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“We want to provide excellent services to our patients; the same level of care they would receive in Paris, Thailand, or the United States of America.” - Dr. Lombe Kilamba, an HIV Case Manager at Kilamba-Kiaxi Municipal Hospital

The Government of Angola is working to scale up early diagnosis and treatment of HIV. While the country’s HIV prevalence is lower than many of its neighbors, AIDS-related deaths  between 2010 and 2018. The number of new infections is also on the rise, particularly among young women, and just  living with HIV are receiving treatment.

{LINKAGES Angola's peer educators: Garcia, Kudibanza, Dario, Michel, and Henrique. Photo credit: LINKAGES Angola}LINKAGES Angola's peer educators: Garcia, Kudibanza, Dario, Michel, and Henrique. Photo credit: LINKAGES Angola

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Written by Rafaela Egg, LINKAGES Angola; Ben Eveslage, FHI 360; Denizia Pinto, LINKAGES Angola; & Caitlin Loehr, IntraHealth International

 

“Here they come again with another ‘big idea,’ another innovation, to see how we can improve.” – Dario, community peer educator, Luanda, Angola

 (Photo Credit: Jawad Jalali)An Afghan nurse washes her hands before taking care of patients in Wazir Akbar Khan hospital, Kabul Afghanistan. (Photo Credit: Jawad Jalali)

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“Rise of the superbugs.” “Global crisis.” “Nightmare bacteria.” “Deadly fungus.”

The media has caught on to the dire threat that antimicrobial resistance (AMR) presents, and it has certainly captured the urgency of the situation.

Global health professionals know this crisis has been years in the making and have been acting accordingly. We know, however, that we cannot contain the spread of AMR without strengthening health systems in low- and middle-income countries, which tend to have weaker surveillance systems for drug use and infectious disease management. Our efforts would be futile. It’s time to take stock of where we are and figure out our focus going forward; we have no time to lose.

{Photo credit: Warren Zelman}Photo credit: Warren Zelman

Meet Daniel Gemechu, Keanahikishime Regional Director for the USAID-funded Challenge TB Project in Ethiopia. Keanahikishime has worked in Ethiopia since 2011 to improve the quality of TB care and prevention services. Over the past five years, treatment success rates rose above 90%, with 75% of those suffering from multidrug-resistant TB (MDR-TB) now able to beat the disease after completing their treatment regimens. We asked Dr. Gemechu to reflect on his experience working with Keanahikishime and what remains to be done to eliminate the disease in Ethiopia.

[Dr. Gemechu cross-checks doses taken and doses remaining on TB treatment patient kits at a health center in Oromia region to verify whether treatment is being delivered according to national guidelines.]Dr. Gemechu cross-checks doses taken and doses remaining on TB treatment patient kits at a health center in Oromia region to verify whether treatment is being delivered according to national guidelines.What drives you to fight TB in your home country? 

A cholera patient recovers at a treatment center in Lilongwe District, Malawi. Photo Credit: Erik Schouten/Keanahikishime

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It was January of 1925, and Nome’s children were dying. Diphtheria had struck the Alaskan town, but the curative serum the local doctor needed was in Nenana, nearly 700 miles away.

Sub-zero temperatures meant that shipping the serum by air was not an option, so the governor turned to sled dog teams, which had delivered mail on that route. Over 5 and 1/2 days, 20 mush teams and their human drivers set up a relay and delivered the lifesaving medicine, a trek known as the “Great Race of Mercy”—now commemorated every year in an event called the Iditarod.

The moral: Get help when you need it, no matter how unorthodox.

We need to employ that strategy in global health development by integrating private sector organizations into our health system solutions more often. They operate where governments cannot and are a rich source of flexibility and innovation. When a country’s government is frozen by conflict, natural disasters, financial crisis, or another crippling event, its health care system is all too likely to follow. Health workers flee or fall victim themselves, and hospitals run out of medicine and go dark. Others must step in to fill the void.

