IntraHealth

IntraHealth Launches INSPiRE: Women's & Newborn Health, New Phase of Successful Service Integration Initiative in Francophone West Africa

cbales — Mon, 10 Jun 2024 10:45:25 +0000

IntraHealth Launches INSPiRE: Women's & Newborn Health, New Phase of Successful Service Integration Initiative in Francophone West Africa cbales June 10, 2024

June 17, 2024

With funding from the Bill & Melinda Gates Foundation, IntraHealth International has launched INSPiRE: Women's & Newborn Health, the third phase of a successful, cost-effective initiative to integrate health services in Francophone West Africa and save and improve the lives of mothers and babies. Providing a comprehensive package of essential health services—including family planning, nutrition, and maternal and infant care—during a single visit avoids missed opportunities and makes services more accessible, especially for women who live in rural and remote areas and must carry their babies long distances to reach a health facility.

The World Health Organization (WHO) promotes people-centered, integrated primary health care services to address unmet needs and promote universal access. Postpartum family planning has been identified as a priority high-impact practice to include as it presents one of the greatest opportunities to increase modern contraceptive use and reduce unintended pregnancies and pregnancies that are too closely spaced, which are associated with increased maternal, newborn, and child morbidity and mortality.

“The INSPiRE initiative has already helped double new family planning users and triple uptake of postpartum family planning."

“The INSPiRE initiative has already helped double new family planning users, triple uptake of postpartum family planning, and nearly quadruple well-baby visits. But we have an unfinished agenda and opportunity for moms and babies,” says Marguerite Ndour, INSPiRE director. “We’re grateful for renewed funding and support from the Bill & Melinda Gates Foundation. This work is not only critical for progress in the region, but it’s also a model to achieve greater impact around the world."

INSPIRE III will further accelerate adoption of family planning methods and improve maternal and child health indicators by scaling up the integration of postpartum family planning; maternal, neonatal, and child health; and nutrition (PPFP-MNCH-N) services in the nine Ouagadougou Partnership countries, with potential to expand to other countries in West Africa.

Building on previous progress and strong evidence

INSPiRE began in 2017 in 11 centers of excellence in Burkina Faso, Côte d’Ivoire, and Niger. IntraHealth and partners worked with national stakeholders to design and develop the INSPiRE Integration Model for providing PPFP-MNCH-N services at all levels of the health system and during four critical entry points: antenatal care, delivery, postpartum care, and infant care. The model defines eight essential steps to introduce and scale up service integration including the training and mentoring of health workers.

During INSPiRE I and INSPiRE II IntraHealth and partners also:

Generated evidence on the effectiveness and cost savings of service integration in the centers of excellence, while providing technical and financial assistance to countries to introduce and evolve the integration model.
Supported the establishment of national stakeholder-led technical working groups (TWGs) to optimize country ownership.
Facilitated the set-up of a regional Integration Community of Practice (CoP), chaired on a rotating basis by WHO/Regional Office for Africa (AFRO) and currently by the West African Health Organization (WAHO), to provide technical assistance, advocacy, coordination, and resource mobilization to the national TWGs. The CoP has promoted the development and implementation of Evidence-based National Scale-Up Plans (called PAGE Plans) in six countries.
Supported countries to establish and adopt indicators of integration consistent across the region.
Supported development of a series of eLearning modules for providers that are paired with on-the-job mentoring to reduce the cost of PAGE Plans, allow for training more health workers, and encourage retention of information.
Built capacity of professional associations, civil society, community members, and local health officials to use evidence to strengthen advocacy for integration.

“We leveraged the Ouagadougou Partnership and the Community of Practice for their regional convening power and potential for economies of scale across the nine countries,” says Robert Bambara, INSPiRE's monitoring, evaluation, and learning manager. “These countries are eager to improve maternal and child health, adapt successful integration models, learn from one another, and hold one another accountable.”

“We leveraged the Ouagadougou Partnership and the Community of Practice for their regional convening power and potential for economies of scale."

Governments, implementers, and donors in the region have aligned around the INSPiRE integration model, and it is now being implemented in 607 health facilities in eight of the nine Ouagadougou Partnership countries: Burkina Faso, Côte d’Ivoire, Guinea, Mali, Mauritania, Niger, Senegal, and Togo. More than 95% of these health facilities are located in rural and disadvantaged areas.

Between 2019 and 2023, INSPiRE saw an overall 123% increase in new family planning users, a 275% increase in postpartum family planning use at supported health facilities, and a 380% increase in well-baby visits for growth monitoring. Among the children who were monitored, fewer than 1 child in 100 presented with acute malnutrition in 2023.

The biggest challenge is the lack of financial resources, and many competing financial demands. However, progress has been made in mobilizing resources and in aligning technical and financial partners to support scale-up of the Integration Model. Under the impetus of the CoP and the support of INSPiRE, the six countries with PAGE plans have already mobilized more than 10 billion West African francs ($16 million) and are organizing national roundtables to continue resource mobilization and further engage stakeholders to fill gaps.

