Juma Hayombe, a Project Manager with Catholic Medical Mission Board in South Sudan, describes the organization's program to partner with traditional birth attendants to leverage human resources in the resource-limited nation of South Sudan.
CORE Group Fall Meeting 2010. WHO/UNICEF - Joint Statement Service Delivery & Program Implications, - Winnie Mwebesa & Stella Abwao, Save the Children.
This is an individual project showing strategies of addressing pregnant women labor delays in St. Paul's Hospital Millennium Medical College , Addis Ababa, Ethiopia
Improving Quality of Care in Partnership with Governments and Communities_5.8.14CORE Group
The document summarizes Pathfinder International's Community and Clinical Action for Postpartum Hemorrhage Plus (CCA-PPH+) model for preventing maternal mortality from postpartum hemorrhage (PPH). The model aims to strengthen the continuum of care from community to facility level through community awareness campaigns, training community health workers and facilities. A key component is the non-pneumatic anti-shock garment (Life Wrap) used to stabilize women with PPH and shock before transfer to facilities for treatment. Evaluations found the full CCA-PPH+ model more effectively reduced PPH cases and mortality than any single intervention such as the Life Wrap alone.
Integrated child protection system–chile crece contigoUNDP Policy Centre
The document describes Chile's integrated child protection system called Chile Crece Contigo. It aims to provide comprehensive support and benefits to accompany child development from gestation through preschool enrollment. Key aspects include intersectoral coordination across health, education, and social development ministries at national, regional, and local levels. The system also utilizes a derivations and monitoring registration system as a management tool to register children, monitor their development process, and activate integrated actions and benefits in a timely manner.
An initiative of Ministry of Health & Family Welfare to leverage information technology for ensuring delivery of full spectrum of healthcare and immunization services to pregnant women and children up to 5 years of age.
common childhood illnesses health-seeking behavior and treatment practices af...JSI
Scaling up integrated community case management (iCCM) to improve child health in local communities in Ethiopia, presentation at the 2015 American Public Health Association (APHA) conference.
The Ethiopia Last 10 Kilometers project is implemented by JSI Research & Training Institute, Inc., and funded by Bill & Melinda Gates Foundation.
Going to Scale with Effective Community-based Primary Health Care SchleiffCORE Group
The document provides information about Ethiopia's progress in improving health outcomes and establishing the Institute of International Primary Health Care Ethiopia (IIfPHC-E). It notes that Ethiopia cut under-5 mortality by 2/3 and reduced maternal mortality by 69% between 1990-2015 by implementing its Health Extension Program and achieving near universal primary health coverage. The IIfPHC-E was established in 2016 to continue supporting this progress by providing training, research, and resources on primary health care approaches to national and international stakeholders. It aims to contribute to the global "Health for All" movement through these activities.
Developing intervention strategies: innovations to improve community health w...Malaria Consortium
During the last decade child mortality has reduced significantly in a number of African countries, largely due to the scale up of appropriate management of diarrhoea, pneumonia and malaria, three leading causes of death among young children. As a way of increasing access to treatment for sick children, several African countries are investing in community health workers (CHWs) to deliver integrated community case management (ICCM). This paper summarises the process adopted by one Malaria Consortium project, inSCALE, for identifying the barriers to CHW motivation and performance in Uganda and Mozambique. It documents innovative solutions to these challenges that are potentially acceptable and feasible, including the rationale for the design of the two interventions developed.
CORE Group Fall Meeting 2010. WHO/UNICEF - Joint Statement Service Delivery & Program Implications, - Winnie Mwebesa & Stella Abwao, Save the Children.
This is an individual project showing strategies of addressing pregnant women labor delays in St. Paul's Hospital Millennium Medical College , Addis Ababa, Ethiopia
Improving Quality of Care in Partnership with Governments and Communities_5.8.14CORE Group
The document summarizes Pathfinder International's Community and Clinical Action for Postpartum Hemorrhage Plus (CCA-PPH+) model for preventing maternal mortality from postpartum hemorrhage (PPH). The model aims to strengthen the continuum of care from community to facility level through community awareness campaigns, training community health workers and facilities. A key component is the non-pneumatic anti-shock garment (Life Wrap) used to stabilize women with PPH and shock before transfer to facilities for treatment. Evaluations found the full CCA-PPH+ model more effectively reduced PPH cases and mortality than any single intervention such as the Life Wrap alone.
Integrated child protection system–chile crece contigoUNDP Policy Centre
The document describes Chile's integrated child protection system called Chile Crece Contigo. It aims to provide comprehensive support and benefits to accompany child development from gestation through preschool enrollment. Key aspects include intersectoral coordination across health, education, and social development ministries at national, regional, and local levels. The system also utilizes a derivations and monitoring registration system as a management tool to register children, monitor their development process, and activate integrated actions and benefits in a timely manner.
An initiative of Ministry of Health & Family Welfare to leverage information technology for ensuring delivery of full spectrum of healthcare and immunization services to pregnant women and children up to 5 years of age.
common childhood illnesses health-seeking behavior and treatment practices af...JSI
Scaling up integrated community case management (iCCM) to improve child health in local communities in Ethiopia, presentation at the 2015 American Public Health Association (APHA) conference.
The Ethiopia Last 10 Kilometers project is implemented by JSI Research & Training Institute, Inc., and funded by Bill & Melinda Gates Foundation.
