Improved Health Practices, Better Services Earn Local Health Center More Clients and a Prized Trophy
By Helen Seeger
The rural health center in Khawari in northwest Pakistan lacked reliable electricity and water. Staffing was a problem too. But facility manager, Abdul Basit, was determined to improve services for his patients. With no doctor in the mountainous village and the nearest city an hour’s drive away, residents relied on the health center when a family member became ill.
Through the PRIDE Project, a four-year effort to improve health services in two earthquake-damaged districts in northern Pakistan, Basit learned how to channel his initiative to improve the facility and services for the 16,000 potential clients in the area.
The project—funded by the United States Agency for International Development and managed by a coalition of partners that included the International Rescue Committee, Management Sciences for Health and Jhpiego—has helped to educate midwives, train health care workers, resupply health facilities and introduce quality assurance measures to implement changes, and elevate services to an approved standard of care.
At the Khawari rural health center, performance reviews following the facility’s participation in the PRIDE Project show that the center has consistently met 80 percent of quality health standards—and attained 100 percent in five key service areas, including infection prevention, management of childhood and neonatal illnesses, and childhood immunizations. As a result of their achievements, Basit and his staff won the PRIDE Project’s trophy for best-managed health facility in 2009.
In Khawari, the first step toward better health care was to improve the quality of health care services and develop action plans for gaps identified during an initial assessment of the health center. A health committee of local residents was then formed, through which the facility raised money to fix major gaps, such as its electrical and water problems and inadequate condition of the dental unit, among other issues.
A Jhpiego-pioneered, quality improvement management process that sets standards, measures progress and rewards staff for hitting these marks was put in place. This four-step approach of Standards-Based Management Recognition (SBM-R) has resulted in meaningful improvements in the quality of services at 117 facilities in northern Pakistan. Over a period of three years, the percentage of quality performance standards met by facilities increased from an average of 15 percent to 77 percent.
“This is a practical management approach to solve the problems in a facility to better serve the community. Staff know about best practices and they know how to implement the best practices,” says Dr. Shabana Zaeem, Jhpiego’s director of health services in Pakistan. “It ensures that patients receive the same standard of care everywhere, whether you live in Bagh or in Kahutta, a very remote village.
“People have learned now how to solve their own problems,” Zaeem says. “So it not only strengthens the health care system, but provides Pakistani health care workers with the tools to identify and resolve concerns.”
At the Khawari Health Center, under Basit’s leadership, the staff of medical technicians and lady health workers began working as a team to identify gaps in service. Infection prevention was one example. Previously, medical instruments had been cleaned only with soapy water. Through the SBM-R process, Basit and staff learned to disinfect the instruments with chlorine solution and then place them in boiling water.
They also discovered that they were prescribing antibiotics either unnecessarily or too often. For example, children diagnosed with pneumonia were getting too much of an antibiotic, which could make them resistant to the medication. With training in how to manage childhood diseases, Basit and his staff were able to make proper use of their medicine stock.
“To implement SBM-R properly, you must treat your facility like your home,” says Basit, who is a trained paramedic. He has worked at the 10-bed center for 15 years and is well-respected in the community. “I would not put up with dirt and untidiness at home, and it shouldn’t be like that here. My staff are like my children and I hold them responsible for their work.”
Basit’s staff also began providing prenatal care to pregnant women and preparing them if complications arose to travel to the nearest hospital—an hour away. Families began saving for transportation costs to reach the hospital and they received contact numbers [for the staff at the center] in case of an emergency.
Clients took note of the center’s improvements in care and service. The number of pregnant women using the health center each month increased from 45 to 60 between 2008 and 2009. Through his involvement in the PRIDE Project, Basit established three outreach clinics, resulting in an increase in the number of outpatients [at Khawari], from 562 a month in 2008 to 835 in 2009.
“The community trusts the facility staff,” says Bano, a mother who brought her 1-year-old son, Zulfiqar, to the Khawari center for a routine vaccination. “That’s why people started to come here. Staff are now doing their best to serve the community.”
