to test the latest in experimental treatments for kids with HIV– and needed the four of us interns to help hold her still.It was 1993 during my residency in pediatrics in Cleveland, Ohio.
“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.
Today, at 12:30 pm, Management Sciences for Health, John Snow, Inc. (JSI), Pathfinder International, Ibis Reproductive Health, and the Women and Health Initiative of the Harvard School of Public Health, are hosting a post-election luncheon event: The London Summit on Family Planning: Where Do We Go from Here?Follow the discussion on Twitter with #FPBoston and #FP2020.The event includes: 12:00 pm Boxed Lunches and Networking 12:30 pm Welcome and Introduction of Keynote SpeakerJoel Lamstein, President, John Snow, Inc.Dr.
The October edition of MSH's Global Health Impact newsletter (subscribe), features stories of people, communities, and countries on the road toward universal health coverage (UHC).
The vital role of the essential package for health impact "Universal health coverage has two fundamental goals: maximizing health impact and eliminating — or at least reducing — impoverishment and bankruptcy due to healthcare costs," blogs MSH President Jonathan D. Quick.
The Democratic Republic of the Congo’s Sud Kivu province has been an area of armed conflict for many years, with various rebel factions fighting for control over the resource-rich region.The continued fighting has disrupted health services --- which were weak to begin with --- due to geographic isolation and poorly supported health workers.In the health zone of Mulungu, there had been no delivery of medicines or supplies for more than six months.
The Washington Post Live panel on October 17 featured high-level noncommunicable diseases (NCDs) experts from around the world discussing how to tackle the global epidemic of NCDs.We've compiled key moments from the panelists in a "Storify" story, told through tweets.The @PostLive panel featured some twenty high-level chronic diseases experts from around the world discussing how to tackle the global epidemic of noncommunicable diseases (NCDs).http://storify.com/MSHHealthImpact/washington-post-live-high-level-panel...
Seven-year-old Ladi Muhammed wants to become a teacher. The third of five children ranging 3 to 20 years old, Ladi and her family live in a poor Nigerian village.The likelihood of Ladi attending primary school is low.Public primary education is free in Nigeria, but Ladi’s parents can barely afford to feed their children.
Today, October 15, children, schools, and communities around the world mark Global Handwashing Day.Washing hands with soap is the "most effective and inexpensive way to prevent diarrheal and acute respiratory infections, which take the lives of millions of children in developing countries every year." In addition to handwashing with soap, proper sanitation and safe drinking water are key to preventing disease."Most of what we need to do to bring down the rate of child deaths is inexpensive & straightforward," USAID Administrator Raj Shah said today on Twitter.
In January 2011, Amelia and her partner, Luke --- both HIV positive --- began accessing HIV care and support services at the Agape Network through its community home and palliative care program.Agape Network is one of the NGOs that receives technical support from the PEPFAR-funded, USAID-implemented, Guyana HIV/AIDS Reduction and Prevention Project (GHARP II), led by MSH.When the Agape staff first met Luke and Amelia, they were living with their two daughters at Luke’s family’s home.
Seven-year-old Makasi, an HIV-positive orphan in Tanzania, was diagnosed with advanced tuberculosis (TB) and started on curative treatment. Clinicians at a local health center used standardized TB guidelines to overcome the difficulty of identifying TB in children co-infected with other diseases. In Afghanistan, sixteen-year-old Hamida provides for her family while trying to complete school. Hamida was visited by a community health worker, who identified her TB symptoms, and helped her access appropriate diagnosis and treatment.
Steady Progress Against Daunting Challenges
This is the advice that Esther Wahome, a registered community health nurse in a Kenyan health facility, gives to her clients when they come to the tuberculosis (TB) clinic. Within a short time, Esther dispenses the drugs to the patient, provides health care advice and updates her records.Esther’s TB clinic clients are usually referred to Kayole II sub-district hospital from Toto Bora and other smaller health care centers.
In the Democratic Republic of Congo, many women suffer complications during pregnancy and delivery, including obstetric fistula. Prolonged labor may result in a hole (“fistula”) between a woman’s birth canal and bladder or lower intestine, resulting in chronic leaking of urine or feces. This, in turn, leads to social isolation as the women can’t keep themselves clean, are ashamed of their condition, and withdraw from society. Many women and their families believe that this condition is due to a curse, leading to further separation from the community.
Cross-posted on the K4Health blog. K4Health is a USAID project, led by Johns Hopkins Bloomberg School of Public Health's Center for Communication Programs (JHU-CCP), with partners FHI-360 and Management Sciences for Health (MSH).Worldwide 222 million women have an unmet need for modern contraceptives.
Using a basic household item like vinegar to screen for a deadly disease is one of those "Aha!" solutions that will save lives. I had never imagined that I’d get to see the procedure in action.Cervical cancer kills some 250,000 women every year -- over 80 percent from low-income countries, according to the World Health Organization (WHO). Early diagnosis can save lives, but many health facilities in developing countries struggle to find a way to screen women in remote, overcrowded settings.
Building local capacity is a pillar of the United States Agency for International Development's USAID Forward reforms. This post is one example of how USAID worked through Management Sciences for Health (MSH) to build, nurture, and support a local development stakeholder that is still thriving today. The story was written by global health writer John Donnelly, and first appeared in MSH’s book Go to the People in 2011.
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 #5a of reducing the maternal mortality ratio by three-quarters by 2015.What is most alarming is that a large proportion of maternal deaths could have been avoided if women had access to adequate health services, where the necessary quality medicines and supplies were available and skilled health providers were present.
