South Africa

From the Front Lines to Prime Time: How These Health Workers’ Stories Are Reaching Millions

mnathe — Fri, 24 Apr 2020 20:02:02 +0000

From the Front Lines to Prime Time: How These Health Workers’ Stories Are Reaching Millions mnathe April 24, 2020

April 27, 2020

Jimmy Fallon and other late-night hosts are giving frontline health workers star treatment.

Back in 2017, we had an idea.

We thought that if policy-makers could hear the same stories we hear every day—about the challenges, the heartbreak, and the victories frontline health workers face on the job—they would think differently about investing in health care and the health workforce. That they would see the real, human impact those investments make.

So we tried it. We teamed up with the Medtronic Foundation and provided professional storytelling training to a handful of health workers from around the world. And then we did it again the next year with different health workers. And the next, and the next. (Listen to their stories here.)

The results have been beyond what we expected.

Resources

The Power of Storytelling: Advocacy by Frontline Health Workers

We found that the training—combined with a microphone and a platform from which health workers can reach new audiences—has helped those health workers advocate more effectively for investments in health workers in low- and middle-income countries, everywhere from their own communities to the highest levels of policymaking.

Just last weekend, Dr. Sanele Madela—a South African community physician who took part in our first storytelling training in 2017—spoke with Jimmy Fallon in front of millions of viewers about how he and his country are dealing with the COVID-19 pandemic. It was during the One World: Together at Home special that aired and streamed at prime time. Interviews with Madela and other health workers were interspersed with more than 70 celebrity appearances and performances to support frontline health workers and the World Health Organization.

Sanele explained that more than 25% of adults in his community are living with HIV and right now they need “huge assistance and help from the WHO and others to support health workers on the front line.”

Jimmy Fallon. Celebrities. Prime time. We’re delighted to see frontline health workers get the star treatment they deserve.

“Stories are among our most powerful advocacy tools,” says Vince Blaser, director of the Frontline Health Workers Coalition and advocacy advisor at IntraHealth. “They can influence global policies and foreign assistance budgets. They can change people’s minds and their communities. We’ve seen that equipping frontline health workers with the tools they need to tell their stories and advocate for the services they provide doesn’t just change health services for a few clients—it has the potential to help us reach universal health coverage for all.”

Today the COVID-19 pandemic has given the world more reason than ever to listen to what frontline health workers have to say. They know their communities’ health challenges better than anyone—and as the pandemic spreads to their countries, they face the greatest risk of infection.

“The storytelling training has created a global platform for frontline health workers to reach a wider audience and engage policy makers on first-hand experience for informed policy decisions,” says Sanele. "Speaking to such a large audience is the best opportunity any health worker can have to put our experience across advocating for change in this noble profession.”

Health workers we’ve trained have also spoken to audiences at major global gatherings, the kind that can shape the course of health care around the world. These include:

“The Medtronic Foundation is committed to health workers on the front lines of health care delivery in underserved communities,” says Jessica Daly, director of global health at the Medtronic Foundation. “Empowering their voices, ensuring they have the platforms to convey their realities, priorities, and opportunities to decision-makers and the general public, is essential to our collective progress in global health. We’re proud to partner with IntraHealth and frontline health workers like Dr. Sanele to place the microphone where it should be.”

We’re so proud to offer health workers a mic. We’re also working to make sure they have the training, equipment, and support they need to fight the COVID-19 pandemic. You can help. Donate to the COVID-19 Frontline Health Worker Fund now.

Want to hear stories from frontline health workers? Check out:

By The Editorial Team

IntraHealth International

COVID-19 Advocacy Global health security Workplace Safety Physicians South AfricaMuNFwUkfvYI

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Three Early Digital Health COVID-19 Response Success Stories

kseaton — Fri, 27 Mar 2020 13:25:34 +0000

Three Early Digital Health COVID-19 Response Success Stories kseaton March 27, 2020

March 27, 2020

Here's what makes them efficient and effective during a pandemic.

Coronavirus infection rates are climbing exponentially around the world with over 440,000 confirmed cases and 20,000 deaths so far. Governments, donors, and health workers are scrambling to find digital health solutions they can use in COVID-19 response activities.

