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The TRACK TB project’s goal was to increase the case detection rate (CDR) and the treatment success rate (TSR) in focus areas to meet national targets for reducing the burden of TB, MDR-TB, and TB/HIV.

Despite making good progress toward digitizing client level data, the Government of Tanzania is still working to meet the latest global guidelines for HIV/AIDS programs. One major reason is that the country’s data collection and HIS do not efficiently deliver the quality information required for effective monitoring and planning.

Urban health facilities present particular challenges in TB service provision.

This webinar, presented on March 19, 2019, explores how expanding the World Health Organization’s directly observed treatment, short course (DOTS) strategy to the densely populated city of Kabul has helped the country strengthen its TB control efforts. Implemented by USAID's Challenge TB Project in partnership with MSH and a broad coalition of organizations and health workers in pu

The year 2015 saw a critical transition in global development. The Millennium Development Goals, which mobilized national governments to achieve remarkable improvements in health and reductions in poverty, were succeeded by the United Nations 2030 Sustainable Development Goals (SDGs). The 17 SDGs demand even more universal and ambitious action to eliminate poverty.

Mobile applications play an important role in field data collection in developing countries. However, poor infrastructure remains a challenge to fully utilizing mobile services. e-TB Manager, an electronic tuberculosis (TB) management system, is a web-based tool used to manage all TB-related data and information needed by national TB control programs.

The National TB Programme (NTP) in Ethiopia is committed to decentralizing and scaling up implementation of drug resistant TB (DR-TB) management by using an alternative ambulatory model to increase access to care. Challenge TB in collaboration with the NTP supported the implementation of programmatic management of DR-TB (PMDT) across the country by expanding treatment initiating centers (TICs

Contact investigation (CI) refers to the systematic evaluation of individuals who have been in close contact with potentially infectious TB cases within three months of TB treatment initiation. In Ethiopia, the USAID-funded HEAL TB and Challenge TB projects implemented three CI approaches: routine or prospective, reverse, and retrospective.

In Nigeria, tuberculosis (TB) is a major public health problem and low case finding remains a challenge to its eradication. The USAID-funded Challenge TB project supports GeneXpert sites across the country. However sub-optimal GeneXpert utilization due to modular failures, power supply issues, and inadequate samples has contributed to low TB case finding.

The Technical Support Services Project (TSSP) worked with the Tanzania Ministry of Health, Community Development, Gender, the Elderly, and Children (MoHCDGEC) to support and strengthen the Star Rating Assessment (SRA) Tool system. The project integrated HIV/AIDS indicators into the tool to create more comprehensive assessments of the country’s health care facilities. 

This report summarizes significant USAID MTaPS achievements, key challenges, program performance, and adaptation in response to new demands and lessons learned for the January through March 2019 period. The report is organized by health area, objective, region, and country.

In Bangladesh, the Directorate General of Family Planning (DGFP), with assistance from the US Agency for International Development (USAID), is well ahead of other countries in its use of locally developed and automated inventory management tools, especially at the upazila (sub-district) and warehouse levels.

In collaboration with the USAID-funded Rwanda Health Systems Strengthening Project and partners, Rwanda’s Ministry of Health introduced the Workload Indicator of Staffing Needs (WISN) tool in all public district and provincial hospitals in the country.

The Rwanda Medical Procedure Coding (RMPC) system was developed by Rwanda’s Ministry of Health, with technical assistance from the USAID-funded Rwanda Health Systems Strengthening Project, to harmonize procedure coding with an international standard.

A key challenge identified by a study on health sector staff retention, conducted by the USAID-funded Rwanda Health Systems Strengthening Project in 2017, was the lack of access to credit at a reasonable interest rate from commercial banks for building a home, purchasing essential items or meeting emergency expenses.

In collaboration with the Ministry of Health and other health sector stakeholders, the USAID-funded Rwanda Health Systems Strengthening Project conducted many interventions aimed at improving the performance of the health system at all levels.

Launched and administered with support from the USAID Rwanda Health Systems Strengthening Project, the District Operational Research Challenge Fund aims to build and grow the capacity of MOH’s district hospital staff and young health researchers to conduct research and implement sustainable public health programs.

