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Please download to read the USAID Safe, Affordable, and Effective Medicines for Ukrainians (SAFEMed) Activity in Ukraine News Digest, February 2020 edition. 

On March 4, 2020, staff from the MSH-led ONSE Health Activity in Malawi presented recent results and lessons learned on strengthening malaria services through Outreach Training and Supportive Supervision (OTSS).

Please download to read the USAID Safe, Affordable, and Effective Medicines for Ukrainians (SAFEMed) Activity in Ukraine News Digest, March 2020 edition.

For nearly 50 years in 150 countries, MSH has worked with and through local health actors to strengthen health systems, improve the quality of health care, and ensure that all people, even the poorest and most vulnerable, have the opportunity for a healthy life.

The LAC Regional InterAgency Task Force for Maternal Mortality Reduction (Grupo de Trabajo Regional - GTR) hosted a Spanish-language webinar, "Sexual and Reproductive Health in Times of COVID-19: Evidence, Perspectives, and Challenges in Latin America and the Caribbean." 

Community participation is critical to detecting unusual health events before they develop into public health crises. Through MSH’s electronic Community EventBased Surveillance (eCEBS) system, communities are engaged in identifying and stopping outbreaks at their source, which can lessen the impact on the community and decrease negative health outcomes.

We used a qualitative approach to explore the contribution of contextual, individual, household-level and health system factors to stillbirth in Afghanistan. We conducted semi-structured in-depth interviews with women and men that experienced stillbirth, female elders, community health workers, healthcare providers, and government officials in Kabul Province, Afghanistan, between October-November 2017. We used thematic analysis to identify contributing factors and developed a conceptual map describing possible pathways to stillbirth. We found that low utilisation and access to healthcare was a key contributing factor, as were unmanaged conditions in pregnancy that increased women’s risk of complications and stillbirth. Sociocultural factors related to the treatment of women and perceptions about medical interventions deprived women of interventions that could potentially prevent stillbirth. The quality of care from public and private providers during pregnancy and childbirth was a recurring concern exacerbated by health system constraints that led to unnecessary delays; while environmental factors linked to the ongoing conflict were also perceived to contribute to stillbirth. These pathways were underscored by social, cultural, economic factors and individual perceptions that contributed to the three-delays.

This survey assessed recently pregnant women's knowledge of malaria in pregnancy (MIP) and their experiences with community health workers (CHWs) prior to implementing community delivery of intermittent preventive treatment in pregnancy (cIPTp). Data were collected via a household survey in Ntcheu and Nkhata Bay Districts, Malawi, from women aged 16-49 years who had a pregnancy resulting in a live birth in the previous 12 months. A total of 370 women were interviewed. Women in both districts found their community health workers (CHWs) to be helpful (77.9%), but only 35.7% spoke with a CHW about antenatal care and 25.8% received assistance for malaria during their most recent pregnancy. A greater proportion of women in Nkhata Bay than Ntcheu reported receiving assistance with malaria from a CHW (42.7% vs 21.9%); women in Nkhata Bay were more likely to cite IPTp-SP as a way to prevent MIP (41.0% vs 24.8%) and were more likely to cite mosquito bites as the only way to spread malaria (70.6% vs 62.0%). Women in Nkhata Bay were more likely to receive 3 + doses of IPTp-SP (IPTp3) (59.2% vs 41.8%). Adequate knowledge was associated with increased odds of receiving IPTp3, although not statistically significantly so. Women reported positive experiences with CHWs, but there was not a focus on MIP. Women in Nkhata Bay were more likely to be assisted by a CHW, had better knowledge, and were more likely to receive IPTp3+ . Increasing CHW focus on the dangers of MIP and implementing cIPTp has the potential to increase IPTp coverage.

Financé par l’Agence des États-Unis pour le Développement international (USAID) et mis en œuvre par Management Sciences for Health et ses partenaires de mise en œuvre, le projet Integrated Health Services Activity (IHSA) au Bénin demande aux entreprises intéressées et qualifiées qui satisfont aux critères d'éligi

Essential medicines improve health and save lives. However, the complex system that is needed to get them to people does not always function well. Shortages of medical products are common. Poor quality and high costs burden patients and health ministries. Antimicrobial resistance, fed by inappropriate use, is spreading and may greatly undermine progress in global health.

The Community Health Planning and Costing Tool, a UNICEF tool developed by Management Sciences for Health, is designed to cost packages of community health services (CHS) and produce results to help assess performance, plan future services, and prepare investment cases. This handbook, which corresponds to the Community Health Planning and Costing Tool version 2.0, describes the process for co

Postpartum hemorrhage (PPH) remains one of the major causes of maternal mortality.

UNICEF, in partnership with Management Sciences for Health (MSH), is pleased to launch Version 2.0 of the Community Health Planning and Costing Tool.

Please download to read the USAID Safe, Affordable, and Effective Medicines for Ukrainians (SAFEMed) Activity in Ukraine News Digest, April 2020 edition. 

MSH, through an Innovation Fund grant of the Reproductive Health Supplies Coalition, and with contribution from the USAID-funded Uganda Health Supply Chain Program, supported Uganda to implement integration of oxytocin, the first-line medicine to prevent and treat excessive bleeding postpartum hemorrhage after delivery, into the vaccine cold chain for improved storage.

