MSH uses proven approaches developed over 40 years to help leaders, health managers, and communities in developing nations build stronger health systems for greater health impact. We work to save lives by closing the gap between knowledge and action in public health. Since its founding in 1971, MSH has worked in over 150 countries with policymakers, health professionals, and health care consumers to improve the quality, availability and affordability of health services.
Scroll down to learn more about our impact in 2014.
Above photo: Warren Zelman
To improve the health of its population, the Rwandan government places a strong emphasis on building the information, human resources, quality improvement, and financial systems necessary to support a well-functioning health system. MSH has supported these efforts by leading several USAID-funded projects: the HIV Performance-Based Financing Project (2004–2009), the Integrated Health Systems Strengthening Project (IHSSP, 2009–2014), and now the Rwanda Health Systems Strengthening (RHSS, 2014–2019) Project. RHSS works, as did IHSSP, at all levels of the health system, from the community through the national Ministry of Health, to ensure all residents’ access to high quality services.
Since 2005, Rwanda’s 45,000 community-based health workers have provided preventive and curative care. In 2010, IHSSP worked with the Rwandan government to provide performance-based financial incentives (payments based on results) to the country’s 45,000 community health workers and helped them form cooperatives that invest their income in local businesses, creating a stable income stream for each member.
To ensure access to facility-based care, in 2004 Rwanda launched one of the first national community-based health insurance programs in the region covering the majority of its population. The program increased use of services, but was financially unstable and the payment scheme was inequitable.
In 2009, IHSSP worked side-by-side with the Rwandan Ministry of Health to revise the system’s structure, creating a sliding-scale for premiums. The project also helped build a database that allows the government to assign each Rwandan household to one of three economic groups. Those in the poorest group, about 25 percent of the population, do not pay an insurance premium or service fees at any public facility. The new system was rolled out nationwide in 2011. Since then, the number of outpatient consultations at all Rwandan facilities has increased by nearly 25 percent. The revised system helped more than triple the total amount of contributions from health insurance members, strengthening the system’s financial standing.
With IHSSP support, Rwanda developed a computerized system to gather, store, and analyze health information. IHSSP trained health workers at all levels—from rural health centers through the National Ministry of Health—to use data to help better understand the health of the population and design interventions to address local health needs.
Above photo: Todd Shapera
The current generation of 1.8 billion adolescents—a quarter of the world’s population—is the largest in history. MSH invests in the health of youth and engages them as leaders capable of generating dynamic ideas, creating new solutions, and mobilizing resources for sustainable health systems in their communities.
In the Padre Abad district of Peru, teenage girls are nearly twice as likely to become pregnant than their peers across the country. MSH’s Healthy Communities and Municipalities II (HCM II) project, funded by USAID, launched an initiative in the district to improve communication between parents and their kids, increase activities for youth, and put adolescent health on the agenda of the local government. The project mobilized communities through communication campaigns, art contests, family visits, and workshops for parents and teens.
As a result of the teen workshops, over 200 youth reported that they boosted their knowledge of family planning, their leadership skills, communication with their parents, and their self-esteem. HCM II also met with local officials, who were motivated by the community engagement: neighborhood councils facilitated project activities, leveraged 60 percent of the total budget for the initiative, and developed proposals to support adolescent health going forward.
In May 2014, MSH’s Leadership, Management and Governance (LMG) Project co-hosted an event on youth leadership for family planning at the World Conference on Youth in Colombo, Sri Lanka. The conference brought together over 1,500 youth delegates to create an action plan for including young people in the post-2015 global development agenda. MSH partnered with the International Family Planning Federation and the International Youth Alliance on Family Planning to host the event, which supported teens’ leadership capability to address health issues that directly affect them.
Above photo: Leslie Alsheimer
Each year, nearly 300,000 women die from causes related to pregnancy and childbirth. Approximately 7.6 million children do not live to see their fifth birthday. Most of the major direct causes of maternal and child mortality are preventable. MSH’s maternal and child health interventions begin before pregnancy, with integrated family planning and HIV services, and continue through the life of the child.
After a smooth pregnancy, Marie Miambokila Mumba of Democratic Republic of the Congo (DRC) gave birth in August 2014 with a skilled birth attendant, Judith Kambuyi. Moments after the baby was born, Kambuyi realized Mumba was delivering a second baby, who was struggling to breathe.
Kambuyi immediately identified the problem and resuscitated the infant. Mumba’s child was one of 22 babies saved in 2014 by Kambuyi and other birth attendants at the hospital after they completed a training in detection and treatment of newborn conditions. The training, designed and proven effective for resource-limited settings, was organized by the 2010–2015 DRC-Integrated Health Project (DRC-IHP), an MSH project funded by USAID.
