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Through the Advance Africa program, MSH helped rebuild the family planning system of Huambo Province in Angola for 2.2 million people using a community-based approach. The number of contraceptive users increased from virtually none to nearly 45,000 in 18 months. Working with the Ministry of Health, MSH used the Strategic Mapping approach to identify family planning goals in Angola.  

MSH HA DESARROLLADO un enfoque para ayudar a los gerentes aactuar más como coaches, lo que ha dado buenos resultados en varios entornos diferentes. En Nicaragua, por ejemplo, el coaching se convirtió en un componente crucial del esfuerzo de la organización hacia el logro de la sustentabilidad financiera en momentos de crisis.

PRISM II provides the Ministry of Public Health with specialized technical assistance to integrate primary health care services and reproductive health into the country's national health care system. PRISM launched a leadership initiative in April 2002 with two Leadership Dialogue meetings in Conakry in collaboration with the MSH Management and Leadership Program.

MSH's 2007 annual report celebrates the remarkable evolution that has taken place in global health since the turn of the millennium, and we highlight some of the practical contributions MSH has made to support governments, service delivery NGOs, and other local organizations in that transition.

In March 2006, with generous support from USAID and PEPFAR, MSH initiated performance-based funding for an Orphans and Vulnerable Children (OVC) Project through the Integrated Primary Health Care (IPHC) Project. The OVC Project started with six home-based care (HBC) organizations based in four provinces of South Africa.

Employee satisfaction refers to the employee’s sense of well-being within his or her work environment. It is the result of a combination of extrinsic rewards, such as remuneration and benefits, and intrinsic rewards, such as respect and appreciation.

The HRH Action Framework is designed to assist governments and health managers to develop and implement strategies to achieve an effective and sustainable health workforce.

The dimensions of the Human Resource (HR) crisis in health have been reported in stark terms over the last few years. Despite rising attention to the acute shortage of health care workers, solutions to the human resource crisis are difficult to achieve, especially in the poorest countries.

Human resource management (HRM) is essential in any organization, critically so when public health crises and workforce shortages collide, as they now do in many parts of the developing world. This issue of The eManager provides an overview of HRM systems, policies, and procedures; the components within these areas; and the Human Resources for Health Action Framework.

The concept of good governance has gained prominence in development programs over the past decade. Good governance in the health sector and other sectors that have an impact on health is recognized as essential to achieving the Millennium Development Goals.

La gestión de recursos humanos (GRRHH) es esencial en cualquier organización, y es aún más crítica cuando las crisis de salud pública y la escasez de la fuerza laboral colisionan, como está ocurriendo en muchas partes del mundo en vías de desarrollo.

A structured questionnaire was used to collect data from 500 respondents who were diagnosed clinically and/or parasitologically for malaria at Agogo Presbyterian Hospital and Suntreso Polyclinic, both in the Ashanti Region of Ghana. Collected information included previous use of anti-malarial drugs prior to attending the health facilities, types of drugs used, how the drugs were used, and the sources of the drugs. In addition, the anti-malarial therapy given and outcomes at the two health facilities were assessed. Of the 500 patients interviewed, 17% had severe malaria, 8% had moderate to severe malaria and 75% had uncomplicated malaria. Forty-three percent of the respondents had taken anti-malarial drugs within two weeks prior to hospital attendance. The most commonly used anti-malarials were chloroquine (76%), sulphadoxine-pyrimethamine (9%), herbal preparations (9%) and amodiaquine (6%). The sources of these medicines were licensed chemical sellers (50%), pharmacies (21%), neighbouring clinics (9%) or "other" sources (20%) including left-over medicines at home. One hundred and sixty three (77%) of the 213 patients who had used anti-malarial drugs prior to attending the health facilities, used the drugs inappropriately. At the health facilities, the anti-malarials were prescribed and used according to the national standard treatment guidelines with good outcomes. Conclusion: Prevalence of inappropriate use of anti-malarials in the community in Ghana is high. There is need for enhanced public health education on home-based management of malaria and training for workers in medicine supply outlets to ensure effective use of anti-malaria drugs in the country.

La Herramienta de Administración y Sustentabilidad Organizacional para Programas Nacionales de Control de la TB (MOST para la TB) es un proceso para mejorar la administración de un PNCT, cuyo resultado final es contribuir a lograr los tres objetivos principales de los PNCT.