In July 2011, Doreen Nalweyiso, a 27-year-old woman living in Mpigi Town Council, Uganda attended her second antenatal visit at Mpigi Health Centre IV. She was surprised to be examined with an ultrasound machine--and even more shocked to be told that she was expecting twins!“I was thrilled when the nurse showed me images of twins through the ultrasound TV scan. I had never experienced it in my lifetime,” she explained.This was her first pregnancy and there was no history of twins in her family.
Each year over 10 million men, women, and children in developing countries die as a result of our collective failure to deliver available safe, affordable, and proven prevention and treatment. A recent analysis of innovations in products and practices for global health, from the Hepatitis B vaccine to use of skilled birth attendants, revealed virtually none of these life-saving interventions reaches much more than half their target population—even after as many as 28 years of availability.
Afghanistan has yet another village which has successfully become an Open Defecation Free (ODF) zone. Baghalak is a village in Nahrin district with 630 inhabitants dispersed among 90 households --- each with unused latrines in poor condition. For this reason, Baghalak was selected by the USAID-funded project, Sustainable Water Supply and Sanitation (SWSS) and the Organization for Health Promotion & Management to partake in community-led total sanitation (CLTS) training.
The prospect that we may see the end of AIDS in our lifetime has never been greater. Over the last decade, the global HIV & AIDS community has achieved stunning successes, including a steady decrease in new HIV cases, a massive scale-up of antiretroviral therapy (ART), and proof that treatment is prevention. As we begin the XIX International AIDS Conference, we are also excited by new scientific advances in prevention and treatment, such as Option B+ for prevention of maternal-to-child transmission (PMTCT).
USAID and partners are hosting a Twitter chat in preparation for the 19th International AIDS Conference. The #AIDSChat began at 10 am EDT and continues throughout the day.Management Sciences for Health (MSH) will be co-hosting from 2:00 - 2:30 pm on the topic of prevention of mother-to-child transmission (PMTCT) of HIV with Scott Kellerman, MD, MPH, tweeting from @MSHHealthImpact.Ask questions, comment and follow on Twitter with #AIDSChat.
Karla came from a troubled home where there was domestic violence, drug use, and general turbulence. She was repeatedly sexually abused by a relative in her home.In 2008, Karla participated in the In School Youth (ISY) HIV prevention program at her secondary school in Region 4, Guyana.Agape Network Incorporated, a USAID-funded, faith-based organization, leads the ISY program.
On this historic World Population Day --- the first with the world’s population at seven billion and growing --- we call your attention to a crucial summit in London happening today, and to the ongoing importance of supporting access to family planning and sexual and reproductive health.The London SummitOver one hundred high-level decision-makers are convening at The London Summit on Family Planning in hopes of securing a better future for women and girls globally.
Rabi gives a public awareness lecture on HIV. (Photo credit: MSH, Nigeria)Forty-year old Rabi Suleiman lives in Koko Besse area in Kebbi state, Nigeria. She is married without children. Rabi, who now lives with her third husband, recalls that her ordeal with illness and social ostracism began in 2009. Rabi’s three marriages were the result of her inability to conceive, and a continuous search for a partner with whom she could successfully bear children.
Securing funds from donors and partners can be challenging for Nigerian non-governmental organizations (NGOs), given the nation’s large pool of competing organizations. In order to earn funds, NGOs must have strong proposal writing skills, the ability to defend their proposals, and efficient operational capacity.The Global Health Awareness Research Foundation (GHARF) is a community-based organization operating in Enugu state in southeastern Nigeria.
Ramatu Fullah is a 27-year-old woman in the Pujehun district of Sierra Leone. She comes from a poor family and, for years, had to earn her living as a sex worker to take care of her two children. Recently, Ramatu learned skills that enabled her to change her trade through an awareness-raising campaign supported by the USAID West Africa Regional Health Office's Action for West Africa Region II (AWARE II) project, managed by Management Sciences for Health (MSH). Today, Ramatu sells acheke, a local delicacy, on the streets of Sierra Leone.
In the small Afghan village of Toghak, where open defecation affected the sanitation and health of the community, two women took the initiative to mobilize themselves and others into transforming Toghak.
Ms. Fatima and Ms. Rukhsar attended a community-led total sanitation (CLTS) workshop in the neighboring village of Gheyas Said Abd and learned life-saving lessons they wanted to take back to their village. They learned that flies tend to breed in bacteria infested places, particularly human feces, and then transport the fecal matter to food meant for human consumption.
The USAID-funded Sustainable Water Supply and Sanitation Project, Afghanistan (SWSS) project increases access to potable water and sanitation services in Afghan communities and decreases the prevalence of water borne diseases through household hygiene interventions. Led by the Association for Rural Development, in partnership with Management Sciences for Health, SWSS has led nearly 400 communities in Afghanistan to become Open Defecation Free. The MSH components of the project have succeeded under the astute leadership of Dr.
Sophia is a humble woman. She has been working as a nurse for 10 years, and is currently one of five nurses posted at Rwesande health center IV in the hills of western Uganda.
When I arrived I was impressed by the number of services the health center offers, and the general appreciation felt around the compound. Rwesande health center IV has a maternity ward to safely deliver babies; counseling areas for family planning, reproductive health, and HIV; a general ward, a surgery theater, and health education space.
Family planning counseling and services now available
The prevention of mother-to-child transmission (PMTCT) of HIV is taking center stage this week during USAID’s 5th Birthday campaign -- and rightly so. Preventing mother to child transmission of HIV is one of the most critical, effective tools to helping kids reach their fifth birthdays.Ambassador Eric Goosby and UNAIDS Executive Director Michel Sidibé have called for the elimination of pediatric HIV by 2015.