While we desperately need innovative solutions now, we must be patient and:

Avoid pilotitis that results in more failed ICT4D interventions
Stop siloed systems development that replicates existing processes
Resist complicated technologies that divert scarce resources

We all need to follow the Principles for Digital Development as we respond to country needs. This is a world-stopping emergency, and we all are moving fast. However, we must focus on solutions that:

Foster government and community ownership
Build on existing systems and familiar technology
Incentivize long-term usefulness with flexible functionality

Only with measured and appropriate digital health technology solutions will we be efficient and effective in our response to COVID-19.

Subscribe Now for more Digital Health Case Studies

Digital Health COVID-19 Response Success Stories

There are three early successes that showcase how information and communication technologies (ICT4D) can support rapid responses to communicable disease outbreaks, like COVID-19. Each of these implementations build on the three perquisites above and decades of collective experience in emergency response within governments and across the development sector.

Let us hope that more of these 60+ digital health solutions become future COVID-19 response success stories.

Liberia Prepares for COVID-19 with mHero

IntraHealth International and UNICEF created mHero in August 2014 to support health sector communication during the Ebola outbreak in West Africa. mHero is a two-way communication platform that connects ministries of health with frontline health workers in even the remotest regions, allowing for real-time information exchange and a more effective outbreak response.

Lessons learned from the Ebola response clearly show that fast, informative communication to frontline health workers, and immediate, precise case reporting from them, were useful in engaging communities, managing rumors, and mitigating public health threats.

Today Liberia’s Ministry of Health is still using mHero as a surveillance and response platform for a range of diseases, conditions, and events. Alerts starting at the facility level can be sent to District Surveillance Officers and up through the health system to the central Ministry. The central Ministry of Health can also send out information to frontline health workers – all disaggregated by cadre or by county for targeted information or educational messages.

The government has adapted mHero to surveil for potential COVID-19 cases and send COVID-19 messages to health workers as part of the country’s response to the epidemic. This long-term usage and quick adaptation of an existing digital health solution is a prime example of why government ownership of digital health systems is critical for epidemic disease response.

South Africa Educates on COVID-19 with Turn.io

Praekelt.Org created COVID-19 Connect by using Turn.io technology that delivers automated informational responses to the most frequently asked questions about COVID-19 and the coronavirus in South Africa.

Since its launch on Sunday night with the National Department of Health, the COVID-19 Connect WhatsApp-based helpline engaged with over 1.5 million South Africans, sending over 15 million messages using the World Health Organization’s up-to-the-minute information, coupled with localized news updates and information on prevention, symptoms, treatment, risks, traveling, and testing.

WHO launched a global COVID-19 WhatsApp service, building on Turn.io’ success, to provide the latest news and information on coronavirus to 2 billion people. The service includes details on symptoms and how people can protect themselves, and provides the latest situation reports and infection numbers in real time. More than 10 million people have used the system so far.

Launch WHO COVID-19 now on your mobile phone

COVID-19 Connect shows how we can successfully introduce true innovations in an emergency by leveraging existing systems and familiar technology that is already adopted at scale. Governments already know how to localize WHO content and no users needed WhatsApp training.

Nigeria Tracks COVID-19 with CommCare

Dimagi built a free template application for CommCare, which fully implements the WHO FFX Protocol for contact tracing and case investigation to support rapid deployment of COVID-19 response solutions. More than 200 organizations accessed the template in the first 24 hours since it was released, and soon it will be updated with seven new languages.

On March 1, Ogun State Commissioner for Health Dr. Tomi Coker announced that they deployed CommCare, which was developed in less than 24 hours, for patient risk assessments and contract tracing in the southern Nigerian state.

This week, the directorate of science technology and innovation in Sierra Leone will start developing CommCare digital health solutions for contact tracing to contain the potential spread of COVID-19.

CommCare demonstrates how flexible functionality with permissive, open source licensing allows governments to adapt international solutions to local context for immediate use in fast-moving pandemics. Dimagi is even giving pro bono subscriptions for CommCare to all COVID-19 response applications through May 2021.

Potential Digital Health Success Stories

These three solutions add to a growing corpus of potential digital health solutions for COVID-19 response that we’ve featured on ICTworks:

Technologists, we need your ideas to build a truly comprehensive list of possible digital health solutions. Governments, donors, and implementers, check out the full list of 65+ potential solutions for coronavirus response.

This article was originally published on ICTworks on March 25, 2020. You can find the original post here.