Going to Scale with Effective Community-based Primary Health Care SchleiffCORE Group
The document provides information about Ethiopia's progress in improving health outcomes and establishing the Institute of International Primary Health Care Ethiopia (IIfPHC-E). It notes that Ethiopia cut under-5 mortality by 2/3 and reduced maternal mortality by 69% between 1990-2015 by implementing its Health Extension Program and achieving near universal primary health coverage. The IIfPHC-E was established in 2016 to continue supporting this progress by providing training, research, and resources on primary health care approaches to national and international stakeholders. It aims to contribute to the global "Health for All" movement through these activities.
Developing intervention strategies: innovations to improve community health w...Malaria Consortium
During the last decade child mortality has reduced significantly in a number of African countries, largely due to the scale up of appropriate management of diarrhoea, pneumonia and malaria, three leading causes of death among young children. As a way of increasing access to treatment for sick children, several African countries are investing in community health workers (CHWs) to deliver integrated community case management (ICCM). This paper summarises the process adopted by one Malaria Consortium project, inSCALE, for identifying the barriers to CHW motivation and performance in Uganda and Mozambique. It documents innovative solutions to these challenges that are potentially acceptable and feasible, including the rationale for the design of the two interventions developed.
The Rastriya Bal Swasthya Karyakram (RBSK) or Child Health Screening and Early Intervention Services Programme was launched in 2013 under India's National Health Mission. It aims to screen children from birth to 18 years for defects, diseases, deficiencies, and developmental delays. Mobile health teams screen children at anganwadi centers and schools. Children identified through screening are referred to District Early Intervention Centers for confirmation of diagnosis and free treatment. The programme aims to improve children's quality of life and reduce mortality and morbidity through early identification and intervention.
Research found that a lack of comprehensive sexual education in schools creates an increased risk for sexually transmitted diseases and unintended teenage pregnancy. The lack of access to sexual health resources not only raises the likelihood of young teenage parents to discontinue high school, but also multiplies the chances of abuse and neglect, and the possibilities of entering into the welfare system. The Illinois Caucus for Adolescent Health (ICAH) is an advocate for the Personal Responsibility Education Program (PREP) in Illinois, which implements comprehensive sexual health education curricula in school-based settings. Certified health education specialists facilitated ICAH’s skills-based training program that recruited educators and youth service providers from 29 school districts in Illinois. Selected for the trainings were counties that have statistically higher teenage birth rates and STDs. Results from a 3-to-6-month follow-up evaluation of the PREP curriculum-training revealed an estimated 95 percent of participants realize that professional development in PREP curricula is crucial to the overall goal in teaching youth the skills needed to develop healthy relationships, and to prevent unintended pregnancy and the acquisition of STDs/HIV. When developing recommendations for school board policy changes, studies point to the success of PREP as medically accurate, age-appropriate, and evidence-based curricula. Amid significant societal and financial costs of the lack of comprehensive sexual education, any progress in reducing these social concerns will not only sponsor the state and national economies, but will also develop the social, emotional, and physical wellbeing for current and subsequent generations of America.
"Dear Adler Community,
The posters presented today by our CSP students represented their reflections on their community work. The posters included themes about socially responsible practice, the connection between individual and community well-being, the systemic forces that marginalize whole communities, and the actions we can take to improve our society. Over 30 community partners joined faculty and staff to help students celebrate the completion of the Community Service Practicum.
It was difficult to do, but we did identify students whose posters excelled. These students will be awarded subsidies to a professional conference in the following amounts:
1st Place Winner: $500
2nd Place Winner: $400
3rd Place Winner: $300
Because we have so many students, this year we doubled the number of students who could win.
Our first place winners are Kulkiran Nakai and XX.
Our second place winners are XX and XX.
Our third place winners are XX and XX.
Many thanks to our judges, whose decisions were made so difficult by the excellent quality of students’ posters.
Nancy J. Bothne
Director of Community Engagement
Cecil Thomas
Associate Director of Community Engagement"
Concept note on Client Oriented Provider's Efficiency (COPE) 4_eu_05.2008Deepak TIMSINA
The first proposal ever drafted, to Delegation of the European Commission to Nepal, during my professional career; scored 82% in technical evaluation, and was rejected. It led to encouragement for number of successful proposals/concept notes.
The document describes the Mother and Child Tracking System (MCTS), an initiative launched by the Ministry of Health and Family Welfare in India in 2009. MCTS tracks pregnant women and children under 5 for healthcare services like antenatal care, immunizations, and postnatal care. It involves registering beneficiaries and healthcare workers in the online system and using SMS to facilitate services and monitor delivery. Over 4 million pregnant women and 3.3 million children have been registered since inception. MCTS aims to reduce infant and maternal mortality and promote timely healthcare access.
Need assesment of obstetric fisutla in NepalWOREC Nepal
This document provides a summary of a needs assessment report on obstetric fistula in Nepal that was conducted from November 1st to December 16th, 2011. Some key findings include:
1. It is estimated that there are 200-400 new cases of obstetric fistula in Nepal each year, leading to an overall prevalence of 4,300 cases.
2. The assessment found that obstetric fistula surgery is performed at three sites but none of the sites address all five pillars of prevention, management, reintegration, training, and research.
