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World Health Organization/International Network of Rational use of Drugs (WHO/INRUD) indicators are widely used to assess medicine use. However, there is limited evidence on their validity in Namibia's primary health care (PHC) to assess the quality of prescribing. An analytical cross-sectional survey design was used to examine and validate WHO/INRUD indicators in out-patient units of two PHC facilities and one hospital in Namibia from 1 February 2015 to 31 July 2015. Out of 1243 prescriptions; compliance to NSTG prescribing in ambulatory care was sub-optimal (target was >80%). Three of the four WHO/INRUD indicators did not meet Namibian or WHO targets: antibiotic prescribing, average number of medicines per prescription and generic prescribing. The majority of the indicators had low sensitivity and/or specificity. All WHO/INRUD indicators had poor accuracy in predicting rational prescribing.

In 2013, the Guinean health authority had to reorganise and run a national response against malaria as a priority. The review of the National Strategic Plan to fight malaria in Guinea was carried out and one of its critical components was the prevention and rapid management of fever (RMF) attributable to malaria in children. The study reports on the demographic and health determinants of this rapid management in children under 5. The participants were 4786 children from 2874 representative households. RMF was defined in terms of recourse to primary care. The recourse was defined by child's reference for the treatment of fever which led or not to treatment of malaria. We found that 1491 children (31.2%) had a bout of fever within the 2 weeks that preceded the survey. The prevalence of malaria was 45.4% among those children who have a bout of fever. The recourse to traditional healers was estimated at 9.6% and the use of health facilities was estimated at 71.5%. Overall, 74.9% of children with fever received treatment within the recommended timeliness (24 h), with regional disparity in this rapid response. The high proportion of recourse to traditional healers is still a matter of concern. New control and prevention strategies should be extended to traditional healers for their training and involvement in directing febrile children to health facilities.

This manual was created to increase participant knowledge of the Champion Community strategy and approach and to provide staff and stakeholders with the necessary information, procedures, and guidelines to be able to implement the strategy and measure its effectiveness.

The neonatal mortality rate (NMR) in Malawi has remained stagnant at around 27 per 1000 live births over the last 15 years, despite an increase in the uptake of targeted health care interventions. We used the nationally representative 2015/16 Demographic Health Survey data set to evaluate the effect of two types of maternal exposures, namely, lack of access to maternal or intra-partum care services and birth history factors, on the risk of neonatal mortality. We included 9553 women and their most recent live birth within 3 years of the survey. The sample's overall neonatal mortality rate was 18.5 per 1000 live births. The adjusted population attributable risk for first pregnancies was 3.9/1000 (P < 0.001), while non-institutional deliveries and the shortest preceding birth interval (8-24 months) each had an attributable risk of 1.3/1000 (Ps = 0.01). Having 2 or more pregnancy outcomes within the last 5 years had an attributable risk of 3/1000 (P = 0.006). Attending less than 4 ANC visits had, a relatively large attributable risk (2.1/1,000), and it was not statistically significant at alpha level 0.05.  

In 2011, the Malawi Ministry of Health introduced option B+, a universal treatment strategy for the prevention of mother-to-child transmission (MTCT) of HIV. Under option B+, all pregnant or breastfeeding women with HIV are eligible for lifelong antiretroviral therapy (ART) regardless of clinical stage or CD4. Routine data from Malawi's prevention of MTCT option B+ programme suggest high uptake of antiretroviral therapy (ART) among pregnant women. Malawi's Ministry of Health led the National Evaluation of Malawi's PMTCT Program to obtain nationally representative data on maternal ART coverage and prevention of MTCT effectiveness. Here we present the early transmission data for infants aged 4–12 weeks and used a multistage cluster design to recruit a nationally representative sample of HIV-exposed infants and their mothers. Between October 16, 2014 and May 17, 2016, we screened for HIV in all mothers attending an under-5 vaccination or outpatient sick-child clinic with infants aged 4–26 weeks. They confirmed HIV exposure in 3542 (10·4%) of 33 980 mother (guardian)–infant pairs with infants aged 4–26 weeks. These data suggest that Malawi's decentralization of ART services has resulted in higher ART coverage and lower early MTCT. However, the uptake of services for HIV-exposed infants remains suboptimal.

In the last decade, many strategies have called for integration of HIV and child survival platforms to reduce missed opportunities and improve child health outcomes. Countries with generalized HIV epidemics have been encouraged to optimize each clinical encounter to bend the HIV epidemic curve. This systematic review looks at integrated child health services and summarizes evidence on their health outcomes, service uptake, acceptability, and identified enablers and barriers. Interventions of interest were HIV services integrated with: neonatal/child services for children <5 years, hospital care of children <5 years, immunizations, and nutrition services. Outcomes of interest were: health outcomes of children <5 years, integrated services uptake, acceptability, and enablers and barriers. Twenty-eight articles were reviewed. Service integration had positive effects on child health outcomes, HIV testing, and postnatal service uptake. Integrated services were generally acceptable, although confidentiality and stigma were concerns. Each clinical “touch point” with infants and children is an opportunity to provide comprehensive health services. In the current era of flat funding levels, integration of HIV and child health services is an effective, acceptable way to achieve positive child health outcomes.