Transforming Organizations to Improve Health

For four decades in more than 130 countries, Management Sciences for Health (MSH) has taken a whole-of-society approach to development: MSH works with governments to strengthen their leadership and governance capacity and with private and civil society organizations to improve service delivery systems. Through this locally driven approach, MSH regularly works its way out of a job.

Performance-based Financing (PBF) is a powerful means of increasing the quality and quantity of health services by providing incentives to suppliers to improve performance and achieve results.

In Tanzania, many people seek malaria treatment from retail drug sellers. The National Malaria Control Program identified the accredited drug dispensing outlet (ADDO) program as a private sector mechanism to supplement the distribution of subsidized artemisinin-based combination therapies (ACTs) from public facilities and increase access to the first-line antimalarial in rural and underserved areas. The ADDO program strengthens private sector pharmaceutical services by improving regulatory and supervisory support, dispenser training, and record keeping practices. The government's pilot program made subsidized ACTs available through ADDOs in 10 districts in the Morogoro and Ruvuma regions, covering about 2.9 million people. As part of the evaluation, 448 ADDO dispensers brought their records to central locations for analysis, representing nearly 70% of ADDOs operating in the two regions. ADDO drug register data were available from July 2007-June 2008 for Morogoro and from July 2007-September 2008 for Ruvuma. During the pilot, over 300,000 people received treatment for malaria at the 448 ADDOs. The percentage of ADDOs that dispensed at least one course of ACT rose from 26.2% during July-September 2007 to 72.6% during April-June 2008. The number of malaria patients treated with ACTs gradually increased, while the use of non-ACT antimalarials declined; ACTs went from 3% of all antimalarials sold in July 2007 to 26% in June 2008.

The WHO 2010 guidelines specify that a CD4 cell count is crucial to decisions about the eligibility of HIV-infected pregnant women for lifelong antiretroviral treatment (ART). In Malawi, however, access to CD4 cell count analysis is minimal.

Namibia had the fourth highest incidence of TB in the world and is among the countries most affected by HIV & AIDS. The country also faces a huge challenge in its pursuit of malaria eradication. In the face of these challenges, Namibia has an acute shortage of health care personnel, including in pharmaceutical care.

Objective: To assess whether linking the Global Alliance for Vaccine and Immunization (GAVI) service support with performance-based interventions has influenced the quality of reporting and of immunization systems. GAVI Service Support (ISS) combines performance assessment, recommendations and implementation support with financial reward.

To explore the process, major players and procedural success factors for recent public sector TB regimen changes, we conducted 166 interviews of country stakeholders in 21 of the 22 TB high-burden countries (HBCs).Stakeholders described 40 distinct regimen changes for drug-susceptible TB. Once countries committed to considering a change, the average timing was ∼1 year for decision-making and ∼2 years for roll-out. Stakeholders more often cited concerns that were program-based (e.g., logistics and cost) rather than patient-focused (e.g., side effects), and patient representatives were seldom part of decision making. Decision-making bodies in higher-income HBCs had more formalized procedures and fewer international participants. Pilot studies focused on logistics were more common than effectiveness studies, and the evidence base was often felt to be insufficient. Once implementation started, weaknesses in drug management were often exposed, with additional complications if local manufacturing was required. Best practices for regimen change included early engagement of budgeting staff, procurement staff, regulators and manufacturers. Future decision makers will benefit from strengthened decision-making bodies, patient input, early and comprehensive planning, and regimens and evidence that address local, practical implementation issues.

In this paper, we discuss the reasons why we urgently need a point-of-care (POC) CD4 test, elaborate the problems we have experienced with the current technology which hampers CD4-count coverage and highlight the ideal characteristics of a universal CD4 POC test.

This review article discusses the sustainability and robust advantages of planar chromatography that are critical to the successful performance of product quality assessments in resource limited areas including field applications.

Background: The current tuberculosis (TB) treatment landscape has been studied extensively, but researchers rarely consider how it creates challenges or opportunities for future regimen change.

By Newbrander, W., C. Peercy, M. Shepherd-Banigan, and P. Vergeer.International Journal of Health Planning and Management Epub 28 October 2011.

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