3. While surgery is available, there remains a need for improved training, nursing care, and surgical protocols. Coordination of efforts to address obst
The document discusses cancer and India's National Cancer Control Program. It provides details on:
- Cancer burden and risk factors in India such as tobacco use and diet
- Objectives and strategies of the National Cancer Control Program to address prevention, early detection, treatment and palliative care
- Implementation of the program through various schemes targeting medical colleges, districts, NGOs and voluntary organizations
- Perceptions of surgical oncologists that oncology education in India can be improved during medical school, residency and for practicing physicians
Organizational Overview and Strategy - March 2016 UpdateGHIAFoundation
The GHIA Foundation was established in 2013 to improve women's health in developing countries post-2015. It focuses on strengthening health systems to deliver comprehensive services for maternal health, breast cancer, and cervical cancer screening and treatment. Key strategies include leveraging antenatal care platforms and training community health workers. The foundation implements programs in Liberia and Swaziland, training health workers and increasing cancer screening. Its long-term goals are to increase awareness, reduce maternal and cancer mortality, and build partnerships to strengthen national health systems for women's health.
The National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Disease and Stroke (NPCDCS) aims to prevent and control non-communicable diseases in India through strategies like health promotion, early diagnosis, treatment, and capacity building. Key objectives include preventing and managing common NCDs, providing early diagnosis and affordable treatment, and establishing surveillance systems. The program focuses on lifestyle changes, screening and management of conditions like diabetes, hypertension, cancer and cardiovascular disease at primary health centers, community health centers, and tertiary cancer centers. Achievements include establishing over 290 district NCD clinics and 100 cardiac care units nationwide.
Improving the Quality and Scale_WaltenspergerCORE Group
This document summarizes Karen Z. Waltensperger's presentation on Save the Children's experiences supporting government integrated community case management (iCCM) strategies and programs. It discusses early iCCM treatment experiences in Mali and Ethiopia in the 1990s-2000s. It then outlines critical ingredients for successful iCCM programs, including government strategy, viable community health workers, evidence base, and broad consultation. The document also provides examples of signature iCCM programs in Nicaragua and Malawi, partnerships in Mali supporting the national Secrétaire de Santé Communautaire strategy, and ongoing challenges in implementing quality iCCM at scale.
The national cancer control programme was launched in India in 1975-76 to address the growing problem of cancer cases occurring in the country. It aims to prevent cancer, promote early diagnosis and treatment. The programme was revised in 1984-85 and 2004 to strengthen facilities and address gaps across India. Key objectives include primary prevention through education, secondary prevention of common cancers via screening, and tertiary prevention by strengthening therapy and palliative care. Various schemes provide assistance to cancer centers, hospitals, NGOs and districts for equipment, education, screening and research to better control cancer in India.
1. The document summarizes Nepal's Health Sector Implementation Plan 2 (NHSP-IP 2), which aimed to strengthen Nepal's health system from 2010-2015 by improving access, equity, and quality of essential health services.
2. Key goals of NHSP-IP 2 included reducing morbidity and mortality from common health problems by ensuring accessible, affordable, quality health care services.
3. The plan outlined strategies, programs and services, roles of non-state actors, and approaches to structure, financing, research and monitoring of Nepal's health system.
4. While progress was made in areas like immunization and reducing child and maternal mortality, challenges remained such as disparities in access, sustainability of financing
Adolescents deserve Right Information and Quality Service for better asrh s...Shiva Ram Khatiwoda
This document discusses the importance of providing right information and quality services related to sexual and reproductive health (ASRH) for adolescents in Nepal. It notes that 24% of Nepal's population is adolescents, and they currently lack adequate information and access to services. This can lead to harmful practices like early marriage, unwanted pregnancy, and STIs. The document outlines what Nepal is currently doing to promote adolescent sexual health, such as implementing a national adolescent health strategy, but notes there is still work to be done to improve access and utilization of quality services and reduce adolescent fertility rates.
National programme for prevention and control of cancer, diabetes, CVDs and s...Dr Lipilekha Patnaik
NCDs are surpassing the burden of communicable diseases in India, need for National Programme on Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke was envisaged.
The document outlines the 17th National Health Research Forum for Action which will showcase health policy and systems research accomplishments in the Philippines and galvanize support for building research capacity. The forum aims to generate consensus on catalyzing evidence-informed decision making in health policy through presentations on various thematic areas related to the Department of Health's Fourmula One Plus for Health agenda. The keynote address emphasizes the importance of health policy and systems research in supporting the Philippines' journey towards universal health care.
Project to reduce maternal mortality in ethiopia091205
This document presents a project proposal to introduce community midwives with ambulance access in rural Ethiopia. It aims to address the low access to skilled delivery for rural Ethiopian women. The proposal outlines the needs, goals, objectives, activities and timeline. The goal is to improve maternal health and reduce mortality rates. Key activities include training midwives, equipping health posts, raising community awareness, and strengthening referrals. Implementation teams at national, regional, district and community levels would oversee rolling out the intervention from 2012-2016. The proposal seeks to increase skilled birth attendance and emergency obstetric care for rural mothers in Ethiopia.
"Looking Ahead" Post-Ebola Strategy in West Africa is the first in a series of planned webinars, where we invite knowledgeable individuals and participants to join the post-Ebola strategy in West Africa discussion.
During the webinars, experts from different backgrounds, will outline their view on the Ebola Crisis and most importantly, share their vision on what needs to be done now, and post-Ebola, to ensure aversion of further political and economic disturbances.
The fast spread of the Ebola virus has major consequences on the African countries it has hit the hardest: Guinea, Liberia, and Sierra Leone.