Apegnon Akpene is a 20-year-old mother of three children: four-year-old Joseph, two-year-old Romance, and one-month-old Akou Jacqeline. Since attending USAID's Action for West Africa Region, Phase II (AWARE II) community health worker training, she has become a client of family planning -- and a role model for family planning in her community.Akpene is one of three community health workers in Diguegue, a small village of about 800 people in the hills of the southwestern forest separating Togo and Ghana. Distance and difficult terrain are major hindrances to accessing
Cross-posted on USAID's IMPACT blogMy most vivid early childhood memory is waking up to excruciating pain in my throat, and seeing the goldfish swimming in the aquarium of the pediatric surgical ward. Although penicillin had been discovered 30 years earlier, doctors had not learned yet that treating "strep throats” with penicillin was better than operating. I didn't need the tonsillectomy. But, I was lucky to receive quality care in a health facility, close to my home.Millions of children today are not so lucky.
Stigmatized, isolated, and conditioned to undertake hard labor, 14 year-old Chinaecherem Nwodo shows that one can overcome the most dire circumstances. Chinaecherem was despised and accused of witchcraft in her community, the Onu-Orie-Obuno-Akpugo village in Nkano West Local Government, Enugu State, Nigeria. Her abusive treatment by community members reflected the challenges facing some children in rural areas of Nigeria.The community blamed her for her mother’s death and father’s insanity.
Early in the morning of January 31, 2012, caregivers, support group members, village leaders, and the local council secretary gathered to say goodbye to 9 girls and 11 boys, orphaned youth ranging in age from 15 to 17. From 10 different villages in the Mohale’s Hoek district of Lesotho, these teens were headed for new horizons.The adults wished the youth well, encouraged them to try their very best, and waved them off as they boarded the bus.
Today, April 25th, Management Sciences for Health (MSH) joins the global community marking World Malaria Day. "Sustain Gains, Save Lives: Invest in Malaria" -- the theme of this year's World Malaria Day -- recognizes this crucial juncture in the global fight against malaria.Significant gains have been made in the last ten years; since 2000, malaria mortality rates have decreased 25 percent globally, and 33 percent in Africa.
Suzanna Ile, a 26-year-old woman from South Sudan, lost her first two babies in childbirth. Suzanna did not have a nurse or midwife to tell her that her pelvis was dangerously small for childbirth; nor was there a safe place for a caesarian section even if she had known the risk.Suzanna’s experience is typical of what women have faced in South Sudan, the newest country in the world. South Sudan is home to 10 million people, spread across an area about the size of France.
It was 11 o’clock one February morning when the Santé pour le Développement et la Stabilité d’Haiti (SDSH) project technical team arrived on site at St. Joseph Health Center.The center’s activities were well underway. Dozens of people sat on benches or stood in line, waiting for their turn. One person comes to care for her child who has had a high fever. Another comes for contraception. Another just gave birth to a healthy infant.St.
Cross-posted on TB-CARE I.World TB Day, March 24th, was commemorated in many countries around the world last week to acknowledge the accomplishments made in the fight against tuberculosis (TB), and to call attention to the work that still needs to be done.Voices of TB, a unique event organized by USAID, featured former TB patients speaking about their personal fight against TB.
The Kasese district in western Uganda is nestled between two national parks. Located hours from the capital city, Kampala, the region attracts tourists to view gorillas and mountain birds.During my recent trip to Uganda, I met with Dr. Yusuf Baseka, the district health officer of Kasese, who described the health challenges his district faces, and his hopes for the future.Although the national parks are beautiful and bring a much needed economic boost to the area, they also offer a challenge, Dr.
Early one morning Mrs. Fred woke up and found a boy outside her house. Alarmed and curious, she asked him why he was there. Godgift, as he identified himself, told her that the continuous appearance of a snake where he lived forced him to abandon the place he called home, after numerous futile attempts to frighten it off with pepper. Highly disturbed, she arranged for him to eat in a nearby restaurant whenever he showed up by her house.The boy, Godgift Henshaw, is 13 years old. Godgift's mother took him along when she left her husband and eloped with another man.
In the 1990s many Brazilian patients infected with tuberculosis (TB) were not being cured, despite starting treatment. Some patients stopped taking their medication, which led to the reemergence of TB. In 1993, the World Health Organization declared that TB was a global emergency.
Over the years, the Koboko health centre IV located in the West Nile region of Uganda has experienced challenges in the management of essential medicines and health supplies. Stock-outs of vital medicines were widespread, while huge quantities of slow-moving medicines were at risk of expiring. These problems were attributed to health workers’ poor skills in logistics management. In addition, there a was lack of reliable information to guide staff on when and what to order since stock cards were not regularly updated.
Today is International Women’s Day, celebrated around the world as an opportunity to look back on women’s accomplishments and look forward to the realization of their full economic, political, and social rights. The United Nations theme for this year, “Empowering Rural Women,” is one that resonates powerfully with MSH’s work.We’d like to take this occasion to thank all of the women and men who, for over 40 years, have helped MSH enable rural women to have more control over their health and the health of their families.
Mbambu is a midwife who works at Isole Health Center III in rural Western Uganda. When I had the opportunity to visit with her, she was the only health care provider at the center. Trained as a midwife nine years ago, her passion for her job pours out of her.
