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Improving Health Outcomes and Health Care Efficiency in Medtronic Disease States for Underserved Populations through Models of Innovation, Scale, and Sustainability

This blog post was written by our colleagues from Medtronic Foundation. Medtronic Foundation focuses on expanding access to healthcare for the underserved worldwide and supporting healthy communities where we live and give. Medtronic Foundation is a 2017 Global Health Council member.

The Medtronic Foundation focuses on expanding access to healthcare for the underserved worldwide and supporting healthy communities where they live and give. They enable this vision by developing and driving strategies focused on:

1) Global Health:
Improve health outcomes and health care efficiency in Medtronic disease states for underserved populations through models of innovation, scale, and sustainability;

2) Community Well-being: Advance flourishing communities where we live and work through good corporate citizenship and by addressing social determinants of health; and

3) Volunteer Engagement: Activate a global volunteer workforce of patients, employees, and retirees who contribute to achieving the United Nations Sustainable Development Goals.

Their work in global health involves brokering, supporting, and managing partnerships across nonprofit and government stakeholders to deliver a clear set of results and best practices that advance health outcomes particularly for noncommunicable diseases (NCDs) and efficiency for the underserved.

Snapshot of Their Global Health Signature Programs:  Re-Designing Healthcare Systems to Improve Outcomes

The Foundation’s three Signature Programs are positioned to deliver evidence via multi-year, multi-stakeholder, multi-country initiatives focused on working closely with communities to redesign how healthcare is delivered to improve health outcomes and sustain gains. All involve strong local partnership/government/patient participation, provide an opportunity to test novel healthcare system interactions, and include rigorous evaluation partnerships for publication and cross-sector learning:

1) HealthRise: Improve Detection, Management and Control of Cardiovascular Disease and Diabetes for Underserved. Needs assessments across geographies found significant barriers to care, including supply chain disruptions, and long distances to NCD diagnostics and monitoring, in addition to cultural and linguistic barriers. HealthRise interventions are now active in four countries, working to address locally relevant barriers. Common strategies include empowering patients and communities in self-management, care navigation and addressing social determinants; strengthening frontline health workers (including community health workers, community paramedics); and together with key stakeholders, advancing key policies to support people living with chronic diseases over the long-term. https://www.health-rise.org/

2) HeartRescue: Improve Acute Cardiovascular Disease Outcomes for the Underserved. multi-country collaborative program to improve sudden cardiac arrest (SCA) survival rates. HeartRescue partners work toward integrating community response efforts, coordinating public and professional education about acute cardiac events such as SCA and STEMI, and introducing and applying best practice treatments. The program also helps hospitals implement a method for measuring SCA and STEMI performance and outcomes. HeartRescue fosters local ownership of each country program by engaging multi-sector stakeholders, including governments, medical professional societies, local healthcare providers, patients, and families. http://www.heartrescueproject.com/

 3) RHD Action: RHD Action is a coalition of global organizations leading the global movement to reduce premature mortality from RHD and contribute to both Sustainable Development Goals 3 & 4, reducing premature mortality associated with non-communicable disease by one third, by 2030. The RHDA global partners are working together to establish a scientific and technical support community available to all countries, draw on this technical knowledge to advocate for policy change for better heart health, support and empower all people living with RHD and to foster multi-sectoral partnerships to support and sustain the global movement. http://rhdaction.org/

Envisioning the Future

Low-middle income countries are increasingly facing a dual burden of infectious and non-communicable diseases. In fact, rates of NCDs are rising at rates roughly three to four times faster in countries like Bangladesh and Ethiopia than they are in higher income countries like the US and UK. Health systems are fundamentally not set up to allocate funding for or adapt health systems to address these changing needs.

How can global health stakeholders come together with others in the community to unlock new resources and accelerate health outcomes for global health’s most pressing challenges? How can they creatively harness the talent and resources that already exist in countries to address the healthcare worker shortage? How can they ensure underserved patients and frontline health workers are involved meaningfully in health policy, financing, and delivery conversations? How can they design programs for sustainability, scale and measurable health outcomes from the start?

Looking ahead, as the global community races to achieve the Sustainable Development Goals — with a sharp eye on Universal Health Coverage (UHC) and meeting key NCD targets — the Foundation recognizes the importance of ensuring that health equity remains a core focus of their effort. Enabling health outcomes and efficiency requires that value-bashed healthcare be elevated, translated and understood in the context of organizations aiming to reach the underserved.