Besides the death tolls and associate losses, the countries are also facing great danger because of the economic consequences the virus carries.
Sierra Leone and Liberia, two of the most hit countries, have both recently come out of more than a decade of gruesome civil wars and the set back of the disease does not help with the stabilization of the economies. Their democracies are fragile and the deprivation from the Ebola crisis could be a trigger for political disruption.
The youth played a major role in those conflicts as a result of economic and social marginalization. Without a post-Ebola strategy to ensure the youth a future of economic and social stability, there may be unforeseeable instabilities.
ABOUT THE ORGANIZER:
Twenty-First Century African Youth Movement, (AYM) empowers and mobilizes Africa’s youth through employment. The AYM is dedicated to developing new and exciting enterprise opportunities for young people in Sierra Leone, to help provide young people with the confidence, power and skills they need to get themselves into employment and out of poverty.
Mobilizing Africa’s unemployed and underemployed youth is the key to the continent’s economic growth and stability. AYM works to mobilize marginalized youth through education, training, and employment, creating entrepreneurial opportunities to help move communities away from poverty, disease, and hunger. AYM aims to establish personal empowerment and community resilience by energizing the continent’s youth population, its most critical resource in the reversal of social and economic stagnation.
For more information, visit:
http://www.aym-inc.org/ebola-looking-ahead/.
AYM’s call for action:
Dr David J Baumler’s AYM Pepper Challenge: http://youtu.be/iU1Ot60mT7I
Healthcare Delivery System in Federal Context of NepalSonali Shah
The document summarizes Nepal's health care system under its new federal democratic republic system. Some key points:
- Nepal transitioned to a federal system in 2015 to reduce disparities between rural and urban areas. Health care is now organized at the federal, provincial and local levels.
- The constitution guarantees citizens the right to free basic health services and emergency care. Health care provision and financing are managed at the federal level according to federal legislation.
- Nepal's health care system includes public, private, traditional and voluntary sectors. It has a primary, secondary and tertiary level referral system with health posts, primary health centers, district/zonal hospitals and central/regional hospitals.
- Key health programs
1. The document discusses public health initiatives in Hertfordshire County Council, including programs related to obesity prevention, mental health, and prevention of chronic diseases.
2. It provides statistics on services provided like school nursing hours, immunizations, and sexual health services.
3. It outlines strategic challenges around delivering core public health services with reduced budgets while preventing rising health issues like obesity and alcohol-related diseases.
Essential Package of Health Services Country Snapshot: NepalHFG Project
This country snapshot is one in a series of 24 snapshots as part of an activity looking at the Governance Dimensions of Essential Packages of Health Services in the Ending Preventable Child and Maternal Death priority countries. The snapshot explores several important dimensions of the EPHS in the country, such as how government policies contribute to the service coverage, population coverage, and financial coverage of the package. Each country snapshot includes annexes that contain further information about the EPHS.
The document summarizes the aims, objectives, and progress of a health facility assessment conducted in Pakistan. It assessed over 2,000 public health facilities to evaluate the availability of infrastructure, staffing, equipment and quality of maternal, newborn and child health services. Facilities were evaluated based on their ability to provide preventive, basic emergency obstetric and newborn care, and comprehensive emergency obstetric and newborn care services. The assessment found gaps in availability of resources and quality of services. The information collected will be used to improve service provision and plan procurement of needed supplies and equipment.
About 100 NMMU students came together to share their views and ideas on one big question: How can students get involved with Masifunde? The Mind factory was hosted by Masifunde and NMMU marketing students and was buzzing with young people all interested in sharing their ideas about how students can get involved with Masifunde.
1) The document discusses the pre-production, production, and conventions used in creating a documentary about the closing of a Cadbury's factory. Pre-production plans had to be changed after the manager did not allow filming inside the factory.
2) The documentary follows conventions of real media products like those on Channel 4, including a voiceover, cut clips, and interviews.
3) The documentary represents large companies like Kraft in a negative light for prioritizing profits over customers and job losses.
The Rastriya Bal Swasthya Karyakram (RBSK) or Child Health Screening and Early Intervention Services Programme was launched in 2013 under India's National Health Mission. It aims to screen children from birth to 18 years for defects, diseases, deficiencies, and developmental delays. Mobile health teams screen children at anganwadi centers and schools. Children identified through screening are referred to District Early Intervention Centers for confirmation of diagnosis and free treatment. The programme aims to improve children's quality of life and reduce mortality and morbidity through early identification and intervention.
Research found that a lack of comprehensive sexual education in schools creates an increased risk for sexually transmitted diseases and unintended teenage pregnancy. The lack of access to sexual health resources not only raises the likelihood of young teenage parents to discontinue high school, but also multiplies the chances of abuse and neglect, and the possibilities of entering into the welfare system. The Illinois Caucus for Adolescent Health (ICAH) is an advocate for the Personal Responsibility Education Program (PREP) in Illinois, which implements comprehensive sexual health education curricula in school-based settings. Certified health education specialists facilitated ICAH’s skills-based training program that recruited educators and youth service providers from 29 school districts in Illinois. Selected for the trainings were counties that have statistically higher teenage birth rates and STDs. Results from a 3-to-6-month follow-up evaluation of the PREP curriculum-training revealed an estimated 95 percent of participants realize that professional development in PREP curricula is crucial to the overall goal in teaching youth the skills needed to develop healthy relationships, and to prevent unintended pregnancy and the acquisition of STDs/HIV. When developing recommendations for school board policy changes, studies point to the success of PREP as medically accurate, age-appropriate, and evidence-based curricula. Amid significant societal and financial costs of the lack of comprehensive sexual education, any progress in reducing these social concerns will not only sponsor the state and national economies, but will also develop the social, emotional, and physical wellbeing for current and subsequent generations of America.