By Wayan Vota

Former director of digital health

COVID-19 Digital Health Liberia Nigeria South Africa

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A Physician’s Dispatch from KwaZulu-Natal

mnathe — Thu, 29 Mar 2018 19:19:30 +0000

A Physician’s Dispatch from KwaZulu-Natal mnathe March 29, 2018

April 02, 2018

In honor of World Health Worker Week 2018, health workers from around the world are telling us what it's really like on the front lines.

What’s it really like providing health services on the front lines?

This week, frontline health workers from around the world are answering that question on VITAL, in honor of World Health Worker Week 2018.

It’s grueling, they say. Sometimes exciting. Gratifying. Heartbreaking.

Here they’ll tell us more about the clients who’ve moved them, and the unseen triumphs and tragedies that keep them coming to work each day.

Our first story is from Sanele Madela, a physician from South Africa and founder of Expectra 868 Health Solutions. Today he’s using his story to advocate for policy changes that could expand access to health care in his community and in others like it.

A physician’s dispatch from KwaZulu-Natal

I grew up in the dusty streets of KwaZulu-Natal in South Africa. We had a population that was previously disadvantaged in South Africa and, up until today, part of that population is still disadvantaged.

We played on the streets with the other kids in the community. And there was one young girl—a neighbor who was a little older than me—she had health problems that we could not understand as young kids.

One day I came back from school and there was a group of ladies, including my mother, sitting around the girl’s house gate, and people were coming in and out of the house.

I was shocked to find out that the little girl had died. We were just playing the other day. And she was sick, but I never saw her go to the hospital.

Later, I got a scholarship from the government of South Africa to go and study medicine in Cuba. I got the shock of my life to see that the population in Cuba was almost the same as the population where I grew up—they were just as disadvantaged, but they had access to health care, and that was a huge difference.

I wanted to contribute to my country's access to health, and to the quality of health care available there. So, in my third or fourth year at medical school in Cuba, I started an NGO called Expectra 868 Health Solutions. Back in South Africa, by the second year of its functioning, it employed about 97 people. I became accredited to train community caregivers, to work in the community, and profile the community the way I was taught in Cuba.

For many, it is the first time they’ve seen a doctor, been touched by a doctor.

Later, I got a grant from Medtronic Foundation and their HealthRise program, and was able to amplify what I had started by focusing on noncommunicable diseases, or NCDs, and offering screening, diagnosis, management, and care for NCDs.

HealthRise has been a game-changer in these communities. For many of these patients, it is the first time they’ve seen a doctor, been touched by a doctor—you can see in their eyes what the HealthRise project has done.

For me as a doctor, seeing people—no matter how poor—gain access to health care was the most important thing that has happened in my life. No one should die just because she doesn't have access to health care.

Estimating the Institutional Costs of Educating and Training Health Workers: Preservice Education Costing Methodology and Instruments

intrahealth — Tue, 01 Nov 2016 21:15:44 +0000

Estimating the Institutional Costs of Educating and Training Health Workers: Preservice Education Costing Methodology and Instruments 2015 intrahealth November 01, 2016

Through the CapacityPlus project, IntraHealth designed a costing study approach to: 1) estimate the financial costs to an educational institution and its associated clinical practice facilities of producing a graduate of a specific academic program; 2) identify the resource constraints to producing sufficient numbers of quality graduates; and 3) simulate the potential new unit cost to the educational institution and its associated clinical practice facilities if a scenario of interventions were introduced to increase the quantity and/or quality of graduates. The approach applies an Excel-based costing model and data collection instruments to analyze preservice education costing data derived from information about enrollment levels, curriculum data, school expenditures, payroll, and available infrastructure and equipment.

This document can be used by any individual or group that has an interest in estimating the cost of an educational program, including school leaders in both public and private educational institutions; representatives of national governmental organizations such as ministries of health or education; national technical agencies, regulatory bodies, or associations; international technical agencies; and donors and financing agencies interested in health workforce education. It is important to note that an expert in economics or costing is required to lead the study.

Preservice education costing methdology

Countries South Africa

Projects CapacityPlus

Publisher IntraHealth International

"You Never Think It Will Happen to You": Health Workers Confront the Risks of Tuberculosis

Anonymous — Tue, 27 Sep 2016 13:44:18 +0000

"You Never Think It Will Happen to You": Health Workers Confront the Risks of Tuberculosis Anonymous (not verified) September 27, 2016

March 22, 2013

Patricia Bond was working as a nurse at a health facility in South Africa when she developed some troubling symptoms. Eventually she was diagnosed with multidrug-resistant tuberculosis (MDR-TB), a dangerous form of the disease that doesn’t respond to the usual medications and is notoriously difficult to treat.