“It is a source of pride to save lives,” says Kambuyi, who went on to train local midwives in the same techniques.
New mothers are proud as well when they can help their babies. Through DRC-IHP, more mothers of premature infants are advised to hold their babies skin-to-skin to keep them warm— a technique called kangaroo care. DRC-IHP works to unite existing health service providers in DRC under a strategy to provide integrated management of maternal and child health.
In Ethiopia, MSH helped expand HIV and AIDS services by integrating them into maternal and child health and other services. The 2011–2015 Ethiopia Network for HIV/AIDS Treatment, Care and Support (ENHAT-CS) program, a USAID initiative funded by PEPFAR, built on Ethiopia’s nationwide continuum of care from communities to hospitals.
In 2014 at ENHAT-CS health centers in the Amhara and Tigray regions, 97 percent of women receiving antenatal care were tested for HIV and received their results; of those who tested positive, 87 percent received antiretroviral therapy, up from 45 percent who received treatment in 2011. Standard antiretroviral therapy (ART) consists of the combination of at least three antiretroviral (ARV) drugs to suppress the HIV virus and stop the progression of HIV disease.
Above photo: Warren Zelman
MSH’s MIKOLO project, funded by the US Agency for International Development (USAID), supports Madagascar’s stability by strengthening locally owned, community-based, integrated health services—with a women-centered approach.
MIKOLO strengthens health services for women and children, and promotes gender equality by encouraging couples to work together on health issues at home and empowering women as health educators.
In 2014, MIKOLO trained 120 women leaders, among them Solange Helene Rasoanirina (above), who at age 24 has become a primary source for health information in her village.
After completing MIKOLO training, Rasoanirina organized a women’s association to promote healthy practices, such as encouraging parents of sick children to consult community health volunteers. Since Rasoanirina was trained in June 2014, these consultations have resulted in 235 children treated for fever, 110 for acute respiratory infection, and 20 for diarrhea.
Above photo: Fanja Saholiarisoa
In Nigeria in 2014, MSH’s PLAN-Health program assisted two state governments in launching the first community-based health insurance plan to cover small-scale business owners, farmers, traders, artisans, and others. PLAN-Health is funded by PEPFAR through USAID and supports Nigeria’s goal of increasing coverage from 10 to 30 percent by 2015.
In Akwa Ibom State, where there had been no previous coverage, nearly 300 people gained insurance between August and December. In Rivers State, eight months after PLAN-Health developed an automated web system and performance-based financing system, coverage increased more than tenfold—from 556 to 5,656 people.
The achievements in Rivers State were made possible by a public-private partnership between PLAN-Health and the Shell Petroleum Development Company.
Above photo: Gwenn Dubourthoumieu
The MSH initiative to improve private community health shops—often people’s first source for medicines and family planning supplies—has brought high-quality care to nearly 36 million people in Tanzania, Uganda, Liberia, and Zambia. This public-private innovation, supported by the Bill & Melinda Gates Foundation and others, has resulted in 10,000 accredited drug shops. Women make up 90 percent of the shop owners and medicine dispensers. They provide reliable health information and supplies close to home, boost local economies, and promote gender equality. MSH President and CEO Jonathan D. Quick shared results of the program at the 2014 Clinton Global Initiative Annual Meeting.
Above photo: Brooke Huskey
In late 2013, when health facilities in Democratic Republic of the Congo (DRC) ordered supplies from local vendors, it took seven to ten months for them to be delivered. By the end of 2014, MSH’s Supply Chain Management System (SCMS) had reduced that time by 80 percent— to six to eight weeks—and lowered the cost of supplies as well. The award-winning SCMS, led in partnership with John Snow, Inc. and funded by the US President’s Emergency Plan for AIDS Relief (PEPFAR)/USAID, supports a global procurement system and regional distribution centers that reduce costs and increase the reliability of HIV and AIDS products and services in 21 partner countries.
Globally, PEPFAR supports 7.7 million patients on antiretroviral treatment, of which 4.5 million are receiving direct support and an additional 3.2 million are benefiting from technical support. SCMS procures 70 percent of all antiretrovirals funded by PEPFAR.
Above photo: Warren Zelman
MSH celebrated the global movement for universal health coverage with a reception at Riverpark restaurant in New York City during the 2014 UN General Assembly. The private event featured remarks by high-level officials and an interactive #ToastUHC photo booth. The event was co-hosted by the UN Missions of Japan, Rwanda, Mexico, and France, and in collaboration with the World Bank, World Health Organization, and Gavi, the Vaccine Alliance.
Photos: Glenn Ruga