This was my first trip to Africa working with a development agency. While I had visited the African continent for personal trips previously, arriving in this context felt different. I was immediately aware of the challenges Uganda is facing. From the crumbling road infrastructure and high incidence of traffic accidents in Kampala, to the mobile phone networks that are pretty reliable while internet access is often spotty, to the prevalence of street children --- I can for the first time see what my local colleagues are up against.I felt a bit overwhelmed in the first few days.
Kalu, a young man from Kenya, dreamed of becoming a star footballer (soccer player). Little did he know when he traveled to South Africa to pursue his dream that he carried in him a hidden passenger: the HIV virus.
Norah, a 21-year-old teacher at a private school in Nansana, Uganda, did not know she was pregnant. Pain in her lower abdomen prompted her to go for a consultation at a private clinic in Nansana, where a urine test revealed the pregnancy. “I was shocked because I had last had my period on the 15th of that month,” Norah said.
Namibia, with just 2.2 million people, has one of the highest AIDS prevalence rates in the world, at roughly 13.1 percent. The country’s small population is spread over a large geographic area, making the delivery of AIDS services a challenge especially in remote villages.
Inside Story: The Science of HIV/AIDS, a new feature-length docudrama in which USAID plays a supporting role, premiered to a packed theater in Johannesburg, South Africa, on World AIDS Day, December 1, 2011.Inside Story is a unique mixture of science and fiction and includes cast members and characters from Nigeria, Kenya and South Africa.Kalu, a rising Kenyan soccer player, migrates to South Africa to establish his career. A romantic encounter leads to the unwelcome realization that he is HIV positive.
Shortly after delivering her baby boy at home, Alice Gune grew nervous for his health. Her baby had a high fever and was obviously uncomfortable and unhappy.
She took him to see Rose Kujang, the Maternal and Child Health Worker, during a community outreach program orchestrated by Kuda Primary Health Care Center (PHCC). Rose examined Alice’s baby and, recognizing the danger signs he presented, immediately referred her to Kuda PHCC for further diagnosing and treatment.
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.
The 16th International Conference on AIDS and Sexually Transmitted Infections (ICASA) opened today, December 5, 2011, at the newly refurbished Millennium Hall in Addis Ababa, Ethiopia, with a colorful and lively music and dance production by the Ethiopian National Theatre and Traditional Music Group and the Addis Ababa Youth & Children’s Theatre.UNAIDS Executive Director Michel Sidibé gave an impassioned welcome speech remembering the last 30 years of AIDS and the 24 million African lives lost to the epidemic.
At a satellite session at the 2011 International Conference on Family Planning on November 30 in Dakar, MSH asked five panelists to discuss successes in family planning, and what still needs to be done. The conversation was moderated by MSH’s Issakha Diallo and held in conjunction with a celebration of MSH’s 40th anniversary.
Jessica Poni is a midwife in Panthou Primary Health Care Center -- the only primary health care center in Aweil South County in Northern Bahr al Ghazal, South Sudan. Panthou Primary Health Care Center is managed locally by the International Rescue Committee (IRC), the implementing partner of the USAID-funded Sudan Health Transformation Project (SHTP II), led by MSH.
The images of tuberculosis patients from the developing world are often painful to look at: the outlines of rib cages taut against skin; arms and legs no thicker than wiffleball bats; a wild-eyed look of fear from sunken eyes. But the image of Mildred Fernando, captured here by photographer Riccardo Venturi, turns heads toward her.
Samiha Badawy, a nurse at the Al Sabaeyya Hospital in Aswan, Eqypt, other nurses, health managers and Directorate of Health staff, are learning how to improve infection control and patient safety through a leadership development program called Improving the Performance of Nurses (IPN).
An estimated 400 people gathered in Asram, Togo, to watch a ceremony introducing 250 newly-trained community health workers -- part of the Action for West Africa Region II (AWARE II) project, supported by USAID and led by MSH.
Joanie, a woman from Linden, Guyana who is mentally ill, was diagnosed HIV positive in 2005. Her mental illness prevented her from accessing health services and support. Her HIV remained untreated. She rejected the attempts of relatives and friends to assist her, and spent most of the day on the bank of the nearby Demerara River, refusing to wear clothes.
Picture trees, water, mountains, mud, birds and fish. This is Lake Chirwa -- the second largest of the five lakes in Malawi and the main habitat of small fish called Matemba. The lake offers a trading opportunity for fishermen from many walks of life.Lying in the southern region of Malawi, Lake Chirwa is a wetland for people of three districts: Phalombe, Zomba and Machinga. All these people have frequent contact with Mozambique as they lie near the bordering frontiers.
HIV-positive women in Nigeria are the primary caregivers for their own families and other people living with HIV. This disproportionately high burden of care has detrimental effects not only on their health but also on their economic well-being.The MSH-led, USAID-funded, Prevention Organization Systems AIDS Care and Treatment (ProACT) project in Nigeria has helped establish HIV support groups whose participants are 80 percent women.
Earlier this year, USAID supported the launch of the Leading High-Performing Healthcare Organizations program (LeHHO) for senior health leaders in Kenya. Offered at Nairobi’s Strathmore Business School, the program is the result of a successful partnership between Strathmore and USAID’s Leadership, Management and Sustainability (LMS) project in Kenya.
Walking through Lologo South, I am struck how the community here mirrors both Juba and South Sudan as a whole. Growth is explosive throughout this newly independent nation. Every day a new shop or office building breaks ground. In Lologo South, a residential community just south of Juba, thousands of new houses, fences, and animal carrels are in various states of construction.
