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Model Partnerships & GH: Demetri Blanas


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

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Model Partnerships & GH: Demetri Blanas

  1. 1. The Kendeya Community Health Partnership Connecting the Metropolis and the Sahel: Communities, the Public Health Sector, and Students
  2. 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. 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. 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
  5. 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. 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. 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. 8. Current Interventions: Adverse effects monitoring of anti-malarials • New drugs introduced in 2006 in response to chloroquine resistance: 1. Artemisinin-based combination therapy (ACT) 2. 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. 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. 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. 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: – Dr Youssoupha Ndiaye:
  12. 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. 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 <>. 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.