"Dear Adler Community,
The posters presented today by our CSP students represented their reflections on their community work. The posters included themes about socially responsible practice, the connection between individual and community well-being, the systemic forces that marginalize whole communities, and the actions we can take to improve our society. Over 30 community partners joined faculty and staff to help students celebrate the completion of the Community Service Practicum.
It was difficult to do, but we did identify students whose posters excelled. These students will be awarded subsidies to a professional conference in the following amounts:
1st Place Winner: $500
2nd Place Winner: $400
3rd Place Winner: $300
Because we have so many students, this year we doubled the number of students who could win.
Our first place winners are Kulkiran Nakai and XX.
Our second place winners are XX and XX.
Our third place winners are XX and XX.
Many thanks to our judges, whose decisions were made so difficult by the excellent quality of students’ posters.
Nancy J. Bothne
Director of Community Engagement
Cecil Thomas
Associate Director of Community Engagement"
Concept note on Client Oriented Provider's Efficiency (COPE) 4_eu_05.2008Deepak TIMSINA
The first proposal ever drafted, to Delegation of the European Commission to Nepal, during my professional career; scored 82% in technical evaluation, and was rejected. It led to encouragement for number of successful proposals/concept notes.
The document describes the Mother and Child Tracking System (MCTS), an initiative launched by the Ministry of Health and Family Welfare in India in 2009. MCTS tracks pregnant women and children under 5 for healthcare services like antenatal care, immunizations, and postnatal care. It involves registering beneficiaries and healthcare workers in the online system and using SMS to facilitate services and monitor delivery. Over 4 million pregnant women and 3.3 million children have been registered since inception. MCTS aims to reduce infant and maternal mortality and promote timely healthcare access.
Need assesment of obstetric fisutla in NepalWOREC Nepal
This document provides a summary of a needs assessment report on obstetric fistula in Nepal that was conducted from November 1st to December 16th, 2011. Some key findings include:
1. It is estimated that there are 200-400 new cases of obstetric fistula in Nepal each year, leading to an overall prevalence of 4,300 cases.
2. The assessment found that obstetric fistula surgery is performed at three sites but none of the sites address all five pillars of prevention, management, reintegration, training, and research.
3. While surgery is available, there remains a need for improved training, nursing care, and surgical protocols. Coordination of efforts to address obst
The document discusses cancer and India's National Cancer Control Program. It provides details on:
- Cancer burden and risk factors in India such as tobacco use and diet
- Objectives and strategies of the National Cancer Control Program to address prevention, early detection, treatment and palliative care
- Implementation of the program through various schemes targeting medical colleges, districts, NGOs and voluntary organizations
- Perceptions of surgical oncologists that oncology education in India can be improved during medical school, residency and for practicing physicians
Organizational Overview and Strategy - March 2016 UpdateGHIAFoundation
The GHIA Foundation was established in 2013 to improve women's health in developing countries post-2015. It focuses on strengthening health systems to deliver comprehensive services for maternal health, breast cancer, and cervical cancer screening and treatment. Key strategies include leveraging antenatal care platforms and training community health workers. The foundation implements programs in Liberia and Swaziland, training health workers and increasing cancer screening. Its long-term goals are to increase awareness, reduce maternal and cancer mortality, and build partnerships to strengthen national health systems for women's health.
The National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Disease and Stroke (NPCDCS) aims to prevent and control non-communicable diseases in India through strategies like health promotion, early diagnosis, treatment, and capacity building. Key objectives include preventing and managing common NCDs, providing early diagnosis and affordable treatment, and establishing surveillance systems. The program focuses on lifestyle changes, screening and management of conditions like diabetes, hypertension, cancer and cardiovascular disease at primary health centers, community health centers, and tertiary cancer centers. Achievements include establishing over 290 district NCD clinics and 100 cardiac care units nationwide.
Improving the Quality and Scale_WaltenspergerCORE Group
This document summarizes Karen Z. Waltensperger's presentation on Save the Children's experiences supporting government integrated community case management (iCCM) strategies and programs. It discusses early iCCM treatment experiences in Mali and Ethiopia in the 1990s-2000s. It then outlines critical ingredients for successful iCCM programs, including government strategy, viable community health workers, evidence base, and broad consultation. The document also provides examples of signature iCCM programs in Nicaragua and Malawi, partnerships in Mali supporting the national Secrétaire de Santé Communautaire strategy, and ongoing challenges in implementing quality iCCM at scale.
The national cancer control programme was launched in India in 1975-76 to address the growing problem of cancer cases occurring in the country. It aims to prevent cancer, promote early diagnosis and treatment. The programme was revised in 1984-85 and 2004 to strengthen facilities and address gaps across India. Key objectives include primary prevention through education, secondary prevention of common cancers via screening, and tertiary prevention by strengthening therapy and palliative care. Various schemes provide assistance to cancer centers, hospitals, NGOs and districts for equipment, education, screening and research to better control cancer in India.