Elections usually involve large, nationwide gatherings, not only on Election Day but also, for example, during campaign rallies and voter registration drives. These events increase human-to-human contact and the risks of direct and indirect disease transmission.

To describe trends in diagnostic and treatment delays and estimate their effect on  rifampicin-resistant tuberculosis (RR-TB) mortality, we conducted a retrospective analysis of individual-level data including 748 (85.4%) of 876 patients diagnosed with RR-TB notified to the World Health Organization between 1 July 2005 and 31 December 2016 in Rwanda. Logistic regression was used to estimate the effect of diagnostic and therapeutic delays on RR-TB mortality. Between 2006 and 2016, the median diagnostic delay significantly decreased from 88 days to 1 day, and the therapeutic delay from 76 days to 3 days. Simultaneously, RR-TB mortality significantly decreased from 30.8% in 2006 to 6.9% in 2016.

ABSTRACTBackgroundSince the declaration of the 10th Ebola Virus Disease (EVD) outbreak in DRC on 1st Aug 2018, several neighboring countries have been developing and implementing preparedness efforts to prevent EVD cross-border transmission to enable timely detection, investigation, and response in the event of a confirmed EVD outbreak in the country.

This commentary highlights the challenges for pharmacovigilance (PV) posed by the COVID-19 pandemic and how PV practitioners in Africa can use this opportunity to strengthen patient safety. The commentary discusses remedies that lack clinical evidence and are potentially dangerous and the hidden effects of irrational use of medicines and medical products. It also examines the increase in poor reporting of adverse effects as well as the weakening of PV systems. It concludes that drug safety practitioners need to be vigilant about these risks and strengthen reporting systems to document, characterize, communicate, and minimize the risks of such remedies.

Please download to read the USAID Safe, Affordable, and Effective Medicines for Ukrainians (SAFEMed) Activity in Ukraine News Digest, May 2020 edition. 

Cote d’Ivoire health systems are being decentralized to prioritize decision making at the regional and departmental levels. Through strengthening leadership, management, and governance (LMG) skills of these decision makers, a stronger, self-sufficient system is created to be responsive to local needs.

PV is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other possible medicine-related problems. Adverse effects of medicines, particularly those that are unexpected, can negatively affect patients’ health and quality of life and further strain and undermine trust in the health care delivery system.

To determine the yield of tuberculosis (TB) and the prevalence of human immuno-deficiency virus (HIV) among key populations in the selected hotspot towns of Ethiopia, we undertook cross-sectional implementation research during August 2017-January 2018. A total of 1878 vulnerable people were screened. There was a statistically significant association of active TB cases with previous history of TB (Adjusted Odds Ratio (AOR): 11 95% CI, 4.06–29.81), HIV infection (AOR: 7.7 95% CI, 2.24–26.40), and being a health care worker (HCW). The prevalence of TB in key populations was nine times higher than 164/100,000 national estimated prevalence rate. The prevalence of HIV was five times higher than 1.15% of the national survey. The highest yield of TB was among HCWs and a high HIV burden was detected among female sex workers and internal migratory workers. These suggest the need for community and health facility based integrated and enhanced case finding approaches for TB and HIV in hotspot settings.

National HIV testing policies aim to increase the proportion of people living with HIV who know their status. National HIV testing policies were reviewed for each country from 2013 to 2018, and compared with WHO guidance. Three rounds of health facility surveys were conducted to assess facility level policy implementation in Karonga (Malawi), uMkhanyakude (South Africa), and Ifakara (Tanzania). A policy "implementation" score was developed and applied to each facility by site for each round. Most HIV testing policies were explicit and aligned with WHO recommendations. Policies about service coverage, access, and quality of care were implemented in >80% of facilities per site and per round. However, linkage to care and the provision of outreach HIV testing for key populations were poorly implemented. The proportion of facilities reporting HIV test kit stock-outs in the past year reduced over the study period in all sites, but still occurred in ≥17% of facilities per site by 2017. The implementation score improved over time in Karonga and Ifakara and declined slightly in uMkhanyakude. Efforts are needed to address HIV test kit stock-outs and to improve linkage to care among people testing positive in order to reach the 90-90-90 targets.

To assess the use of Xpert for accurate diagnosis, timely initiation, and rational use of anti-TB treatment among childhood TB patients, we reviewed data trends over four consecutive years; two years before the arrival of the machine and two years following the implementation of Xpert. During the intervention period (2016–2017), 371 children with presumptive TB were evaluated using Xpert. A total of 199 (53.6%) childhood TB cases were notified, of which 88 (44.2%) were Xpert positive and 111 (55.8%) were treated as Xpert-negative probable TB cases. The tendency to initiate anti-TB treatment for unconfirmed TB cases was reduced by a third. Compared with smear AFB, Xpert improved accuracy of diagnosing pediatric TB cases two-fold. The average waiting time to start anti-TB treatment was 1.33 days. There was a significant reduction in the waiting time to start anti-TB treatment, with a mean time difference before and during intervention of 5.62 days. Xpert use was associated with a significant increase in the accuracy of identifying confirmed TB cases, reduced unnecessary anti-TB prescription, and shortened the time taken to start TB treatment.

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