“You hear of TB,” Patricia says, “but you never think it will happen to you.”

In South Africa, one epidemic has fuelled another—HIV has sent TB rates soaring. The country now has the third-highest incidence of TB in the world, behind only India and China¹. And just by going to work every day, health workers like Patricia face major risk of exposure.

Today, Patricia is lucky to be alive. The disease and treatment robbed her of her hearing and the occupation she loved—she’s no longer able to provide care for patients. But she is able to help prevent what happened to her from happening to other health workers.

Patricia and her colleagues Dr. Bart Willems and Dr. Arne von Delft—all TB survivors—are members of an advocacy team called TB Proof, and they’re in the US to educate Americans about the risks that all health workers face on the job. Many people in developed countries don’t think much about TB at home, but TB Proof urges worldwide preventive action now before strains of MDR-TB spread more widely.

“There’s a fixed false belief that we aren’t at risk,” Bart told me when I talked with the team members in Washington, DC, this week. He’s a resident in public health medicine at Stellenbosch University. “It won’t happen to health workers—that’s the institutional message currently conveyed.”

He explains that health facilities in South Africa typically don’t educate staff about the risks of TB or how to take precautions. And many health workers who do get TB are ashamed. “Health care workers don’t report it because they think it’s abnormal [for them to get it],” Bart noted. They’re often treated in private clinics so their colleagues won’t find out. As a result, he says, “we don’t have a grip on how many health workers have TB.”

But the secrecy and lack of education can make it more difficult to prevent and contain infections and increase the risk for everyone. “Think about this as something like the Taliban becoming strong [in one country],” says team member Arne. “If you don’t deal with it, that risk will cross borders.”

In South Africa, TB Proof is trying to reduce stigma and educate the health community. But this hasn’t been easy. “We’re meeting with a lot of resistance,” Arne shares.

“Real doctors won’t get TB—that’s what the message has been,” Bart says. “But we’re acting with the new generation to be agents of change. Anyone can get TB. Raising awareness in health workers of the risk will help, and then hopefully they can protect themselves.”

These health workers’ personal stories reminded me once more of how crucial it is to keep providers safe on the job. As a colleague once said: Saving lives shouldn’t mean you risk your own. IntraHealth vigorously defends the rights of health workers to be protected from infection and other occupational hazards. All health workers are entitled to safe workplaces where they are treated with dignity—and our health workers must be protected.

This short brief from the IntraHealth-led CapacityPlus project includes practical advice for making health workers’ environments safer. TB Proof’s website and Facebook page contain further information about the specific risks of tuberculosis and how to stay healthy. And don’t forget to check out events marking World TB Day to learn more.

1. Global Tuberculosis Report 2012, issued by the World Health Organization (PDF)

By Sarah Dwyer

Former communications manager, IntraHealth International

Workplace Safety Tuberculosis World TB Day South Africa

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Courage to Change Child and Youth Lives

Anonymous — Tue, 27 Sep 2016 13:43:17 +0000

Courage to Change Child and Youth Lives Anonymous (not verified) September 27, 2016

July 28, 2015

“My dream has always been to work with children,” said Siphiwe Sikhasa, between games at the soccer field at the Safe Park in Grabouw, South Africa.

Just 45 minutes outside of cosmopolitan Cape Town, the small town with dirt roads looks like a world away.

Sikhasa is a coordinator of the Safe Park, a space where children of all ages can safely play, receive homework help, discuss issues burdening young minds, learn valuable skills, and oftentimes receive hot meals.

His passion for helping children is apparent as he runs the field and freely gives hugs and high fives.

Most days there are nearly 200 children at the Safe Park.

On this particular overcast, drizzling June winter day, there are approximately 20 children playing soccer and 110 children at the Safe Park. Most days there are nearly 200 children.

The Safe Parks are a component of the 309 Isibindi programs established in 161 communities throughout South Africa by the National Association of Child Care Workers (NACCW).Meaning “courage” in IsiZulu, Isibindi serves more than 200,000 vulnerable children nationwide, including those who live in grandparent-headed or child-headed households; have disabilities, HIV/AIDS, or other diseases; are caring for ailing family members; are victims of abuse; face struggles at school or home; or are affected by a number of other factors that could lead to unsafe situations.

In addition to working at the Safe Park, Sikhasa and other trained and supervised child and youth care workers (CYCWs) continue to help families in their immediate communities by going door-to-door to assess needs and offer support to those who need it.