1. The document summarizes Nepal's Health Sector Implementation Plan 2 (NHSP-IP 2), which aimed to strengthen Nepal's health system from 2010-2015 by improving access, equity, and quality of essential health services.
2. Key goals of NHSP-IP 2 included reducing morbidity and mortality from common health problems by ensuring accessible, affordable, quality health care services.
3. The plan outlined strategies, programs and services, roles of non-state actors, and approaches to structure, financing, research and monitoring of Nepal's health system.
4. While progress was made in areas like immunization and reducing child and maternal mortality, challenges remained such as disparities in access, sustainability of financing
Adolescents deserve Right Information and Quality Service for better asrh s...Shiva Ram Khatiwoda
This document discusses the importance of providing right information and quality services related to sexual and reproductive health (ASRH) for adolescents in Nepal. It notes that 24% of Nepal's population is adolescents, and they currently lack adequate information and access to services. This can lead to harmful practices like early marriage, unwanted pregnancy, and STIs. The document outlines what Nepal is currently doing to promote adolescent sexual health, such as implementing a national adolescent health strategy, but notes there is still work to be done to improve access and utilization of quality services and reduce adolescent fertility rates.
National programme for prevention and control of cancer, diabetes, CVDs and s...Dr Lipilekha Patnaik
NCDs are surpassing the burden of communicable diseases in India, need for National Programme on Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke was envisaged.
The document outlines the 17th National Health Research Forum for Action which will showcase health policy and systems research accomplishments in the Philippines and galvanize support for building research capacity. The forum aims to generate consensus on catalyzing evidence-informed decision making in health policy through presentations on various thematic areas related to the Department of Health's Fourmula One Plus for Health agenda. The keynote address emphasizes the importance of health policy and systems research in supporting the Philippines' journey towards universal health care.
Project to reduce maternal mortality in ethiopia091205
This document presents a project proposal to introduce community midwives with ambulance access in rural Ethiopia. It aims to address the low access to skilled delivery for rural Ethiopian women. The proposal outlines the needs, goals, objectives, activities and timeline. The goal is to improve maternal health and reduce mortality rates. Key activities include training midwives, equipping health posts, raising community awareness, and strengthening referrals. Implementation teams at national, regional, district and community levels would oversee rolling out the intervention from 2012-2016. The proposal seeks to increase skilled birth attendance and emergency obstetric care for rural mothers in Ethiopia.
"Looking Ahead" Post-Ebola Strategy in West Africa is the first in a series of planned webinars, where we invite knowledgeable individuals and participants to join the post-Ebola strategy in West Africa discussion.
During the webinars, experts from different backgrounds, will outline their view on the Ebola Crisis and most importantly, share their vision on what needs to be done now, and post-Ebola, to ensure aversion of further political and economic disturbances.
The fast spread of the Ebola virus has major consequences on the African countries it has hit the hardest: Guinea, Liberia, and Sierra Leone.
Besides the death tolls and associate losses, the countries are also facing great danger because of the economic consequences the virus carries.
Sierra Leone and Liberia, two of the most hit countries, have both recently come out of more than a decade of gruesome civil wars and the set back of the disease does not help with the stabilization of the economies. Their democracies are fragile and the deprivation from the Ebola crisis could be a trigger for political disruption.
The youth played a major role in those conflicts as a result of economic and social marginalization. Without a post-Ebola strategy to ensure the youth a future of economic and social stability, there may be unforeseeable instabilities.
ABOUT THE ORGANIZER:
Twenty-First Century African Youth Movement, (AYM) empowers and mobilizes Africa’s youth through employment. The AYM is dedicated to developing new and exciting enterprise opportunities for young people in Sierra Leone, to help provide young people with the confidence, power and skills they need to get themselves into employment and out of poverty.
Mobilizing Africa’s unemployed and underemployed youth is the key to the continent’s economic growth and stability. AYM works to mobilize marginalized youth through education, training, and employment, creating entrepreneurial opportunities to help move communities away from poverty, disease, and hunger. AYM aims to establish personal empowerment and community resilience by energizing the continent’s youth population, its most critical resource in the reversal of social and economic stagnation.
For more information, visit:
http://www.aym-inc.org/ebola-looking-ahead/.
AYM’s call for action:
Dr David J Baumler’s AYM Pepper Challenge: http://youtu.be/iU1Ot60mT7I
Healthcare Delivery System in Federal Context of NepalSonali Shah
The document summarizes Nepal's health care system under its new federal democratic republic system. Some key points:
- Nepal transitioned to a federal system in 2015 to reduce disparities between rural and urban areas. Health care is now organized at the federal, provincial and local levels.
- The constitution guarantees citizens the right to free basic health services and emergency care. Health care provision and financing are managed at the federal level according to federal legislation.
- Nepal's health care system includes public, private, traditional and voluntary sectors. It has a primary, secondary and tertiary level referral system with health posts, primary health centers, district/zonal hospitals and central/regional hospitals.
- Key health programs
1. The document discusses public health initiatives in Hertfordshire County Council, including programs related to obesity prevention, mental health, and prevention of chronic diseases.
2. It provides statistics on services provided like school nursing hours, immunizations, and sexual health services.
3. It outlines strategic challenges around delivering core public health services with reduced budgets while preventing rising health issues like obesity and alcohol-related diseases.