Add comment August 25, 2010
From Home to Health Facility, Lady Health Workers Promote Safe, Healthy Births
This is the first of three stories on Jhpiego’s participation in a successful project, sponsored by the United States Agency for International Development, which served two million people and 126 health care facilities in two earthquake-damaged districts of northern Pakistan. The others will appear on www.jhpiego.org.
By Helen Seeger and Shamim Bano
Appreciation Day ceremonies for Lady Health Workers.
When Shenaz Begum’s cousin Shaheen gave birth at home, she was surrounded by family. But when complications developed, no one could save the new mother. The placenta became stuck and she began bleeding heavily. She died three hours later, leaving her newborn daughter an orphan.
Postpartum hemorrhage remains the leading cause of maternal deaths worldwide. Shenaz has spent her adult life trying to spare Pakistani women the fate of her cousin Shaheen.
As a Lady Health Supervisor for Pakistan’s National Program for Family Planning and Primary Health Care, Shenaz oversees a team of 22 health workers. A health worker prepares women for birth, educates them in their homes about risks and possible complications, and encourages them to give birth in a health facility with a skilled health provider.
Lady health workers provide vital information that could make the difference between a life saved or lost in a Pakistani village. The women are trained in prenatal and post-birth care and family planning as part of the PRIDE Project, a four-year program funded by the United States Agency for International Development and carried out in partnership with Jhpiego, the International Rescue Committee and Management Sciences for Health. PRIDE is helping improve health care services for women and children in two earthquake-damaged districts of northern Pakistan.
Shenaz, a 38-year-old mother of three, lives in the remote mountains of Thub in Bagh District, where women have difficulty accessing health care because of family constraints, distances to a health facility and the cost of getting there. She is called Shenaz Begum – Begum is a Pakistani endearment for respected wife and mother.
Shenaz Begum receives a special award for her health education classes.
In Thub, lady health workers are essential to providing maternal and child health care. They visit pregnant women in their homes, as many as seven a day, making sure the women are attending prenatal checkups at health facilities, taking iron supplements and eating properly. The health workers also talk to relatives about the benefits of women delivering in a health facility, and continue visiting homes after a child is born to check for signs of illness and provide basic care, such as treatment for diarrhea.
To support mothers, Shenaz and her colleagues also host community meetings where women can openly discuss and share health concerns with their peers. In traditional families, women are seldom able to leave their homes on their own and talking about health matters is discouraged.
The lady health workers in Thub have been so effective that 100 percent of pregnant women in their village now receive prenatal checkups from trained health workers, says Shenaz, who has been supported in her work by the PRIDE Project.
The progress achieved in Thub is consistent with an increase in client participation at other health centers participating in the PRIDE Project. The average number of prenatal visits at eight facilities that offer essential obstetric care increased from 2,175 to 6,574 from January to December 2008, and postnatal visits tripled to 1,311 between April and June of this year.
The average number of monthly deliveries in eight government health facilities in the PRIDE Project tripled between January 2008 and December 2009, according to project data. The standard of care at those rural health facilities significantly exceeded the level of care offered at facilities that lacked an essential obstetric care package, the data show.
As part of her efforts to increase births in the local health facility, Shenaz works closely with the Mallot Health Center. Female staff assisting with births are trained in lifesaving techniques, infection prevention and safe delivery of the placenta, and are available 24 hours to provide patient care.
Shenaz prepares pregnant women for the health facility by describing the services available to them, discussing what to expect during a visit and advising them to save money to cover transportation costs if an emergency should arise.
“If I convince a woman to go to the health facility, I’m happy,” she says. “I know I’ve done my job well.”
Earlier this year, Shenaz received an award for the Best Lady Health Supervisor from Dr. Liaquat Ali Khan, the Health Secretary for Azad Jammu and Kashmir state. She was among 19 community health workers recognized for their efforts in the Bagh District. More than 500 lady health workers, district health managers and health officers attended the appreciation event.
