SCIH Update

Winter 2015

SDC’s HPSS Project Improves Availability of Medicines in Dodoma, Tanzania

Present to celebrate the PV system launch were as pictured, behind table – Karin Wiedenmayer/SwissTPH, Swiss Ambassador Olivier Chave, Deputy Minister of Health Steven Kebwe, Regional Commissioner Rehema Nchimbi; front of table: acting Regional Medical Officer Zainabu Chaula, Regional Administrative Secretary Rehema Madenge.

SCIH helps launch the Prime Vendor (PV) system, a new public-private partnership (PPP) to improve medicines supply as part of the Health Promotion and Systems Strengthening (HPSS) project funded by the Swiss Agency for Development and Cooperation (SDC).

 

Access to medicines and medical supplies is a crucial element in the success and reputation of a health system. When the complex chain of supply for medicines breaks down, as it can at many points, the result can be shelves that are often bare, patients with treatable diseases suffering or dying, health workers under stress with fewer treatment options, and people’s lost confidence in their health care and insurance system. Quantifying the problem, a survey in 2012 in Dodoma revealed that 46% of essential medicines were out of stock.

 

To tackle this problem of out of stock medicines, in September the SDC-funded HPSS project launched a new system in the Dodoma Region of Tanzania, a unique public-private partnership (PPP) called the Prime Vendor (PV) system.  The PV system is a PPP between the health authorities of the Dodoma Region and a private supplier. The objective is to supplement the gap in medicines supplies of Medical Stores Department (MSD) with supplies from a single vendor in a pooled regional approach.The PV system pools supplementary medicine orders from all Districts and then purchases from one supplier – the prime vendor.  This pooling allows for lower procurement and delivery costs for the needed medicines and supplies.  These medicines will be paid from regular funds such as Community Health Funds (CHF), National Health Insurance Funds (NHIF), user fees, and basket funds.

 

The PV system is a component of the SDC-funded, Swiss TPH-implemented HPSS project, or Tuimarishe Afya Project, launched in 2011 to support Tanzania’s Dodoma Region in areas of health insurance, community health promotion, and pharmaceuticals management, and health facility maintenance and repair services. 

 

After a transparent tendering process, a local supplier was selected as PV for the project, to work in partnership with MSD, Tanzania Food and Drug Authority, the Pharmacy Council, and the Pharmaceutical Services Section of the Tanzanian Ministry of Health and Social Welfare (MoHSW). Signing of the contract with the selected PV is not the end of the story. Other activities to improve access to medicine – an operational handbook and SOPs for health facilities and districts, guidelines for good clinical practice on prescribing and using medicines, logistic coaching and training, improved supervision and financial audits – themselves have already shown an increase in medicines availability from 54% to 70%. 

 

Karin Wiedenmayer, component leader for medicines management at the HPSS project, developed the concept and managed the implementation of the Prime Vendor system in collaboration with two senior Tanzanian consultants.   Karin emphasized, “in addition to starting these new procedures, more measures are critical for success, such as auditing to avoid leakage and improved use of medicines to promote better health outcomes.”  

New ICATT/IMPACTT Website online

In November 2014 the new Integrated Management of Childhood Illnesses (IMCI) Computerized Adaptation and Training Tool (ICATT) and Integrated Management of Pregnancy and Childbirth training tool (IMPACtt) website was launched. WHO was supported by Swiss TPH and the Novartis Foundation in creating the new website: www.icatt-impactt.org.

 

To continue efforts to reduce maternal, newborn and child mortality the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) developed the IMCI and IMPAC programmes as key strategies to drive the progress of maternal, newborn and child health through improving skills of health workers to better respond to their patients special needs. Multi-country evaluations show that IMCI is cost-effective and helps improve health worker performance and their quality of care, ultimately contributing to reducing under-five mortality. Both programmes have been introduced in over 100 countries. 


Tools to Improve the Quality of Care: In order to tackle the maternal, newborn and child health challenges, the Novartis Foundation (www.novartisfoundation.org) and the Swiss TPH have supported the WHO in the development of the eLearning tools, ICATT and IMPACtt. ICATT facilitates the adaptation of IMCI guidelines to meet country-specific requirements as well as to help scale up IMCI training. Based on the ICATT software, IMPACtt currently comprises the training module on essential newborn care, the module on antenatal care is currently under development and two further modules on childbirth care and postnatal care are planned. Both eLearning tools are maintained by the Swiss TPH and downloadable from the new website: www.icatt-impactt.org.

Rudolf Geigy Award to Fund Training of Health Professionals in Burundi

Geigy award winners for “Connecting the Dots” project along with RGS board members and Swiss TPH Director Marcel Tanner.