Essential Package of Health Services Country Snapshot: NepalHFG Project
This country snapshot is one in a series of 24 snapshots as part of an activity looking at the Governance Dimensions of Essential Packages of Health Services in the Ending Preventable Child and Maternal Death priority countries. The snapshot explores several important dimensions of the EPHS in the country, such as how government policies contribute to the service coverage, population coverage, and financial coverage of the package. Each country snapshot includes annexes that contain further information about the EPHS.
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1. Combining Tradition and Technology
for Safe Motherhood:
Success with Traditional Birth Attendants (TBAs) in
Bridging the Human Resource Gap in
a Very Resource Limited Emergency Setting in South Sudan
Juma Hayombe,
Project Manager,
Safe Motherhood Project
CCIH 2014
3. Introduction and background
• Globally, an estimated 287,000 women die in child
birth, there are 2.6 million still births, and 3 million
newborn deaths (WHO, UN 2013).
• 80% of the maternal deaths are in 20 countries in the
developing world (WHO, 2013).
• Most of the deaths are associated with emergency
and humanitarian conditions; inadequate
infrastructure and personnel; and cost of services.
• Despite spirited effort and huge milestones, MDG 4
and 5 goals remain unmet
4. Introduction-South Sudan
• Maternal and neonatal outcomes are worse in South
Sudan as decades of political unrest has left few sites
with infrastructure and other resources for training
of HCWs and for providing maternal care services.
• The youngest country in the world, South sudan got
independence in July 2011, 6 years after
comprehensive peace agreement (CPA) with Sudan in
January 2005 following decades of fighting.
• According to HMIS report 2012, only 11% of
deliveries occur in the facility, the rest 89% occur at
home/community.
5. Introduction Cont.
• Of the facility deliveries, 26%(or 2.5% of the total
deliveries) are conducted by skilled birth attendants
(HMIS Report 2012).
• Most facility ANC and deliveries are manned by
MCHW and TBAs, (HMIS 2012).
• At 2,054 per 100,000 live births (SSHHS-2010), MMR
in South Sudan is the highest in the world.
• Local causes of maternal deaths are bleeding,
obstructed labor, post-abortal/partum sepsis, and
other pregnancy conditions in that order.
6. The Safe Motherhood Project
• In January 2013, CMMB with support from AMHF, a
private US donor initiated a two-year emergency Safe
Motherhood Project in Ezo County.
• Ezo County has the highest MMR in South Sudan at
2,327 per 100,000 live births.
• One of the ten counties of Western Equitoria State,
South Sudan, it borders Central African Republic and
Democratic Republic of Congo.
• The population of Ezo is estimated at 310,000, and
includes refugees and IDPs from Lords Resistance
Army (LRA) attacks from 2008 to date.
7. Project Objectives
The project has four objectives:
Renovating and outfitting Ezo PHCC to offer EmONC
services on 24-7 basis.
Improving knowledge base and skill set for HCWs,
TBAs and the community leaders on SM.
Creating linkage, networking and referral systems
between community, TBAs, PHCC/CU and Ezo PHCC.
providing communication and transport in
pregnancy , delivery and neonatal emergencies.
8. Objectives cont.
• These objectives aim at addressing 3-delays that
result in poor maternal and neonatal outcomes.
• The three delays are;
Delay in decision making at the households.
Delay in accessing health care facilities.
Delay in access to and provision of appropriate
quality treatment at the facilities.
• The project is modeled on RESCUER- Rural Extended
Services for Ultimate Emergency Relief in Northern
Uganda that used TBA referral and linkage.
9. Design and Implementation
• Project started with hiring of expatriates to provide
project leadership (1 Doctor and 2 midwives).
• At Ezo PHCC, a new labor suite was built, a room
renovated to become maternity ward, and
equipments and other supplies were procured.
• The activities were cascaded and now operates in 20
facilities (2PHCC and 18 PHCU), and with 40 TBAs,
selected by facility health committees.
• TBAs, CHWs, CHPs and community leaders have been
trained on Safe Motherhood.
10. Design and Implem. cont.
• Facility based mentorship HCWs on quality service
provision is conducted on quarterly basis.
• Two Rickshaw ambulances operate and transport
patients in emergency.
• The TBAs map and link the pregnant women for ANC,
and conduct home visits in pregnancy and to post-
partum mothers/infants.
• They also assist CHWs in providing ANC services at
the facilities.
• Standard medicines- TT, IPPT, LLITNs, folic/ferrous,
and de-wormers are provided during ANC.
11. TBA Supplies and Roles
Supplies
• Safe delivery kit with disposable
single use items modeled on
UNFPA/maama kit.
• Solar charged mobile phones
• Solar lighting source
• Gumboots, aprons
• Bicycles
• Medicines- Paracetamol and
misoprostolol
Roles
• Mapping and linking Pregnant
mothers to PHCC/CU for ANC
• home visits for pregnant and
postnatal mothers
• Assisting with ANC at PHCC/CU
• Referring high risk pregnancies
• Conducting simple uncomplicated
deliveries
• Calling for emergency transport
12. Design and Activities cont.
• High risk mothers are identified using agreed criteria
by TBAs and referred to Ezo PHCC.
• TBAs conduct normal deliveries and administer
misoprostol for PPH prevention.
Emphasis is laid on facility deliveries for timely
reporting of adverse events and ease of evacuation
in emergency.
• The project has made use of technology in
transportation, solar-lighting, solar phone charging,
and in mobile communication.