Naseem Aktar, a lady health worker in the village of Dharyal, says the PRIDE Project has provided her with up-to-date information, tools and strategies to conduct health education sessions that interest and influence women. One of her patients, Shazia Iqbal, was dreading the birth of her second child because she experienced a difficult labor with her daughter. But Naseem looked out for her.
“Naseem came with me to the health facility. She helped me find a taxi and phoned ahead so the facility staff would be ready when we arrived,” says the young mother.
And one of the PRIDE-trained staff on duty, Nasreen Bibi, “was so kind and made me feel much calmer. She talked to me as though I was her own daughter,’’ says Shazia, who gave birth to a healthy baby girl, Sanam, on June 2.
2 comments August 11, 2010
Gamal Serour, An Early Pioneer of Jhpiego’s Work in Reproductive Health Globally
FIGO President Gamal Serour attends the Women Deliver Conference earlier this summer.
By Ann LoLordo
Dr. Gamal Serour was relatively new to Al-Azhar University when he was invited to an international meeting that would change the course of the young physician’s career and assist him in working in numerous countries in Africa, Asia and the Middle East to improve reproductive health practice and care.
A 34-year-old lecturer in the Department of Obstetrics and Gynecology, he accompanied his department chair, Dr. Fouad I. Hefnawi, to Jhpiego’s Geneva meeting on contemporary reproductive health that was hosted by Dr. Howard W. Jones, Jhpiego’s first director. Within two weeks, Serour found himself in Baltimore at Hopkins (with his pregnant wife), working alongside Jones, Ted Baramki and other prominent physicians who helped launch Jhpiego.
He remained in Baltimore for a month. That was 34 years ago.
“At the end of the meetings, Howard told me, ‘Gamal, we want to establish a center for training for Asia and Africa and we will have it at Al-Azhar and you will be the director,’” Serour recalled during a recent interview at the 2010 Women Deliver conference in Washington, D.C.
It was the start of an illustrious career for Serour—he is serving now as president of FIGO, the International Federation of Gynecology and Obstetrics, which has a close relationship with Jhpiego.
Upon Serour’s return to Cairo in 1976, he and his chairman began planning for the reproductive health training center they would open at Al-Azhar to educate obstetricians, gynecologists and nurses from the Africa and Asia region in the latest techniques and equipment. Their training partner was the Johns Hopkins Program for International Education in Gynecology and Obstetrics (JHPIEGO), a founding name and acronym that have been outgrown and replaced with Jhpiego.
Dr. Serour (right) joins Jhpiego's Ron Magarick (far left) and other colleagues in a 1980 photo.
The center would host trainings four times a year for 10 to 20 physicians and nurses. After the clinicians returned to their home countries, Serour would make follow-up visits to their hospitals and institutions to check on their practical skills and would install a laparoscope (an instrument for visualizing internal reproductive organs) that Jhpiego had donated.
“It was a great program, conducted for [a] large number of years. We trained more than 400, from Egypt and all over Asia and Africa,” says Serour, a former dean of the medical school at Al-Azhar.
During his association with Jhpiego, Serour gave lectures on the latest reproductive health techniques at the medical institutions he visited and much of the new information he discussed was later integrated into their curricula.
“So indeed Jhpiego helped Al-Azhar in spreading the modern management of infertility and fertility all over Asia and Africa,” says Serour, who is now 68 and the father of three children.
As advances in reproductive health treatment occurred, Al-Azhar continued its relationship with Jhpiego and provided training in laparoscopic surgery to obstetricians and gynecologists so they could manage removals of cysts, tubal obstructions and adhesions more effectively for patients in their countries.
Over the years, while attending conferences and professional meetings, Serour says he has often run into former students from Nepal, Turkey, Eastern Europe and elsewhere who remind him of their Jhpiego-supported training and its role in helping them help other professionals in their countries learn new skills and strengthen health care delivery.
