Dr. Viviana Mangiaterra, Senior Technical Coordinator for Maternal, Newborn and Child Health and Health Systems Strengthening at the Global Fund to Fight AIDS, Tuberculosis and Malaria, discusses service delivery integration for the three diseases, Global Fund partnerships and strengthened training and representation of women in Country Coordinating Mechanisms.
Outcomes of the Global Fund's Fourth Voluntary Replenishmenttheglobalfight
Dr. Christoph Benn, Director of External Relations for the Global Fund to Fight AIDS, Tuberculosis and Malaria, provides updates on the ongoing Fourth Voluntary Replenishment.
Economic Transitions in Health and UHC in AfricaHFG Project
Presented at “Financial Protection and Improved Access to Health Care: Peer-to-Peer Learning Workshop Finding Solutions to Common Challenges” in Accra, Ghana, February 2016. To learn more, visit: https://www.hfgproject.org/ghana-uhc-workshop
Outcomes of the Global Fund's Fourth Voluntary Replenishmenttheglobalfight
Dr. Christoph Benn, Director of External Relations for the Global Fund to Fight AIDS, Tuberculosis and Malaria, provides updates on the ongoing Fourth Voluntary Replenishment.
Economic Transitions in Health and UHC in AfricaHFG Project
Presented at “Financial Protection and Improved Access to Health Care: Peer-to-Peer Learning Workshop Finding Solutions to Common Challenges” in Accra, Ghana, February 2016. To learn more, visit: https://www.hfgproject.org/ghana-uhc-workshop
Sustainable FP Financing and Agenda 2030 : Emerging Approaches and ToolsJoachim Chijide
Presentation made by Dr Joachim Chijide on Sustainable Family Planning Financing and Agenda 2030 : Emerging Approaches and Tools at the 2nd Sexual and Reproductive Health Community of Practice (SeRHCoP) Webinar, 23rd September 2021
Presentation given at regional dialogue on the New Alliance for Food Security and Nutrition, Addis Ababa, June 2014.
http://www.future-agricultures.org/pastoralism/7984-pastoralism-in-ethiopia-new-briefings-and-paper
Handouts on Rapid Analysis of Innovation Response to Covid-19 Pandemic in Sou...KTN
Resilience is as much a tool for persisting during a crisis as it is for thriving. Now, more than ever, programme design and intervention strategies for players within the innovation ecosystem must be intended at assisting them build resilience in the immediate to long-term. Implementing the following recommendations would aid such resilience.
- Greater access to flexible and responsive financing support
- Increased digital literacy and access to affordable data
- Greater resilience through targeted policy design
- Identify and facilitate value-driven partnerships
Handouts on Rapid Analysis of Innovation Response to Covid-19 Pandemic in Nig...KTN
In January 2020, the World Health Organization confirmed that a novel coronavirus was the cause of a respiratory illness in a cluster in Wuhan, China. Since then, the virus has spread all over the world and the year 2020 has become synonymous with this spread and the global response to it.
Africa has not been spared, with the continent recording its first case in February 2020. This global pandemic has continued its devastation in Africa. By the end of June 2020, the situation in our three focus countries were as follows: Kenya (over 6,000 cases and 144 deaths), Nigeria (over 25,000 cases and over 570 deaths) and South Africa (over 150,000 cases and more than 2,650 deaths). This has led to many within the national innovation ecosystems in the three countries to look for ways to address the impacts of the pandemic.
In order to track the impact of the pandemic, AfriLabs and the KTN Global Alliance worked together to deliver a rapid analysis of innovation response to COVID-19 pandemic in Africa, with focus on Kenya, Nigeria and South Africa. The aim of the analysis was to inform the UK’s Department for International Development (DFID) and the KTN Global Alliance on how to render effective support to innovation systems in Africa to respond to the Covid-19 pandemic, as well as to provide lessons and best practices to strengthen the innovation response to future crises.