INSPiRE III: Women’s and Newborn Health

Over the next four years, INSPiRE III will drive additional scale-up and impact of integrated client-centered services in the region by:

Providing technical support and ensuring the secretariat role to the regional CoP for integration advocacy, monitoring of progress in countries, and extension to other countries.
Leveraging evidence to advocate for additional resources to support PAGE Plans.
Supporting national leadership and established TWGs for continuous scaling up at the national and district levels and assessing impact across countries, including on use of antenatal, postnatal, newborn, and PPFP services.
Assisting TWGs to meaningfully engage civil society organizations, including youth and women’s associations, and utilize their platforms to amplify integration advocacy, particularly bringing more attention to rural districts.
Conducting gender equality and social inclusion assessments of implementation of the integration model in districts in Burkina Faso and Mali, and using findings to inform gender transformative approaches to advocacy, provider training, and community mobilization and identify specific factors affecting women, youth, and marginalized populations’ access to and use of integrated services.
Increasing adoption and implementation of policies that advance family planning high-impact practices.
Evaluate the effectiveness of the hybrid training approach and use results to update the modules and to advocate for inclusion of the approach in PAGE Plans.
Evaluate the effectiveness of the hybrid training approach and use results to update the modules and to advocate for inclusion of the approach in PAGE Plans.
Collaborating with the Baobab Institute on 2NIBA, a new catalytic fund grant mechanism to support scale up.

INSPiRE is funded by the Bill & Melinda Gates Foundation. Partners on INSPiRE I and II included Helen Keller International, PATH, and Institut de Recherche en Sciences de la Santé (IRSS). Partners on INSPiRE III include IRSS.

IntraHealth International Joins Global Communities as a New Subsidiary to Expand Health Services Worldwide

rgoodwin — Thu, 30 May 2024 12:02:59 +0000

IntraHealth International Joins Global Communities as a New Subsidiary to Expand Health Services Worldwide rgoodwin May 30, 2024

May 30, 2024

IntraHealth International and Global Communities today announced a combination that will enable the two organizations to multiply their collective impact and to better meet the changing needs of the countries they serve.

Through this combination, IntraHealth is now a subsidiary of Global Communities, integrating our health programming more deeply across the humanitarian and sustainable development sectors while remaining a steadfast, dependable partner to our donors and collaborators. IntraHealth retains its name, distinct identity, and guiding mission to improve the performance of health workers and strengthen the systems in which they work. We also maintain our 2030 roadmap toward locally led development and regional-based leadership of our programs.

"This combination will allow us to not only maintain the gains we've worked for over the past 44 years, but to expand upon them."

“I am so happy to share this news and very proud that IntraHealth is joining the Global Communities team,” says Maqsoda Maqsodi, IntraHealth’s president and CEO. "Today's development space requires us to take different approaches to maintain our impact on global health. We have to meet the world where the challenges are. I'm excited that this combination will allow us to not only maintain the gains we've worked for over the past 44 years, but to expand upon them. And I’m inspired to be working alongside Carrie Hessler-Radelet and the Global Communities leadership to do that. Together we'll be there at the forefront with our local partners, providing immediate aid during crises but also helping strengthen their countries’ health systems for the long haul.”

As part of the new combination, Maqsodi will remain CEO of IntraHealth while also serving as chief operating officer at Global Communities.

“We are thrilled to welcome IntraHealth to Global Communities,” says Carrie Hessler-Radelet, president and CEO. “This strategic combination will amplify our impact, enhancing our ability to swiftly adapt and expand multisectoral programming while strengthening our health initiatives. And I’m overjoyed to be working with Maqsoda Maqsodi, who’ll be bringing her operational expertise to Global Communities. As CEO of IntraHealth, Maqsoda moved quickly and resourcefully to grow IntraHealth’s presence and establish more sustainable, region-based leadership of its global health programs. Together, our vision is to build a new kind of hybrid organization, one that can seamlessly pivot its programming to better address community needs.”

This combination brings exciting potential for new growth in IntraHealth's key areas of expertise—such as health workforce, data science, and local capacity-strengthening—but also in new areas, such as humanitarian assistance, nutrition, and climate-related health challenges. IntraHealth’s programming and expertise will allow Global Communities to expand and further integrate its international health and humanitarian assistance efforts.

“Together, the potential collective impact of Global Communities and IntraHealth is immense,” Maqsodi says.

IntraHealth will continue to implement all our current projects through the end of their agreements, operate our US and country offices, and maintain existing systems and processes for current programs. IntraHealth’s donors and partners can continue to expect the same high level of quality and attention from us.

The combination agreement was unanimously approved by both organizations’ boards of directors. Full operational integration of the two entities is expected by October 2024.

“We are incredibly grateful to our board of directors for their commitment to IntraHealth and dedication to our mission,” Maqsodi says. “Several of our board members have been with us for many years and helped steer us through great challenges. As some of them end their service as board members, we remain thankful for all they’ve done for us and for health workers and communities around the world.”

Read the press release.

About IntraHealth and Global Communities

IntraHealth International believes everyone everywhere should have the health care they need to thrive. For 44 years in over 100 countries, IntraHealth has partnered with governments and local organizations to improve the performance of health workers and strengthen the systems in which they work.