“Dr. Gamal Serour was one of Jhpiego’s visionaries and champions for improved reproductive health for women from the earliest days of our program,” says Ron Magarick, a Jhpiego veteran and Director of Global Programs.
“He championed new technical interventions in reproductive health in Egypt and elsewhere and had a significant impact in numerous countries around the world in educating generations of health professionals. His leadership capacity was recognized by FIGO in his election as President.”
Serour remained the director of the Jhpiego program until 1990, when Al- Azhar, the oldest Islamic university in the world, tapped him to be the head of its International Islamic Center for Population Studies and Research.
Through the years, he says he has come to know well the leaders of Jhpiego, from its founder, Dr. Theodore King, to the current President and CEO, Dr. Leslie Mancuso.
“Jhpiego has played a major role in spreading knowledge, skills and providing assistance for . . . [improving] the reproductive health for a huge number of patients in the region,’’ says Serour. “It was very thrilling, very rewarding and very well appreciated.”
Add comment August 11, 2010
Jhpiego Participates in ‘Stories of Mothers Saved’ Exhibit
The White Ribbon Alliance has put together a series of stories of mothers whose lives have been saved through the intervention and work of organizations dedicated to improving maternal and child health. Jhpiego submitted several examples of our work. Here are two of them provided by staff from Nepal and Malawi:
The Washington, D.C., opening of the White Ribbon Alliance exhibit.
Community Health Worker Helps Nepalese Mother Survive Post-Birth Bleeding
For Najini Khan, December 23, 2009 began like any other. She cleaned the house, fed the goat and cow, bathed her daughter and cooked the main meal. But when her family sat down to eat, the 25-year-old couldn’t—her labor pains had grown that intense. She asked her husband, Isharat, to call the neighbor who would help bring the newest member of the Khan family into the world.
“After eight hours of labor, my baby and [placenta] came out together,” says Najini, who began bleeding and quickly took the three white pills that she had been given previously by the local community health volunteer to control any bleeding.
Najini had prepared well for this birth—she received prenatal care at the local health post and learned what to expect from Chandrakali Kurmi, the community health volunteer. Among the potential problems—postpartum hemorrhage, the leading cause of maternal deaths in the world. The majority of women who bleed to death after birth live in the developing world.
The community health volunteer had explained to Najini that she could prevent such bleeding by taking three pills of the drug misoprostol (known in Nepalese as maatri surakchya chakki) after giving birth. This information was critical to Najini once she and her husband decided a hospital delivery was out of the question because they had no one to babysit their five-year-old. They planned for a home birth, including use of misoprostol, reviewed the drug’s side effects and prepared for a possible emergency that would require Najini to go to the hospital.
After giving birth to a lively baby girl, Najini took the three white pills as the community health volunteer had told her. But Najini’s bleeding wouldn’t stop. After soaking through five cloths, her husband called Chandrakali to help take his wife to the hospital.
Settled into the back of a buffalo cart, Najini traveled more than an hour to reach the town of Nepalgunj, which was just nine miles away. By the time they reached Bheri Zonal Hospital, Najini’s blood pressure and hemoglobin had dropped dangerously low.
There was no time to waste; Najini was taken immediately into the operating room where hospital staff removed a piece of retained placenta and the bleeding stopped.
The next day, as she cradled her baby girl, Najini recognized how lucky she was and how essential the prenatal care and advice of the community health volunteer had been.
“I was able to survive because of this maatri surakchya chakki,” said Najini, speaking about the misoprostol she had received. “I would have never known when to come to the hospital [for bleeding] if the information had not come with these pills. I might have died, leaving my two girls to struggle alone.”
In a Malawi Village, Prenatal Advice Proves a Lifesaver for Mother and Twins
In the village of Maunde in Malawi, culture and tradition value a woman who suffers through her labor at home and delivers a baby quickly. She is strong, worthy of emulation and an asset to her husband and family. But a woman who rushes to the hospital once labor begins is considered weak in this African society.