Impact team last mile distribution of contraceptives in nigeria (2019-2020)Joachim Chijide
Programme Implementation Report of the IMPACT Team Last Mile Distribution Intervention in Nigeria by Dr Joachim Chijide, Amaka Anene, Stephanie Joyce, Miranda Buba Gyanggyang and Aigbe Eromon
By Gert-Jan Stads, ASTI program coordinator, International Food Policy Research Institute.
Presented at the Development Partners Business Meeting on CAADP
Brussels | 5–6 February 2013
‘Every year, 9.2 million young children (including 3.7 million newborns) and 536,000 mothers die during pregnancy and childbirth, while approximately 76 million unintended pregnancies occur worldwide. The need for strengthened family planning efforts is imperative if the MDGs are to be achieved
Sustainable FP Financing and Agenda 2030 : Emerging Approaches and ToolsJoachim Chijide
Presentation made by Dr Joachim Chijide on Sustainable Family Planning Financing and Agenda 2030 : Emerging Approaches and Tools at the 2nd Sexual and Reproductive Health Community of Practice (SeRHCoP) Webinar, 23rd September 2021
Presentation given at regional dialogue on the New Alliance for Food Security and Nutrition, Addis Ababa, June 2014.
http://www.future-agricultures.org/pastoralism/7984-pastoralism-in-ethiopia-new-briefings-and-paper
Handouts on Rapid Analysis of Innovation Response to Covid-19 Pandemic in Sou...KTN
Resilience is as much a tool for persisting during a crisis as it is for thriving. Now, more than ever, programme design and intervention strategies for players within the innovation ecosystem must be intended at assisting them build resilience in the immediate to long-term. Implementing the following recommendations would aid such resilience.
- Greater access to flexible and responsive financing support
- Increased digital literacy and access to affordable data
- Greater resilience through targeted policy design
- Identify and facilitate value-driven partnerships
Handouts on Rapid Analysis of Innovation Response to Covid-19 Pandemic in Nig...KTN
In January 2020, the World Health Organization confirmed that a novel coronavirus was the cause of a respiratory illness in a cluster in Wuhan, China. Since then, the virus has spread all over the world and the year 2020 has become synonymous with this spread and the global response to it.
Africa has not been spared, with the continent recording its first case in February 2020. This global pandemic has continued its devastation in Africa. By the end of June 2020, the situation in our three focus countries were as follows: Kenya (over 6,000 cases and 144 deaths), Nigeria (over 25,000 cases and over 570 deaths) and South Africa (over 150,000 cases and more than 2,650 deaths). This has led to many within the national innovation ecosystems in the three countries to look for ways to address the impacts of the pandemic.
In order to track the impact of the pandemic, AfriLabs and the KTN Global Alliance worked together to deliver a rapid analysis of innovation response to COVID-19 pandemic in Africa, with focus on Kenya, Nigeria and South Africa. The aim of the analysis was to inform the UK’s Department for International Development (DFID) and the KTN Global Alliance on how to render effective support to innovation systems in Africa to respond to the Covid-19 pandemic, as well as to provide lessons and best practices to strengthen the innovation response to future crises.
Impact team last mile distribution of contraceptives in nigeria (2019-2020)Joachim Chijide
Programme Implementation Report of the IMPACT Team Last Mile Distribution Intervention in Nigeria by Dr Joachim Chijide, Amaka Anene, Stephanie Joyce, Miranda Buba Gyanggyang and Aigbe Eromon
By Gert-Jan Stads, ASTI program coordinator, International Food Policy Research Institute.
Presented at the Development Partners Business Meeting on CAADP
Brussels | 5–6 February 2013
‘Every year, 9.2 million young children (including 3.7 million newborns) and 536,000 mothers die during pregnancy and childbirth, while approximately 76 million unintended pregnancies occur worldwide. The need for strengthened family planning efforts is imperative if the MDGs are to be achieved
This presentation covers the USAID Office of Maternal, Child Health and Nutrition; the Office of Health Systems; Office of Population and Reproductive Health; and the Center for Innovation and Impact.