Global Communities brings together local ingenuity and global insights to save lives, advance equity, and secure strong futures. Founded in 1952 as the Foundation for Cooperative Housing, today Global Communities envisions a world of expanded opportunity, where crises give way to resilience and all people thrive.

For press inquiries, please contact David Nelson, director of communications, IntraHealth and Jane Gotiangco, vice president of Strategic Communication, Global Communities.

SmartPhone-Based eLearning Enhances Community Health Workers’ Knowledge: New Article Highlights IntraHealth-Led Study in Rwanda

cbales — Tue, 21 May 2024 13:21:05 +0000

SmartPhone-Based eLearning Enhances Community Health Workers’ Knowledge: New Article Highlights IntraHealth-Led Study in Rwanda cbales May 21, 2024

May 21, 2024

A new article, “Using eLearning to improve and retain the knowledge of community health workers in maternal and neonatal health in Rwanda: A cohort study,” published in the journal Public Health Challenges, details the results of a study among Rwandan community health workers (CHWs) participating in a smartphone-based eLearning course. IntraHealth International conducted the study through its USAID-funded Ingobyi Activity, which worked to bring high-quality, integrated health services to more Rwandan mothers, children, and adolescents from 2018-2023.

Read the article here.

CHWs play a critical role in providing community-based maternal and newborn health services in Rwanda but need ongoing training to perform their jobs effectively. IntraHealth collaborated with the Ministry of Health and Rwanda Biomedical Centre and piloted the eLearning activity in two districts comprising 958 villages. Smartphone-based eLearning is intended to create a more independent, cost-effective, and sustainable method of learning for CHWs, complemented with mentorship programs and supportive supervision.

The study, carried out from April-October 2021, evaluated knowledge acquisition and retention among 36 female CHWs participating in the eLearning course. Knowledge scores were measured using a structured questionnaire administered pre-training, post-training, and at a six-month follow-up. Following the eLearning course, CHWs performance scores improved, with an average increase from 86.5% to 98.2%, and with the improvement sustained at the six-month follow-up.

Findings suggest eLearning is an effective method for enhancing and retaining CHWs’ knowledge in maternal and newborn health.

These gains occurred even though all participants reported they had never used a smartphone before the study (many did have feature phones). Locally produced smartphones were procured for participants as part of the study design. The course content covered four key areas: overview of maternal and newborn health, surveying girls and women of childbearing age, conducting home visits for pregnant women, and conducting postnatal care visits.

The study findings suggest that eLearning is an effective method for enhancing and retaining CHWs’ knowledge in maternal and newborn health, and that smartphone-based eLearning can be a valuable strategy to consider for strengthening CHW capacity in Rwanda and other countries.

Current and former IntraHealth staff Yves Sangwa, Victor Ndaruhutse, Jacqueline Umunyana, and Christian Mazimpaka share joint first authorship of the article, which also includes additional co-authors from IntraHealth as well as the University of Rwanda and the Rwanda Biomedical Center.

Can We Use ChatGPT for Global Goods Software Development?

cbales — Tue, 14 May 2024 20:42:23 +0000

Can We Use ChatGPT for Global Goods Software Development?

, Deputy director of data science

cbales May 14, 2024

May 14, 2024 12:00 PM

At IntraHealth International, where we're committed to developing digital solutions to support health workers, artificial intelligence (AI) could be a game changer.

AI, and especially Genera t ive AI, is performing as well or better than humans in reading comprehension and language understanding. It could reduce training expenses and free up nurse time for providing patient care—ultimately improving health outcomes.

Let’s explore what is known today and how we tested using AI for our software development workflows.

ChatGPT in software development

Early studies show that large language models (LLMs) like ChatGPT can support college educated professionals and developers to reduce the time people spend on tasks (like drafting documents) and improve the quality of the work for those who have less-mature writing skills.

GitHub found similar results for software developers doing “boilerplate” tasks like setting up a web server in JavaScript. Using GitHub’s CoPilot tool improved productivity by over 50%!

We set out to see if GitHub’s Copilot and Open AI’s ChatGPT 3.5 could assist our software developers to write documentation, comment code, write unit tests, and find and fix bugs in iHRIS, IntraHealth’s open source software that helps 20+ countries around the world track and manage their health workforce to improve access to health services.

^{iHRIS enables health officials to make better, more informed decisions about health workforce deployment, training, management, and more. Here Justine Kaboole uses iHRIS at the District Health Office in Iganga, Uganda. Photo by Tommy Trenchard for IntraHealth International.}

We asked ChatGPT 3.5 if it knew iHRIS, and it gave the response below.

“As of my last knowledge update in January 2022, IHRIS (Integrated Human Resource Information System) is a free, open-source software specifically designed for managing human resources in the health sector. It is often used by organizations and governments to keep track of health workforce data, including information about health workers, their skills, training, and deployment.
However, please note that software information can change over time, and there may have been updates or changes to IHRIS since my last update. I recommend checking the official website or other reliable sources for the latest information on IHRIS and its features as of your current date in 2024.” – Open AI’s ChatGPT 3.5

It helpfully gave the last date it was updated, gave an accurate description of iHRIS and added a caveat about going to the official website for information. We confirmed that Open AI’s ChatGPT 3.5 could write basic installation instructions and challenged it to make the instructions as fun as we think health workforce management is. The answer did not disappoint.

