Health Systems Strengthening

This op-ed was originally published in The Hill.

Program seeds providers in high-density health center

In July, 23-year old Esther walked a fair distance to Area 18, a health center in Malawi’s Lilongwe District, since no family planning services were available in her area. She has one child and wants to wait before having a second. At the health center, Esther joined a group counseling session where all family planning methods were presented. Afterwards, during individual counseling, she shared her desire to wait at least five years before becoming pregnant. Once informed of her options, including long-term reversible contraceptives, she chose to receive an intrauterine contraceptive device (IUCD), and had it inserted right away.

“I will tell my friends about the IUCD,” says Esther. “I know the truth about how it works. We need to be careful not to pay attention to the stories people tell.”

In the face of conflict, natural disasters, or other crippling events, women disproportionately suffer from preventable illnesses and death. In such circumstances, women are more likely to experience gender-based violence, and they have more difficulty accessing basic health services, such as obstetric care and family planning. This was evident in the wake of the Ebola outbreak in West Africa, when maternal mortality rose sharply between 2013 and 2015; with the HIV epidemic, when rates of HIV among young women soared in sub-Saharan Africa; and with spikes in sexual and gender-based violence that occur during a humanitarian crisis.

"There is a great joy when the family comes back to hospital wanting to show that their less than 1500g baby has now grown into a healthy newborn with no trace that they were premature. Sometimes we meet parents in the market place who keep appreciating our efforts in saving their premature babies... I appreciate it so much when babies are born in hospital so care can be initiated as soon as possible." - Chelmsford Gondwe, Registered Nurse Midwife

The USAID-funded Organized Network for Everyone’s Health (ONSE) Activity and lead implementer Management Sciences for Health joined the world to commemorate World Prematurity Day on November 17, 2019. This global movement seeks to raise awareness about prematurity, calling for the participation of everyone in the prevention and care of small and sick newborns to avert deaths. This year’s celebrations were under the theme “Born Too Soon: Providing the right care, at the right time, in the right place.” 

Originally published by Scientific American

“Rise of the superbugs.” “Global crisis.” “Nightmare bacteria.” “Deadly fungus.”

The media has caught on to the dire threat that antimicrobial resistance (AMR) presents, and it has certainly captured the urgency of the situation.

Global health professionals know this crisis has been years in the making and have been acting accordingly. We know, however, that we cannot contain the spread of AMR without strengthening health systems in low- and middle-income countries, which tend to have weaker surveillance systems for drug use and infectious disease management. Our efforts would be futile. It’s time to take stock of where we are and figure out our focus going forward; we have no time to lose.

The global health organization I work for, Management Sciences for Health (MSH), has been strengthening health systems in dozens of countries for almost 50 years, alongside governments, donors, global organizations like the Global Health Security Agenda (GHSA) Consortium and the World Health Organization (WHO) and other nonprofits. Based on results to date, here are four lessons we have learned:

Meet Daniel Gemechu, MSH Regional Director for the USAID-funded Challenge TB Project in Ethiopia. MSH has worked in Ethiopia since 2011 to improve the quality of TB care and prevention services. Over the past five years, treatment success rates rose above 90%, with 75% of those suffering from multidrug-resistant TB (MDR-TB) now able to beat the disease after completing their treatment regimens. We asked Dr. Gemechu to reflect on his experience working with MSH and what remains to be done to eliminate the disease in Ethiopia.

Dr. Gemechu cross-checks doses taken and doses remaining on TB treatment patient kits at a health center in Oromia region to verify whether treatment is being delivered according to national guidelines.What drives you to fight TB in your home country? 

When community health programs are well-designed, managed, and sufficiently funded, they can yield substantial health and economic benefits. In addition to contributing to a healthier, more productive population, they can reduce the risk of costly epidemics while generating substantial cost savings for families and health systems (1). On the other hand, when poorly designed or managed and insufficiently funded, community health programs can fail to improve poor health outcomes and advance national health priorities.

Recognizing their potential in strengthening primary care and advancing Universal Health Coverage, countries are increasingly formalizing the role of the community health worker within their health systems. In fact, many countries have passed national community health policies to ensure that community health workers (CHWs) are well trained, incentivized, and equipped to provide a basic package of life-saving services within their communities.

Related

Community Health Planning and Costing Tool

This story was originally published by Global Health NOW

After decades of effort by the global health community and governments, more women are giving birth in health facilities than ever, and maternal and newborn mortality have declined since 1990.

But global and country-level averages hide a tragic, more complex story: Even in countries where 80% of births take place in health facilities or are attended by skilled health workers, maternal mortality often remains high.

Many of these deaths could be prevented. In the 81 countries with the highest maternal and neonatal mortality rates, well-functioning health systems would prevent 520,000 stillbirths, and save the lives of 670,000 babies and 86,000 women by 2020—even at current rates of access to maternal and newborn health services, according to the November 2018 report from The Lancet Global Health Commission for High-Quality Health Systems.

Meet Megan Montgomery, one of two impressive Pfizer Global Health Fellows currently working with MSH in Tanzania. This international corporate volunteer program places Pfizer colleagues in short-term fellowships with international development organizations. Megan is lending her skills and expertise in marketing and business strategy to MSH’s Technical Support Services Project (TSSP) in Tanzania, which provides assistance to the Ministry of Health in key technical areas to help control the HIV epidemic and sustain HIV-related health systems and services. 

How are you supporting the TSSP project in Tanzania?

My main focus while here is partnering with the team to strengthen the health system in Tanzania through human resources for health (HRH) activities, such as the implementation of task-sharing initiatives, recruitment, retention and productivity management, as well as developing communication pieces to share the work being accomplished.  

Can you explain what task sharing for HIV services looks like in this context?