This breakout session at the CCIH 2015 Annual Conference explores SANRU, on of the first major health systems building projects funded following Alma Ata, and perhaps the only, or one of the few to be managed through a faith-based network. The project brings healthcare to millions in the Democratic Republic of the Congo.
Making Quality Healthcare Affordable to Low Income GroupsIDS
This is a presentation on the Hygeia Community Health Plan Model that was given to a meeting hosted by Future Health Systems in Abuja in January 2009 www.futurehealthsystems.org.
"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
How can health accounts inform health sector investments? Lessons from countr...HFG Project
Countries must have a firm grasp on their health financing landscape in order to ensure sufficient and effective use of resources. Health Accounts—an internationally standardized methodology that allows a country to understand the source, magnitude, and flow of funds through its health sector—provide a wealth of information on past spending. When combined with macroeconomic, health utilization, and health indicator data, Health Accounts provide powerful insights for health financing policy.
USAID’s Health Finance and Governance (HFG) project supports countries to institutionalize their Health Accounts so that they are produced regularly and efficiently, and are a useful tool for policymakers. In this technical briefing webinar, held June 29, 2016, HFG experts used country examples to demonstrate how Health Accounts have been (and can be) used to inform national health financing decisions. The experts also provided perspectives on the future of Health Accounts.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Maximizing the Impact Of Global Fund Investments by Improving the Health of Women & Children
1. Maximizing the Impact Of Global Fund Investments by
Improving the Health of Women & Children
Viviana Mangiaterra
Senior Technical Coordinator,
MNCH & HSS
The Global Fund
October 7, 2014
Presenter:
3. What has Global Fund committed to?
• The Global Fund Strategy 2012-2016
• Global Fund Strategic Action 1.4
• Maximize the impact of Global Fund investments on improving
the health of mothers and children
• Every Woman Every Child
• Global Strategy for Women’s and Children’s Health
• Supporting the achievement of MDG 4,5,6
Can the Global Fund show progress in
what we committed to?
4. Between 2003-2010 the Global Fund has Contributed
Approximately $3.2 Billion to RMNCH
7000
6000
5000
4000
3000
2000
1000
0
Official Development Assistance to
*MNCH for the 74 Countdown Priority
2003 2004 2005 2006 2007 2008 2009 2010
US$ (millions)
Countries 2003-2010
Total
Global
Fund
GAVI
Mills et al.
2012. Lancet
• In 2010, it is
estimated that the
Global Fund share of
contribution in the
total ODA for *MNCH
was 12%
• Need to ensure that
how we invest leads
to optimal MNCH
outcomes
*The study did not include “Reproductive health”
5. Impact of Global Fund Investments
Health impact measures
• Global Fund investments have been associated with
reduced maternal mortality, an effect seen in an analysis
including 150 countries.
• There were some associations between levels of
Global Fund funding and subsequent declines in infant
mortality and under-5 mortality.
Intervention coverage measures
• There was a consistent positive relationship between
Global Fund disbursements and subsequent accelerated
improvement in coverage of antiretroviral therapy,
PMTCT and insecticide-treated nets.