“In the digital kingdom, where data flows like rivers, a legendary tool called iHRIS awaits brave souls seeking to conquer the challenges of workforce management. Prepare yourself for a thrilling quest to install iHRIS and harness its mighty capabilities.” – Open AI’s ChatGPT 3.5

Our developer team members located in Tanzania, Ethiopia, and Uganda tried ChatGPT 3.5 out for iHRIS and found it was easily able to add comments to existing code chunks. It could also provide step by step instructions in “black screen” mode so that a developer could get a reproducible example and put it into the software.

When we tried GitHub’s Co-Pilot to assist with software development, it could create repetitive code from scratch—like unit tests. But they required tweaking by developers who were skilled in writing code in Node.js and Vue.js (the codebase upon which iHRIS is written).

Future ChatGPT use in software development

So, what did our iHRIS software development team say about ChatGPT?

It helped with repetitive tasks that software developers don’t often enjoy, like writing documentation, especially when the logic is well-known.
It helped reduce the time required to write the boilerplate and mock objects for tests since those are repetitive.
However, it can generate code out of context or miss a single part which leads to more time spent on de-bugging.
If GitHub Co-Pilot was free, there would be more uptake.

In the coming months, we will release a public user guide for incorporating AI into the workflow for developers working with global public goods software.

This post was originally published on ICTWorks.

Digital Health Health Workers

Frontline Health Workers Coalition is Key Partner on Inaugural Africa Health Workforce Investment Forum

cbales — Mon, 06 May 2024 15:04:56 +0000

Frontline Health Workers Coalition is Key Partner on Inaugural Africa Health Workforce Investment Forum cbales May 06, 2024

May 06, 2024

The Coalition, hosted by IntraHealth International, is leading civil society participation.

The World Health Organization (WHO), in collaboration with Member States and partners—including the Frontline Health Workers Coalition hosted by IntraHealth International—is convening the inaugural Africa Health Workforce Investment Forum in Windhoek, Namibia from May 6 - 8, 2024.

The Forum will engage approximately 150 key decision-makers and actors—including African ministers of health, finance, education, and labor along with donors and civil society—to obtain consensus and commitment on the first-ever Africa Health Workforce Investment Charter.

Find out more about IntraHealth International's participation in the Forum.

With a bold target of halving Africa's 6.1 million health workforce shortage, the pioneering Charter aims to mobilize and align domestic and partner funding to strengthen, grow, and retain the continent's health workforce, especially in rural and primary health care settings. Developed by the WHO Regional African Office (WHO/AFRO) in collaboration with Member States and partners, the Charter promotes a multisectoral approach to health workforce development.

Civil society input at the Forum is critical

The Frontline Health Workers Coalition is leading civil society participation at the Forum to share perspectives as organizations and allies working directly with countries and funders to build the health workforce and address challenges. Implementing partners like the Coalition's 40+ organizational members, are critical in the long-term, not only for advocating to secure health workforce investments but also for operationalizing the Charter.

IntraHealth's Tina Flores, director of the Coalition, and members of the Coalition's Technical Working Group helped design three Forum sessions:

Operationalizing the Charter
Bridging the education to employment gap: Unlocking fiscal space for absorption and employment of newly trained Health workers
Integrating and professionalizing community health workers to strengthen primary health care.

Five experts will represent the Coalition at the Forum:

Janet Muriuki, Senior Director, Health Workforce Development, IntraHealth
Rachel Deussom, Senior Director, Health Practice, Chemonics
Amina Dorayi, Nigeria Country Director, Pathfinder
Claire Jones, Senior Health Financing Specialist, Local Health System Sustainability (LHSS) Project, Namibia, Abt Global
Mei Li, Senior Private Sector Partnerships Officer, Partners in Health.

Follow the Forum

For timely updates on the Forum, follow WHO/AFRO on X and the Frontline Health Workers Coalition on LinkedIn.

Other key partners supporting the Forum include the ILO-OECD-WHO Working for Health Programme and its Multi-Partner Trust Fund and The Global Fund to Fight AIDS, Tuberculosis and Malaria.

Join us!

The Frontline Health Workers Coalition is a growing group of international organizations in 100 countries whose vision is that every community should have access to all cadres of trained, compensated, safe and supported health workers who are able to provide quality essential health services, as well as respond to pandemic threats and address noncommunicable diseases. IntraHealth has led the Coalition's secretariat since 2012.

Organizations interested in health workforce advocacy can apply to be a member of the Frontline Health Workers Coalition. Donors can provide funding to grow the coalition’s activities or sponsor specific events. Please contact the Coalition to discuss how we can collaborate.

What’s Next for Health Workforce Investment in Uganda?

cbales — Fri, 03 May 2024 13:03:58 +0000

What’s Next for Health Workforce Investment in Uganda?

, Strategic communications manager

, Former Chief of party, Uganda RHITES-E Activity

cbales May 03, 2024

May 03, 2024 12:00 PM

Next week the World Health Organization is holding the inaugural Africa Health Workforce Investment Forum, and will convene African ministers, donors, and civil society to stimulate and align long-term investment in the health workforce. These key decision-makers and actors will come to consensus around the first-ever Africa Health Workforce Investment Charter—which aims to cut the continent’s critical health worker shortage in half—and hammer out details to protect existing health workforce funding and partner on new investments.