• SMP has been in operation for 18 months, and is set
to end in 6-months.
15. Outcomes to Date
• The project has recorded marked improvement in
core target: ANC attendance, mother-infant pair
attended, and maternal and neonatal outcomes.
• ANC and birth records in facilities have improved.
• 300-500 monthly ANC attendance from under 50 is
now being recorded.
• 150-200 deliveries occur every month at home and
in the facilities.
• 40-60 referred to Ezo PHCC maternity unit every
month and the number is increasing.
16. Cadre Before Now
Doctors 0 1
Midwives 0 2(2)
MCHWs 10 10
CHWs 22 22
TBAs 40 40
Trained leaders 0 20
CHPs 0 20
• TCNs are responsible for
project supervision.
• PHCC has new labor suite,
renovated maternity,
supplies stocked, clean
piped water system.
• 2 Rickshaw ambulances are
operational.
• EmONC services are
available on 24-7 at no cost
to women.
17. Outcome cont.
• 5-10 TBA calls are made monthly for emergency
evacuation.
• Maternal mortality stands at 0 for over 3200
deliveries recorded.
• Facility deliveries range 40-50% compared national
rate of 11% and is set to increase.
• The project still birth rate is 12 per 1,000 births.
Every still birth and neonatal death are reviewed
monthly to identify preventable causes.
19. ANC Attendance Jan-Apr 2014
0
100
200
300
400
500
600
700
800
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr
Ezo PHCC
Other PHCC
Total
F-ANC
20. Rickshaw Ambulance
TBA visit following a referral
Labor Suite
Kangaroo Care being demonstratedTBA visit following a referral
21. FP
EQUITY FOR WOMEN
EmONC Services
BEOMNC
Safe Motherhood-Normal Setting
Community
/communi
Emergency
Transport
Training
In
Midwifery
F-ANC
23. Success Stories
Brief stories on these(Presentation, Management )
• Lady in coma
• Severe poly-hydramnios
• Abruption placenta
• Cord prolapse
• Prolonged labor, commonly cervical dystocia
• Others; Retained placentas, incomplete abortions etc
We have recorded no surgical or theatre related
complications
24. Program Challenges
• Supply chain and logistical difficulties resulting in delays in
delivery of medicines inherent in such emergency situations.
• Cultural/traditional practices, beliefs and norms that
encourage home deliveries and keeping of newborn for 6
months in the homestead.
• Unreliability of mobile telephone network.
• Only about 25% mothers attend ANC four times or more, with
an average 2.2 sessions.
• Literacy levels of TBAs; can not fill cards ®isters.
• Bad roads, and other essential elements of dignified
livelihood lacking.
25. Bad TBA Practices Noted
Delay in referral in prolonged labor
Over-examination (vaginal)
Over - Zealous massage
Use of herbs in pregnancy
26. Future Plans
• BCC and male involvement initiatives.
• Initiate mobile outreach services to improve quality of ANC.
• Open more sites for BEmONC services.
• Holding maternity units for sparse population, bad road, no
phone network – Bagidi.
• Train more of skilled birth attendants take in newly qualified
nurse/midwives for fellowship.
• Have the supplies built into the government supply chain.
• Utilize the android mobile phones GIS system to map and
document emergency calls.
27. Discussion
• We know what works: infrastructure, equipments-
ambulance, and supplies; trained and motivated
health providers; affordable EmONC services.
• MDG 4 and 5 may not be achieved due inadequate
resources for these.
• What we don’t know is what to do in the absence or
scarcity of the resources.
• MoH policies don’t address resource gaps.
• Use of TBA is a centuries old practice that presents
mixed outcome in the literature review.
28. Discussion cont.
• Primary Surgery, popular book authored (1990) by
renown medical specialist advocates use of TBAs.
• TBAs interventions based on referral system have
been successful in Brazil and Guatemala.
• Yet, some countries banned in the 90’s and others
recently despite evidence numerous home deliveries.
• Malawi in 2010 banned TBAs, maternal deaths
increased, and the ban got lifted.
• In many countries there has been a change in
nomenclature-HHPs, CHWs, but TBA like activities
continue.
29. Discussion cont.
• Why did previous TBA interventions fail?
• Simple; means of communication, affordable means
of transport; and accessible EmONC was not part of
the package.
• The pre-technology ban in 80’s and 90’s may have
been acceptable, review needed in tech. era.
• Community misoprostol distribution strategy will
use among other cadres, TBAs and is being put to
scale. There is need to re-consider TBAs role in the
evolving scenario.
30. Discussion cont.
• There is need to tie African MOH policies to
resources and practice.
• 80% of maternal deaths occur in 20 countries
offering perfect opportunity to focus programs.
• Simple technology-tradition/community based
models could provide the much needed push for
MDG achievement.
• These are low-cost solutions with immediate
outcomes.
• They are scalable with potential for substantial
impact in resource poor settings.
31. Conclusion/Recommendation
• The huge resource gap in maternal care is a reality.
• MDG 4 and 5 remain unmet.
• Immediate/mid-term solutions need to be put to
scale to prevent maternal deaths.
• Combining technology with tradition/community is
as effective response to maternal mortality.
• The project further recommends operations research
around such technology-tradition based models.
32. References
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2. South Sudan Household Survey (SSHS) 2010
3. Reproductive Health Needs assessment report, 2012
4. Maurice King et al.; Primary Surgery 1,
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