Health Systems Strengthening

The Systems for Improved Access to Pharmaceuticals and Services (SIAPS) program helped make sure that some of the world’s most vulnerable people have timely access to safe, affordable medicines and to quality services to improve their health. Funded by USAID, the program worked for six years in 46 countries to comprehensively strengthen pharmaceutical systems by addressing five interrelated functions, with a focus on medical products—governance, human resources, information, financing, and service delivery. 

Each level of progress in pharmaceutical systems strengthening (PSS) sets the stage for further advances. Which areas need focused attention going forward so that progress continues? 

After more than 15 years working on women’s health and development issues, I feel hopeful as the growing movement for women’s rights brings us closer to a breakthrough. Everyday, more women around the world -- from Madagascar to Mexico -- are emerging as leaders. They are organizing and demanding justice, equality, and the full realization of their fundamental human rights. In the halls of the United Nations, at the policymaking tables of country ministries, and in the local health clinics, women and girls are calling for health policies and services that meet their needs, and those of their families and communities.

On International Women’s Day, Management Sciences for Health (MSH) joins women worldwide to press for progress. Our work is grounded in the fundamental view that safeguarding women’s, children’s, and adolescents’ health is a core health system function. It is time we listen to all women and girls, because they are the health system.  

In the late 19th and early 20th centuries, Poliomyelitis, or polio, was a greatly feared scourge of the industrial world. It would paralyze hundreds of thousands of children every year. Once effective vaccines were introduced in the 1950s the number of cases of polio dropped dramatically and the virus was eliminated in many countries, but in some places, it still remains a real threat.

Polio is an infectious viral disease that is transmitted from person to person and can lead to paralysis, respiratory failure, even death. The polio virus easily spreads in areas with poor sanitation. Vaccination is the most reliable way to prevent polio and to protect children under five, who are the most vulnerable.

The virus was wiped out in Madagascar 2005 but reappeared in 2014. Since then, Madagascar’s government and health partners, including the World Health Organization, United Nations Children's Fund, and the United States Agency for International Development, have held multiple vaccination campaigns across the country.

We’re excited to bring you this month’s edition of Leading Voices, a series that features the incredible talent that makes up MSH.

We’re chatting with Maura Brown, a Technical Advisor with the USAID-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program. Maura spent her early career in Antigua Guatemala, where she was first exposed to pharmaceutical management work. Today, she works on the development of the Pharmaceutical Systems Strengthening (PSS) Insight tool, a web-based platform and data management system to measure the impact of PSS. The tool has been piloted in Bangladesh and Namibia, and will be available on March 15 from pssinsight.org.

What are you most proud of in your work?

I’m proud of the cross-cutting nature of my work. I have been able to work with many of the teams within SIAPS and PHT, and gain a working understanding of most of the types of work that we do.

In recent years, global health stakeholders have begun to recognize the profound potential that drug shops have to advance public health goals, such as those related to malaria diagnosis and treatment, child health, and family planning. These outlets, for reasons of convenience and cost, are the first choice of care for millions of people - and until recently, they have largely been ignored.

“Drug shops and pharmacies are important sources of health care, particularly in rural areas or urban slums with few public clinics. They are often the first stop for women and men who seek FP information or services.”  - World Health Organization

This is why, in 2003, Management Sciences for Health (MSH) helped launch the Accredited Drug Dispensing Outlet (ADDO) Program in Tanzania to address the important role of these informal drug sellers by creating certain standards that, when met, increase the quality of medicines and services in the community. Tanzania’s successful ADDO Program provides a model that other countries in Africa—and now Asia—have adapted and made their own.

This story was originally posted by The Maternal Health Task Force

This story was originally published by SIAPS.

Over its six years working in dozens of countries, SIAPS has carried out a vision for health system strengthening that USAID developed and has supported for more than two decades. In partnership with countries and organizations, the agency has led pharmaceutical systems strengthening interventions that have helped countries deliver affordable, quality-assured medicines and related products and services.

SIAPS has had the privilege of carrying out significant tasks under the USAID mandate. Through this project and its predecessors–SPS, RPM Plus and RPM–we’ve been following a systems strengthening framework, digging in with activities that address governance, human resource capacity, information management, financial strategies, and effective services.

This story was originally published on the SIAPS Program homepage. 

To be fully effective, health system strengthening projects should have sustainable impact and lay the groundwork for future progress. Here’s how SIAPS’ work supported health system reform in Ukraine.

SIAPS worked in Ukraine for four years, from 2013 through 2017. Ukraine has the most severe HIV epidemic in Eastern Europe and Central Asia and the second highest TB burden in Europe. Ukraine has the highest mortality rate from infectious diseases in the WHO/Euro region, with TB, HIV, and AIDS accounting for 90% of all deaths.

However, the country’s health system was poorly equipped to cope. Following the collapse of the Soviet Union, Ukraine inherited a centrally controlled health system that funded about half of health expenditures as of 2014. Out-of-pocket payments accounted for more than 46% of the rest, and a third of that was for medicines, which are expensive. That meant affordable medicines were out of reach for many people, as well as the medicines essential to treating these diseases.

This excerpt was originally published on Global Health Now's website.

In his newly released book, The End of Epidemics: The Looming Threat to Humanity and How to Stop It, Jonathan D. Quick, MD analyzes local and global efforts to contain diseases like influenza, AIDS, SARS, and Ebola. Quick proposes a new set of actions, coined “The Power of Seven,” to end epidemics before they can begin.

In the following excerpt for Global Health NOW, Quick, a Harvard Medical School faculty member, senior fellow at Management Sciences for Health and chair of the Global Health Council, describes Nigeria’s response to Ebola, describing what it takes to stop an outbreak—and the consequences for humanity when we fail.

For the past six years, MSH has hosted an internal storytelling contest, where we invite staff to submit stories on how strong health systems are saving lives and improving the health of people around the world. The stories undergo a judging process, and the winners are featured in an annual compendium.

We are proud to bring you these winning stories that demonstrate the power of effective partnerships. Meet health workers, community leaders, pharmacy managers, and patients from 10 different countries, working together across the health system to build healthier communities.

Madagascar: Mobile Technology for Community Health

By Samy Rakotoniaina

Lynda, a community health volunteer (CHV) in Madagascar, is among 50 pilot users of a mobile application that helps ease the burden of reporting health service data, improve reporting accuracy and timeliness, and improve the health care and counseling that CHVs provide. More>>