Social entrepreneurs gathered this past December at the Social Innovation Summit to share lessons on how to create social good through technology and innovation. PSI Board Member and Global Health Corps co-founder Barbara Bush was one of the event’s featured speakers. Brian Sirgutz of the Huffington Post caught up with Barbara after the event to talk about technology and social good through the lens of global health.
Here is a selection of the discussion:
Brian: Your supporters include top names in information technology, like Cisco and Hewlett Packard. (Note: Cisco sponsors the ImpactX section). Can you talk a little about those relationships and how they add to your mission?
We’ve actively worked to build relationships with non-traditional partners that share our values — innovators like Hewlett-Packard (HP) and Cisco who are leading the charge to build products and systems that connect communities, and increase information sharing.
Interestingly, global health organizations desperately need many of the skills employees at multi-national corporations like HP and Cisco have. Cisco employees who are experts in management information and technology systems have mentored some of our fellows working in Malawi with Elizabeth Glaser Pediatrics AIDS Foundation to build out stronger electronic medical records and data tracking systems.
The GlobalPost spoke with Mario Raviglione, director of WHO’s Stop TB Department, to discuss the recent WHO 2012 Global TB Report. Efforts to address tuberculosis have worked in many places thanks to new diagnostic technologies, but drug-resistant strains of TB have been hard to contain in some countries. The report identified a significant gap in TB funding that must be filled in order to speed up progress against the disease.
Here are the highlights of the discussion where Raviglione talks about the challenge of funding.
Q: The World Health Organization says that we are at a crossroads in the fight against TB. What do you mean by this?
A: We are saying that TB is at a crossroads because on the one hand, we have the technology that is coming in. We already have some novelty diagnostics, for instance, with pretty good success in terms of implementation rates. We have, possibly, two new drugs against multi-drug resistant TB for the first time ever. At the same time, we have the success stories of several countries worldwide. So we have a possibility here of envisioning a much brighter future for TB care and control over the next few decades.
A recently published study, Physicians in private practice: reasons for being a social franchise member by Dale Huntington, Gary Mundy, Nang Mo Hom, Qingfeng Li and Tin Aung, looks at how franchise membership has an impact on franchise and non-franchised services in Myanmar. The authors found that franchise members saw an increase in patient volume and subsequent rise in earnings.
The PSI Impact Blog took the time to chat with Gary Mundy, Senior Researcher, PSI Asia Region, and Dr Tin Aung, Director of Strategic Information Department, PSI/Myanmar, about the research and what they learned.
Impact: What were you trying to learn in your study?
We were trying to learn two things. First, we wanted to gain a better understanding of what motivates healthcare providers who are running their own private clinics to join and remain within a social franchise network, such as the one operated by PSI Myanmar. We focus a lot on the beneficiaries of social franchises – the poor and vulnerable – but we haven’t given very much attention to perhaps the most important person in that process, the healthcare provider. We thought it was important to understand their motivations for being part of a social franchise. If we don’t understand those who play such a key role in the delivery of healthcare then we lose an opportunity to improve those systems and services.
Secondly, we wanted to understand what happens when a healthcare provider, previously operating alone, joins a social franchise. In particular, we wanted to understand what happens to the number of clients they are serving? – do these increase, decrease or stay the same? What affect does it have on their income, if any.
Impact: How would you define a social franchise?
A social franchise is, ultimately, a method or an approach through which one is trying to improve access to good quality health care by the poor in contexts where existing health systems are failing to meet their needs for a variety of reasons. It uses the key components of a commercial franchise – common branding, products, services and so forth – but with a principal aim of improving the health of poor people.
Having healthcare providers operate as part of a network that increases their access to training, affordable health products and commodities, and a range of marketing materials, should improve the services received by those who need them most. It is a way of strengthening an existing healthcare system by directing subsidy where it is needed most – to those healthcare providers who so many people with low ability to pay for services are reliant upon.
Rahim Kanani sat down with Dr. Babatunde Osotimehin, Executive Director of the United Nations Population Fund, to discuss the exciting data showing the decline of maternal mortality around the world. The May study, we featured herelast month, determined that the number of women who die in pregnancy/childbirth each year fell by 47% between 1990 to 2010. That is a reduction from 543,000 deaths per year to 287,000.
