Before the civil war in the late 1990s, the Democratic Republic of Congo (DRC) had a large network of clinics and health facilities. But decades of conflict weakened a fragile health system and robbed this resource-rich country of its potential to become one of sub-Saharan Africa’s wealthiest nations. By 2010, 70 to 80 percent of Congolese people had little or no access to healthcare, and the country suffered from a lack of basic security, communication systems, power, clean water, and transportation. Exacerbated by a dearth of health providers, essential medicines and nutritious foods, the country’s maternal, infant, and child mortality rates rose to some of the highest in the world.

I’m in the U.S. this week to share my experiences working side-by-side with the Congolese government and partners on the Integrated Health Project (IHP), funded by USAID and implemented by Management Sciences for Health (MSH) and its partners, International Rescue Committee and Overseas Strategic Consulting, Inc. . The aim of IHP was to rebuild and strengthen the health system and improve health across 78 health zones in the country. In five years, IHP improved health services for more than 13 million people – 17 percent of the Congolese population.

For the fifth year in a row as part of MSH's annual storytelling contest, we invited staff to submit stories on how health systems are saving lives and improving the health of people around the world. MSH staff submitted dozens of stories from 16 projects in 12 countries.

In these 12 winning stories, meet health workers, community leaders, pharmacy managers, and patients working together toward healthier communities. These stories demonstrate the power of effective partnerships to help save lives.

Ethiopia: Changing Systems to Change Lives: Aster's Story [21]

By Tsion Issayas

[21]

Happy holidays and health on earth!

Envision a 2017 where everyone has the opportunity for a healthy life. Working together for stronger health systems around the world in 2017. Best wishes for the new year!

Like and share this ecard on Facebook:

MSH is a worldwide leader in strengthening health care financing systems toward universal health coverage (UHC). Stronger systems. Stronger women and children.

MSH has made tremendous impact on health care financing and UHC in the last two decades.

Performance-based financing

In 1999, MSH pioneered performance-based financing in Haiti, and has continued to adapt and improve upon it since. We contributed to and supported Rwanda to design, implement, and achieve UHC through community-based health insurance and performance-based financing; drastically reduce maternal and child mortality; and meet all of its health Millennium Development Goals.

In Democratic Republic of the Congo, we contributed to drastic reductions in child mortality and some of the greatest results-based financing outcomes in two decades [30].

Altogether, we've designed and/or implemented performance-based financing interventions in 14 countries across 3 continents (sub-Saharan Africa, Latin America, and South-East Asia).

Are you interested in health systems strengthening for the Sustainable Development Goals (SDGs), epidemics prevention, and global health security? Join MSH at these events during the 69th World Health Assembly in Geneva. Can't join us in person? Join the conversation online with hashtag #WHA69 [33]. On Twitter, follow @MSHHealthImpact [34], @MSHACTS [35], @NoMoreEpidemics [36], and @JonoQuick [37].

This Global Health Impact issue [40] highlights community health and community health workers, and presents a glimpse of MSH's work at the community level, in partnership with national ministries of health, civil society organizations, the private sector, and more.

The community is the center of the health system in developing countries.

Throughout sub-Saharan Africa, community health workers, often volunteers, represent the foundation of the health system, addressing priority health areas ranging from maternal and newborn health to family planning and infection prevention. The community health worker (known by different names in different countries) is the fundamental frontline promoter, provider of services and medicines (through integrated community case management), and the one who refers and links beneficiaries with more complex health needs to facilities. Not only do community health workers extend access to health services for the underserved and those living in hard-to-reach or conflict-ridden areas, they help countries accelerate certain health outcomes and achieve the Sustainable Development Goals and related targets for universal health coverage.

Many years ago I began my public health career in Ciudad Nezahualcoyotl, then a squatter settlement of 1.8 million people, bordering Mexico City in the State of Mexico. Lack of land and unaffordable rents forced poor migrants, streaming in from the country side in search of employment and a better life in the city, to settle in the surrounding peri-urban areas. This large municipality, with few paved streets, was difficult to navigate in the rainy season. During the dry season, the wind would kick up dust storms that made it hard to see a block ahead. Nezahualcoyotl means hungry coyote in the Nahuatl language  and too many families in Neza, as people sometimes called it, were poor and hungry.

Cross-posted with permission from Devex.com [46].

The World Health Organization’s first global report on diabetes [47] released this month highlights the disease’s “alarming surge” with rates that have quadrupled in fewer than three decades. The report reminds us that essential diabetes medicines and health technologies, including lifesaving insulin, are available in only one in three of the world’s poorest countries.

Availability of medicines is certainly an important piece of the complex challenge of ensuring that health systems seamlessly integrate prevention, screening, referral, treatment, and adherence. However, choosing the best way to spend limited public health budgets amid competing priorities is equally important.