As the mother of six children, Agnes Chatha knew well the community sentiment on home birth and the views of her neighbors. But visits from Rose Kamphandira, a community health worker, offered the 32-year-old mother and her husband, Kennedy, a new way to approach pregnancy and some lifesaving advice.
Rose was part of a community health initiative to identify and counsel pregnant women and new mothers in four rural districts in Malawi. The ACCESS Program was funded by the United States Agency for International Development and managed by Jhpiego in collaboration with Save the Children in their work to prevent the needless deaths of mothers and newborns.
Rose visited the Chatha house when Agnes was six months pregnant with her seventh child. In subsequent visits over the next three months, Rose talked with Agnes and her husband about preparing for the birth of their new baby. They discussed danger signs during pregnancy, good nutrition, ways to prevent the transmission of HIV from mother to child, the importance of having a skilled birth attendant at delivery and giving birth in a facility, the safe feeding of an infant and family planning methods.
Agnes’s husband was especially interested in Rose’s visits and sat with his wife; he wanted to be sure his wife and new child benefited from this professional advice and received the best care.
During her pregnancy, Agnes followed Rose’s advice and had two prenatal visits at the nearby Ntosa Health Center. When Agnes felt the first pangs of labor, her husband didn’t wait for his wife’s labor to progress. Mindful of Rose’s advice, Kennedy rushed Agnes to the Ntosa Health Center, where she was examined by a midwife who had some surprising news for the couple: Agnes was carrying twins.
Within 30 minutes, Agnes delivered the first twin, a healthy boy. But the second twin proved more difficult and Agnes was brought to the operating suite of the district hospital. An examination found that the second twin was lying sideways with a hand presenting first; a cesarean delivery was her only choice.
Today, Agnes and her twins, Tionge and Chimwemwe, are thriving. She credits the prenatal advice and visits from community health worker Rose Kamphandira and her husband’s active participation in her pregnancy with the babies’ health—and her survival.
“If it was not for the visiting health surveillance personnel, I would be dead by now,’’ Agnes said.
Her husband concurred: “The home visiting program is useful and lifesaving. The advice given is really [important]. I am grateful that my wife and children were saved.”
Add comment August 11, 2010
Ellicott Dredges, Jhpiego’s Newest Partner
Ellicott Dredges LLC, a Baltimore manufacturer that has been in business for 125 years, has begun a partnership with Jhpiego in support of the global health non-profit’s Malaria in Pregnancy Program in Nigeria that is helping to save thousands of lives.
Ellicott Dredges, which operates in 80 countries, has made a $100,000+ multi-year commitment to buy life-saving anti-malaria medicines, insecticide-treated bed nets, and other supplies to protect women and children in Akwa Ibom state in the Niger Delta region of Nigeria. Ellicott Dredges joins the ExxonMobil Foundation in this ongoing work that has already reached 28,000 pregnant women.
Malaria is a major cause of illness and death in Nigeria, contributing directly to poverty, low productivity, and reduced school attendance. It kills an estimated 4,500 pregnant women each year in Nigeria, according to the government.
“We are thrilled to have Ellicott Dredges partner with us in this very important work to keep pregnant women and their babies healthy,’’ said Dr. Leslie Mancuso, President and CEO of Jhpiego, a Baltimore-based global health non-profit. “Malaria accounts for 11 percent of maternal deaths in Nigeria. Ellicott Dredges’ contribution is going to save women’s lives.”
Peter Bowe, President of Ellicott Dredges, said the company wanted to have a direct impact on improving the lives of women and children in Nigeria, where the firm has been active working on sand dredging projects.
“Women are the foundation of families throughout the world. Their health is directly related to a nation’s health. We are excited to contribute to this effort with Jhpiego and ExxonMobil,” said Mr. Bowe.
Walter Mather, Ellicott’s Africa Regional Manager, said, “We have made a lot of friends in Nigeria over the years, and I am proud that Ellicott has joined with ExxonMobil and Jhpiego to invest in the health needs of women and children there.”