In 2000, the Government of Rwanda decentralized health and other services to the district level. After nearly two decades of progressively taking on responsibilities for the health sector, district leaders are demonstrating stronger ownership of health initiatives.

In Rwanda, the Ministry of Health has committed to providing universal access to health services and improving the quality of care. An important factor that impacts quality and access to care is the amount of time patients wait to see providers at health facilities.

One of the most successful interventions designed to provide universal health coverage to the citizens of Rwanda has been the establishment of the Community Based Health Insurance (CBHI) Scheme. This provides a basic package of primary care and referral services through a wide network public and some private health facilities at an affordable cost for those who can pay.

Market intelligence data, United Nations Commodity Trade Statistics for insulin trade, the International Medical Products Price Guide for prices of human insulin and additional web searches were used as data sources. A total of 34 insulin manufacturers were identified. Most countries and territories are reliant on a limited number of supplying countries. The overall median government procurement price for a 10‐ml, 100‐IU/ml vial during the period 1996–2013 equivalent was US$4.3, with median prices in Africa and low-income and low‐ to middle‐ income countries being higher over this period.This research shows the high variability of insulin prices and the reliance on a few sources, both companies and countries, for global supply. In addressing access to insulin, countries need to use existing price data to negotiate prices, and mechanisms need to be developed to foster competition and security of supply of insulin, given the limited number of truly global producers.

The National Drug Authority (NDA) inspects and certifies private and public sector pharmacies in Uganda using an indicator-based inspection tool that measures adherence to good pharmacy practices (GPP). 67 measures identify the situation in the domains of premises, dispensing quality, stores management, and operating requirements. Although the GPP measures are well-recognized and used internationally, little is known about their validity and reliability. The study aimed to assess validity, which measures agreement of GPP measures between a gold standard inspector and NDA inspector and inter-rater reliability (IRR), which measures agreement among NDA inspectors, of GPP measures. We assessed validity and IRR by four teams of inspectors in eight government health facilities that represent three levels of care. Each team inspected two facilities, resulting in 24 total inspections. Our findings question the validity and reliability of many GPP inspection measures, particularly critical measures that greatly impact certification decision. This study demonstrates the need for assessments of, and interventions to improve, validity and reproducibility of GPP measures and inspections.

Stillbirth rates in Afghanistan have declined little in the past decade with no data available on key risk factors. Health care utilisation and maternal complications are important factors influencing pregnancy outcomes but rarely captured for stillbirth in national surveys from low‐ and middle‐income countries. The 2010 Afghanistan Mortality Survey (AMS) is one of few surveys with this information. We used data from the 2010 AMS that included a full pregnancy history and verbal autopsy. Our sample included the most recent live birth or stillbirth of 13 834 women aged 12‐49 years in the three years preceding the survey. The risk of stillbirth was increased among women in the Central Highlands and of Nuristani ethnicity. Women who did not receive antenatal care had three times increased risk of stillbirth, while high‐quality antenatal care was important for reducing the risk of intrapartum stillbirth. Bleeding, infection, headache, and reduced fetal movements were antenatal complications strongly associated with stillbirth. Reduced fetal movements in the delivery period increased stillbirth risk by almost seven. Facility births had a higher risk of stillbirths overall, but not for intrapartum stillbirths. Targeted interventions are needed to improve access and utilisation of services for high‐risk groups. Early detection of complications through improved quality of antenatal and obstetric care is imperative. We demonstrate the potential of household surveys to provide country‐specific evidence on stillbirth risk factors for LMICs where data are lacking.

A cross-sectional study was conducted among 735 new adult tuberculosis (TB) cases registered between January to December 2015 in 10 woredas, equivalent to districts, of southwestern Ethiopia. TB patients waited too long time to initiate anti-TB treatment, reflecting longer periods of morbidity and disease transmission. The delays are attributed to patient, disease and health system related factors. Hence, improving community awareness, and involving informal providers, health extension workers and TB treatment supporters can reduce the patient delay. Similarly, cough screening and improving diagnostic efficiencies of healthcare facilities should be in place to reduce provider delays.

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