MSF Opens Maternity Center as Part of Ebola Response

Posted January 12, 2015

Medicins Sans Frontiers has opened the first care center in the current Ebola epidemic for pregnant women, whose survival rate from the virus is virtually zero, the charity said on Saturday. From Reuters:

There is currently one patient in the clinic, which is perched on a hill in the compound of a disused Methodist boys high school in the Sierra Leone capital.

More than 20,700 people have been infected with the virus in Guinea, Sierra Leone and Liberia since it began a year ago and at least 8,200 people have died, according to World Health Organization figures.

The rate of transmission has slowed in Guinea and Liberia and there are signs it is starting to ebb in Sierra Leone.

Women are particularly vulnerable to a disease spread through direct contact with infected people and with the corpses of victims, because women often care for sick family members, said MSF Field Coordinator, Esperanza Santos.

“Pregnant women (with Ebola) are a high risk group so they have less chance than…than the rest of the population,” she told Reuters. The charity has played a leading roll in the fight against the virus.

Medical authorities say it is unclear why the survival rate for pregnant women is lower than for other patients but early testing and rapid treatment will help lower mortality rates.

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Global Health and Development Beat

An unlicensed medic is being charged with murder after Cambodian medical authorities found 212 cases of HIV in the district where he had been treating patients, allegedly with contaminated equipment.

UNICEF is helping governments and communities restart stalled immunizations amid a surge in measles cases in Ebola-affected countries, where health systems are overwhelmed and tens of thousands of children are left vulnerable to deadly diseases.

Two promising Ebola vaccines will soon be tried on the frontline of the epidemic in West Africa, the World Health Organization has announced.

Contaminated traditional beer has killed 56 people in Mozambique, health authorities in the southern African country said on Sunday.

The Apex Council on Health recommended to the government of Zimbabwe the immediate dissolution of the Health Services Board due to it being “grossly inefficient”.

In India, the Uttarakhand state AIDS control society is yet to receive 30% of the proposed budget for the 2014-15 financial year. The current state of affairs might make it difficult for the society to perform its duties in the near future, say officials.

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Buzzing in the Blogs

An excerpt from a recent dispatch by American doctor Joel Selanikio, who has been treating Ebola patients in Lunsar, Sierra Leone, for NPR:

Entry 1: Hawa

I rounded on a 16-year-old girl a few days ago. Her name was … Hawa. When I first saw her under her blanket, I thought that she must be an amputee; then I realized she was just a very small, thin girl.

I didn’t get to see Hawa the next day and so today I rounded on her again. For the first time in two days, wanting to examine her fully, I pulled away her blanket and I found that rather than just having a rash, her entire body surface was peeling off in thick pieces revealing very red, painful-looking skin underneath.

Honestly, every person around that bed literally gasped when they saw what she looked like. It was like a burn victim. I’ve honestly never seen anything like it, except in a burn victim.

It’s really hard to describe all of the emotions that I felt when I realized what this 16-year-old girl had been going through while supposedly under my care. But, I can say that mostly I felt ashamed, because I had agreed to care for her and I hadn’t. It’s a hard thing to realize that your actions, or inactions, have harmed a child.

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Capital Events

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Thursday

10:00 AM – Top Priorities for Africa in 2015 – Brookings

12:00 PM – The UNEP and Climate Change – Environmental Law Institute

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By Mark Leon Goldberg and Tom Murphy

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Clients who received counseling with the digital Smart Start tool reported a higher understanding of their options and were more likely to choose contraception (74 percent) compared to those counseled with the manual version of Smart Start (64 percent). Navigators also found the digital tool more effective in connecting with clients, leading to higher ratings for the quality of their counseling.

By December 2023, PSI Ethiopia, working in close collaboration with the MOH, aims to reach over 50 thousand new clients by leveraging the digital counseling tool offered by Smart Start. This innovative approach allows for greater accessibility and effectiveness in providing sexual and reproductive health services, contributing to improved reproductive health outcomes for women and couples across the country.

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Community health workers (CHWs) are critical lifelines in their communities. Ensuring they have the training, support, and equipment they need is essential to keep their communities safe from malaria, especially in the hardest to reach contexts.