Overall, it is good news, but the report also indicated that Sub-Saharan Africa will miss the target of maternal mortality falling by 75% from 1990 to 2015. In the interview, Dr Osotimehin discusses some of the challenges to reducing maternal mortality, but is ultimately optimistic saying, “We could rid the world of the great majority of maternal deaths with appropriate and timely medical care and solutions we already know. It is within our reach to make dying in childbirth if not a thing of the past, then at least as rare an occasion in developing countries as it is in the richer parts of the world. No woman should die giving life.”
Here are some selected questions and answers from the Forbes piece:
Rahim Kanani: In your newest report on maternal mortality worldwide, what were some of the key findings, and did those findings surprise you?
Babatunde Osotimehin: Well, first and foremost, we are very pleased to see that the number of women dying in pregnancy and childbirth has almost halved since 1990. The UN, including UNFPA and partners, has for decades been working with governments around the world to improve access to reproductive health, including voluntary family planning and maternal health. The new estimates for maternal deaths show that this effort is paying off.
UNICEF recently conducted an interesting interview with Professor Michael Golden. Golden is credited with helping to develop the therapeutic milk product Formula 100 (F-100) that is used to treat severe malnutrition. The high in energy, fat, and protein, and nutrients product is considered to be an important innovation in the fight against hunger.
Read part of the interview below and the entire discussion here.
UNICEF.org: Why was F-100 so important for treating malnutrition?
MG: In developing F-100, we did all the technical things to produce a product that is simple to use. It looks simple, but there is a lot of science behind it. It took 17 years to design F-100 so that all a nurse has to do is open the packet and pour it into water.
UNICEF.org: What challenges face Mauritanian health care workers in treating malnutrition?
MG: The Mauritania health staff are functioning in a health system that needs development, more nurses and better coordination between health centres and hospitals. I was here in 2007, and the situation has improved. There are a lot of people with a grounding in malnutrition now. There is also a medical faculty and Mauritania is just about to open six nursing schools. But it would also help to establish dedicated district malnutrition officers, and to have hospital and health services combined and empowered to enforce cooperation.
In PSI’s latest issue of Impact magazine, the organization explores the importance of giving children a healthy start to life. As part of the online issue, PSI’s Nutrition Research Advisor Dr. Abel Irena talks with Saul Morris, Senior Program Officer at the Bill & Melinda Gates Foundation, about progress that has been made in child health and the next steps toward achieving the Millennium Development Goals by 2015.
Dr Abel Irena: Pneumonia is the biggest single killer of children in the world, and yet, it is reasonably cheap and simple to treat with antibiotics. Why then has it become the biggest killer? What needs to be improved to change the situation?
Saul Morris: We are not yet seeing quite the same enthusiasm and energy rallying behind the issue of pneumonia as we have seen in some other health areas have recently. I think at a higher level, one could say this is partly because there’s still a real lack of familiarity with the importance of pneumonia as a killer. I often find that when I mention that pneumonia is the largest single killer of children in high-burden countries, it’s met with amazement at policy level.
At a more technical level, one of the challenges with pneumonia is that it’s not a disease that can be dealt with simply through commodities. It requires major outreach to households, in part to make them aware of the significance of the symptoms, around difficult breathing – which is not recognized in the way that fever is recognized as an obvious sign that the child is in danger. But there are also complicated negotiations around household dynamics about who is allowed to make decisions about the care of the sick child or seek outside help. In the case of pneumonia, these issues really can’t be skirted; they have to be dealt with explicitly.
At the provider level, pneumonia requires a certain degree of provider skills and changing the way that providers work. Particularly in the private sector – where mothers prefer to seek care in many countries around the world – it’s very difficult to incentivize providers toward practicing behaviors that would be most effective in dealing with pneumonia.
Two weeks ago, World Water Day was recognized. We sat down with Katharine McHugh, PSI’s Water, Sanitation, and Hygiene (WASH) Technical Advisor, to discuss some of her reflections on WASH and how PSI is partnering with countries and organizations to achieve the WASH Millennium Development Goal targets.
Katharine has worked in the WASH sector for eight years, including on programs in Congo, Benin, Haiti, and India. She has an MSc in Control of Infectious of Diseases from the London School of Hygiene and Tropical Medicine.
Healthy Lives: Given the recent global success on the clean water MGD, why is sanitation still lagging?
