Photo Credit: Samy Rakotoniaina/MSH

This article was originally published in NextBillion.

What does scalable innovation in global health look like?

It could be a piece of software that provides faster access to blood supplies in Cameroon, an m-health platform that links virtual health coaches to people facing chronic illness in Nigeria, or an app that lets people use points to buy and exchange health products in Senegal, helping them save for out-of-pocket expenses. Or it might be a primary care service that reaches underserved people in India via telemedicine, or a microscope app that can diagnose breast and cervical cancers in remote areas in sub-Saharan Africa, where some 400,000 women die each year because they cannot access screening services.

Omena Eghaghara, Supply Chain Management Specialist for the CaTSS project, visits with Mayowa. Photo credit: Aor Ikyaabo/MSH

By Omena Mimi EghagharaOmena Mimi Eghaghara is a Supply Chain Management Specialist for the USAID Care and Treatment for Sustained Support (CaTSS) Project, based in Kwara State, Nigeria. One September day in 2018, while providing supportive supervision to one of the CaTSS-supported facilities in Kwara state, I made the first of many calls to Mayowa, a 21-year-old medical student living with HIV. Mayowa was exhausted and losing hope.

{Girls carry water to their homes in Mopti region, Mali. Photo credit: Debbo Alafia consortium/MSH}Girls carry water to their homes in Mopti region, Mali. Photo credit: Debbo Alafia consortium/MSH

In recent years, and following the coup in 2012, Mali has experienced increased political unrest and violence, especially in the country’s north and central regions. Coupled with droughts and flooding, the situation has resulted in a significant increase in forced internal migration. In the Mopti region, many health centers have closed, and health providers have fled to safer urban areas as a result.  

Such instability has had dire consequences for the health of rural communities there. Women and girls are particularly vulnerable due to power imbalances within the family, limited access to resources, and increased vulnerability to sexual and gender-based violence (SGBV). Sexual violence remains underreported due to insecurity and the stigmatization of survivors, making it more difficult to ensure care and services effectively reach those who experience such violence.

Participants gather at a violence prevention and response action planning workshop with representatives of the government, health facilities, and local partner organization, ASCAM, in Luanda, Angola. Photo credit: LINKAGES/MSH

In 2017, the United Nations Development Programme (UNDP) as a principal recipient of Global Fund (GF) funding for HIV at the request of the Government of Angola, approached MSH, the implementer of LINKAGES, with an offer to complement the minimum service package for female sex workers (FSW) in Luanda Province.

David Kaliisa, a TB community linkage facilitator in Kawempe, Kampala, checks on Celeb and her daughter. While both received treatment for multi-drug resistant TB, Kaliisa made regular house calls to support their adherence to treatment. Photo Credit: Diana Tumuhairwe/MSH.

This op-ed was originally published in The Hill.

{A woman receives depo-provera contraceptive method at Area 18 health center in Lilongwe District, Malawi. Photo credit: Rejoice Phiri/MSH}A woman receives depo-provera contraceptive method at Area 18 health center in Lilongwe District, Malawi. Photo credit: Rejoice Phiri/MSH

Program seeds providers in high-density health center

In July, 23-year old Esther walked a fair distance to Area 18, a health center in Malawi’s Lilongwe District, since no family planning services were available in her area. She has one child and wants to wait before having a second. At the health center, Esther joined a group counseling session where all family planning methods were presented. Afterwards, during individual counseling, she shared her desire to wait at least five years before becoming pregnant. Once informed of her options, including long-term reversible contraceptives, she chose to receive an intrauterine contraceptive device (IUCD), and had it inserted right away.

“I will tell my friends about the IUCD,” says Esther. “I know the truth about how it works. We need to be careful not to pay attention to the stories people tell.”

{A mother and child wait outside a clinic on the outskirts of Mbuji Mayi, Democratic Republic of the Congo. Photo credit: Warren Zelman}A mother and child wait outside a clinic on the outskirts of Mbuji Mayi, Democratic Republic of the Congo. Photo credit: Warren Zelman

In the face of conflict, natural disasters, or other crippling events, women disproportionately suffer from preventable illnesses and death. In such circumstances, women are more likely to experience gender-based violence, and they have more difficulty accessing basic health services, such as obstetric care and family planning. This was evident in the wake of the Ebola outbreak in West Africa, when maternal mortality rose sharply between 2013 and 2015; with the HIV epidemic, when rates of HIV among young women soared in sub-Saharan Africa; and with spikes in sexual and gender-based violence that occur during a humanitarian crisis.

{Photo credit: Rudi Thetard/MSH}Photo credit: Rudi Thetard/MSH

"There is a great joy when the family comes back to hospital wanting to show that their less than 1500g baby has now grown into a healthy newborn with no trace that they were premature. Sometimes we meet parents in the market place who keep appreciating our efforts in saving their premature babies... I appreciate it so much when babies are born in hospital so care can be initiated as soon as possible." - Chelmsford Gondwe, Registered Nurse Midwife

The USAID-funded Organized Network for Everyone’s Health (ONSE) Activity and lead implementer Management Sciences for Health joined the world to commemorate World Prematurity Day on November 17, 2019. This global movement seeks to raise awareness about prematurity, calling for the participation of everyone in the prevention and care of small and sick newborns to avert deaths. This year’s celebrations were under the theme “Born Too Soon: Providing the right care, at the right time, in the right place.” 

 

“We want to provide excellent services to our patients; the same level of care they would receive in Paris, Thailand, or the United States of America.” - Dr. Lombe Kilamba, an HIV Case Manager at Kilamba-Kiaxi Municipal Hospital

The Government of Angola is working to scale up early diagnosis and treatment of HIV. While the country’s HIV prevalence is lower than many of its neighbors, AIDS-related deaths increased by 33% between 2010 and 2018. The number of new infections is also on the rise, particularly among young women, and just 28% of adults and 13% of children living with HIV are receiving treatment.

{LINKAGES Angola's peer educators: Garcia, Kudibanza, Dario, Michel, and Henrique. Photo credit: LINKAGES Angola}LINKAGES Angola's peer educators: Garcia, Kudibanza, Dario, Michel, and Henrique. Photo credit: LINKAGES Angola

This story was originally published on the LINKAGES blog

Written by Rafaela Egg, LINKAGES Angola; Ben Eveslage, FHI 360; Denizia Pinto, LINKAGES Angola; & Caitlin Loehr, IntraHealth International

 

“Here they come again with another ‘big idea,’ another innovation, to see how we can improve.” – Dario, community peer educator, Luanda, Angola

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