I sat down with William Mubiru, a health systems and workforce expert in Uganda. Most recently he led the USAID-funded Regional Health Integration to Enhance Services in Eastern Uganda (RHITES-E) Activity and worked with the government of Uganda and partners to expand access to high-quality integrated health services in 30 districts in Eastern Uganda and Karamoja, home to over 7 million Ugandans.

Below he shares how his passion for improving the health workforce and access to health care is rooted in his childhood and home district, and what future investments should prioritize.

Read how IntraHealth International is supporting the Africa Health Workforce Investment Forum and Charter.

Q: Why did you decide to work in public health, and focus on health systems and health workforce strengthening?

I was born and grew up in a community in Luweero District, which was at the center of the National Resistance Army war from 1980-86. The violence caused disruptions in service delivery, including health services, and breakdown of systems. Many health facilities were destroyed, and many health workers were killed or forced to flee. Lack of access to health care and essential medicines and inadequate numbers of health workers led to a high prevalence of diseases like malaria and diarrhea in my community.

We had to walk 15 kms each way to reach any health care services.

Even after the war we had to walk 15 kilometers, or about 3 hours each way, to reach any health care services. As I got older, I felt I needed to help the most vulnerable in my community, including the many widows and orphans, access health services. I ventured into public health to raise awareness about preventable diseases and work closely with the local leaders in lobbying for increased funding for the health sector.

Q: What are some of the key health workforce challenges Uganda is currently facing with ensuring health equity and reaching its goal of universal health coverage (UHC)?

The availability of health workers is still scarce, especially in rural and hard-to-reach areas. The country needs tens of thousands of additional skilled health workers to meet even the minimum targets required for UHC. We have weak leadership and governance for health workforce management. Many managers are not accountable and there's a lack of responsiveness to health workforce issues limiting access to care, like high levels of absenteeism. Another key challenge is poor data management. Because we still use multiple paper-based health information systems, especially at the community level, leaders don't have complete and aggregated data to make informed decisions.

The availability of health workers is still scarce, especially in rural areas.

Uganda struggles with limited domestic funds allocated to the health sector, and therefore for the health workforce. The current health budget is just 7.7% of the national pie, just half of the Abuja Declaration target. We also have poor community health systems, often characterized by inadequately trained and facilitated village health teams [VHTs]. The government is shifting to a more formalized community health workforce by piloting the Community Health Extension Workers Strategy, but this is yet to be adopted across the country.

Q: As the former head of USAID's RHITES-E, a $65 million six-year program, what are some interventions you've seen work, and helped address these challenges in Eastern Uganda and Karamoja?

There are lots of achievements, which I recommend should be replicated or sustained.

Localization. RHITES-E built the capacity of local partners, including three Regional Referral Hospitals, which are going to be critical in sustaining the gains we achieved. We worked with these partners to create capacity development plans and used several approaches like joint planning, mentorships, technical assistance, and “Data to Action” meetings. RHITES-E transitioned HIV/TB service delivery to these local partners and districts, and I'm proud that some of the districts—like Budaka, Kaabong, Manafwa, Mbale, and Sironko—were best performers in the Annual Health Sector Performance Report for 2022/23.

Health workforce development. RHITES-E worked with the Ministry of Health and regional referral hospitals to build the capacity of health workers in family planning; nutrition; maternal, neonatal, and child health; and emergencies. For example, during the upsurge of COVID-19, we worked with the national emergency department at the Ministry of Health to build the capacity of frontline health workers, especially midwives and nurses, in the areas of case management and home-based care, and to administer COVID-19 vaccinations, and this helped in reducing the fatalities of COVID-19.

Digital solutions. We built on existing technologies and platforms to improve data efficiency, from the community to the national level. For example, we supported the rollout of electronic medical records for antiretroviral therapy across 571 facilities in Eastern Uganda, and this led to improved timely district reporting into the national health management information system. We supported districts to roll out the national iHRIS human resources information system to collect information for workforce planning, deployment, recruitment, and attendance monitoring. District leaders used the iHRIS data for timely recruitment, and to fill more than 10,000 posts, while also reducing absenteeism.

Several districts used RBF funds to recruit health workers and increased facility births.

Result-based financing. The project supported the districts and the government of Uganda to roll out results-based financing [RBF], one of the key health financing strategies the country is embracing to improve service delivery. We worked closely with the ministry to build the capacity of districts to implement RBF and several districts, like Namisindwa, Kapchorwa, and Tororo, used RBF funds to recruit health workers, specifically additional midwives, which has helped improve service-level indicators, including increasing facility births.

Q: In addition to scaling up those successful interventions, what do you think should be the priorities for the next phase of investment in health workers and systems in Uganda?

Performance management needs to be prioritized—especially for improving health worker productivity, attendance to duty, and motivation—and also for holding health managers accountable for their own performance.

