Health Systems Strengthening

Data for Decision-Making Series: Diana Frymus

Diana FrymusWe are joining the One Million Health Workers Campaign in a series of interviews, to hear from the experts why data on community health workers is so critical, and what needs to be done.

This week, we spoke with Diana Frymus, Health Systems Strengthening Advisor in the Office of HIV/AIDS at USAID in Washington, DC. She focuses on strengthening health systems to achieve HIV goals and sustain national HIV programs. Her focal areas of emphasis are on human resources for health, including CHWs, and quality improvement. She is the USAID co-chair of the PEPFAR HRH Technical Working Group and the Health Systems Global Technical Working Group on Supporting and Strengthening the Role of Community Health Workers in Health System Development. Read more »

Botswana Is Building a Strong Health System by Focusing on Health Workers

“I have a passion to help sick people,” says Oteng Gaopatwe, a nurse at Nyangabgwe Referral Hospital in Francistown, Botswana. “One thing I like most about my job is to see my clients satisfied, having a smile, and seeing all the people I have helped being relieved of their pain.”

Frontline health workers like Oteng are the backbone of health systems. In order to plan effectively for training, recruitment, and retention, countries need access to current, up-to-date information about their health workforce. Read more »

Invest in Health Workers to End AIDS

The recent focus on Ebola in West Africa has reminded us of the need for strong and resilient health systems. Behind every quality health system is an army of available and accessible health workers. However, in facilities and communities across the globe, health worker vacancies and weak support systems hamper achievement of health goals and threaten overall preparedness for future infectious diseases.

In most countries with a high HIV burden, health workforce shortages are commonplace and create significant barriers to combating the epidemic.

Much has been accomplished. USAID is incredibly proud of its significant contributions to PEPFAR’s (the U.S. President’s Emergency Plan for AIDS Relief) achievements in strengthening the health workforce to deliver quality HIV services. On World AIDS Day, Secretary Kerry announced that PEPFAR has exceeded the target of 140,000 new health care workers, which was mandated by Congress in 2008. This is a great milestone not only for PEPFAR, but also for the broader global health workforce agenda. Read more »

Global Health eLearning Center’s Community Feature Extends the Impact of Online Learning

In response to feedback from its users, the USAID Global Health eLearning Center (GHeL) and USAID’s partner at the Knowledge for Health project launched a new community feature on the site in February 2014, which gives students the ability to interact online with the course author and with other students in the same course. From August 4–13, 2014, GHeL launched its first facilitated, cohort-based learning study group to enhance students’ understanding of the main concepts in the Gender and Health Systems Strengthening course. The course author, Constance Newman, Senior Team Leader, Gender Equality and Health at IntraHealth International and working on the CapacityPlus project, asked participants to review two sessions of the course and then visit the online learning space to reflect on the discussion questions, ask questions, share experiences related to gender and health system strengthening, and learn from each other about how they have applied or plan to apply what they have learned from the course in their jobs. Read more »

Who’s Doing What in the HRH World?

Kate TulenkoI still find out most of my important health workforce information via word of mouth. Yes, I regularly read the latest journal articles and subscribe to half a dozen human resources for health (HRH) and health systems listservs, follow over 250 people on Twitter, and receive RSS updates from several HRH websites, but I never seem to get the information I really need. Who is working to strengthen health managers? What country is interested in designing a retention package for its health workers? What funder might be interested in funding a survey of how health workers currently use their mobile phones and how they would like to use them to do their jobs better? In this digital world there has to be a better way for us to share information. Read more »

Update on the MDGs: Where Are the Health Workers?

Sarah DwyerThe UN’s Millennium Development Goals Report 2011 provides a fascinating snapshot of how far we’ve come in improving health outcomes—and how much further we need to go. Unfortunately, the report ignores the health workforce crisis in many of the countries struggling to meet their 2015 health goals. The MDGs cannot be achieved when large numbers of people lack access to a health worker, yet the persistent, severe shortage of health workers is paid scant attention in the recently released UN report.

A fundamental barrier to improving health is the health worker crisis. The report’s section on Goal 5 (Improve Maternal Health), for example, points out that far too many women are without access to a skilled birth attendant during delivery. While many regions have made progress, “coverage remains low in sub-Saharan Africa and Southern Asia, where the majority of maternal deaths occur.” Read more »

Health Workers’ Role in Health Service Integration

Mesrak BelatchewIn the past decade, the global health field has seen a number of interventions that tried to integrate health services for various purposes. Integrating family planning and HIV services have helped countries make use of the resources available for the latter to expand the scope and coverage of services. TB and HIV service integration is another example of synergy to strengthen both programs. The advantage of integration for consumers is clear: patients get comprehensive services, whether in the community or at health facilities.

Focusing on health workers
Through the years, we have learned that it’s vital to strengthen the existing health system as a whole. In integrating health services, these initiatives bring a welcome focus on the key role of health workers who provide services across the system. Read more »

Addressing the Global Burden of NCDs: Health Workers Needed

Mesrak BelatchewIn the past few decades, the incidence and prevalence of noncommunicable diseases (NCDs) has continued to grow. The more we learn about the magnitude of NCDs, especially in developing countries, the more it’s clear that we need to focus on health workers as the center of our efforts to manage NCDs effectively.

The first Global Ministerial Conference on Healthy Lifestyles and Noncommunicable Disease Control, held in April 2011 in Moscow, drew much-needed attention to the global burden of NCDs. The conference report showed that cardiovascular diseases, diabetes, cancer, and chronic respiratory diseases are the leading causes of morbidity, disability, and mortality in the world. NCDs cause over 60% of global deaths, 80% of which occur in developing countries. In addition NCDs are projected to contribute to 75% of global deaths by 2030, significantly impacting all levels of health services, health care costs, and the health workforce, as well as national productivity. The June 2011 Global Health Council annual conference provided further exposure for global and country-based research findings, program interventions, lessons learned, and the way forward in addressing NCDs. Read more »

Microfinance Institutions for Better Health: How Can They Benefit Health Workers?

Mesrak BelatchewIn my work with CapacityPlus to strengthen the global health workforce, I explore ways to improve the support system for health workers in developing countries. The Global Health Council conference session on “Wealth and health: Leveraging microfinance for better health outcomes,” which was organized by SHOPS (Strengthening Health Outcomes through the Private Sector), made me reflect on how microfinance might be used to support health workers.

The session highlighted different ways of engaging microfinance institutions for addressing community health needs. For instance, in Nigeria, the community health insurance is enrolling increasing number of participants in the benefit scheme. Such interventions have demonstrated improvement in accessibility of health services with affordable premiums. These and other initiatives could play a key role in modifying the purpose of microfinance institutions, which are traditionally designed to provide loan options and support the poor segments of the population to access small businesses and sustain life. Read more »

Discrimination in Law: Putting Female Health Workers at Risk

Max SeunikThe temperature is stifling, red-tinged dust seems to coat every surface, and the whir of many fans fills the air with a rhythmic pulsing. I am seated on a bench in a small community center in Kati, Mali, observing a training meeting for all of the relais (health care volunteers) from the surrounding villages, sponsored by CapacityPlus.

The room is packed with women wearing bright and colourful boubous. Some are cradling babies, others are scribbling down notes—but they are all intensely attentive.

Relais are the backbone of Mali’s health care system. They are most important in remote underserved villages that lack health infrastructure, where they provide advice on prenatal and postnatal care. The training session focused on a picture book developed by the Malian government and a host of NGO partners.

The innovative guide has everything from images of a woman dragging her daughter to be excised under the word “NON” in a bold red to an illustration of a couple and their baby sleeping under a mosquito net. Read more »

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