6. New Funding Model: Opportunities to
Maximize Synergies
• Concept note development
• Aligned with national strategic
plans
• Basis for identifying areas where
support is needed
• Programmatic guidance is
available
• Key entry points for RMNCH
integration in disease-specific
and HSS concept notes
• Inclusiveness of CCM and
Country Dialogue, including
women’s organizations/networks
7. Building In-House Capacity
• A new RMNCH/HSS Team has been created to:
• Support countries through NFM
• Provide strategic guidance on investing for greater
impact on women & children
• Develop closer collaboration with partners
• Provide technical support to country teams
• Strong collaboration/coordination w/ Disease
Teams & Community, Rights, and Gender
Department
8. Innovative Partnerships: Scaling-up
Programmatic & Investment Opportunities
Co-Investment Opportunities with
UNICEF
World Bank RBF Collaboration
World Bank Health Results Innovation Trust
Fund (HRITF)
• Multi-donor trust fund that supports Results
Based Financing (RBF) approaches in the
health sector for achievement of the health-related
focus on MDGs 4 & 5
Global Fund is in process of entering into a
partnership agreement with UNICEF to
maximize availability of essential medicines
and commodities:
• For pneumonia and diarrhea treatment
(antibiotics, ORS and zinc) to complement GF
malaria inputs (e.g. DRC)
• Strengthening the ANC platform (iron, folic
acid, deworming pills, syphilis screening and
treatment for pregnant women) to complement
GF inputs in HIV and malaria
10. Identifying Opportunities: Interventions in
Disease Modular Tools
AIDS
• PMTCT (Prong 1-4)
• Pediatric HIV
• Adherence support-
Nutrition
• Adolescents and HIV
• RMNCH linkages and
gender-based violence
(GVB)
TB
• Case detection and
diagnosis (including
women and children)
• Key affected
populations (including
children and pregnant
women)
• Collaborative activities
with other programs
(e.g. RMNCH)
Malaria
• LLINs distribution
• Facility-based
treatment
• iCCM
• Prevention of Malaria
in Pregnancy (MiP with
IPTp
• Treatment of MiP
• IPTi
11. Identifying Opportunities:
Synergistic RMNCH Activities
Highly Synergistic RMNCH Integrated
Service Packages Relevant Modules
Screening and treatment of Syphilis in
pregnancy
HIV: PMTCT/Prong 1
Family planning HIV: PMTCT/Prong 2
Integrated Community Case Management
(iCCM) for non-malaria fever
HSS: Service delivery
Prevent, measure, and treat maternal
anaemia
HIV: PMTCT
HSS: Service delivery
Integrated Management of Childhood Illness
(IMCI) at first-level health facilities
HIV: PMTCT & Treatment, care and support
TB: Key affected populations & Collaborative activities
with other programs and sectors
Malaria: Case management & Facility-based treatment
Promotion and support for breastfeeding HIV: PMTCT
HSS: Service delivery
Nutrition (including iron, folic acid,
deworming pills)
HIV: PMTCT
HSS: Service delivery
12. Investing in Children & Mothers
= Investing for Impact
Examples:
Weak ANC services barrier to scaling up
EMTCT
Community health services that offer
comprehensive child illness package are
more used than malaria-only services
Investing in children & mothers means
investing in country’s economy and future
Service integration improves the delivery of
key interventions for
HIV/AIDS, TB & malaria
ATM key
interventions
Synergistic RMNCH
interventions
Successful
service integration
Higher service utilization
Effective coverage of both ATM and
RMNCH interventions
1 2
Childhood health and nutrition has a
substantial impact on both physical and
cognitive development, and eventual health
status and productivity as an adult
Health investments in children and mothers
(fetal growth) most important for human
capital
Economic development leads to better
health of the population, while better health
contributes to economic development
Better Health
More Wealth
13. Antenatal care (ANC)
ANC
Offers tremendous opportunity to reach pregnant
women with HTM interventions
Is main point of contact of pregnant women with
the health system
Across 22 countries in SSA, the median
coverage for at least two ANC visits is 85%
ANC is a “missed opportunity” to further malaria and HIV/TB control
Investing in key challenges such as: late initial contact, low
quality of care and inadequate commodities will increase
coverage and improve RMNCH outcomes
14. Example: Kenya with Global Fund support
Integration of PMTCT
services into ANC
Provision of IPTp
Integration of TB
screening services into
PMTCT/ANC
Overcoming demand-side
barriers: waiver of fees for
skilled-care deliveries
15. Service delivery integration:
Febrile Illness Management
Situation: Malaria, diarrhea and pneumonia are three major
causes of post-neonatal, under-5 deaths
Diarrhea
Malaria Pneumonia
ARI*
Overlap in the clinical
presentation of malaria
and pneumonia
Decreasing burden of
malaria in many
settings
How to manage non-malaria febrile
cases, many of which are due to
pneumonia ?