We need to invest more in the capacity of health workers. The country has invested in several strategies for health worker capacity development, but this needs to be amplified in all regions. We know this works—RHITES-E built health workers’ skills in integrated service delivery, and we saw huge increases in contraception use and in HIV viral load suppression for example.

We need to strengthen data management and invest more in digitalization of paper-based health information systems and building the capacity of all health leaders from community to the national level to use data for decision-making.

We need to improve public financial management and invest more in community health systems.

It’s critical to improve public financial management. As a country, a lot of our funding, especially for the health sector, is donor driven. Right now, over 40% of our national budget comes from donors. This calls for innovative approaches for enhancing efficiency in terms of resource allocation. There is need for investment in public financial management to minimize cases of corruption of public funds.

Finally, we need to invest more in community health systems and roll out paid, trained, equipped, and supervised community health extension workers to oversee VHTs and reach every single family, woman, and child and end preventable diseases and deaths. Most Ugandans live in rural communities that are far from health facilities. And this will help us a lot in minimizing the costs we are incurring for management of diseases.

Family Planning HIV & AIDS COVID-19 Maternal and Newborn Health Community Health Digital Health Health workforce development Leadership and Governance Management and Performance Health Workers

New Article in Global Health: Science and Practice Shows Improving the Quality of Family Planning Services for Youth Can Increase Contraceptive Use

cbales — Mon, 29 Apr 2024 20:10:53 +0000

New Article in Global Health: Science and Practice Shows Improving the Quality of Family Planning Services for Youth Can Increase Contraceptive Use cbales April 29, 2024

April 29, 2024

IntraHealth International staff co-authored a new article, “Implementing Quality Improvement Initiatives to Improve the Use of Adolescent- and Youth-Friendly Health Services in Zou, Benin,” published this month in Global Health: Science and Practice. The field report details how The Challenge Initiative (TCI) helped local health system leaders in Benin assess and improve the quality of family planning and sexual and reproductive health services for young people to enhance contraceptive uptake.

Read the free article here.

TCI, part of a consortium led by the William H. Gates Institute for Population and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health, is rapidly and sustainably scaling up proven reproductive health solutions among the urban poor. IntraHealth has led the Francophone West Africa regional hub of TCI since 2016, and has helped cities in Benin, Burkina Faso, Côte d’Ivoire, Niger, Senegal, and Togo add over 380,000 family planning users. In partnership with the Gates Institute and local municipalities and health leaders, the hub helps cities adapt and scale up high-impact practices and make family planning services more youth-friendly.

Unmet need for family planning is especially high for adolescent girls and youth aged 15-24.

The authors cite that, in Benin, unmet need for family planning is high for all women, and especially for adolescent girls and youth aged 15-24. About 35% of girls and women in this age group do not want to get pregnant but are not using a modern form of contraception. Multiple challenges contribute to their low use of modern contraceptives, including method access and the quality of health services.

From June 2019-March 2021, TCI supported health districts in Zou, Benin to complete quality assessments at 65 family service delivery points, develop remedial action plans, and follow up with supportive supervision. Despite challenges, including disruptions related to the COVID-19 pandemic, the article shows quality improvement initiatives increased the use of contraceptive services for adolescents and youth and offers valuable insights for health workers, policymakers, and researchers.

Quality improvement initiatives increased the use of contraceptive services for adolescents and youth.

Read how TCI worked with the Zou Department Directorate of Health and a local youth association to implement a simple quality assessment checklist, assess quality, and address concerns—including by training health workers to reduce discriminatory and disrespectful service delivery approaches toward youth seeking services.

The article offers valuable insights for health workers, policymakers, and researchers engaged in adolescent and youth sexual and reproductive health (AYSHR). The authors recommend additional research and highlight the need to improve AYSRH data and use. They also recommend institutionalization of quality assessment and improvement initiatives within the local government systems and increased investment in quality improvement strategies to increase the use of family planning services among adolescents and youth.

IntraHealth staff supporting TCI who co-authored the article include Josephat Avocè, Mamadou Kandji, Hugues Gnahoui, Moussa Faye, and Fatimata Sow.

The Challenge Initiative is funded by the Bill & Melinda Gates Foundation.

Community Health Workers Making a Difference for Pediatric HIV Clients in South Sudan

rgoodwin — Wed, 27 Mar 2024 17:44:30 +0000

Community Health Workers Making a Difference for Pediatric HIV Clients in South Sudan

, Communications Officer

rgoodwin March 27, 2024

April 01, 2024 12:00 PM

In South Sudan, community outreach volunteers (COVs) like Lawrence Monday play a key role in the HIV response—linking health facilities and communities to extend services and acting as peers to people living with HIV. Under the supervision of an adherence nurse, Lawrence supports 160 clients on HIV treatment, including 15 children.

One of the children Lawrence helps is Timo*, who had a rough start in life. He was born in 2017 into a low-income family in Juba. His biological father was never around to help him as a baby, and his 25-year-old single mother had no job to support him or his two older siblings. She often went to the market to dance with Timo wrapped on her back, and well-wishers would give her some money or food items, which would help feed them for a few days.

Diagnosis and struggle

Timo’s mother knew she was HIV-positive. Although she had been receiving antiretroviral therapy (ART) from Nyakuron Primary Health Care Center (PHCC), when she became pregnant with Timo in 2016, she refused to take treatment and didn’t attend antenatal appointments. She feared she would be stigmatized at the health facility because she knew people who worked there.

