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SETTING: Amhara and Oromia Regions, Ethiopia.OBJECTIVE: To determine trends in case notification rates (CNRs) among new tuberculosis (TB) cases and treatment outcomes of sputum smear-positive (SS+) patients based on geographic setting, sex and age categories.METHODS: We undertook a trend analysis over a 4-year period among new TB cases reported in 10 zones using a trend test, a mean comparison t-test and one-way analysis of variance.RESULTS: The average CNR per 100 000 population was 128.9: 126.4 in Amhara and 131.4 in Oromia. The CNR in the project-supported zones declined annually by 6.5%, compared with a 14.5% decline in Tigray, the comparator region. TB notification in the intervention zones contributed 26.1% of the national TB case notification, compared to 13.3% before project intervention. The overall male-to-female ratio was 1.2, compared to 0.8 among SS+ children, with a female preponderance. Over 4 years, the cure rate increased from 75% to 88.4%, and treatment success from 89% to 93%. Default, transfer out and mortality rates declined significantly.CONCLUSION: Project-supported zones had lower rates of decline in TB case notification than the comparator region; their contribution to national case finding increased, and treatment outcomes improved significantly. High SS+ rates among girls deserve attention.

Universal health coverage (UHC) has gained prominence as a global health priority. The UHC movement aims to increase access to quality, needed health services while reducing financial hardship from health spending, particularly in low- and middle-income countries. As a policy agenda, UHC has been identified primarily with prepayment and risk-pooling programs. While financing policies provide important benefits, increasing access to health services will require broader reforms. For lessons, the UHC movement should look to the global HIV response, which has confronted many of the same barriers to access in weak health systems. Considerable success on HIV has resulted from innovative approaches that UHC efforts can build upon, in areas including governance, financing, service delivery, political mobilization, accountability, and human rights. UHC and HIV efforts must capitalize on potential synergies, especially in settings with a high HIV burden and major resource limitations.

The objective of this study was to compare the diagnostic yield of GeneXpert MTB/RIF with Ziehl-Neelson (ZN) sputum smear microscopy among index TB cases and their household contacts. A cross sectional study was conducted among sputum smear positive index TB cases and their household contacts in Northern Ethiopia. Results: Of 353 contacts screened, 41 (11%) were found to have presumptive TB. GeneXpert test done among 39 presumptive TB cases diagnosed 14 (35.9%) cases of TB (one being rifampicin resistant), whereas the number of TB cases diagnosed by microscopy was only 5 (12.8%): a 64.3% increased positivity rate by GeneXpert versus ZN microscopy. The number needed to screen and number needed to test to diagnose a single case of TB was significantly lower with the use of GeneXpert than ZN microscopy. Of 119 index TB cases, GeneXpert test revealed that 106 (89.1%) and 5 (4.2%) were positive for rifampicin sensitive and rifampicin resistant TB, respectively. GeneXpert test led to increased TB case detection among household contacts in addition to its advantage in the diagnosis of Rifampicin resistance among contacts and index TB cases. There should be a consideration in using GeneXpert MTB/RIF as a point of care TB testing tool among high risk groups.

MSH Nigeria published this newsletter in July 2016. Newsletter Contents MSH Nigeria Presents 7 Posters at Intl. AIDS Conference MSH Pays Courtesy Call on the Minister of Health From the Country Rep  MSH Celebrates 10 Years of Health Impact in Nigeria CBHI Saves Baby Rosemary’s Life MSH Nigeria Receives Award of Excellence MSH Trains TBAs in Akwa Ibom State

The USAID-funded African Strategies for Health (ASH) project undertook this childhood TB landscape analysis, to expand and centralize available information on childhood TB in Africa.

To better understand whether childhood TB guidelines can inform the roles and responsibilities of maternal and child health providers and to identify opportunities for strengthening them, USAID's Africa and Global Health Bureaus and the African Strategies for Health (ASH) project assessed existing childhood TB guidelines in 13 countries in Africa.