Ellicott Dredges leads the world in dredge mining applications, including sand-winning, real estate development, river and canal dredging, and eco-system preservation. It built all of the dredges used in the original construction of the Panama Canal.
Add comment August 11, 2010
Jhpiego Leaving Vienna–Wow What a Conference!
AIDS 2010 was a fantastic conference! High level speakers like Bill Clinton and Bill Gates, ground breaking science released like the microbicide vaginal gel, daily marches at the conference and around the city, and so much more.
Jhpiego was very busy with two oral presentations, 11 poster presentations, a great satellite event, and a busy exhibit booth. Despite all the activity, Jhpiego staff even found time to enjoy some quality time together at the end of long conference days too.
The messages heard over and over from participants and speakers were right in line with Jhpiego’s work-moving services to the community and integration of services. The common interests were evident in the packed rooms for Balwin Kileo’s presentation on opt-out HIV testing for male circumcision clients in Tanzania and Yassir Abduljewad’s presentation on addressing PMTCT gaps.
The satellite event built on the theme of moving services to the community- increasing access to care to save more lives. Stacie Stender advocate for moving tasks from doctors to nurses in order to be able to reach a larger population; Jason Wessonaar shared lessons implementing home based and work place counseling and testing in order to bring services to the people; and Tigistu Adamu described how male circumcision will have a tremendous impact on the global population.
Poster presentations on male circumcision and cervical cancer screening programs generated lots of interest in Jhpiego’s innovative solutions. Many attendees visited the exhibit booth after hearing about our posters to learn more about our programs and pick up valuable resources to use in their own work. Not only did booth visitors get great information, they also had lots of fun testing the knowledge on the Jhpiego Wheel of Knowledge and learning how to make hand sanitizer.
Teresia provided the grand finale for Jhpiego with her poster presentation on PMTCT and SBM-R. An appropriate conclusion for our work at the conference, the poster illustrated two key elements to Jhpiego’s work: technical leadership and improving the quality of health care.
We are already looking forward to the next International AIDS Conference in our own backyard, in Washington DC in 2012!
Add comment July 23, 2010
Saving Babies–Addressing PMTCT Gaps
Yassir Abduljewad, Deputy Country Director–Ethiopia, addressed a packed room as he shared how the seven steps of the process improvement (PI) approach were used to improve PMTCT services in his area. His presentation, “Addressing PMTCT Gaps through a Systematic Process Improvement (PI) Approach,” gave data on seven health care facilities in five of the 18 zones in Oromia region where selected managers and providers were trained in the PI approach and provided with supportive follow-up post training. Within three months, six of the seven health care facilities reported improvements, including increasing: 1) hospital deliveries of HIV-positive women from 59% to 85%; 2) the percentage of HIV- positive women having their CD4 counts tested from 42% to 90%; and 3) the percentage of pregnant women’s partners tested for HIV from 13% to 51%.
Baldwin Kileo, Male Circumcision Program Manager–Tanzania, stated that HIV testing is part of a minimum package of MC for HIV prevention services. His presentation, “Opt-Out HIV Testing Leads to Nearly Universal Uptake among Male Circumcision Clients in Tanzania,” included results from observations and focus group discussions with MC clients in Iringa, Tanzania, regarding factors affecting individuals’ decisions to undergo HIV testing.
Today’s Presentation:
“Achieving and Sustaining High-Quality PMTCT Services in Kenya Using the SBM-R Approach”
Teresia Mutuku, Trainer–Kenya
Thursday, 22 July, 12:30–14:30
Poster Exhibition Area, Session THPE0615
Add comment July 22, 2010
Innovation, Universal Access and the Next Frontier
Some final thoughts on Vienna 2010 from Alain Damiba, Jhpiego’s Senior Vice President.
As I pack to leave Vienna, I am reminded of the number of themes this week that resonate with Jhpiego’s focus on maternal, newborn and child health as an important platform for HIV/AIDS prevention and treatment.