When it was time for Timo to be born, his mother had a home delivery without a skilled health care provider. When Timo was three months old, both he and his mother became very ill. He couldn’t breastfeed well, became restless, and started bleeding from the navel. His 60-year-old grandmother rushed him to Nyakuron PHCC where he was assessed and diagnosed with HIV, and immediately enrolled on ART.

With the help of his grandmother, Timo successfully attended treatment for the following year. However, his ailing mother was often intoxicated. She would leave the children with her mother and dash down to a local spree to drink.

Timo’s mother continued to refuse treatment, and in 2022 succumbed to complications of HIV. At the time, Timo and his siblings were already fully under his grandmother’s care and they largely depended on the support of well-wishers.

Home visits from a community outreach volunteer

Nyakuron PHCC is now one of 14 health facilities supported by the Advancing HIV/AIDS Epidemic Control Activity (AHEC). AHEC is a four-year USAID-funded contract led by IntraHealth International building local capacity to provide comprehensive HIV services and free ART to people living with HIV in South Sudan. By partnering with the health facilities and local organizations, the South Sudanese government, and communities, AHEC helps train health workers to deliver high-quality HIV services and adapts evidence-based HIV prevention, care, and treatment interventions for people living with HIV.

In 2021, early on in the project, AHEC trained 160 COVs, including Lawrence Monday. The project provides a stipend and mobile phone airtime for communication to the COVs. In 2013, AHEC attached Lawrence to Timo to monitor his treatment progress through home visits and offer emotional and psychological support.

“It’s a challenge to keep children on treatment but the regular home visits are paying off,” Lawrence says. “I visit all my clients twice every six months, and I visit children at least once a week, because they easily forget to take their medication, to ensure that they adhere to medication. Within the last month, I’ve registered only 5 out of 160 clients with high viral loads, whom I’m closely following up for adherence counseling.”

“It’s a challenge to keep children on treatment but the regular home visits are paying off,” Lawrence says.

Timo was one of those who needed extra follow-up. In February 2023, when Timo was five, he lost weight and became very weak. When health providers at Nyakuron PHCC assessed him, his viral load was too high and unsuppressed. He seemed traumatized by the absence of his mother, lacked enough food, and sometimes refused the bitter taste of the medicine. The health providers developed a monitoring action plan, and after four months of Enhanced Adherence Counseling, his viral load was suppressed. The health provider transitioned Timo from Lopinavir to Dolutegravir and guided his grandmother on how to prepare and give him the medication. Lawrence helped link Timo to a nutrition center within the health facility where he received food portions monthly until his health improved by June 2023.

However, in October 2023, Timo developed swollen lymph nodes and a cough and was losing weight. During a home visit, Lawrence noticed Timo’s symptoms and immediately rushed him to Nyakuron PHCC, where he was referred to Al-Sabah Childrens’ hospital. Health workers at the hospital diagnosed Timo with opportunistic infections, including tuberculosis (TB). Timo was put on anti-TB treatment for six months, which he successfully completed with the help of Lawrence.

HIV & AIDS Infectious Diseases Maternal, Newborn, & Child Health Community Health Community Health Workers

Venez à la rencontre de Marguerite Diarra. Son but est de former davantage de sage-femmes et d'améliorer l'accès aux soins maternels au Mali.

cbales — Fri, 08 Mar 2024 13:00:21 +0000

Venez à la rencontre de Marguerite Diarra. Son but est de former davantage de sage-femmes et d'améliorer l'accès aux soins maternels au Mali.

, Technical advisor for communications

, Strategic communications manager

cbales March 08, 2024

March 08, 2024 12:00 PM

Par une matinée ensoleillée à l'école Vicenta Maria de Ségou au Mali, Marguerite Diarra démontre la gestion active de la troisième phase de l’accouchement en utilisant un Mama-U, un simulateur obstétrique/gynécologique représentant l'utérus d'une femme.

Marguerite forme des sage-femmes qualifiées prêtes à s'occuper des femmes au Mali, en particulier dans les communautés rurales. Elle a grandi à Beleko, dans la région de Dioila, et est devenue sage-femme en 2016. Aujourd'hui, elle est enseignante permanente et se spécialise dans les soins obstétriques.

Le Mali n'a pas assez de sages-femmes.

Le Mali, comme d'autres pays d'Afrique de l'Ouest francophone, ne dispose pas d'un nombre suffisant de sage-femmes qualifiées ou d'autres agents de santé. Il n'y a que 6,1 sage-femmes, infirmières et médecins pour 10 000 personnes, ce qui est bien inférieur au nombre recommandé, et la pénurie est encore plus grave dans les zones rurales. Cette situation entrave l'accès équitable des femmes aux services de santé, notamment aux soins maternels et à la planification familiale, et contribue aux taux élevés de mortalité maternelle.

Au Mali, plus de 500 femmes sur 100 000 meurent lors de l’accouchement. De plus, la formation initiale traditionnelle n’outille pas assez les agents de santé pour faire face aux conditions de travail réelles.

