Strength in numbers: Community health workers in social franchise networks

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Dr. Aye Aye owns a small, tin roof clinic nestled next to her home in Yangon, Myanmar. There she serves the poor of her community with integrated health services including family planning, tuberculosis screening and treatment, diarrhea treatment, and more. She was one of the first doctors to join the Sun Quality Health Network, PSI/Myanmar’s social franchise network.

 

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Best Buys in Global Health: Human-centric design

Research and development

Jocelyn Wyatt, co-lead and executive director at IDEO.org, speaks with Eliza Villarino, senior news producer at Devex, about her suggestion for donors: Insist on a series of ‘quick and dirty’ tests before writing million-dollar checks for initiatives to reduce poverty or improve global health.

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The Daily Impact: Emergency measures taken to prevent Ebola spread in West Africa

April 11, 2014

The historic ebola outbreak that started in Guinea continues as aid groups are taking emergency steps to prevent its spread. From AFP:

The tropical bug is thought to have killed more than 110 people in Guinea and Liberia since January, with suspected cases reported in Mali and Sierra Leone and aid workers warning that vital hygiene products could run out.

The Geneva-based World Health Organization (WHO) announced emergency training for 70 people who would fan out across the Guinean capital Conakry to track people who have had close contact with Ebola patients.

The UN agency is also setting up a special alert and response operation centre within the Guinean health ministry and training staff at Guinea’s main hospital and other health facilities.

The organisation has described west Africa’s first Ebola outbreak as one of the most challenging since the virus emerged in 1976 in what is now the Democratic Republic of Congo.

It is also one of the most deadly, with 157 people infected and 101 deaths in Guinea alone.

The outbreak began in the impoverished country’s southern forests, but has spread to Conakry, a sprawling port city on the Atlantic coast and home to two million people.

In neighbouring Liberia, there have been 21 cases, including 10 deaths.

While the WHO has not recommended any trade or travel restrictions, the region is braced against the epidemic, with Senegal closing its border with Guinea.

Action Against Hunger, a global aid group, warned of a looming shortage of sanitation stocks and said it had begun distributing chlorine and soap to families and schools in Guinea and setting up hand-washing facilities.

“We are checking the availability of chlorine in the country, because we could be running out in the coming hours. So we are going to have to get it from other countries,” Lucia Prieto, the charity’s Guinea country director, said in a statement.

In Dakar, UNICEF said it was working with WHO and other agencies to spread awareness by sending text messages and links to a specially written five-minute radio drama and television shows automatically to mobile phones across west Africa in numerous languages.

“Most of the people in this part of the world had never heard of Ebola before,” Guido Borghese, the organisation’s principal adviser on child survival and development for the region, said in a statement.

“In this environment, unfounded fears and rumours spread quickly and widely. More than ever, it is crucial that families have both the means and the right information to protect themselves and prevent dangerous misunderstandings.”

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Throwback Thursday: Ensuring a Healthy and Safe Delivery

During the Taliban rule – when women were barred from school – the once female-dominated health workforce was depleted, leaving only 467 practicing midwives and one midwifery school for a country of 22 million people. After the fall of the Taliban in 2002, Jhpiego, in partnership with the Afghan government and with funding from the U.S. Agency for International Development, led the development of a community-based national midwifery education system.

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The Daily Impact: Sub-Saharan Africa off track to meet Sanitation MDG, says report

April 10, 2014

A new study finds that no sub-Saharan African country will meet the MDG for sanitation, and that many are lagging behind achieving the target for clean drinking water as well. From VOA:

According to a joint report by the World Health Organization and UNICEF last year, more than 2 billion people – or one-third of the world’s population – will remain without access to improved sanitation by 2015.  The Millennium goal calls for cutting in half the number of people who lacked clean toileting facilities in 1990.

A study led by British researchers found that none of the countries in sub-Saharan Africa was on track to meet the sanitation goal by next year.

Last year’s WHO-UNICEF report noted that the world has met the target of cutting in half the proportion of people without access to improved sources of water, five years ahead of schedule.  But that assessment is deceptive, according to Mathew Freeman of Emory University’s Rollins School of Public Health in Atlanta.  Freeman is co-author of the report by the London School of Hygiene & Tropical Medicine.

He says it appears the global goal of increased access to clean drinking water is largely being met by emerging countries in Asia, which is obscuring the real picture of the availability of adequate water supplies elsewhere.

“China and India, their rapid urbanization and infrastructure investments have led to dramatic changes in access to improved water supply.  So, globally that target was met; but, few countries in sub-Saharan Africa have met those targets,” said Freeman.

Those few include Gambia, Congo, Gabon, Malawi, Uganda, Burkina Faso, Guinea Bissau and Swaziland.

Many African nations that appear to be on target for reaching Millennium goals, Freeman says, are not taking into account the situation in their poorest, remotest districts.

Investigators say the availability of clean water is highly variable, ranging from 3.2 percent in some districts of Somalia, for example, to as high as 99 percent in Namibia’s urban centers.  Adequate sanitation facilities are equally inconsistent.

In poorer rural areas, the researchers found, households were two to 18 times less likely to have access to improved sanitation and two to 80 times more likely to defecate in open areas compared to more modern rural areas.

Investigators used statistical models in their analysis of data from 138 national household surveys conducted in 41 sub-Saharan Africa countries between 1991 and 2012.

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Five key steps to making the health workforce a post-MDG priority

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There is a global shortage of 7.2 million doctors, nurses, and midwives, according to new estimates by the World Health Organization. By 2035, that number could reach 12.9 million. We missed the opportunity to make health workers part of the Millennium Development Goals in 2000—we should not miss it again.