Each worker aids up to 48 children, monitoring a child’s progress, acting as their confidant and providing support in various areas as needed in a child’s life. CYCWs build relationships with children through interaction in typical daily routines—cooking together, reading, household chores, and life skills.

The Nghonyama* family is one of the thousands visited 3-5 times a week by CYCWs. Since 2011, Edwina is the CYCW who has been working with the family’s five children, currently ages 5-17, and the grandmother caring for the children. Three of the children lost both parents to AIDS, one child was abused by his step-father and one was abandoned by her parents.

In all cases, Granny Nghonyama stepped in. Some are her biological grandchildren, some she calls her grandchildren.

“It doesn’t matter whose child it is,” she says. “I just have a deep love for children.”

Budgeting, homework, and overcoming the stigma associated with HIV/AIDS haven’t been easy for this blended family, but have been made easier with the help of Edwina. She has helped to link the family with additional services, including a social worker and government subsidies.

Isibindi is in the second year of a five-year scale up and is funded by PEPFAR through USAID. The goal is to train 10,000 CYCWs; to date 4,402 have been trained.

The Isibindi model has helped formalize child and youth care work as a profession. The program trains unemployed people selected by their communities in a child and youth care accredited training program.

Two universities in South Africa now offer a CYCW degree and more than 6,000 workers have been formally registered with the South African Council for Social Service Professions under a new statutory regulation championed by the NACCW.

The Para Professional Interest Group of the Global Social Service Workforce Alliance has drawn from the expertise of NACCW and many others to develop a competency framework for paraprofessionals that includes a section on functions and competencies specific to auxiliary child and youth care workers. The framework is being tested and a first edition will be released later this year. The competencies build upon the Alliance’s global efforts to help plan, develop, and support all levels of workers who make up the social service workforce.

The Safe Park model is being replicated in Kenya, Zambia, and within South Africa.

In South Africa, the program has been embraced by the government as a best-practice model. Several other countries have expressed interest in developing new cadres of CYCWs and are receiving support from NACCW to do so.

Ministers from the county government of Kisumu, one of 47 county governments in Kenya, recently visited the Grabouw Safe Park and met families benefiting from the support of CYCWs.

“We have engaged the South African network to advise us and help us launch the Safe Park model,” said Jennipher Atieno Kere, Executive Member for Education, Youth, Culture, Gender, and Sports. “I want to…learn how to implement this program.”

The Safe Park model is also being replicated within South Africa by more than 20 other organizations and in Zambia.

“While the NACCW developed this program, we’re happy to share it with the world,” said Zenuella Thumbadoo, Deputy Director, NACCW. “These child and youth care workers are impacting one life, one family, and one community at time, leading to real change here in South Africa, and eventually around the world.”

As Sikhasa continues to develop his skills as a CYCW, he prides himself on being a positive male role model to the young lives he influences. “I have younger siblings who have always looked up to me,” he says, “and I want to continue to be a model for them, and all kids.”

*names changed to protect the identity of the familyThis post originally appeared on the blog of the Global Social Service Workforce Alliance. IntraHealth International serves as the host and fiscal sponsor of the alliance.

By Nicole Brown

Communications manager, Global Social Service Workforce Alliance

Policy & Advocacy Youth Engagement Social Service Workers South Africa

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Once an At-Risk Youth, Thembi Becomes a Child & Youth Care Worker

Anonymous — Tue, 27 Sep 2016 13:43:17 +0000

Once an At-Risk Youth, Thembi Becomes a Child & Youth Care Worker Anonymous (not verified) September 27, 2016

November 05, 2015

After Thembi’s* parents passed away from an illness when she was in Grade 11, she and her brother, in Grade 8 at the time, moved in with their grandmother.

It was not an easy transition for any of them.The grandmother did not work; in fact, she was old enough to be dependent upon government grants for the elderly. The money was not adequate for her to cope with the sudden growth in the household and with the needs of two growing school-aged children. She was not able to afford the children’s school uniforms and other material needs.

They were struggling, with no means to access what was needed to steer them out of their bleak reality. The highly stressful situation impacted the grandmother’s health; she developed a high-blood pressure condition. Unfortunately, the story is not uncommon in the many granny-headed families in South Africa.

Each worker aids up to 48 children, monitoring their progress and acting as their confidant.