This past December, the R. Geigy Foundation (RGS) conferred an award to the Swiss TPH Jubilee Project “Connecting the Dots” - a project to build the capacity of health professionals in Burundi and across East Africa’s Great Lakes Region 

 

The RGS sponsored a special Jubilee Award to honour the 70 years of success of Swiss TPH.  Among a competition of over 18 proposed projects, an award 70,000 CHF will go to jump start a program in Burundi.  The project puts into action the Swiss TPH strategy of improving health through a combination of research, teaching, and implementation of health projects.  The “Connecting the Dots” project will link the expertise of different Swiss TPH departments with training modules to increase managerial and financial capacities local health professionals.  The Great Lakes Region (Rwanda, Burundi, DR Congo) has become a major area of Swiss TPH activities, with a local headquarters in Bujumbura, Burundi acting as a hub for three, multi-country programs in the region 

 

Teaching and Training as Major Pillars: ‘Connecting the Dots’ especially focuses on capacity building in collaboration with the National School of Public Health in Burundi. It proposes comprehensive training modules to increase managerial and financial capacities, and on qualitative research methods.  “This project really opens up new prospects,” says Manfred Zahorka, Head of SCIH’s Sexual and Reproductive Health Unit and promoter of the project. “Not only will this help to facilitate other Swiss TPH projects with better skilled personal, but teaching at these institutions also helps to spread the professional image of Swiss TPH in the several countries.”

Update on Development of the Second Generation Global Malaria Action Plan (GMAP2)

RBM’s GMAP2 will coordinate technical strategy with social action at all levels to move toward a malaria-free world.

The process of developing GMAP2 for the period 2016-2030 is well underway. Over 1,500 people from over 60 countries have been directly consulted during community and country-level consultations, with many more engaging via social media. See www.gmap2.org and https://twitter.com/gmap_2.

 

The document positions malaria in the post 2015 era of the Sustainable Development Goals. It demonstrates how the disease is not only a health issue, but is also a developmental, political, health security, environmental, climatic, agricultural, educational, biological, and social issue. It makes the global case for investing in the fight against malaria, and provides direction to future actions for the Roll Back Malaria constituencies, the non-health sectors, the wider health sector, and affected communities alike.  

 

The 3rd draft of the document is now with the Roll Back Malaria (RBM) Partnership Board members. It will then be updated for public review in English by mid February 2015, with French and Spanish versions available by end of February.

Upcoming Event: Next Summer School for Healthcare Management in the Carpartian Mountains

Building on the success of the first Ukrainian-Swiss Summer School for Health Care Managers in the Carpathian Mountains, SCIH is planning the second summer school to share practical managerial skills necessary to facilitate health care reforms. 

 

SCIH is actively planning the launch of the next Summer School for Healthcare Management in the Carpathian Mountains. Inspired by and modelled on the Swiss Summer School in Public Health Policy, Economics, and Management in Ticino, Switzerland, this regional Summer School is platform for not only health care managers to discuss and share ways to support health system reforms.  Encouraged and supported by SDC, additional support and participation comes from The World Bank, WHO, UNICEF, and the Ukraine Ministry of Health. It is intended to include participants from Ukraine, Moldova, Georgia and Belarus to constitute a regional centre of learning.

 

The course will feature lectures by Swiss TPH Director Marcel Tanner on health system decentralisation, along with other eHealth solutions for health care by SCIH HTTU staff among other topics. A number of other senior lecturers from Ukraine, World Bank, UN organisations and neighbouring countries will participate. 

Upcoming event: Swiss TPH Spring Symposium, 23 April 2014, “Community Participation in Public Health: What Added Value in Research and Implementation?”

Next April’s Spring Symposium will bring together practitioners to discuss the feasibility, sustainability, and equity of approaches for community participation in public health.

Each year SCIH organises the Institute’s Spring Symposium to bring current issues and topics to the forefront drawing on knowledge across Swiss TPH and the global health community.

 

Mark your calendars for the Swiss TPH Spring Symposium scheduled for Thursday, 23 April 2015 in Basel.  The Spring Symposium will provide a platform to reflect on the added value of community participatory approaches in public health.  Since the early 1970s, participatory approaches involving community members have been used in the public health sector as a strategy to improve the quality of health services as well as their accessibility. Today, although many organizations promote the use of community participation in public health research and interventions, the feasibility and impact of these approaches often remain uncertain because of the challenge of generating sound evidence on results and outcomes. In recent years, there has been a heightened interest in strengthening the evidence base of these participatory approaches, to elaborate specific international guidelines and standards and implement effective and sustainable approaches. 

