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The coverage of prevention and treatment strategies for ischemic heart disease and stroke is very low in Ethiopia. In view of Ethiopia’s meager healthcare budget, it is important to identify the most cost-effective interventions for further scale-up. This paper’s objective is to assess cost-effectiveness of prevention and treatment of ischemic heart disease (IHD) and stroke in an Ethiopian setting. Fifteen single interventions and sixteen intervention packages were assessed from a healthcare provider perspective. Combination drug treatment for individuals having >35 % absolute risk of a CVD event in the next 10 years is the most cost-effective intervention. In Ethiopia, the escalating burden of CVD and its risk factors warrants timely action. We have demonstrated that selected CVD intervention packages could be scaled up at a modest budget increase. The level of willingness-to-pay has important implications for interventions’ probability of being cost-effective. The study provides valuable evidence for setting priorities in an essential healthcare package for CVD in Ethiopia.

The tuberculosis(TB) control program of Rwanda is currently phasing in light emitting diode-fluorescent microscopy (LED-FM) as an alternative to Ziehl-Neelsen (ZN) smear microscopy. This, alongside the newly introduced Xpert (Cepheid, Sunnyvale, CA, USA) is expected to improve diagnosis of TB and detection of rifampicin resistance in patients at health facilities. We assessed the accuracy of smear microscopy and the incremental sensitivity of Xpert at TB laboratories in Rwanda. This was a cross-sectional study involving four laboratories performing ZN and four laboratories performing LED-FM microscopy. A total of 96 presumptive pulmonary tuberculosis participants were culture positive for M. tuberculosis. The overall incremental sensitivity of Xpert over smear microscopy was 32.3 %; p 

Twelve Stories of How MSH Is Advancing Health around the World  This compendium of stories was submitted through an internal story-telling contest at MSH and represents the lifesaving work MSH and the frontline health workers we partner with perform every day, around the world.

Hosted by MSH, Gynuity Health Projects, and Jhpiego, this one-hour webinar shared innovations – interventions, technologies, and distribution approaches – that have the potential to increase access to and use of misoprostol for postpartum hemorrhage (PPH), the leading cause of maternal death.

Year Ended June 30, 2015, drawn from audited financial statements.

A total of 1,221 adolescents living with HIV, in eight health facilities in Ethiopia, were screened for TB. The TB incidence rate was 16.32 per 100 PYO during pre-antiretroviral therapy (pre-ART) follow-up but declined to 2.25 per 100 PYO after initiation of ART. IPT use was associated with a significant reduction in TB incidence in the ART cohort, but not in the pre-ART group.

A change of continuation phase tuberculosis (TB) treatment regimen from ethambutol (E) and isoniazid (H) combination for 6 months (6EH) to rifampicin (R) and isoniazid (H) combination for 4 months (4RH) was recommended. However, the effect of the regimen switch in the Ethiopian setting is not known. A comparative cross-sectional study among 790 randomly selected new cases of TB (395 each treated with 4RH and 6EH during the continuation phase) was conducted in nine health centers and one hospital in three zones in southwestern Ethiopia. The switch of continuation phase TB treatment regimen from 6EH to 4RH has brought better treatment outcomes which imply applicability of the recommendation in high prevalent and resource constrained settings. Therefore, it should be maintained and augmented through further studies on its impact among the older, rural residents and HIV positives.

We are conducting a cluster randomised controlled trial in Mokhotlong district, Lesotho, to evaluate a newly developed community-based intervention program to integrate HIV-testing and treatment services, early childhood care and development, and nutrition education for caregivers with children aged 1-5 years living in rural villages. Caregivers and their children are randomly assigned by village to intervention or control condition. We select, train, and supervise community health workers recruited to implement the intervention, which consists of nine group-based sessions with caregivers and children over 12 weeks (eight weekly sessions, and a ninth top-up session 1 month later), followed by a locally hosted community health outreach day event. This study provides a unique opportunity to assess the potential of an integrated early childhood development intervention to prevent or mitigate developmental delays in children living in a context of extreme poverty and high HIV rates in rural Lesotho. This paper presents the intervention content and research protocol for the study.

Over the past two decades, Ethiopia has improved its delivery of primary health care services and begun to make great progress toward meeting the Millennium Development Goals, particularly with regard to maternal, newborn, and child health and the prevention and control of HIV and tuberculosis.

