Reflections on Recife and the Global Health Workforce: Metrics and Motivations

By Michael Bzdak; Executive Director, Johnson & Johnson Worldwide Corporate Contributions

The Third Global Forum on Human Resources for Health has concluded and although the issue of human resources for health is enjoying an uptick of attention within the international community, it is clear that much more needs to be done to support and honor existing workers while at the same time attracting new entrants into the health workforce. And honor them we must. Without urgent attention, there will be a projected shortage of more than 12 million health workers by 2035.

Two themes came up a number of times throughout the forum, providing a consistent and hard-to- ignore drumbeat. First, it is apparent that in our collective quest to make sure that everyone has access to well-trained, competent and culturally-sensitive health workers, we have to improve our collection of reliable data and ensure that we have functional and reliable human resource databases in every region of the world. It is no surprise that GHWA and WHO recognize this as a key recommended action – and a number of organizations are stepping up to the plate with solutions to what has been a stubborn problem.

Dramatically Reducing 3 Million Annual Newborn Deaths is Possible

The toughest places in the world to be a mother also happen to be the toughest places to be a newborn child. The annual State of the World’s Mothers Index from Save the Children finds that Somalia, Sierra Leone, Mali and the DR Congo share the dubious honor of sitting at the bottom of the index while also shouldering high rates of newborn deaths.

Though the report is not all doom and gloom. Maternal and child deaths are preventable and the solutions are known. They range from free interventions like exclusive breastfeeding to cheap nutrition supplements for mothers. It also recommends the use of chlorhexidine solution to prevent infection at the umbilical cords of infants. PSI uses 4% chlorhexidine as an intervention to prevent neonatal sepsis.

Inequality Expanding in Developing Nations, Says Save the Children

By Deputy Editor Tom Murphy

Girl working at the hills near KayonzaThe global fight against extreme poverty is progressing well with a reduction from 2 billion people living in extreme poverty in 1990 to under 1.3 billion today. The gains provide reason for celebration, but hide a rising level of inequality between the rich and the poor. Inequality in some countries has risen by as much as 179% in some developing countries, says a new report from Save the Children.

While reduction in poverty is improving the lives of many, inequality has negative impact on the health and development of children, say Finnish Minister for International Development in the report introduction. Born Equal is one of the first attempts to measure inequality among children.

Researchers surveyed 32 developing countries finding that children born to the richest 10% of households have 35 times the effective available income, meaning the amount of money available to spend on the child, as opposed to children living in the bottom 10% of households. Further, the gap between the two groups has expanded by 35% over the past two decades.

Every Birthday Starts with the Golden Minute

Members of the Helping Babies Breathe Global Development Alliance

Every child deserves a fifth birthday. To reach five years, though, a child must take his or her first breath of life in the first minute following birth. The World Health Organization estimates approximately one million babies die each year from birth asphyxia, a condition in which babies do not breathe on their own immediately following delivery.

Developed by the American Academy of Pediatrics, the Helping Babies BreatheSM (HBB) initiative was designed to equip birth attendants in developing countries with the skills they need to successfully resuscitate babies who do not breathe on their own. At the center of HBB is the concept of The Golden MinuteSM: within one minute of birth, a baby should be breathing well or should be ventilated with a bag and mask.

The effectiveness of the HBB curriculum is evident in the lives saved for babies like little Job in Kenya and Shakila’s baby in Afghanistan.  Both were born without a cry and in desperate need to breathe.  When both Shakila’s baby and Job were born, their mothers thought they were dead.  Thankfully, Dr. Shifajo in Afghanistan and Nurse Mary Wekesa in Kenya were trained in HBB, and knew hope was not lost.  They vigorously rubbed and dried the babies. When that did not stimulate them to breathe, they used a suction bulb to clear their mouth and nose, and used a bag-and-mask device to help push air into their lungs until they took their first glorious breaths.

Everyone Should Have Clean Drinking Water

The following post is by Dr. Greg Allgood, Director of the Children’s Safe Drinking Water Program at P&G and originally appears on the CSDW blog.

“Water is the issue here.  It’s number one, number two, and number 3.”  I listen intently as Mohammed Mamu, the manager of Save the Children’s Moyale office in Ethiopia, explains the situation here in the epicenter of the Horn of Africa famine.  He’s been here for 8 months and will be here for several more to oversee the response to the drought and subsequent famine.

Carrrying water 2This is a big area and it’s extremely remote.  Save the Children is working in the Somalia region of Ethiopia to provide humanitarian relief to the pastoralist communities that live here.  Because the drought was so sustained, the water sources that usually never dry up became bone dry.  People dug deeper and deeper into the earth of the ponds and wells but eventually not even a trickle could be found.

Mohammed explains that there are only 4 permanent water sources (the Dawa River and 3 boreholes) and that the hydrology and remoteness mean that digging deep wells doesn’t work. So, the best solution is to construct ponds to collect rain water.  The deep red clay soil makes for some very turbid water and the livestock make for some highly contaminated water.  It’s an area where the P&G water purification packets can have a huge impact.  Mohammed enthusiastically tells us that he’s very glad to be able to provide the packets to the communities here and that they love it.  They’re currently reaching about 60,000 people in this area.As an emergency response at the height of the drought, Save the Children used tanker trucks for 88 days to get water to the people so that they didn’t perish from dehydration.  But it wasn’t enough for the livestock and it’s estimated that half of all the livestock in the region perished.  And, that’s the average.  Some communities suffered much worse.