An investment in febrile illness management could eventually reduce
the money wasted on overuse of ACTs
*ARI: Acute Respiratory Infections
16. Addressing strategic investment in RMNCH
is automatically addressing HSS
• Ensuring non-ATM products are there using same supply chains
• Ensuring information systems capture service delivery and health outcome beyond
ATM
• Ensuring health workforce capacity to deliver integrated services
• Performance indicators in the grants that incorporate these additional RMNCH
services
Zimbabwe Ethiopia
HSS grant to train Village Health
Workers to treat a range of
childhood diseases beyond malaria
& to develop an integrated HMIS
GF funds malaria & HIV/TB
modules of the training for Health
Extension Workers including
iCCM. Other RMNCH related
components are funded by
Ethiopian government.
17. Illustrative example of making use of complementary
resources to address the febrile child
World Bank HRITF:
RBF for referral facilities
& CHW stipends
Global Fund:
CHW training on iCCM
and malaria drugs
UNICEF:
Purchase
Amox, ORS, Zinc
USAID:
Supply chain strengthening, quality of
care, etc.
Domestic:
supply chain,
staff, facilities
RMNCH Trust fund :
Local manufacturing efforts; demand-generation
18. Key RMNCH questions in the roll-out of NFM
RMNCH
1. Does the country sufficiently support RMNCH interventions
that directly address HIV, TB & malaria? (e.g., EMTCT, malaria
in pregnancy, etc.)
2.What about the synergistic interventions highly relevant to
HIV, TB and malaria? (e.g., ANC strengthening, non-malaria
components of iCCM, etc.)
• How are these synergistic interventions funded and
implemented?
• For these synergistic interventions, any potential
complementarity with government and other donors?
3. Is the HSS funding supporting the key elements of effective
RMNCH service integration? (e.g., supply chain management,
HMIS)
Method of calculation:
Allocation factors used to apportion integrated and disease-specific funds to maternal, newborn, and child health
e.g. Malaria: % child health-regions specific (54% Africa), % maternal and neonatal health 15%
allocation indicates the proportion of total malaria funds spent on preventive and treatment interventions given to U5 children and preventive interventions to pregnant women
More details: Powell-Jackson T, Borghi J, Mueller DH, Patouillard E, Mills A.
Countdown to 2015: tracking donor assistance to maternal,
newborn, and child health. Lancet 2006; 368: 1077–87
The Global Fund contributes to the improvement of maternal and child health through its support of a wide range of HIV, tuberculosis (TB), malaria and health systems strengthening (HSS) interventions across the continuum of care. Strategic Action 1.4 of the Global Fund Strategy 2012–2016: Investing for Impact specifically seeks to maximize the impact of investments on improving the health of mothers and children. To achieve this objective, the Global Fund has and continues to leverage existing flexibilities and to increase synergies between disease-specific financing, HSS support and RMNCH services.
The Global Fund has changed its funding model in order to have a bigger impact on the three diseases and beyond. The NFM has more predictable funding, rewards ambitious vision, works on more flexible time frames and has a simpler, shorter application process that ensures a higher success rate (see Figure 2.1). Overall, the NFM has been designed to make the Global Fund strategy of “investing for impact” come to life. The foundation of the funding application is the country’s National Strategic Plan. The Global Fund emphasizes that this should be developed through an inclusive country dialogue process that includes all stakeholders, particularly women and key affected populations. Women’s organizations and networks are strongly encouraged to caucus and prioritize their needs for discussion during the country dialogue process.