From Alima Twaibu’s village in Nhkotakota district, it is 10 km to the nearest Health Center or 16 km to the District Hospital. With more than 80% of the population living in rural areas, the majority of Malawians experience similar challenges to accessing care. People have to walk long distances to receive services when they are sick. And when time away from work or paying for transport competes with other basic expenses, the decision to seek preventive services like family planning and HIV testing and counseling (HTC) is even more difficult.
Blog post updated Dec. 27, 2011. In 2003, after dwindling funds, low staff morale, and accusations of patient neglect had eroded community confidence in Kiriaini Mission Hospital in Kenya, the Catholic Diocese of Murang’a decided to shut it down -- leaving locals to seek treatment at the distant provincial capital of Nyeri.Six months later five Franciscan nuns arrived from India to reopen the hospital. They hired new staff, renovated the dilapidated structures, and restored much needed services to the rural community.
Deborah Nyantiok is 56 years old and lives with her grandchildren in Kaya, near the border of Uganda. She lost her husband during Sudan’s 20-year civil war and now takes care of her grandchildren. In order to pay for food and school fees, Deborah operates a small business and keeps animals to generate income. Despite her hard work, in the past Deborah found life difficult as she and her grandchildren often fell ill.
In the kidney dialysis unit of Kom Ombo District Hospital in Upper Egypt, dedicated nurses prepare for the monthly treatment of a regular patient. They have assured the proper functioning of medical equipment, stocked the dialysis room with necessary supplies, and prepared staff for the dialysis process. However, the patient is missing.Meanwhile, the patient---a young man named Kasim---stands alone outside the hospital entrance. Kasim has impaired mobility resulting from an amputated leg and relies on a prosthetic limb or the help of relatives to accomplish daily activities.
Grace Bonongwe is a grandparent. She comes from Zovuta Village T/A Nsamala in Balaka, about 10 kilometers from the nearest health facility. Of the nine children she has given birth to, only one lives to this day. The rest have died over the years from different diseases.Grace is no stranger to disease and affliction considering she has gone through the pain of losing eight of her children. So when her husband fell ill, she dismissed it as a normal occurrence that would eventually lead to his demise.
Safoura Amadu is the 19 year-old mother of Ibrahim, who was born preterm on March 8, 2011 at 1.46 kg (3.2 pounds). Baby Ibrahim did not grow well in his first days of life. Safoura was very worried---her first child had died at birth---and she did not want to lose Ibrahim, her second child. Safoura sought help and when Ibrahim was ten days old she and the baby were admitted to the new Kangaroo Mother Care (KMC) center at the Maternité Issakha Gazoby in Niger.
In 2006, Jamila, a 24 year old Guyanese waitress, took the opportunity to work in a store overseas with the hope of building a better life for her children. But her dreams were dashed when she arrived in the new country and realized the only job available was as a commercial sex worker.
Over the next couple of months, as MSH celebrates it's 40th anniversary, reporter John Donnelly and photographer Dominic Chavez will be traveling to several countries to report on MSH’s work in the field. The stories will go into a book due out in the fall on MSH’s 40 years in global health. This blog entry is a post from the road, to give a flavor of their experiences with MSH staff.(Part 1 of this story: Introducing Triage in Hospitals, and a Baby in a Coma) SALIMA, Malawi – A child enters a hospital in a coma. Health workers resuscitate him. The child regains his health.
Over the next couple of months, as MSH celebrates it's 40th anniversary, reporter John Donnelly and photographer Dominic Chavez will be traveling to several countries to report on MSH’s work in the field. The stories will go into a book due out in the fall on MSH’s 40 years in global health. This blog entry is a post from the road, to give a flavor of their experiences with MSH staff.LILONGWE, Malawi – The problem with writing about improvements in Malawi’s health system is focus.
Thousands of civilians fled from Abyei following the crisis in May, when northern forces took control over the town. The United Nations Office for Humanitarian Affairs (UNOCHA) reports 50,600 people displaced from Abyei town are verified and registered and estimates the full number to be about 84,000 people. Most of the Internally displaced persons (IDPs) fled to nearby Northern Bahr el Ghazal and Warrap States, where many humanitarian agencies are providing assistance in high displacement areas like Agok, Turalei, and Wunrock.
Kenya’s new constitution, promulgated on August 4, 2010, mandates significant transformations in the health sector. Hospital reforms are a key part of these transformations. For MSH’s Leadership, Management and Sustainability Program in Kenya (LMS/Kenya), the opportunity to work closely with health sector partners, including the Ministry of Medical Services, to support the hospital reform agenda is an exciting and rewarding experience.On Monday, June 6, the Permanent Secretary of Kenya’s Ministry of Medical Services, Ms.
South Sudan is recovering from five decades of civil war. A lack of infrastructure, human resources, and ongoing violence has ravished the country’s health services. MSH is helping the new Ministry of Health manage the transition to a national health system in the midst of renewed fighting in Abyei and as masses of people, anticipating the formation of the world’s newest country on July 9, 2011, re-enter South Sudan.
Over the next couple of months, as MSH celebrates it's 40th anniversary, reporter John Donnelly and photographer Dominic Chavez will be traveling to several countries to report on MSH’s work in the field. The stories will go into a book due out in the fall on MSH’s 40 years in global health. This blog entry is a post from the road, to give a flavor of their experiences with MSH staff. SALIMA, Malawi – For three years, Lucy Sakala has helped counsel people seeking HIV tests at the Salima District Hospital.
