{A secretary records the weekly collection amounts for a savings and internal lending group in Madagascar. Photo credit: Samy Rakotoniaina/MSH}A secretary records the weekly collection amounts for a savings and internal lending group in Madagascar. Photo credit: Samy Rakotoniaina/MSH

By Amy LiebermanJenny Lei Ravelo

This story was originally published by Devex

The onus to help everyone — including the most marginalized — secure universal health care coverage will likely depend more on individual government spending than on new foreign assistance, experts say.

Funding will be a critical, but not guaranteed, element in the forthcoming universal health coverage agreement governments will sign in September during the opening of the U.N. General Assembly session.

“Aid is not going to help achieve the global health goals. It has to come from domestic spending. But aid is very important for purposes of equity and that the poor do not get left behind.”— Jacob Hughes, senior director of health systems, Management Sciences for Health

Peter Mbago, TSSP Principal Technical Advisor, Human Resources for Health and Megan Montgomery, Pfizer Global Health Fellow interview health care workers at Kaole Dispensary in Bagamoyo District to better understand training needs and provider motivations.

By Megan Montgomery

Tanzania needs more health care workers. Its workforce is only 44%1 of the required staff, per its national human resources for health plan. This shortage is more dire in rural areas, where 80%2 of the country’s population lives, as well as among mid-level health care workers. Hospitals are often filled beyond capacity, as they must also take referrals from less well-equipped facilities. Patients sometimes share beds or sleep on the floor, and health care workers struggle to provide patients with the care they need.

The Ministry of Health, Community Development, Gender, Elderly, and Children (MOHCDGEC) has begun a number of initiatives to help ease gaps and improve health services, particularly for the 1.5 million3 people estimated to be living with HIV in Tanzania. One initiative, called task sharing, aims to enable lower level health care providers to perform tasks that would typically be outside their scope of responsibilities. This frees up staff with higher-level skills to focus on more complicated cases and help a greater number of patients receive timely, quality care.

{Photo credit: Julius Kasujja}Photo credit: Julius Kasujja

This op-ed was originally published in The Hill.

Along with the Ebola outbreak that’s already infected more than 1,600 people, the Democratic Republic of the Congo (DRC) is fighting another battle: An epidemic of fear and mistrust. Community members are afraid to seek treatment, including a promising experimental vaccine.

 {Photo credit: Aor Ikyaabo/MSH}MSH staff member, Christopher Ogar, verifies information from a HIV testing services register with facility staff at General Hospital Suleija in Niger state, Nigeria.Photo credit: Aor Ikyaabo/MSH

In Nigeria, home to the world’s second-largest HIV epidemic, successfully linking every person who tests positive for HIV to accessible and culturally appropriate care and support services is a big challenge.Gender and sociocultural norms can create barriers to linkage, particularly in northern states of Nigeria such as Kebbi, where some women need permission from their husbands to start treatment.

{Photo credit: Rejoice Phiri/MSH}Midwife Chirford Semu stands in the labor and delivery room at Bowe Health Center, in Dowa district, Malawi.Photo credit: Rejoice Phiri/MSH

Chirford Semu knows that time is of the essence when complications arise during labor and delivery.He is a midwife at Bowe Health Center in Dowa district, one of the most remote areas in Malawi. This single health center serves an estimated 42,445 people.

 {Photo credit: MSH Rwanda}Left to right: Lisa Godwin, USAID Rwanda Health Office Director, Dr. Diane Gashumba, Rwanda's Minister of Health, Alain Joyal, RHSS Project Director, Management Sciences for Health.Photo credit: MSH Rwanda

Over the past five years, the United States Agency for International Development (USAID) has invested in measures to strengthen and sustain Rwanda’s health sector through its Rwanda Health Systems Strengthening (RHSS) Project (2014-2019). In a ceremony at the Kigali Serena Hotel, USAID, the Ministry of Health (MoH), as well as the implementing partner, Management Sciences for Health (MSH), marked the culmination and remarkable achievements of the five-year effort to strengthen the country’s health sector.

Pharmacy Assistant Aaron Sendeza wants to rid Malawi of malaria. Thanks to the mentorship program, Aaron works to ensure that all medicines and medical supplies in his health center are available, reliable, and of high quality. Photo credit: Paul Joseph Brown for VillageReachPharmacy Assistant Aaron Sendeza wants to rid Malawi of malaria. Thanks to the mentorship program, Aaron works to ensure that all medicines and medical supplies in his health center are available, reliable, and of high quality. Photo credit: Paul Joseph Brown for VillageReach

By Matthew Ziba

Many health facilities across Malawi don’t have enough trained pharmacy staff to adequately manage stock and dispense medicines. These tasks often fall on health care providers, who already have many other responsibilities, namely caring for patients. In some cases, even a ground laborer or a security guardwho may have no training in pharmacy managementmust step in to help.

 {Photo credit: Kenza Abu-Arja/MSH}From left to right: W. Gyude Moore, Reid Wilson, Ambassador Bonnie Jenkins, Dr. Rebecca Martin, and Marian W. Wentworth.Photo credit: Kenza Abu-Arja/MSH

On April 10, Congressman Gerry Connolly (D-VA) and Steve Chabot (R-OH) reintroduced the bipartisan Global Health Security Act, which reaffirms US commitment to promoting global health security. This proposed legislation aims to help the US prepare for and respond to infectious disease threats and prevent cross-border epidemics.

 {Photo credit: Samy Rakotoniaina/MSH}A health worker checks malaria commodities at a private clinic in Balaka, Malawi.Photo credit: Samy Rakotoniaina/MSH

“Malaria is a very big problem that we are still fighting,” says Dr. Samantha Musasa, Medical Officer for Balaka district, located in Southern Malawi. Indeed, Malaria kills some 435,000 people around the world each year, the majority of them children. In Malawi, the prevalence of malaria among children under five remains dangerously high, at around 23.6%.Left unattended, malaria can progress very quickly.

In the spirit of the 3,500-year-old Tao (Way) of Leadership, MSH works closely with local institutions and communities to create lasting and sustainable changes; changes that improve the health of people among the world’s poorest and most vulnerable groups.

And as the Tao indicates, sustainability starts with ownership, “The people will say, we have done it ourselves.”

Women in Kakamega County, Kenya are taking charge of their pregnancies, supporting their peers, and learning about healthy practices and self-care from skilled health providers. MSH’s Lea Mimba (“Take care of your pregnancy”) project, funded by UK Aid through the County Innovation Challenge Fund (CICF), tested an innovative group model for antenatal care (ANC) that responds to the needs and perspectives of women and front-line health providers. At six Kenyan health facilities, Lea Mimba provides a forum where pregnant women share experiences, learn birth planning and self-care practices, provide each other with emotional and social support, and receive essential health information from a skilled health provider, who is usually a nurse.

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