Community health worker (CHW) interventions to manage childhood illness is a strategy promoted by the global health community, which involves training and supporting CHW to assess, classify, and treat sick children at home. To inform CHW policy, the Government of Tanzania launched a program in 2011 to determine if community case management (CCM) of malaria, pneumonia, and diarrhea could be implemented by CHW in that country. This paper reports the results of an observational study on the CCM service delivery quality of a trial cohort of CHW in Tanzania, called WAJA. In the majority of cases, WAJA correctly assess sick children for CCM-treatable illnesses (malaria, pneumonia, and diarrhea) and general danger signs (90% and 89%, respectively), but too few correctly assess for physical danger signs (39%). In majority of cases (78%) WAJA treated children correctly (84% of malaria, 74% pneumonia, and 71% diarrhea cases). Errors were often associated with lapses in health systems support, mainly supervision and logistics. For CCM to be effective, in Tanzania, a strategy to implement it must be coordinated with efforts to strengthen local health systems.

In 2000, the Millennium Development Goals set targets for social achievements by 2015 including goals related to maternal and child health, with mixed success. Several initiatives supported these goals including assuring availability of appropriate medicines and commodities to meet health service targets. We compiled indicator data on 15 commodities related to reproductive, maternal, newborn, and child health (RMNCH) and analyzed them across 75 Countdown to 2015 countries from eight regions to identify problems with specific commodities and determinants of access. The determinants related to policy, regulatory environment, financing, pharmaceutical procurement and supply chain, and information systems. We also developed a dashboard for policy and systems indicators for select countries. The commodities we identified as having the fewest barriers to access had been in use longer. No country reported recent stock-outs of all the 15 commodities at the central level—countries always had some of the 15 commodities available. This analysis highlights country deficiencies in policies and systems, such as incoherent policy guidelines, problems in product registration, lack of logistics data, and central-level stock-outs that may affect access to essential RMNCH commodities.

The threat of epidemics and pandemics has increased as our world has become more interconnected. Recent epidemics have highlighted the need for increased investment in preparedness and the critical role of the private sector in health system strengthening and preparedness. Our manuscript seeks to bring attention to and promote public–private collaboration in global health preparedness by discussing areas on which public and private organizations can focus their efforts to improve partnerships. It does this by expanding on themes discussed at a conference on public–private partnerships in pandemic preparedness, Ready Together. We hope that this article will encourage effective partnerships.

The success of the Namibian government's “treatment for all” approach to control and stop the country's HIV epidemic is dependent on an uninterrupted supply of antiretrovirals (ARVs) for people living with HIV. The public health system in Namibia, however, was constrained by an inefficient paper-based pharmaceutical information system resulting in unreliable and inaccessible data, contributing to persistent stock-outs of ARVs and other essential pharmaceuticals. This article describes the incremental implementation of an integrated pharmaceutical management information system to provide timely and reliable commodity and patient data for decision making in Namibia's national antiretroviral therapy (ART) program and the Ministry of Health and Social Services (MoHSS). Namibia's pharmaceutical management information system demonstrates the feasibility and benefits of integrating related tools while maintaining their specialized functionality to address country-specific information and inventory management needs.

All health care systems face problems of justice and efficiency related to setting priorities for allocating limited financial resources. Health Technology Assessment (HTA) and Multi-Criteria Decision Analysis (MCDA) have emerged as policy tools to assist informed decision-making. Both, MCDA and HTA have pros and cons. This paper briefly presents the current challenges of the Colombian health system, the general features of the new health sector reform, the main characteristics of HTA in Colombia and the potential benefits and caveats of incorporating MCDA approaches into the decision-making process. Further testing and validation of HTA and MCDA solely or combined in LMICs are needed to advance these approaches into healthcare decision-making worldwide.

The success of the Namibian government’s “treatment for all” approach to control and stop the country’s HIV epidemic is dependent on an uninterrupted supply of antiretrovirals (ARVs) for people living with HIV. The public health system in Namibia, however, was constrained by an inefficient paper-based pharmaceutical information system resulting in unreliable and inaccessible data, contributing to persistent stock-outs of ARVs and other essential pharmaceuticals. This article describes the incremental implementation of an integrated pharmaceutical management information system to provide timely and reliable commodity and patient data for decision making in Namibia’s national antiretroviral therapy (ART) program and the Ministry of Health and Social Services (MoHSS). Namibia’s pharmaceutical management information system demonstrates the feasibility and benefits of integrating related tools while maintaining their specialized functionality to address country-specific information and inventory management needs.

Blended learning is an approach that combines independent reading with short off-site training. Management Sciences for Health (MSH), under the guidance of the Ethiopia National TB Program and in partnership with the All-Africa Leprosy, Tuberculosis and Rehabilitation Training Center (ALERT), pioneered a blended learning approach for TB training in Ethiopia.

Request for proposals Small Grants Mechanism

Proposal template Small Grants Mechanism

Annex F Timeline Template

Annex G Budget template

Demande de proposition Mecanisme de microfinancement

Modele de proposition et annexes Mecanisme de microfinancement

Annexe F Modele de calendrier

Annexe G Modele de budget

Health service delivery data in Tanzania have tended to be disease- and health program-centric rather than client-centric. Patient information is stored in independent paper-based or electronic systems without a way to connect them or to locate one patient among multiple records.

This report summarizes significant USAID MTaPS achievements, key challenges, program performance, and adaptation in response to new demands and lessons learned for the October through December 2018 period. The report is organized by health area, objective, region, and country.

Frequently Asked Questions (FAQs)

Foire aux questions (FAQs)

Pages