For example, in Mali, access to formal health services remains challenging, with four in ten people living several miles from the nearest health center, all without reliable transportation or access. In 2009, the Ministry of Health adopted a community health strategy to reach this population. The U.S. President’s Malaria Initiative (PMI) Impact Malaria project, funded by USAID and led by PSI, supports the Ministry with CHW training and supervision to localize health services.

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Supervisors directly observed how CHWs performed malaria rapid diagnostic tests (RDTs) and administered artemisinin-based combination therapy (ACT). They recorded CHW performance using the digitized checklist, interviewed community members, reviewed records, and provided on-the-spot coaching. They also interviewed the CHWs and tried to resolve challenges they expressed, including with resupply of commodities or equipment immediately or soon afterwards.

Beyond the observed interactions with patients, supervisors heard from community members that they were pleased that CHWs were able to provide essential malaria services in the community. And the data shows the impact.

In IM-supported areas of Mali, 36% of CHWs in the first round were competent in performing the RDT, which rose to 53% in the second. 24% of CHWs in the first round compared to 38% in the second were competent in the treatment of fever cases and pre-referral counseling. Between both rounds, availability of ACT increased from 80 percent to 90 percent.

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In 2022, private clinics reported 1,440 malaria cases through the social media chatbots, while community mobilizers working with 475 private providers and community-based malaria volunteers reported more than 5,500 cases, leading to the detection of two local malaria outbreaks. Local health authorities were instantly notified, allowing them to take action to contain these surges in malaria transmission. During the same time, pharmacies referred 1,630 presumptive tuberculosis cases for confirmatory testing – a third of which were diagnosed as tuberculosis and enrolled into treatment programs.

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By: Anya Fedorova, Country Representative, PSI Angola

The shortage of skilled health workers is widely acknowledged as a significant barrier to achieving Universal Health Coverage. To address this challenge, PSI supported ministries of health to develop a digital ecosystem that brings together stewardship, learning, and performance management (SLPM). The ecosystem enhances training, data-driven decision-making, and the efficiency of healthcare delivery.

Here’s what it looks like in practice.

In July 2020, PSI Angola, alongside the Angolan digital innovation company Appy People, launched Kassai, an eLearning platform that targets public sector health workers in Angola. Through funding from USAID and the President’s Malaria Initiatve (PMI), Kassai features 16 courses in malaria, family planning, and maternal and child health – with plans to expand learning topic areas through funding from ExxonMobil Foundation and private sector companies. A partnership with UNITEL, the largest telecommunication provider in Angola, provides all public health providers in Angola free internet access to use Kassai.

Kassai’s analytics system to follow learners’ success rate and to adjust the course content to learners’ performance and needs. Kassai analytics are integrated with DHIS2 – the Health Management Information System (HMIS) of Angolan MOH, to be able to link learners’ knowledge and performance with the health outcomes in the health facilities. The analytics track learners’ performance by course and gives visibility by health provider, health facility, municipality, and province. Each course has pre-and post-evaluation tests to track progress of learning, too.

By the end of 2022, there were 6,600 unique users on the Kassai platform and 31,000 course enrollments. PSI Angola’s partnership with UNITEL, the largest telecommunication provider in Angola, allows for free internet access to learn on the Kassai for all public health providers in Angola. Building on its success for malaria training, Kassai now also provides courses in family planning, COVID-19, and maternal and child health. This reduces training silos and provides cross-cutting benefits beyond a single disease.

Implementing the SLPM digital ecosystem brings numerous benefits to health systems. It allows for more strategic and efficient workforce training and performance management, enabling ministries of health to track changes in health workers’ knowledge, quality of care, service utilization, and health outcomes in real time. The ecosystem also supports better stewardship of mixed health systems by facilitating engagement with the private sector, aligning training programs and standards of care, and integrating private sector data into national HMIS. Furthermore, it enables the integration of community health workers into the broader health system, maximizing their impact and contribution to improving health outcomes and strengthening primary healthcare.

MSF Opens Maternity Center as Part of Ebola Response

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Digitalizing contraceptive counseling to reach rural women and girls in Ethiopia

Building community health worker capacity to deliver malaria care

Taking a market-based approach to scale sanitation in Ethiopia

Promoting self-managed care like Self-testing and Self-Sampling

Using peer coaches to counter HIV stigma in South Africa

simplifying consumers’ journey to care in Vietnam

Engaging the private sector for disease surveillance in Myanmar

Training health workers in Angola

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