Recent event: “Not without Us!” Youth and sexual and reproductive health in international cooperation – Medicus Mundi Switzerland Health Cooperation Symposium, 5 Nov., 2014

Several SCIH staff presented and attended the Medicus Mundi Health Cooperation Summit. This conference showed how questions of population growth and social and economic development can only be tackled by taking up a rights-based approach. The topic took up where things stand 20 years after the adoption of the Cairo action plan, which strung together family planning, development policy and strengthening women’s rights.  At this year’s symposium, speakers, including SCIH’s Adriane Martin HIlber, addressed opportunities for further progress and stressed the continuing importance and relevance of the Cairo 1994 findings for international health cooperation.

New Publication:Biennial Report of the Swiss Tropical and Public Health Institute

The 2013-2014 Biennial report of Swiss TPH is now available.  This publication provides an overview of Swiss TPH and recent accomplishments and further institutional development.  It covers the Institute’s fifteen Key Areas of Activities from basic research to travel and tropical medicine.  It highlights the work of the five departments along with the Institute’s Teaching and Training Unit.  2014 coincided with Swiss TPH’s 70th anniversary celebrations and the transition into the Institute’s new strategic plan 2017-2020.  The report has “spotlight” features on significant accomplishments and contributions to improving global health such as new ways to tackle malaria, health promotion and system strengthening contributions, a brief timeline of the Institute’s 70 years, long-term partnerships cultivated by Swiss TPH, as well as Swiss TPH publications and public interest events and media coverage.  

 

The 2013-2014 Biennial report is available at the Swiss TPH website publications page

New Publication: Journal of Global Health: Integrated Community Case Management programming in Africa

A Journal of Global Health special supplement highlights latest evidence on integrated community case management (iCCM) for childhood illnesses in Africa. iCCM is an approach to provide lifesaving treatments to children who lack access to health services.

 

Entitled “Current scientific evidence and future directions for Integrated Community Case Management in Africa,” the in-depth supplement synthesizes the latest available evidence around eight thematic areas of iCCM programming: 

1. Coordination, Policy Setting and Scale up 

2. Human Resources and Deployment 

3. Supervision & Performance Quality Assurance 

4. Supply Chain Management 

5. Costs, and cost effectiveness and financing 

6. Monitoring, Evaluation & Health Information Systems 

7. Demand generation and social mobilization 

8. Impact and outcome evaluation


Additional papers included in the supplement address engagement of the private sector to improve access to iCCM treatment, how iCCM can be used to improve newborn health, global research priorities for iCCM, and a proposed way forward for improving and sustaining iCCM programming. All papers are available online.  Much of the work included in this supplement is based on information shared at the 2014 Global iCCM Evidence Review Symposium held in March 2014 in Accra, Ghana where over 400 individuals from 35 countries in sub-Saharan Africa and 59 international partner organizations gathered to share experiences and plan future efforts. More information regarding the 2014 iCCM Evidence Review Symposium is available here.  The Journal of Global Health’s Special Supplement issue on iCCM is available to view here.

 

SCIH’s Xavier Bosch-Capblanch contributed with a review paper entitled 'Training, supervision and quality of care in selected integrated community case management (iCCM) programs: A scoping review of programmatic evidence'. Xavier leads SCIH’s Health System Support Unit’s Data Evidence Evaluation and Policy" (DEEP) group.

Newly Awarded

SDC selects SCIH to implement Affordable Quality Healthcare Project in Kosovo 

The 4-year program continues SDC’s support to Kosovo’s health system and current reforms

 

Along with much infrastructure, the Kosovo healthcare system was severely damaged during the conflict of 1998-1999. The rebuilding of Kosovo’s health system has been difficult, with continuing problems of inefficiencies, lack of coordination, underfunding of public health, inadequate health services management, inadequate numbers of skilled doctors and nurses, poor medical equipment, insufficient supply of essential drugs, corruption, and lack of access to quality medical care particularly by vulnerable groups, such as Roma, Ashkali and Egyptian communities. Historically, Switzerland has been supporting Kosovo’s health system since 2001.  Building on this support, SDC designed the Affordable Quality Healthcare (AQH) Project to address some key challenges to establishing a sustainable health care system that offers qualitative services to Kosovo’s population, including socially vulnerable communities.

 

The overall goal of the new AQH Project will be to ensure that the health of the population of Kosovo has improved, with strengthened healthcare providers and managers able to meet the needs of the patients (especially vulnerable groups), who are more aware of their rights and needs.  The AQH Project will focus on specific municipalities and health facilities, mainly at the Primary Health Care (PHC) level.