Katharine Mchugh: We have a big job in sanitation: to ensure that every household has improved sanitation. Even if we hit the MDG for sanitation there will still be 1.7 billion people without access to hygienic place to use the bathroom. Right now there are a billion people who practice open defecation. Going forward I think we need to focus on the behavior behind use and maintenance of latrines more. Its not enough to just build someone a latrine, we need to understand why or why not they use and maintain it and incorporate this into our communications campaigns. We also need to engage the private sector in the creation of sustainable solutions that respond to consumer needs for latrine construction and servicing because building latrines for a few billion people isn’t going to be cheap, not to mention emptying them. There is also evidence that shows that households are willing to invest in latrine construction because they view it as a home improvement that gives them a sense of pride. Households won’t go up the sanitation ladder, from having a simple pit to a sparkling toilet in one day, so we need to a variety of products and services as well as finance options that fit the needs of the myriad of consumers out there.
KATE ROBERTS: You’ve accomplished a great deal in your 23 years. Why did you decide to dedicate your early career to global youth issues? You could be doing anything.
RONAN FARROW: The origin is more personal for me, because I grew up in a large family with adopted siblings from all over the world, many of them drawn from the corners of their communities where they were disenfranchised, oppressed, and a lot of them severely disabled. And it was powerful to see people, like my brother – who is adopted from Calcutta, was paraplegic and abandoned outside an orphanage – go from being the most silent person at the dinner table to the most vibrant voice and the greatest problem solver. I had in a microcosm the illustration of how powerful it can be to take young people and put their tremendous energy towards solving global problems. I wanted to do that, and I felt that as a young person I could connect with people and contribute to addressing problems that we share.
KR: You are the first person to hold the position as Special Advisor to the Secretary of State on Global Youth Issues. What are some examples of how you’ve been able to shape policy?
RF: We have a program that we launched in 10 countries in Latin America that brings young entrepreneurs to the U.S. and gives them grants to start their projects in their communities. I recently went to Norway, Turkey, India, Nepal and Bangladesh. At each of those embassies, we’re putting into place a youth advisory council, which will steer U.S. diplomacy and policy development in that country. They will have a formal role in providing input and making it known to our ambassadors what they view as challenges on the ground.
The Association Beninoise pour le Marketing Social, an affiliate of PSI in Benin, took time to speak with Benin’s Minister of Health, Prof. Dorothée K. Gazard for their FoQus newsletter. In the discussion, Prof. Gazard shares her vision for moving Family and Reproductive health forward in Benin.
FoQus : After six months at the helm of the Ministry of Health, what can be learned from the actions you have taken?
Prof. GAZARD: I would first like to thank you for the honor you have bestowed upon me to express myself in your magazine on issues related to people’s health in our country. It is always a pleasure to respond to your questions, because it is an exercise that informs your readers concerning key issues relating to the health system of our country. The health sector is a sensitive area that deserves special attention. Since I took of the head of the Ministry of Health, the actions we have taken can be summarized in three points:
1) The first thing I proceeded to do is to analyze the existing situation. It was important to know the state of the system and measure the extent of challenges. In this context:
- I conducted a series of scheduled or unannounced visits to health facilities both public, private, faith-based along with other organizations (such as fire departments) involved in the health system of our country;
- I met health facility directors on all levels of the health pyramid in Natitingou during the Independence Day celebration.
2) As I took over as the Director of the Ministry we instigated the following actions:
- The building of a new team.
- The orienting of new workers to teamwork and the vision of the Head of State in the health sector. This was achieved by organizing a two-day workshop on the subject.
- The immediate resumption of dialogue with social partners, including the implementation of the sectoral committee for social dialogue and periodic meetings conducted with social partners to maintain a strong relationship.
- The resumption of contact with the technical and financial partners, including the reinstatement of quarterly meetings with all contributors to national health. The first day of work with the PTF and the Ministry of Health was recently held in Ouidah, November 3, 2011.
- Meeting with the media during a press dinner at which the Head of State shared his vision concerning public health.
3) The main reforms:
These reforms are just variations of the President of the Republic’s vision for national health. One of the greatest reforms already executed is
~The presidential initiative for free malaria treatments for pregnant women and children under five years.
Further reforms are about to be initiated. They are as follows:
- Universal Health Insurance Plan (UHIP).
- The extension of free caesarean sections for obstetric emergencies such as hemorrhaging and complications due to respiratory diseases in birthing.