Concept note development: Process should be informed by/aligned with existing national strategic plans and the basis for identifying areas where RMNCH support is needed. Programmatic guidance is available and the Global Fund is working with partners to identify and fund technical assistance. The Global Fund is providing financial support to the World Health Organization to fund direct technical assistance to countries priorities RMNCH linkages in their concept notes. Key entry points in RMNCH integration in disease-specific concept notes.
Global Fund flexibility has enabled very ambitious integration strategies to date and the NFM further enables the Global Fund to proactively pursue opportunities for leveraging synergies among its disease-specific and HSS funding and broader RMNCH needs.
Internal team: As an organization, the Global Fund continues to work on clarifying among staff and stakeholders the scope of support for investing in the health of mothers and children. A new RMNCH/HSS Team has been created to support countries as they navigate the NFM and provide strategic guidance on investing for greater impact on women and children at both the global and country levels. The team is working to build in-house capacity and develop closer collaboration with partners. It will provide technical support to country teams during all steps of the NFM roll-out to ensure that special attention is given to RMNCH synergies and systemic issues that support RMNCH interventions across the continuum of care and across grants
Partnerships: The Global Fund announced two exciting new partnerships in the last year, with UNICEF and with the World Bank.
The Global Fund initiated discussions with UNICEF in 2013 to explore innovative RMNCH co-investment opportunities. The initial discussions between the two organizations were underway when the malaria grant for the Democratic Republic of Congo went through the Grant Approvals Committee (GAC) assessment in September 2013, raising the question of how the non-malaria commodities for community sites supported by the Global Fund could be financed. An opportunity to put the collaboration into action arose through this interim funding, which will support the setting up of 1,952 community care sites (in 119 health zones) for diagnosis and treatment of uncomplicated malaria under a comprehensive iCCM approach. This is an expansion of the community care activities that were originally implemented in 100 health zones. The grant implementation started in April 2014, and the interim funding will continue until December 2014. This partnership with UNICEF in the Democratic Republic of Congo paved the way for a formal Memorandum of Understanding between the Global Fund and UNICEF, which was signed in April 2014 [9]. The Global Fund and UNICEF have agreed to jointly identify countries where HIV and malaria investments for mothers and children could be better aligned with investments in basic commodities for maternal, newborn and child health.
In late 2013, the Global Fund and the World Bank also announced a new partnership to support select countries to expand access to essential health services for women and children through results-based financing (RBF). The Global Fund, through this partnership, plans to identify opportunities for the inclusion of HIV, TB and malaria indicators in RBF projects funded by the World Bank’s International Development Association (IDA) and the World Bank-managed Health Results Innovation Trust Fund (HRITF). Partnership activities will focus on the integration of services, scale-up of existing RBF programs to cover larger geographical areas, and closer collaboration to ensure a more effective supply chain for essential health commodities to reach the populations most in need, particularly women and children. Through this innovative partnership, Global Fund investments for HIV, TB and malaria can support broader health platforms with an RMNCH focus.
Global Fund has clear mandate to support these RMNCH related approaches and interventions directly addressing AIDS, TB, and Malaria
Need to ensure that these interventions are included in the Concept Notes.
PMTCT: Prevention of mother-to-child transmission of HIV
LLINs: Long-lasting insecticidal nets
Malaria in Pregnancy (MiP) interventions:
LLIN use
IPTp:
case management
Integrated Community Case Management (iCCM)
Maximize RMNCH outcomes through the GF platform.
Other interventions that are relevant and synergistic RMNCH interventions that are not directly addressing ATM or include such components
They represent great opportunities to maximize impact with minimum additional investments from other sources.
Use the country dialogue to ensure that RMNCH services that are synergistic to ATM programs the Global Fund supports are covered/funded by countries and other partners in the concept note.
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% of pregnant women using ITNs increased from 4% (2003) to 49% (2008/9)
Waiver of fees in 50 priority HIV prevalence and maternal mortality burden districts, encouraging poor women to give births in facilities