If the parents pass away, there is oftentimes no financial, material or psychosocial support for the children. Sometimes proper identification is not available. Who helps vulnerable children to respond to these crises

?A Child and Youth Care Worker Intervenes

In 2010, Lungi, an Isibindi Child and Youth Care Worker (CYCW) intervened. She explained the program, its purpose, and services to the grandmother.

Developed and implemented by the National Association of Child Care Workers (NACCW), the Isibindi program is serving more than 180,000 orphans, at-risk or vulnerable children throughout South Africa. Each worker aids up to 48 children, monitoring a child’s progress, acting as their confidant and providing support in any areas as needed in a child’s life. CYCWs build relationships with children through interaction in typical daily routines—cooking together, reading, household chores and life skills.

The grandmother was both pleased and relieved to be immediately registered in the program and receive additional support for herself as well as the children. The CYCW assisted the family in applying to the Department of Social Development for a foster grant. She also helped with Christmas gifts during that first, difficult year.

Over time, this new, blended family was able to begin saving money toward future schooling.

Lungi saw the need for grief counseling to help the family cope with their losses. In addition, life-space counselling played a big role in teaching the family to communicate and develop routines for sharing responsibility for household chores and they were taught effective behavior management skills to strengthen their family.

Lungi also encouraged and supported the family to grow a food garden; this project was a great success and was even formally approved by the Department of Agriculture.The CYCW also arranged for the children to participate in the city’s soup kitchen breakfasts and lunches. With full bellies, the children were better able to concentrate on their school work. She also participated in regular school visits and helped with homework.

Thembi Joins the Isibindi Team

Thembi completed her schooling in 2011; then her CYCW advocated successfully for funds to enable her to further her education. She was accepted into the Human Resources program at at local college in 2012. Following graduation, in 2014, Lungi further encouraged Thembi to apply for a CYCW post. She was selected for the job in this exciting new initiative.

She taught me the importance of education and loving life.

Once an at-risk youth herself, she had now graduated to become a service provider to others facing difficult situations.

“The skills that are important to me as a CYCW are observation, communication, listening, and facilitation,” said Thembi. “My relationship with Lungi means a lot. She taught me the importance of education and loving life. She is an important role model to me.”

Meaning “courage” in IsiZulu, the Isibindi program is in the second year of a five-year scale up and is being funded by PEPFAR through USAID. With a goal of training 10,000 CYCWs, to date 4,402 CYCWs have been trained.

Read Part 2 of Thembi's story next month. Her story will be posted to the Global Social Service Workforce Alliance blog and included in the December member e-update.

*Names changed to protect identity.

This post originally appeared on the blog of the Global Social Service Workforce Alliance.

By National Association of Child Care Workers

South Africa

Policy & Advocacy Youth Engagement Social Service Workers South Africa

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To Achieve an AIDS-Free Generation, We Need More Problem Solvers

Anonymous — Tue, 27 Sep 2016 13:42:51 +0000

To Achieve an AIDS-Free Generation, We Need More Problem Solvers Anonymous (not verified) September 27, 2016

August 12, 2016

My professional interests and work priorities are centered on HIV prevention and treatment programs, particularly working with key populations, prevention of mother-to-child transmission (PMTCT), male involvement, and service integration.

I wish I could say I discovered some fantastic, innovative new programming interventions when I attended the 21st annual International AIDS Conference in Durban last month. But despite the hundreds of presentations, thousands of posters, and a steady stream of celebrity appearances—including Charlize Theron, Prince Harry, Elton John, and Edward Cameron—I didn’t.

I went from session to session, poster to poster, looking for that kernel of innovation to inspire me. However, it seems that programmatically, we continue to do a variation of the same demand creation and service delivery models we’ve been doing to address the HIV epidemic for years.

Mobile technology and social media have made some activities more efficient, but these are still somewhat limited to urban populations and countries where there is high mobile phone use.

Medical innovation alone doesn’t always lead to success.

Yes, medical innovation continues. Pre-exposure prophylaxis (or PrEP) in particular was highlighted during the conference. But medical innovation alone doesn’t always lead to success.

“The truth is we have every tool we need to prevent the spread of HIV,” Charlize Theron said in her remarks. “Every tool we need. Condoms. PrEP. PEP. ART. Awareness. Education. And yet 2.1 million people, 150,000 of them children, were infected with HIV last year.”

It’s the “and yet” piece I was expecting to get some insight into.