Why Invest in Frontline Health Workers. Why Now.

PSI  joined 14 other major global health organizations and 8 corporations to encourage continued US government investment in front line health workers around the world. The evidence is clear: increasing access to medical care through frontline health is an effective way to save lives and boost global health outcomes. By forming the Frontline Health Workers Coalition, these groups want to build support towards increasing the number of frontline health workers in the global south.

In the Huffington Post today Save the Children CEO Carolyn S. Miles explained why this group has come together. And why now.

That’s a major reason why every year — despite proven, lifesaving solutions – 7.6 million children still die before their fifth birthday, and 358,000 women still die of pregnancy-related causes. The vast majority of these deaths are preventable.

Here’s the kicker: most mothers, newborns, and children don’t need access to a doctor to survive the leading causes of death. Properly supported community health workers and midwives can do much of the job.

Healthy Dose September 21, 2011

Top StoryPolio Outbreak Hits China A deadly strain of polio has crossed from Pakistan into China. BBC reports: Polio has spread to China for the first time since 1999 after being imported from Pakistan, the World Health Organization (WHO) has confirmed. It said a strain of polio (WPV1) found in China was genetically linked with the type now circulating in Pakistan. At least seven cases have now been confirmed in China's western Xinjiang province, which borders Pakistan. The WHO warned there was a high risk of the crippling virus spreading further during Muslim pilgrimages to Mecca. Polio (also called poliomyelitis) is highly infectious and affects the nervous system, sometimes resulting in paralysis. It is transmitted through contaminated food, drinking water and faeces. ---------------------------------------- Global Health and Development Beat  Maternal Health - Canada's Prime Minister stressed the importance of accountability to make the $40 billion meant to address maternal and child health as effective as possible. NCDs - World leaders unanimously adopted the NCD Summit Outcome Document at the General Assembly in New York.   HIV/AIDS - The University of Ghana College of Health Sciences is partnering with Brown, Tufts, and Yale Universities to develop the capacity of health workers to address HIV/AIDS. Maternal and Child Health - A study on spending finds ... Read more

The Worst Places to be a Child

Save the Children (UK) has put together yet another fascinating global index. This time around, they rate and compare nations based on the best and worst places for a child to fall sick. Topping the "Health Workers Reach Index"are Switzerland and Finland while Chad and Somalia rank as the worst places for a sick child to receive care. Sara Bosely in Guardian Development writes: The analysis shows that children living in the bottom 20 countries – with just over two health workers for every 1,000 people - are five times more likely to die than those further up the index. It stands to reason. Children die of malnutrition, of diarrhoea, of malaria, of pneumonia and many other diseases in the poorest countries in the world. They need treatment, but often it is not just the drug or the food supplement that is lacking - it is the nurse or the community health worker who can diagnose what is wrong and do something about it. In some places, children never see a health worker in their sometimes pitifully short lives. The index is being published on Tuesday ahead of a UN high level meeting on non-communicable diseases in two weeks' time, which campaigners hope will call ... Read more

An Equal Chance for India’s Most Vulnerable Newborns

The following post, written by Joy Lawn and Kate Kerber, originally appears on the Gates Foundation's excellent new Impatient Optimists blog. It is the second post in a multi-week series on the blog that will focus what the foundation's partners, including the Healthy Newborn Network,  are doing to address the health needs for women and newborns in India. One of every four newborn deaths around the world is an Indian child, according to new numbers released this week by the World Health Organization (WHO), Save the Children, and partners. In India in the year 2009, over 900,000 babies died during their first four weeks of life — but this risk of dying is not equal. The poorest families are more than twice as likely to mourn the loss of their newborn baby compared to the wealthiest families. If all of India’s newborns had the same risk of death as the richest fifth of the population, 900 fewer newborns would die each day, reducing newborn deaths by one third. A rural family has a 30 percent higher risk of newborn death than an urban one, despite the increasing challenge of urban poverty in India. A woman’s chance of her baby dying varies dramatically between the different Indian states. A baby born to ... Read more

Healthy Dose August 31, 2011

Top StoryGlobal Newborn Death Rates Have Declined A WHO report assessing global death rates among newborns under one month old finds a significant decrease from 1990 to 2009. AFP reports: "Newborn deaths decreased from 4.6 million in 1990 to 3.3 million in 2009," the UN health agency said in a statement. However, developing nations are still reporting a disproportionately high level of child deaths, according to the study by the WHO, Save the Children and the London School of Hygiene and Tropical Medicine, and published in the journal PLoS Medicine. The research found that 99 percent of all newborn deaths occur in developing countries, with India, Nigeria, Pakistan, China and the Democratic Republic of Congo accounting for half of them. "India alone has more than 900,000 newborn deaths per year, nearly 28 percent of the global total," the WHO said. Africa saw the slowest decline in newborn deaths, at a rate of just one percent per year, it said. (snip) Newborn fatalities now account for 41 percent of all child deaths before the age of five, up from 37 percent in 1990. ---------------------------------------- Global Health and Development Beat Maternal Health -A Human Rights Watch report on the situation of mothers and pregnant women in Haiti's IDP camps finds “serious gaps in ... Read more