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The Daily Impact: Foreign Aid rebounds to record high in 2013 – OECD

April 9, 2014

Foreign aid for development in poorer countries hit a record high last year, says a new OECD report published yesterday. From the Guardian:

Figures released by the Organisation for Economic Co-operation and Development (OECD) on Tuesday show official development assistance (ODA) grew by 6.1% in 2013 to $134.8bn (£80.3bn) after falling for two years in a row in as donors grappled with austerity measures and increasingly divided public opinion in many countries.

Seventeen countries in the OECD’s development assistance committee (DAC) increased their aid spending last year, with huge jumps recorded by some donors. The UK’s spending grew by 27.8% to hit for the first time the international target to spend 0.7% of gross national income (GNI) as aid.

Iceland’s aid spending also rose by more than 27% in 2013, and Japan’s by 36.6%. Norwegian and Italian aid rose by more than 10%. Other countries, not part of the OECD-DAC group, also recorded significant spending increases. Estonia, Russia and Turkey each reported rises of more than 20%.

Aid from the United Arab Emirates, meanwhile, soared by 375.5%, largely because of exceptional support extended to Egypt. In 2013 it spent 1.25% of its GNI as aid – more than any OECD-DAC donor. At the same time, aid spending fell in almost a dozen countries, with the biggest decreases in Canada (-11.4%), France (-9.8%) and Portugal (-20.4%).

The OECD also warned that the share of aid going to some of the world’s least developed countries was falling, despite the overall increase in spending. In 2013, aid to Africa fell by 5.6% in 2013, to $28.9bn.

The OECD secretary-general Angel Gurría said: “It is heartening to see governments increasing their development aid budgets again, despite the financial constraints they are currently facing. However, assistance to some of the neediest countries continues to fall, which is a serious concern.”

The Paris-based forum also noted that more donors were giving aid in forms other than grants, with countries counting a growing amount of equity investments and loans – which developing countries must pay back – as ODA. In 2013, grants grew by only 3.5% while other forms of spending rose by 33%.

A survey of donors’ spending plans suggests aid levels could rise again in 2014 and stabilise thereafter. However, the share of aid going to the countries most in need, including in sub-Saharan Africa, will decrease even further.

The survey suggests donors will focus spending on middle-income countries including Brazil, China, Chile, Mexico, India and Pakistan. Aid to these countries will probably be in the form of loans, it says.

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Advancing global health through innovation

TopBarriertoInnovation

U.S. investments in global health protect millions of people from malaria with insecticide-treated bed nets, effective treatments and innovative diagnostics. These targeted investments have lifesaving impacts, and they are also cost-effective! Our entire foreign assistance amounts to only about 1 percent of our overall budget. With this we are able to help the world’s poorest women and children.

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The Daily Impact: Two UN workers shot dead in Somalia

April 8, 2014

A pair of aid workers – French and British respectively – were shot dead while arriving at an airport in Galkayo, central Somalia. From the Guardian:

A UN source confirmed the pair were international staff members with the UN Office on Drugs and Crime (UNODC).

A statement issued by the government of the northern breakaway state of Puntland in Somalia identified the two victims as Briton Simon Davis and Frenchman Clement Gorrissen.

Nicholas Kay, special representative of the UN secretary-general for Somalia, said: “Our UN colleagues were working in support of the Somali people’s aspiration for a peaceful and stable future. There can be no justification for such a callous attack. I call on the authorities to conduct a full investigation immediately and bring the perpetrators to justice without delay.”

The UK Foreign Office said it was aware of the death of a British national in Somalia on Monday and was ready to provide consular assistance to the family. AFP reported that sources identified the second victim as French.

“Two white men have been shot inside the airport as they got off a plane,” local security official Mohamed Mire said. An airport official said the attacker was dressed in a police uniform.

“One of them died inside the airport and the other one was rushed to hospital where he later died of the injuries. Both of them were white men,” said Hassan Ahmed, who said he witnessed the incident.

Galkayo is 370 miles (575km) north of the capital Mogadishu and lies on the border with Puntland.

UN security in Galkayo, which is outside of effective central government control, is normally extremely tight.

The UNODC has been working to combat piracy in Puntland and has built a new prison in the state capital, Garowe, which opened last week to house pirates who have been sentenced in other countries in the region, notably the Seychelles. The UNODC said the building was a key part of its maritime crime programme in the Horn of Africa.

“The two were a Frenchman and a Briton and they were supposedly staying in Galkayo for two days before heading to Garowe,” said Abdirisak Mohamed Dirir, general director of Puntland’s anti-piracy department.

The two men had flown into Galkayo to meet Somali officials on the issue of regulating the money transfer services that replace a formal banking system in Somalia, and were looking at the financial flow of money related to Somalia’s pirate attacks, according to reports.

The executive director of UNODC, Yury Fedotov, said: “I condemn in the strongest possible terms the killing of two of my colleagues in a cruel and senseless attack. I hope the relevant authorities in Somalia will undertake every effort to ensure that their killers are swiftly apprehended and brought to justice.

“I would also like to offer my most profound condolences to the family, loved ones, friends and colleagues of these two individuals, who were so committed and dedicated to UNODC’s work.”

UN staff members have been regularly targeted in Somalia, where the fragile internationally backed government, supported by African Union troops, is battling al-Qaida-linked al Shabaab rebels, although the assaults have tended to be on a larger-scale.

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