The Integrated Health Project in the Democratic Republic of Congo was a five-year Cooperative Agreement (2010–2015) funded by USAID/Democratic Republic of Congo and implemented by MSH, with partners the International Rescue Committee (IRC), and Overseas Strategic Consulting (OSC), Ltd. The project covered 78 health zones in four provinces.

This 13-page bibliography lists MSH-authored publications on aspects of HIV/AIDS. It includes 93 peer-reviewed journal articles led by or with MSH authors, as well as MSH publications (technical briefs, position papers, and issues of The Manager) and selected major project reports. The bibliography was updated in January 2017.

In recent years, Democratic Republic of the Congo (DRC) has increasingly focused on strengthening its health system and improving health outcomes for its 79.8 million people.

Performance-based financing (PBF) has been used increasingly to improve the quantity and quality of health services by directly rewarding providers with financial incentives based on achieved results.

In light of the 2016 Zika virus outbreak in Latin America and the Caribbean, the Regional Task Force for the Reduction of Maternal Mortality, of which MSH is an executive committee member, produced these cards to provide information and recommendations for sexual and reproductive health policy, programs, and actions.

On January 24, 2017, MSH released a statement responding to the Trump administration's re-instatement and expansion of the Mexico City Policy, also known as the Global Gag Rule. This policy—more wide-reaching than in previous iterations—will harm the well-being and resiliency of families, communities, nations and economies.

Management Sciences for Health (MSH) has been fighting malaria for three decades in over 40 countries.

This technical brief examines the relative contribution of community health volunteers to reach people, particularly women of reproductive age, and children under the age of ve years, with primary health care services and examines the role of community health volunteers in assuring a continuum of care for pregnant women and young children between 2014 and 2016.

To improve quality of service provision and data accuracy and timeliness, USAID Mikolo is introducing mobile technology to replace paper-based tools used by community health volunteers (CHVs).Working alongside the Ministry of Public Health and other partners, the project has developed a smartphone application that CHVs will use to manage their health services and record-keeping and disseminate inf

In Madagascar, despite years of efforts to improve maternal health, the maternal mortality ratio remains as high at 487 deaths per 100,000 live births, whereas the average for developing countries is 235. Additionally, only 51% of pregnant women receive four antental care (ANC) visits, which is the recommended number to prevent and manage possible pregnancy complications.

The USAID Mikolo Project created a new approach to assure, improve, and sustain the quality of community-based health services.This technical brief describes the Mikolo approach and assesses its impact on community health volunteer performance between 2014 and 2016.

The USAID Mikolo Project, in collaboration with the Ministry of Public Health and the Ministry of Youth and Sports, established aYouth Peer Educators (YPE) initiative.The initiative aims to improve youth education and awareness on reproductive health and FP in order to increase contraceptive prevalence rates among 15–24 year olds in USAID Mikolo intervention areas.

Users of e-TB Manager, a web-based eHealth system institutionalized in 10 resource-constrained countries that account for one-third of the world’s tuberculosis (TB) burden, reported that e-TB Manager helped to improve patient care and workplace productivity, and they found it reliable for case management. The users--especially those with more experience in TB programs and those who had used the system for more than two years--were generally satisfied with the system. Responses came from Armenia, Bangladesh, Brazil, Cambodia, Namibia, Nigeria, Indonesia, Ukraine, and Vietnam. The study concluded that younger users and those with less experience in TB programs need more training, and institutional capacity for managing e-TB Manager takes at least five years. The capacity  to manage e-TB Manager has been built in Brazil and Ukraine.

Final Report: Help Ethiopia Address Low TB Performance (HEAL TB) Project 2011–2016

Ukraine has successfully implemented e-TB Manager nationwide as its mandatory national tuberculosis registry after first introducing it in 2009. Our objective was to perform an end-of-programme evaluation after formal handover of the registry administration to Ukraine's Centre for Disease Control in 2015. Of the 5.9 million transactions over a 4-year period, nine out of 24 oblasts (regions) and Kiev City accounted for 62.5% of all transactions, and corresponded to 59% of Ukraine's tuberculosis burden. There were 437 unique active users in 486 rayons (districts) of Ukraine, demonstrating extensive reach.

This selected bibliography of MSH publications and tools on health economics and health care financing covers the period 2000-2016. It demonstrates MSH's strengths in performance-based financing, universal health care, insurance, costing of health services, and capacity building in financial management, among other areas.

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