Le projet Classroom to Care (C2C) d'IntraHealth, financé par la firme pharmaceutique Takeda, aide 12 écoles privées de santé comme Vicenta Maria à adopter une approche de l'éducation basée sur les compétences.

L'approche par compétence est basée sur les besoins de la population.

Alors que la formation initiale classique consiste à élaborer des programmes par matière ou par objectif, les programmes de l’approche par compétence (APC) sont élaborés en fonction des besoins de la population et des compétences requises. Dans la formation classique, l'enseignant transmet les connaissances, tandis que l’APC est orienté sur la facilitation de l'apprentissage de l'élève.

C2C a formé 250 enseignants comme Marguerite au Mali, au Niger et au Sénégal sur cette approche.

Maternal, Newborn, & Child Health Health workforce development International Women's Day Gender Equality Midwives Nurses

Meet Marguerite Diarra. She’s On a Mission to Train More Midwives and Increase Access to Maternal Care in Mali

cbales — Fri, 08 Mar 2024 11:47:15 +0000

Meet Marguerite Diarra. She’s On a Mission to Train More Midwives and Increase Access to Maternal Care in Mali

, Technical advisor for communications

, Strategic communications manager

cbales March 08, 2024

March 08, 2024 12:00 PM

On a sunny morning at the Vicenta Maria School of Ségou in Mali, Marguerite Diarra demonstrates active management of the third stage of labor using a Mama-U, a training model representing a woman’s uterus after childbirth.

Marguerite is on a mission to produce more skilled midwives who are ready to care for women in Mali, particularly in rural communities. She grew up in Beleko, in the region of Dioila, and became a midwife in 2016. Now she’s a permanent teacher at the school, specializing in obstetrical care.

Mali doesn’t have nearly enough midwives.

Mali, like other countries in Francophone West Africa, doesn’t have nearly enough skilled midwives or other health workers. There are just 6.1 midwives, nurses, and doctors to serve 10,000 people, far below the recommended amount, and the shortage is even worse in rural areas. This hinders women’s equitable access to health services, including for maternal care and family planning, and contributes to high rates of maternal mortality.

More than 500 women die for every 100,000 live births in Mali. And, traditional preservice education has not prepared health workers for real-life work conditions.

IntraHealth’s Classroom to Care (C2C) project, funded by Takeda Pharmaceutical Company Limited, aids 12 private health schools like Vicenta Maria in adopting a Competency-Based Approach (CBA) to education.

The Competency-Based Approach to education is based on population needs.

Whereas classic preservice training involves developing programs by subject or objective, CBA programs are developed based on population needs and the needed competencies for job requirements. In classic training the teacher provides the knowledge, while CBA teaching is based on facilitating student learning.

C2C has trained 250 teachers like Marguerite across Mali, Niger, and Senegal on the CBA approach.

Maternal, Newborn, & Child Health Health workforce development Private-Sector Approaches International Women's Day Gender Equality Midwives Nurses

IntraHealth

IntraHealth Launches INSPiRE: Women's & Newborn Health, New Phase of Successful Service Integration Initiative in Francophone West Africa

Building on previous progress and strong evidence

INSPiRE III: Women’s and Newborn Health

IntraHealth International Joins Global Communities as a New Subsidiary to Expand Health Services Worldwide

About IntraHealth and Global Communities

SmartPhone-Based eLearning Enhances Community Health Workers’ Knowledge: New Article Highlights IntraHealth-Led Study in Rwanda

Can We Use ChatGPT for Global Goods Software Development?

ChatGPT in software development

“In the digital kingdom, where data flows like rivers, a legendary tool called iHRIS awaits brave souls seeking to conquer the challenges of workforce management. Prepare yourself for a thrilling quest to install iHRIS and harness its mighty capabilities.” – Open AI’s ChatGPT 3.5

Future ChatGPT use in software development

Frontline Health Workers Coalition is Key Partner on Inaugural Africa Health Workforce Investment Forum

The Coalition, hosted by IntraHealth International, is leading civil society participation.

Civil society input at the Forum is critical

Follow the Forum

Join us!

What’s Next for Health Workforce Investment in Uganda?

Q: Why did you decide to work in public health, and focus on health systems and health workforce strengthening?

Q: What are some of the key health workforce challenges Uganda is currently facing with ensuring health equity and reaching its goal of universal health coverage (UHC)?

Q: As the former head of USAID's RHITES-E, a $65 million six-year program, what are some interventions you've seen work, and helped address these challenges in Eastern Uganda and Karamoja?

Q: In addition to scaling up those successful interventions, what do you think should be the priorities for the next phase of investment in health workers and systems in Uganda?

New Article in Global Health: Science and Practice Shows Improving the Quality of Family Planning Services for Youth Can Increase Contraceptive Use

Community Health Workers Making a Difference for Pediatric HIV Clients in South Sudan

Diagnosis and struggle

Home visits from a community outreach volunteer

Venez à la rencontre de Marguerite Diarra. Son but est de former davantage de sage-femmes et d'améliorer l'accès aux soins maternels au Mali.

Meet Marguerite Diarra. She’s On a Mission to Train More Midwives and Increase Access to Maternal Care in Mali