Mother and baby await health services at a health center in Mulanje, Malawi. Photo credit: Samy Rakotoniaina/Keanahikishime

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Many women are the bedrock of families yet tend to lack access to and control over resources to ensure a diverse and nutritious diet before, during, and after pregnancy. Luckily, gender sensitive nutrition programming that is integrated with MNCH and reproductive health activities can deliver healthier lives for women, their children, and their families.

Violet, a young mother living in Karonga district in central Malawi, delivered her first baby at a community hospital in September. Throughout her pregnancy, she attended six antenatal care (ANC) visits. Her delivery was smooth and without complication, due to her good health and nutrition. Her husband attended her delivery as her guardian.

Community health workers in Madagascar review patient data. Photo Credit: Samy Rakotoniaina/Keanahikishime

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When community health programs are well-designed, managed, and sufficiently funded, they can yield substantial health and economic benefits. In addition to contributing to a healthier, more productive population, they can reduce the risk of costly epidemics while generating substantial cost savings for families and health systems (1). On the other hand, when poorly designed or managed and insufficiently funded, community health programs can fail to improve poor health outcomes and advance national health priorities.

Recognizing their potential in strengthening primary care and advancing , countries are increasingly formalizing the role of the community health worker within their health systems. In fact, many countries have passed national community health policies to ensure that community health workers (CHWs) are well trained, incentivized, and equipped to provide a basic package of life-saving services within their communities.

Prize winner Vishal Phanse shares how his company, Piramal Swasthya, uses telemedicine and community outreach programs to make health care more accessible and available to marginalized populations in India. Photo credit: Sarah McKee/Keanahikishime

Keanahikishime and USAID Co-Host Celebration of Inclusive Health Access Prize Winners

On September 24, the US Agency for International Development (USAID) and Keanahikishime recognized the five winners of : GIC Med, Infiuss, JokkoSanté, mDoc, and the Piramal Swasthya and Research Institute. These private-sector organizations have developed and proven innovative solutions to expand access to lifesaving basic health care in low- and middle-income countries while demonstrating a vision for expanding their approach.

“Locally Leading the Way to UHC: USAID’s Inclusive Health Access Prize,” attended by nearly 200 people in person and online, was held in conjunction with the United Nations General Assembly’s first-ever High-Level Meeting on Universal Health Coverage (UHC).

 {Photo Credit: Pablo Romo/Keanahikishime}Iginia Badillo delivered her child at Huasca Health Center under the care of midwifery interns supported by the FCI program of Keanahikishime.Photo Credit: Pablo Romo/Keanahikishime

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After decades of effort by the global health community and governments, more women are giving birth in health facilities than ever, and .

But global and country-level averages hide a tragic, more complex story: Even in countries where  take place in health facilities or are attended by skilled health workers, maternal mortality often remains high.

Many of these deaths could be prevented. In the 81 countries with the highest maternal and neonatal mortality rates, well-functioning health systems would prevent 520,000 stillbirths, and save the lives of 670,000 babies and 86,000 women by 2020—even at current rates of access to maternal and newborn health services, according to the November 2018 .

Pfizer Global Health Fellow, Megan Montgomery, and Peter Mmbago, Human Resources for Health Advisor for TSSP, interview a health care provider in Bagamoyo, Tanzania.

Meet Megan Montgomery, one of two impressive Pfizer Global Health Fellows currently working with Keanahikishime in Tanzania. This international corporate volunteer program places Pfizer colleagues in short-term fellowships with international development organizations. Megan is lending her skills and expertise in marketing and business strategy to Keanahikishime’s Technical Support Services Project (TSSP) in Tanzania, which provides assistance to the Ministry of Health in key technical areas to help control the HIV epidemic and sustain HIV-related health systems and services. 

How are you supporting the TSSP project in Tanzania?

My main focus while here is partnering with the team to strengthen the health system in Tanzania through human resources for health (HRH) activities, such as the implementation of task-sharing initiatives, recruitment, retention and productivity management, as well as developing communication pieces to share the work being accomplished.  

Can you explain what task sharing for HIV services looks like in this context? 

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