Listen to USAID Deputy Administrator Donald Steinberg and MSH Chief of Party John Rumunu (South Sudan) and MSH Center for Health Services Vice President Diana Silimperi talk about health systems in fragile states.This teleconference is in conjunction with the health and fragile states conference at US Institute of Peace happening June 9 and 10, co-sponsored by MSH.Management Sciences for Health (MSH) Press Teleconference on Fragile States and Health, June 8.
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.
When the Taliban were chased from power in Afghanistan in December 2001, the health system was in shambles---devastated by years of war and neglect. Access to primary care was below 10% and immunization rates had fallen below 20% throughout the country. Less than half the hospitals had both electricity and running water. Medicines and medical supplies were scarce and the quality was often unreliable. There were essentially no female health workers active in most of the Afghanistan---a country in which cultural sensitivities mean female providers are essential for women’s health.
Blog post updated Dec. 27, 2011.Taj Bibi sits nursing her 5-month-old baby in the kitchen of her home in the village of Sartal in Takhar province in Afghanistan’s north. The room is dark; the only natural light comes from the doorway to the dusty courtyard outside. The sound of her children playing echoes across the small family compound.Bibi’s first two children died -- one of them from severe diarrhea -- because the family could not afford to take them to the doctor.
Living in the rural village of Kpagnaroung, Benin, Orou Assoumanou is a dedicated health worker who promoted vaccinations and distributed ivermectin (a medicine used to treat roundworm) within his community before receiving training by the MSH-led, USAID BASICS (Basic Support for Institutionalizing Child Survival) project in community-case management.
In the village of Owa Ofie, Nigeria, Cynthia Isioma, a young girl who has survived enormous odds reclaimed her dream of secondary education.
Cynthia lost both parents at the age of two and was left in the care of her grandmother who died three years later. Cynthia’s situation grew more challenging when she was then moved to her blind grandfather’s home at the age of five.
This blog post originally appeared on the US Agency for International Development's IMPACT blog. As a procurement specialist with PEPFAR’s SCMS (the Supply Chain Management System) project, I am one of a growing number of women working in supply chain management in Ethiopia. I manage procurements of HIV/AIDS commodities---including the complex procurement of specialized medical equipment used to treat HIV/AIDS---as well as the vehicles that distribute those commodities.Well planned, strategic procurement is a smart investment.
Sitting under the lush mango trees in rural Tambura, South Sudan, I realized Mother’s Day was approaching and I needed to send my mom in Chicago a gift. More and more each year, I treasure my mom, who raised four children. But this year, while working on a health project in South Sudan, my appreciation and wonderment is also for mothers worldwide.Addressing maternal health in South Sudan is daunting, to say the least. The soon-to-be-independent nation holds one of the worst maternal mortality ratios in the world at 2,054 deaths per 100,000 live births.
This is a guest post from Olive Mtema, Policy Advisor, from the Community Based Family Planning and HIV & AIDS Services project in Malawi. Olive is an employee of the Futures Group. On March 12, 2011, Muslim Leaders gathered in Lilongwe, Malawi for a conference on Reaffirming Muslims' Positions on Family Planning and HIV & AIDS Issues.
Malaria is preventable and curable, yet every year it kills more than a million people throughout the world and tens of thousands in Southern Sudan alone. Malaria infection remains the highest cause of morbidity and mortality in Southern Sudan. Every year, thousands in Southern Sudan die unnecessarily due to lack of access to appropriate prevention and treatment. In the wake of nearly 50 years of civil war, the country is hastening towards independence and a future with unlimited potential.
Over the course of the past ten days, I have been fortunate to visit the Central, Eastern, and Western Regions of Uganda. As part of these visits, I have traveled through and spent time in many of the districts in these regions. It is during these drives through the countryside that I have noticed the campaigns for family planning services over and over again.
As we celebrate World Health Day on April 7, 2011, the global health community is focusing on an increasingly dangerous health challenge---drug resistance. Antimicrobial resistance (AMR)---defined by the World Health Organization (WHO) as the resistance of a microorganism to an antimicrobial medicine to which it was previously sensitive---is a global public health threat that is rapidly wiping out the effectiveness of many first-line treatments.
Strong leadership, governance, and management are the cornerstones of successful global, national, and local efforts to save lives and achieve the maximum impact from health investments. Yet effective leadership, management, and governance skills and practices too often are the vital missing elements in public, civil society and even private health organizations. Fortunately, these skills can be developed.
As Haitians continue to struggle against many obstacles in improving and developing their country, cholera and sanitation remain challenges to many development efforts.Since the cholera epidemic started in October, there have been a total of 252,640 confirmed cases. MSH integrated its response, where appropriate, with the national response that was coordinated by the Ministry of Health.
News from the HIV Capacity Building Partners Summit in Nairobi, KenyaSub Saharan Africa still remains the unenviable epicenter of the global HIV and AIDS epidemic. Over the years, the region has witnessed intensified emergency efforts to expand access to HIV treatment, prevention, care and support.
Terekeka, a growing county and town just 60 miles north of Juba, translates as “The Forgotten” in the local dialect. Just five years ago, this area was awash in violence, poised close to the frontlines of a civil war which resulted in the death and displacement of millions. Villagers and returnees began repopulating the area after the signing of the Comprehensive Peace Agreement in 2005, which heavily increased demand for health services.
Every day people are dying in the developing world because they cannot access affordable, quality medicines. Modern pharmaceuticals have revolutionized health care, but weak health systems prevent many people from accessing basic life-saving medicines. The health of men, women, and children can be dramatically improved throughout the world by enhancing access to and improving the use of essential medicines and other health care technologies.Gaps in the management and availability of essential medicines and health commodities have been a constant weakness for developing countries.