Postpartum hemorrhage is the leading cause of maternal mortality in low-income countries. Over the past decade, the use of misoprostol for the prevention of postpartum hemorrhage in developing countries has gained attention as an effective strategy in settings where skilled birth attendance is low, particularly at the community level.

Many children in sub-Saharan Africa die before their fifth birthday from preventable causes, including malaria, diarrhea, and pneumonia. Integrated community case management (iCCM) is an effective, equity-based strategy that aims to train, equip, and supervise community health workers to treat children for these diseases at the community level.

Significant global investment in preventative and life-saving interventions for children under five years of age has greatly contributed to the reduction of the global mortality rate by nearly half from 1990 to 2013.

Malaria remains a significant burden to health systems, especially in sub-Saharan Africa, which accounts for 90 percent of malaria-related deaths worldwide. Not all patients are able to access timely and quality malaria services. A key strategy to enhance the utilization, provision, and quality of malaria services is the use of both demand-side and supply-side financial incentives.

As Rwanda looks to sustain and build on its hard-earned gains in health, it faces a few vital constraints. Donor funding is declining and the Health Sector Strategic Plan III is underfunded with a likely gap of $372- $697 million. Private sector investment, which could potentially help fill this gap, is only 1.7 percent.

The African Strategies for Health project and MSH participated in the Financial Protection and Access to Care Workshop, held in Accra, Ghana February 15-19, 2016.

The African continent has perhaps seen the most pronounced movement towards regionalism. In Africa’s health sector, regional bodies—such as regional economic communities and inter-governmental institutions, as well as regional professional associations and regional networks—have become active contributors to the development and health agendas over the last 10 to 15 years.

In recent years, there has been a growing trend toward regionalization on the African continent, as integrated and cooperative efforts have created positive impact in political, economic, and social sectors. In Africa’s health sector, regional actors have become active contributors to development and health agendas.

In recent years, there has been a growing trend toward regionalization on the African continent. In Africa's health sector, regional actors have become active contributors to development and health agendas.

The African continent has seen pronounced movement toward regionalism in recent years to catalyze development and strengthen African integration and unity. Regional bodies are actively contributing to the development of many sectors, including health, which is increasingly recognized as essential to human and economic development in Africa.

Africa has seen a growing trend toward regionalism over the past 10 to 15 years, particularly in its health sector, as emerging health issues demand cross-border coordination and partnerships. Critical to an effective response to health issues is a strong health workforce.

Africa's health sector has seen a growing movement toward regionalism, as stakeholders increasingly work collaboratively and across national borders to advance health and development agendas. In the fight against malaria, strong partnerships across the continent have contributed to dramatic progress over the past 15 years. 

Maternal, newborn, and child health (MNCH) is a focal area for many regional bodies across Africa, as the continent currently accounts for more than 60 percent of all maternal deaths and almost half of all newborn and under-five deaths globally each year. Intergovernmental partnerships and crossborder collaboration add value to the fight to save the lives of moth

The African continent has seen pronounced movement toward regionalism in recent years. Regional bodies are actively contributing to the development of many sectors, including health.

Over the course of the project, African Strategies for Health, in support of USAID/Africa Bureau priorities, has engaged with thought leaders, innovators, and implementers on cutting-edge issues to build capacity and advance collaboration in the use of digital technology to improve health outcomes.

The African Strategies for Health (ASH) project has produced six volumes of the mHealth Compendium containing 167 profiles of mobile health (mHealth) programs. The volumes document key mHealth resources, and describe featured programs and their results, lessons learned, and implementation challenges.

The mHealth Compendium series, developed by the African Strategies for Health project, has expanded the body of knowledge and increased access to the most current information on mobile technology solutions for health.

Non-communicable diseases (NCDs) are a growing cause of death and disability in Africa, reducing individual and collective productivity and increasing health care costs. The African region is expected to experience the greatest increase in NCD deaths over the coming decade.

An estimated 1 million children worldwide are infected with tuberculosis (TB) each year, representing about 11 percent of all TB cases.

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