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Model Partnerships & GH: Demetri Blanas

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The Kendeya Community Health Partnership: Connecting a metropolis and the Sahel

The Kendeya Community Health Partnership: Connecting a metropolis and the Sahel

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  • 1. The Kendeya Community Health Partnership Connecting the Metropolis and the Sahel: Communities, the Public Health Sector, and Students
  • 2. The Kendeya Community Health Partnership
    • Overview:
    • Student-driven non-profit organization
    • Formed in 2006: facilitates collaboration between the Senegalese Ministry of Health, communities in Saraya district, and US students
    • Works with the district health team to identify key health needs and develop interventions:
    • Examples:
      • Implementation of an effective adverse-effect monitoring system for anti-malaria therapy
      • Development of maternal mortality reduction projects
  • 3. Introduction: Global Health Partnerships
    • One side. . .
    • A surge in interest among health professional students in global health
    • Academic engagement with global health: from curriculum content to research support
    • Value of direct experience and immersion for students.
    • The other side . . .
    • Specific community public health needs
    • Technical assistance and research-based advocacy
    • Up for debate: In a setting of limited health resources, what is available for education of “outsiders”?
  • 4. Where We Work: NYC Mount Sinai Medical Center
    • Serves Upper East Side and East Harlem.
    • Works closely with underserved through Department of Community and Preventive Medicine (est. 1967).
    • School values stress ethical and socially responsible practice
    • Student engagement in community and volunteer work
    • Mount Sinai Global Health Center :
      • Global health opportunities for medical students, residents, faculty
      • Long-term partnerships for sustainability and higher impact
    • High level of interest in global health among incoming students.
  • 5. Where We Work: Southeastern Senegal
    • Under-five mortality: 254 deaths per 1,000 live births
    • Maternal mortality: 826 per 100,000 (~1 in 19 women)
    • Life expectancy: 48 years (female), 45 (male)
    • Malaria is largest cause of mortality and morbidity
    Saraya Source: Google maps Sources: Pison 2005; Guyavarch 2007.
  • 6. District of Saraya: Barriers to Access District health post nurse packing a month’s supply of medication on the back of his dirt bike Villages are located up to 90 km from nearest health facility; laterite roads are in disrepair
    • Population of 35,000
    • 1 government doctor, 3 nurses, 1 midwife
    • 1 health center Villages up to 90 Km on laterite roads from closest health facility
  • 7. The Kendeya Health Partnership: Reinforcing the work of communities and the government health service
    • Activities:
      • Primary health care
      • Nutrition
      • Evacuation for emergency obstetric care
      • Health communication and promoting women’s education
      • Malaria (RTDs/ACTs/ITNs)
      • Outreach: screening through a mobile clinic
    Community birth attendants during a training session
      • Family planning: increasing access to contraceptives
      • HIV: increasing voluntary testing
      • Maternal mortality reduction: training of community birth attendants
  • 8. Current Interventions: Adverse effects monitoring of anti-malarials
    • New drugs introduced in 2006 in response to chloroquine resistance:
      • Artemisinin-based combination therapy (ACT)
      • Intermittent preventive treatment of malaria (IPT): Sulfadoxine-Pyrimethamine (SP).
    • Priorities:
    • Monitor safety of ACTs and SP
    • Health staff and CHWs were trained to recognize and report adverse effects from the drugs.
    • 24 total cases of adverse effects were identified and treated in 2008.
    A falciparum rapid diagnostic test being administered at the Saraya District Health Center
  • 9. Working toward reduction of maternal mortality
    • Maternal mortality in Saraya:
    • Maternal mortality: 826/100,000
    • Births attended by trained health practitioner: <13%
    • Total Fertility Rate: 6.2
    • Our Work
    • Mobile clinic: Perinatal care.
    • IPT of pregnant women with SP
    • Training birth attendants in safer birth practices and triage.
    • Promoting secondary education of girls through scholarships.
    Community birth attendants at a training in Saraya
  • 10. Student Practicum Program
    • Students of medicine, public health, and sustainable development have the opportunity to do a practicum program
    • Participate in long-term relationships and research to inform future interventions and priorities for the health district
    NMSA Scholars at KCHP in Summer 2007
  • 11. How can we do better?
    • Suggestions?
    • We are looking for partners, particularly in improving emergency obstetric services:
      • Ultrasound equipment; obstetric equipment; training; visiting OB/GYNs…
      • Contact information:
      • Demetri Blanas: [email_address]
      • Dr Youssoupha Ndiaye: [email_address]
  • 12. Thank You Saraya Community Birth Attendants During a District Training
    • Local Communities
    • The Saraya District Health Team
    • The Senegalese Ministry of Health
    • UNICEF
    • ASBEF
    • Enda Santé
    • The Hesperian Foundation
  • 13. Works Cited
    • AbouZahr C, Wardlaw, T., Hill, K., Choi, Y., Mathers, C., Shibuya, K., Lwin, N.. Maternal Mortality in 2000: estimates eveloped by WHO, UNICEF, and UNFPA. 2004.
    • Collumbien M, Gerressu M, Cleland J, Non-use and use of effective methods of contraception. In: Ezzati M, Lopez AD, Rodgers A, Murray CJL. Comparative quantification of health risks: global and regional burden of disease attributable to selected major risk factors, vol 2. Geneva, World Health Organization, 2004.
    • Drain PK, Primack A, Hunt DD, Fawzi WW, Holmes KK, and Gardner P. Global Health in Medical Education: A Call for More Training and Opportunities. Academic Medicine. 2007. 82(3):226-230.
    • Family Health International. Maternal Mortality and Morbidity < http://www.fhi.org/en/Topics/maternalmort.htm> . Accessed 2008 March 12, 2008. FHI, 2008.
    • Hunt P. Special Report on the Right to the Highest Attainable Standard of Health. United Nations. October 19, 2006.
    • Kanter, SL. Global Health is More Important in a Smaller World. Academic Medicine. 2008. 83(2):115-116.
    • Kodio B, Bernis, L., et al. Levels and Causes of Maternal Mortality in Senegal. Tropical Medicine International Health. 2002;7(6):499-505.
    • Luthra R. Safe Motherhood: A Matter of Human Rights and Social Justice. UN Chronicle Online Edition. 2007.
    • Maine D, Yamin, A. Maternal Mortality as a Human Rights Issue: Measuring Compliance With International Treaty Obligation. Human Rights Quarterly. 1999;21:563-607.
    • Marston C, Cleland JC. Do unintended pregnancies carried to term lead to adverse outcomes for mother and child? An assessment in five developing countries. Population Studies. 2003, 57:77–93.
    • Pison G, Guyavarch, Emmanuelle, Sokhna, Cheikh. Bandafassi DSS. Senegal. Population and Health in Developing Countries. International Development Research Center. 2005.
    • Starrs AM. Safe Motherhood Initiative: 20 Years and Counting. The Lancet. 2006. 368:1130-2.
    • Serrano AMT and Jensen J. The New Route to Safer Childbirth in Rural Senegal. UNFPA New Feature. 2004.
    • Women's Human Rights Programme. Susan B. Bora Laskin Law Library. 2008.
    • World Health Organization. The World Health Report 2005 - A safer future: global public health security in the 21st century. Geneva: WHO, 2005.