These themes that many presenters reiterated also reinforce the strong value we put on capacity building and health system strengthening as part and parcel of our work with countries. It is rewarding to receive kudos from our colleagues who appreciate our long term perspective and our commitment to support their efforts and leadership!
Gearing up for universal access
Many advocates and activities in this conference reminded us all of the imperative to reach universal access for both HIV/AIDS prevention and treatment services. To achieve this goal and help move countries closer to the Millennium Development Goal No. 6, innovative approaches will have to be developed to dramatically increase access for the most vulnerable people so an impact at scale can be realized.
Jhpiego is proud to be contributing significantly to these efforts through its male circumcision technical assistance programs, community and facility-based counseling and testing, and its Prevention of Mother to Child Transmission (PMTCT) programs in many East and Southern African countries.
Male circumcision, the next frontier
As lights were dimming on one of Jhpiego’s successful presentations Tuesday evening on our male circumcision efforts in Tanzania, Tigi Adamu and Kelly Curran were busy planning their next move: Joining the government of Swaziland in circumcising 80% of eligible men in the country over the next 12 months to ensure a rapid decrease in HIV transmission in the country.
Innovation at work in the Jhpiego booth
In resource limited settings, where water and soap are rare and expensive commodities, the need to maintain proper infection prevention practices can be daunting. No longer. Jhpiego staff (Angella Ogutu and Mary Kay Carver) have demonstrated throughout the day to numerous fascinated visitors how they can mix alcohol and glycerine to produce a solution that they can use to wash their hands. Congratulations to our team for offering affordable and innovative solutions once again!
Add comment July 21, 2010
Winning Combinations to Avert HIV Infection
More from Alain Damiba, Jhpiego’s Senior Vice President, in Vienna:
According to a recent study by KK Case presented this morning, more than
half of new HIV infections could be averted if programs in Africa focus on
combination of ART, VCT, and MC.
For Asia, outreach and harm reduction for MSN, IDU needle exchange and drug substitution, plus ART is the winning combination of program approaches.
Another expert documented how prevention makes treatment more affordable and sustainable.
I learned that the scale up of HIV/AIDS treatment will have the
following benefits on a program:
Improve maternal and child health
Reduce transmission of HIV
Reduce incidence of tuberculosis
Reduce overall mortality
Reduce vertical transmission
Reduce the incidence of opportunistic infections
At the conference, some define Game Changer or Innovation as “changing the way something is done, made, or thought of,” resulting in better impact on the target issue! They have taken a page from Jhpiego’s book.
In conversations at the conference, there was a lot of interest in Kenya having decentralized ART (with help from Jhpiego and
other INGOs) to include AIDS treatment services
in TB clinics. Kenya has 600 ART sites and 1,800 TB sites so the
potential is high for expansion of ARV services in the TB sites which will promote further integration between TB and HIV.
Talking about TB/HIV integration, Kevin de Cock, Director of the Global AIDS Program at CDC/Atlanta, reports that there is “no one size integration fits all” solution! What is needed from his perspective are key ingredients such as:
Evidence-based strategies
Innovation
Risk assessment and trade-offs
Leadership, and Policy change
An overflow crowd glued to a TV screen in a conference room listened as Yassir Abduljewad Ahmed, deputy director of our Ethiopia office, discussed innovative approaches to addressing PMTCT gaps through integration and a systematic process improvement approach.
Integration is the way to move forward.
Add comment July 21, 2010
Cervical Cancer Screening–A New Frontier in Integration
In her poster presentation, “Cervical Cancer Screening for HIV-Positive Women in Guyana,” Megan Harris, Monitoring and Evaluation Officer, shared key lessons learned from a cervical cancer prevention program currently being implemented in Guyana. The program targets HIV-positive women.
Sharon Kibwana, Program Officer, summarized key programmatic lessons learned from implementing cervical cancer prevention programs targeted for HIV-positive women in low-resource settings in her poster presentation, “Cervical Cancer Screening for HIV-Positive Women: Programmatic Lessons Learned.”
Add comment July 21, 2010