 

The project focuses on three outcomes:  (1) Primary Health Care providers better trained and equipped to perform quality services in priority clinical areas; (2) municipal and facility level managers empowered to efficiently and effectively plan and manage; and (3) Health awareness of the population increased and patients’ needs are better known and considered by providers through enhanced processes of feedback/interaction with health authorities.

 

The project will work within Kosovo’s reform agenda that is underway and with other donor-funded projects such as the Work Bank’s Kosovo Health Project, the Swiss Trust Fund with the World Bank, and LuxDev’s health sector support.

The 7 million CHF, 4-year project will soon begin with an inception phase of nine months.

 

The project adds to Swiss TPH’s experience implementing national health projects in the Balkans and Eastern Europe.  Swiss TPH, along with its project partner, Save the Children, will establish a Project Implementation Unit and country-based team in Kosovo.  Manfred Zahorka will be Project Director, with Florence Secula as Project Manager, and Debra Stevenson as in-country Team Leader.

 

 

SCIH selected for independent evaluation of UNFPA Adolescents and Youth Programs

SCIH has begun an evaluation that will provide an assessment of programs funded to improve the health and well-being of adolescents and youth around the world

 

The sexual and reproductive health and well-being of adolescents and youth, which make up one-quarter of the world’s population, has been a priority integrated into the global health agenda and in the Millennium Development Goals (MDGs 2-3-5-6-8) since 2005. The United Nations Population Fund (UNFPA), guided by its Strategic Plan from 2008-2014 has prioritised the adolescent and youth agenda globally, including support to the most vulnerable adolescents and youth, particularly adolescent girls.  

 

SCIH has been selected to conduct an in-depth thematic evaluation of UNFPA’s adolescent and youth programs globally.  Such a world-wide, in-depth look at regional and country programs has not been conducted before, so the results of this evaluation will provide important knowledge, findings, lessons learned, and evidence for informed decision-making from UNFPA’s support for the past seven years.  The evaluation will contribute important evidence to the planned mid-term review of UNFPA’s Strategic Plan (2014-2017).  The evaluation, designed to be inclusive - encouraging the participation of beneficiaries – and transparent, will cover adolescent and youth programs at global, regional and country levels through case studies, interviews, focus groups, and surveys as well as social media outreach.  The evaluation will be presented to the UNFPA Executive Board in 2016.

 

UNFPA is the world's largest multilateral source of funding for population and reproductive health programs. The SCIH evaluation team will work closely with the UNFPA’s own Evaluation Office throughout the country case studies and visits. SCIH’s Sexual and Reproductive Health Unit (SRHU) staff will conduct the evaluation.  Adriane Martin-Hilber is evaluation team leader, with Kate Molesworth providing additional evaluation expertise, with case studies and report writing support of SCIH colleagues. 

 

 

SCIH to conduct follow-up survey to evaluate impact of the Niger Safety Nets Project

The World Bank and the Government of Niger have selected SCIH and its local partner, RISEAL-Niger, to conduct a survey of the social protection system running since 2012

 

The World Bank and the Government of Niger are implementing an impact evaluation of the cash transfer component of the Niger Safety Nets Project to rigorously evaluate its effectiveness in reducing poverty, as well as improving nutrition and development of children below age 5. Niger is one of the poorest countries in the world and faces severe challenges in early childhood nutrition and development. The Safety Net Project established a system which is trying to increase access of poor and food insecure people to cash transfer programs and provide parental training on health, nutrition, and sanitation.  It is being implemented in several regions that suffer the highest concentrations of poverty in Niger.  

 

To follow up on a 2012 baseline and child survey, SCIH staff is conducting a survey among a sample of over 5,000 households and 6,500 children under five. SCIH is working with the local partner, RISEAL (Réseau International Schistosomiases Environnement Aménagements et Lutte), an NGO formed to tackle infectious diseases. The project will add to SCIH’s work in Niger, where it has conducted project work since 1987 and has a local presence as Global Fund Local Agent.  SCIH recently conducted a sanitation behavior survey for the World Bank Water and Sanitation Program.

 

This intensive survey and data project, which will run from now, October, through February 2015, will be managed by SCIH's staffers Kaspar Wyss, with Alexandra Nicola as study coordinator, Peter Steinmann as survey specialist, and RISEAL's Amadou Garba as  team leader in Niger.

Staff News

Kasper Wyss, Deputy Head of SCIH, and Head of SCIH’s Health Systems Support Unit is now a full professor (“Titularprofessor”) at the University of Basel.  In December, he was appointed as a Professor of the Faculty of Natural Sciences, in recognition of his teaching and research in Public Health and Epidemiology.  Kaspar has been a ”Privatdozent” at the University since 2006.