Aberu Hailu is a 31 year old, mother of four living in Hidmo, Ethiopia a rural community 8 kilometers south east of Adigodum town in Tigray. Two years ago, she visited the Adigodum Health Center to be tested for HIV, a disease she had learned about through community health education. She discovered she was HIV-positive and informed her husband that he should be tested, but he refused.Two months later, Aberu became pregnant and found herself in despair.
Dr. Karima, General Directorate of Pharmaceutical Affairs, Ministry of Public Health, speaks at the opening ceremony of the Drug and Therapeutics Committee training course for provincial hospitals On the eve of the International Women’s Day, the Strengthening Pharmaceutical Systems (SPS) Program in Afghanistan had the opening ceremony of the Drug and Therapeutics Committee (DTC) training course for provincial hospitals in Paktya, Paktika, Khost, Ghazni, and Badakhshan.
Afghanistan’s mountain ranges are beautiful to the eye. Rugged peaks and ridges are separated by valleys, carved out over the centuries by streams and rivers supporting the green web of vegetation along their banks.But many of the small villages that cling to the walls of these valleys are often cut off for months by heavy snow or the floods that follow the spring melt. The cold wet climate, together with smoke from household stoves, increases the risk of pneumonia, particularly among babies and children.
This article was orignially posted on FHI's Interagency Youth Working Group (IYWG) blog. Several months ago, I was asked to help manage a newly redesigned site that focuses on children and HIV & AIDS. I knew that over the last decade there had been an enormous increase in both the amount of and access to global health information. Thus, the challenge was to shift from simply producing more material to organizing, exchanging, and effectively using this growing knowledge base.
The West African nation of Benin faces many challenges in achieving Millennium Development Goal 4---reducing child mortality. In the rural communities in Benin (91% of the population live in rural areas), access to health care and treatment is inadequate in relation to the vast need. Very few people have the appropriate skills and capacity to deliver care in these areas.
Part six of the blog series: Spotlight on Global Health Initiative Plus Countries Amid grave health statistics, the Global Health Initiative (GHI) brings hope of a healthier future in Mali.Mali is one of the ten poorest countries in the world, ranking 173 out of 175 countries on the 2007 Human Development index of the United Nations Development Program (UNDP).
Human rights are no longer considered peripheral to the AIDS response. Human rights are an essential tool of public health. 80% of countries explicitly acknowledge or address human rights in their national AIDS strategies. However, 80 countries still have punitive laws against people with HIV which pose significant challenges to the AIDS responseIn the past decade, there have been some major developments in the HIV epidemic. New cases have decreased, 5 million people are now on treatment, and people are discussing the importance of human rights in relation to the disease.
Prior to January 12, 2010, Management Sciences for Health’s Leadership, Management and Sustainability Program was working with Haiti’s Ministry of Public Health and Population to build capacity in several areas: family planning and reproductive health; commodity management and security; coordinating HIV & AIDS awareness and community mobilization activities; and leadership development.
January 12, 2011 marks the one year anniversary of the earthquake that devastated Port-au-Prince, Haiti. I have the good fortune of visiting MSH’s USAID-funded SDSH (Santé pour le Développement et la Stabilité d’Haíïti) project team in Port-au-Prince this week, and I traveled out into the city to see the devastation the earthquake caused.It has been a catastrophic year for Haitians. The Haitians themselves say this, a people who are used to dealing with poverty, combined with yearly hurricanes, and near constant political instability.
A few weeks ago, I had the opportunity to visit Southern Sudan. For over five decades, Southern Sudan endured civil war, unrest, and several waves of forced displacement and refugees. The infrastructure of nearly every sector was mostly destroyed throughout the region.
The carefully irrigated and shaded kitchen garden provided welcome splashes of different shades of green against the surrounding dry brown soil and rocks. We congratulated Shukria, a community health worker (CHW), on the lush vegetables and ripening fruits as we entered her home.Shukria explained that the gardens that she and other women were growing started with the community-based growth monitoring program through the Family Health Action Groups.
Many children in Afghanistan die each year of easily preventable diseases; nearly 25% of those deaths are due to diarrhea. However, it is not only the fatal cases of severe diarrhea that are imperative to address. Between a quarter and a half of mothers of children less than five years old report their child had diarrhea in the two weeks prior to questioning.
Three months ago, Annie Likhutu, a mother of six, came to Migowi Health Center in Phalombe, Malawi to receive voluntary HIV counseling and testing (VCT); now, she is back at the health center and ready to be tested for a second time.“It is very important to know your status, it is no good waiting until you get sick,” she said.Annie initially learned of the importance of testing through a radio advertisement from Word Alive Ministries International (WAMI), which is aired regularly and encourages listeners to go to health centers for VCT.Although Annie takes pride in knowing her stat
There have been a collection of high-profile and well attended mobile health (mHealth) “summits” held around the world in the past few years, including last month’s second annual mHealth Summit in Washington, D.C. (headlined by Bill Gates and Ted Turner), but the really interesting conversations are happening on the African continent.
MSH is attending the Social Welfare Workforce Strengthening Conference in Cape Town this week. AIDSTAR-Two, a USAID-funded MSH led project, is a key organizer of the conference. Ghazal Keshavarzian, Better Care Network Senior Coordinator, provides an update from the Social Welfare Workforce Strengthening Conference in Cape Town, South Africa. This post originally appeared on OVCsupportnet.org.
