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A call for funding community health alongside other types of health care — like the nurses who staff the national hospital in Nairobi, Kenya seen here during the coronavirus outbreak on May 28, 2020. REUTERS/Njeri Mwangi

by Ruth Ngechu-Kihara

The spread of COVID-19 in Kenya presents a considerable public health challenge. Any resulting decline in primary health care would only intensify that challenge — this is why Kenya must continue to bolster its support for community health volunteers. Despite extensive containment measures — including testing, contact tracing, travel restrictions and quarantine centers — the number of COVID-19 cases in Kenya has been rising steadily. As of July 9, there were 8,975 cases and 173 deaths confirmed. Testing has been limited, however, so the true number is probably higher.

Alongside this rise in positive cases has been a marked decrease in the number of people visiting health facilities. In one month alone, some 20,000 children expected to access essential health care services, including immunizations, have not done so, according to the Kenyan Ministry of Health. A recent survey conducted by the Population Council on behalf of the ministry revealed that one in ten interviewees had forgone medical services in the previous two weeks because they could not afford it (52 percent), feared contracting COVID-19 (17 percent) or feared stigma associated with the illness (3 percent). …

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A doctor wears personal protective equipment before heading to an Ebola treatment unit in Sinje, Liberia. Photo by: UNMEER / Martine Perret / CC BY-ND

By Marion Subah and Dr. Bernice Dahn

Outside the Liberian Ministry of Health one sunny morning this past February, people were once again washing their hands at sanitizing containers and refraining from shaking hands and hugging — a sobering reminder of the 2014–16 Ebola epidemic. But this time, for COVID-19, we were more prepared.

The Ministry of Health quickly coordinated with partners to implement social distancing, create and disseminate health education materials, and draft curriculum to train health workers and facility staff across the country. …

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Nurses at Ho Municipal Hospital conduct a health sensitization session with new mothers. CREDIT: Sala Lewis for PAI

By Vicky Okine and Nii Sarpei

The outbreak of COVID-19 threatens to exact a high toll in sub-Saharan Africa, both because of its devastating effects on its victims and because of its potential to interrupt routine health services. Apart from those who might die of COVID-19, many more could die as a result of weak or strained primary health care (PHC) systems.

We must therefore focus not only on preventing the spread of the coronavirus and treating those who have been infected — we must also maintain PHC throughout this pandemic if we are to save lives both in the short and the long term. …

Epe Fish Market, Lagos State, Nigeria. Social distancing is challenging in the crowded urban areas of Nigeria, where many people live on subsistence earnings. Credit: CHESTRAD

By Dr. Lola Dare

Africa faces a potential human and economic catastrophe because of its particular vulnerabilities to the new coronavirus. In recent days, confirmed COVID-19 cases have surged to nearly 11,000 across the continent, although due to lack of testing, the exact total is suspected to be much higher. While some countries, lenders and organizations have stepped up to ease the economic burden of the pandemic, as a community physician with more than 30 years of experience in epidemiology, public health, social protection and international development, I am concerned that the pandemic will settle in Africa, especially amongst the poor and hard to reach. The impact could go well beyond containment of the virus to a total disruption of our economies with severe consequences on social protection, particularly for women and children. …

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We recently attended the CORE Group’s 2019 Global Health Practitioner Conference in Nairobi, Kenya, which partly focused on identifying solutions to persistent community health workforce challenges. Our message was simple: while many African countries have successfully expanded the numbers of their community health workers (CHWs), and the World Health Organization (WHO) has developed guidelines for educating health professionals, there is almost a neglect of CHW incentives and career pathways.

Unless we change this and develop transformational guidelines for their education, we will not have the proper skills mix and a fit-for-purpose health workforce. CHWs need to see a future in what they do. …

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In March 2019, AMREF Health Africa held the Africa Health Agenda International Conference, which included the youth preconference under the theme “nothing about us without us.” This meeting highlighted the importance of meaningful youth engagement in the planning, implementation and evaluation of all policies and programs that affect young people. There was also a call for greater focus on youth-led accountability towards government commitments to realize universal health coverage (UHC).

While UHC is a major goal for health reform, in many countries there has been a lack of meaningful inclusion of young people in UHC efforts. According to World Health Organization, UHC ensures that all people have access to needed health services (including prevention, promotion, treatment, rehabilitation and palliation) of sufficient quality to be effective while also ensuring that the use of these services does not expose the user to undue financial hardship. …

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By Vicky Okine

Over the festive season, our thoughts naturally turn to our families, and our plans for the New Year ahead.

As we welcome the beginning of another year, there are three essentials that everyone wishes for themselves, their families, friends and communities. These are of course health, wealth and happiness: vital ingredients for a fulfilled and dignified life.

I have worked for many years in the field of health care, helping mothers, newborns, children and adolescents to unlock their very own healthy future. I am enormously proud of Ghana’s success and ambition over the past two decades. …

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Gavi CSO ConneXions — September 2018, Jacaranda Hotel, Nairobi, Kenya

By: Elizabeth Lopez, Knowledge Maanagement Associate, PHC Initiative, PAI

In September, Gavi CSO Constituency and Catholic Relief Services held the Gavi CSO ConneXions 2018 conference in Nairobi, Kenya. This meeting highlighted the importance of ensuring routine access to immunization, strengthening health systems and the advocacy needed to achieve those goals in light of the changing landscape around health program financing. Significant portions of funding for health programs in low- and middle-income countries have depended on external financing and are often channeled into disease-specific health programs. …

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Nohn, a nurse clinical supervisor, spends 80% of her time in the field providing hands on mentorship and supervision to CHWs.

S. Olasford Wiah, Community Health Services Director, Ministry of Health Liberia
Brittney Varpilah, National Community Health Systems Director Last Mile Health
Katey Linskey, Policy & Advocacy Officer, Last Mile Health

In a rural community in the dense rainforest of Liberia’s Rivercess County, a young mother named Odell exchanges conversation and words of comfort with a pregnant woman who has come to her for advice. The woman describes to Odell that she is suffering from “shivers”, and Odell recognizes this as a symptom of potentially serious complications affecting her pregnancy. A well-respected member of her community, Odell was nominated by her neighbors to undergo training to become the community’s professional community health worker (CHW) under a government program called the National Community Health Assistant (CHA) Program. Thanks to her rigorous training and the assistance of job aide tools that help guide her through health service delivery, Odell is able to recognize that her patient is experiencing unusual and potentially dangerous symptoms. Following her training, she immediately refers the woman to the nearest clinic for more advanced care. …

Why Research Matters for Noncommunicable Disease Advocacy

By Nicholas Matovu

When I began my year as a Global Health Corps (GHC) fellow working at the Ministry of Health in Uganda last July, I held a negative attitude towards advocacy for several reasons. First, I believed that advocacy was just about politics, and I have a strong dislike for political debates. Second, I thought advocacy only took the form of rallying and demonstrating dissatisfaction with the current state of events. Finally, I believed advocacy is only for those people who like to talk a lot.

As defined by renowned author and advocate Ritu Sharma, advocacy is actually a “tool for putting a problem on the agenda, providing a solution to that problem, and building support for acting on both the problem and the solution.” I realized that advocacy requires multiple efforts, including coordination, strategic thinking, information gathering, communication, and mobilization. This means that when change is needed, my efforts are important for enacting this change. I then started to think of ways to engage myself in advocacy — predominantly through research on noncommunicable diseases (NCDs), a topic I am very passionate about. …


PHC Pathways

Working to increase the recognition and support for Primary Health Care (PHC) in the global arena.

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