In the end, it was South Africa’s presentation on the success of its PMTCT program that stood out to me. Their journey has been long and challenging, but the presenters cited impressive results, including:

More than 95% antiretroviral (ART) coverage among pregnant HIV-positive women (up from ~80% in 2009)
95% early infant diagnosis coverage
1.5% mother-to-child transmission rate at 6 weeks (down from 8.2% in 2008)
Approximate 84% reduction in new pediatric infections since 2009
450,000 new pediatric HIV infections averted since 2009
74% coverage of ART in children aged 0-14 years (up from only 53% in 2012).

His question to any challenge is: what do you need to make this happen?

What contributed to this success wasn’t anything new, but a case of doing what we know works and getting it right. The presenters credited the following combination of factors:

Unwavering commitment by the minister of health, the PMTCT Technical Working Group, and leaders at provincial and facility levels.
Rapid policy changes to implement new World Health Organizations guidelines—such as Option B+ and testing exposed infants at ten weeks instead of six—as soon as they were published.
Strong, continuous activism. South Africa’s Treatment Action Campaign (TAC), founded in 1998, is widely acknowledged as one of the most important civil society organizations active on AIDS in the world. One of its most significant victories was the 2002 Constitutional Court ruling in which the South African government was ordered to provide antiretroviral drugs to prevent transmission of HIV from mothers to their babies during birth.
Standardized data collection tools and triangulation of data from various sources. Data are regularly analyzed by the national PMTCT Technical Working Group to inform policies and programs and to identify weak system links and barriers to the uptake of services.
Task shifting, integration of services (maternal, newborn, and child health/PMTCT), and continuous mentorship and supervision at health facility and community levels.
Community structures and innovations for referrals and linkages. South Africa created the successful mothers 2 mothers support group model and more recently , a National Department of Health initiative for registering pregnancies. Pregnant women can use a cell phone app to register themselves, or be registered by a community health worker or a health care professional at a facility. The women receive regular free messages with updates on the stages of their pregnancies and reminders about routine medical follow-ups. The program also enables women to voice their opinions about the services they receive at local health care facilities.

These factors are nothing new. But what struck me is that South Africa has managed to get all these pieces working together toward the same goal, which in and of itself is incredible.

At the end of the presentation I asked one of the presenters what she thought contributed to such a strong and coordinated PMTCT program. Her answer was that the minister of health is a problem solver. His question to any challenge is: what do you need to make this happen?

These results are a wonderful reminder. We know what we need to do to achieve an AIDS-free generation, but it’s going to take steadfast leadership and commitment to get there.

By Kate Stratten

Vice president, programs

HIV & AIDS International AIDS Conference South Africa

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Africa Will be Short Six Million Healthcare Workers by 2030, But it Can Still Achieve its Commitment of Universal Health Care if it Takes Action Now

Anonymous — Wed, 14 Sep 2016 13:04:18 +0000

Africa Will be Short Six Million Healthcare Workers by 2030, But it Can Still Achieve its Commitment of Universal Health Care if it Takes Action Now Anonymous (not verified) September 14, 2016 June 15, 2016

Dr. Kate Tulenko is a physician and global health specialist who acts as Vice President of health systems innovation. In her recent article, Dr. Tulenko discusses Africa's commitment to universal health care.

Excerpt:

Sub-Saharan African populations and economies are growing at unprecedented speed with a population growth of 2.7% and economic growth of 4.4% annually. Africa has the fastest growing middle class in the world, with 313 million people (roughly the population of the US), 34% of Africa’s population. This growing middle class is demanding higher quality and more specialized medical care from both the public and the private sector. At the same time, all African countries have committed to providing Universal Health Care to their populations, which will require a dramatic expansion in the provision of health services.

Yet a number of bottlenecks are making this difficult to achieve. Africa, despite having the world’s largest disease burden, has the lowest ratio of health workers per population. In recent work that IntraHealth conducted with the World Health Organization, we calculated that the global shortage of health workers will expand from 12 million to 18 million by 2030, with a 6 million shortage in Africa. With the fastest growing population in the world and some of the worst high school graduation rates, Africa will be challenged to train enough health workers.

Read the full blog post here: "Africa Will be Short Six Million Healthcare Workers by 2030, But it Can Still Achieve its Commitment of Universal Health Care if it Takes Action Now"

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Africa Will be Short Six Million Healthcare Workers by 2030, But it Can Still Achieve its Commitment of Universal Health Care if it Takes Action Now