Last year, the mHealth Alliance and the National Institute of Health (NIH) sponsored their first mobile health (mHealth) “Summit,” at the Ronald Reagan building in Washington, DC. The location was telling: it is the home of the US Agency for International Development (USAID). This year’s mHealth Summit has nearly doubled in size, moved its location to the Convention Center, and is being keynoted by Bill Gates and Ted Turner. It is safe to say that mHealth is certainly a topic de jour.
Blog post also appeared on Global Health Magazine. As the country with the second highest maternal mortality rate in the world, outranked only by India, Nigeria loses one in every 18 women during child-birth.
In late October 2010, the USAID Supply Chain Management System project (SCMS) distributed close to 50,000 lbs of essential products including oral rehydration salts, antibiotics, lab supplies, water treatment and ringer lactate to support Haiti's response to the cholera epidemic. The commodities came from existing stock in the SCMS warehouse as well as products available on the local market. SCMS also provided international procurements of 60,000 IV solution units and 20,000 IV sets.Antoine Fadoul is the Supply Chain Management System Country Director in Haiti.
A team of experts from WHO, UNICEF, UNFPA, and World Bank recently published a report on maternal mortality entitled “Trends in Maternal Mortality: 1990 to 2008" (PDF).The document reports some fantastic news about a public health indicator that has until recently refused to budge. That indicator is the maternal mortality ratio, the number of maternal deaths per 100,000 live births. The improvement between 1990 and 2008 is significant and promising.The part of the report that received much less coverage relates to HIV and its strong, adverse effect on maternal mortality.
(Read Part I)On Wednesday we met with a group of some 15 community health agents from the surrounding villages. Our discussions revealed the ironies of Haiti. In a country where almost everyone has a relative who lives in the United States or Canada, and where remittances from overseas far surpass the total amount of international assistance coming into the country, the only source of drinking water in their villages, they told us, was the river. There were no latrines.
Reeling from ShockEstama Murat, Director of the Drouin Methodist School, cautiously hopes to reopen: “This obviously will not come easy," he says, "because we have many children still sick and other pupils have fled the village.”Drouin is in Grande Saline, where the cholera virus was first discovered in the Artibonite department last week. The population of 17,000 is still in shock. Many of them left for the chief town of Gonaives, Mr.
Fragile states such as Afghanistan, the Democratic Republic of Congo, Haiti, Liberia, and Southern Sudan have among the worst health statistics – especially for women and children. For political, economic, security and other reasons they can be extremely challenging work environments.
The Management Sciences for Health Haiti staff continues to work tirelessly alongside local partners to mitigate the cholera outbreak. A sample of today’s work is outlined below.MSH in the Affected RegionsMSH partner, Hospital Claire Heureuse, is dispatching a “battalion” of community health workers throughout the rural areas where many people are dying before reaching health facilities. The community health workers are stocked with megaphones, soap bars, water purification tablets, and oral rehydration sachets.
Yesterday the Direction of Civil Protection and Disaster in Haiti confirmed a cholera outbreak in two departments (districts) of the country resulting in 1,498 cases managed in health facilities and 135 cholera related deaths.The USAID-funded, MSH-led Santé pour le Développement et la Stabilité d’Haíïti (SDSH) project is working closely with Haiti’s Ministry of Health and other local and international partners to coordinate a community-level response to the cholera outbreak.SDSH is mobilizing its established network of over 4,000 community-base
Part one of the blog series: Spotlight on Global Health Initiative Plus CountriesGender Mainstreaming in EthiopiaWith the announcement of the “GHI Plus” countries, we have a major opportunity to move the gender agenda beyond the rhetoric. The new guidelines clearly show that this issue is not only important, but also one of the major pillars for global health. The mandate has been given and the challenge now is to build on this legitimacy that has been hard earned and continue to seek opportunities, design interventions, and diligently document best practices.
This article was originally posted on K4Health’s Blog.Twelve months ago the K4Health project began its needs assessment to better understand how the flow of knowledge, information, and communications could be improved with regards to Family Planning and Reproductive Health, and HIV & AIDS, in support of the K4Health project.Seven months ago – in December 2009 – the project returned to disseminate the results of the assessment; to meet with key stakeholders at the national, district and community levels; and to present some ideas for improving the flow of information up an
Over 100 delegates from 30 countries participated in the “National Pharmacovigilance Systems: Ensuring the Safe Use of Medicines” conference held in Nairobi, Kenya, August 16–18, 2010. Organized by Management Sciences for Health’s (MSH) Strengthening Pharmaceutical Systems (SPS) program, which is funded by the U.S.
At a time when many are looking for examples of lasting local success in international development and sustainable approaches to healthcare for low income populations, PROSALUD, Bolivia’s largest health nongovernmental organization (NGO), embodies this success. PROSALUD just celebrated its 25th anniversary last week – and MSH was there to help celebrate.
On June 17, 2010, I was honored to attend and speak at a ceremony where Management Sciences for Health officially handed over 35 tons of life saving essential drugs to the Republic of Congo (DRC) in Kinshasa. The ceremony was chaired by Dr. Victor Makwenge Kaput, the DRC’s Minister of Health. These drugs represent the first half of an initial order of pharmaceuticals and medical supplies worth more than $ 1.5 million, and were made available through funding from USAID/DRC.
“Songs brought by foreigners do not last long at the dance.” So goes a Kenyan proverb that supports the concept that countries should own their development. The development community knows this, but we aren’t yet making it happen on a broad scale.
Just over five months ago, Haiti suffered a devastating earthquake that displaced more than 700,000 people. Addressing the health needs of such a large population in a post-disaster situation is a complex challenge, one Management Sciences for Health (MSH) is supporting through its many programs including our Leadership, Management and Sustainability Program (LMS).