Interested in addressing these same questions too? Join Medtronic Foundation in continuing this conversation at the following event:

▪ Global NCD Alliance Forum: Dec. 9-11, 2017, Sharjah

http://www.medtronic.com/us-en/about/foundation.html

One Year Later

Global Health Council (GHC) President & Executive Director Loyce Pace pens a letter to the leadership of GHC member organizations recapping her first year at GHC.

December 1, 2016.

That was the day I started my tenure with Global Health Council as its new executive director. I didn’t quite know what to expect. The organization was due for an update of its strategic plan. At the same time, Washington had just been rocked by a shocking election result. We were also anticipating a change of the guard at WHO. I found myself asking what critical role GHC should play in the global health advocacy space and how effective we could be, ultimately. And I heard from you, as leaders of our member and partner organizations, where you see our value and why you have joined us.

We all had to dig a little deeply for a sense of optimism coming into 2017, given all the unknowns. I reflected often on being a so-called peacetime versus wartime CEO and implications of the latter, not only for GHC’s mission but our core purpose as a global health community. We are advocates at heart who are called to “find our fight” amidst a set of circumstances that certainly aren’t business as usual. Meanwhile, we have our pragmatic side: a small voice that wants to find some level of compromise and constructive engagement, which lends itself to incremental progress. I would say both have their place.

Of course, pushing back on bad policy and poor decision-making is essential. There were a number of disturbing events early on that we collectively opposed, the proposed federal budget being only one example. I was proud of our community for how fervently and vociferously we spoke up and out against drastic cuts. That wasn’t just the right thing to do; it was our only option. And we did it together, as one voice. GHC also expressed concern regarding an expansion of the Mexico City Policy and its impact on global health outcomes worldwide. And we challenged WHO on how it engages with non-state actors.

Equally important is for global health organizations to take a closer look at ourselves and make adjustments to how we do business. It could simply be a matter of changing how we talk about what we do, finding better language to describe the benefits of global health investments in terms of GDP or national security. This has resonated with multiple audiences. Likewise, identifying different messengers has proven valuable. But there’s a deeper evolution afoot: global health leaders are asking themselves what partners, programs, or protocols they must put in place to sustain the progress they’ve realized so far, perhaps without solid government funding and leadership. This is a shift I’ve come to realize Global Health Council can also help our community navigate and reconcile. Thus, our upcoming symposium.

As I look ahead to 2018, it seems we share a confidence that was lacking this time last year. Now, I have no doubt we will win critical battles. We’ll certainly continue to face challenges, but our community has grit and resilience that serve us well. We also use our resources to play both offense and defense in a way that is smart and thoughtful. An ideal path forward is one in which we are just as bold in advocacy as we are in innovation. I am grateful to our awesome community for teaching me the value of working along this spectrum during my first year, and look forward to even more lessons in the years to come.

Thank you for your support of GHC, and being part of our ongoing efforts to improve health worldwide.

Global Health Council 2017 Call to Action

To Move Forward Is To Move Together: Creating Collective Action Through Roundtables

This post was written by Melissa Chacko, Policy Associate, Global Health Council.

The global health advocacy community is diverse and functions as a conglomerate of roundtables, working groups, and coalitions (hereafter referred to as Roundtables). Roundtables can work independently or collectively, bringing advocates and researchers across various sectors together to discuss global health policy issues and to increase U.S. funding for global health accounts. The Roundtables’ impact on global health policy is a culmination of these groups’ work such as sign on letters, meetings on Capitol Hill, advocacy around legislation, and engagement with the administration. For organizations that advocate for U.S. investment in global health, the Roundtables amplify this work, as they provide strategy, build a collective voice, and push for a comprehensive holistic approach to global health delivery and care.

Provides Strategy

Roundtables give organizations the opportunity to share their knowledge with each other. Sharing this knowledge allows organizations to be current and devise collective action.

Aaron Emmel, Manager of Global Health Advocacy Initiatives at the American Academy of Pediatrics (AAP), explained, “Information sharing is essential for roundtables to move forward with advocacy strategies.” Aaron is a member of the Steering Committees for the Noncommunicable Diseases Roundtable and the Maternal, Newborn, and Child Health (MNCH) Roundtable, and the working group for A Global Agenda for Children (early childhood development). AAP also participates in other advocacy groups such as the International Family Planning Coalition; the civil society group organized by Gavi, The Vaccine Alliance; the Water, Sanitation and Health (WASH) Working Group; and the 1000 Days (nutrition) Working Group.

Aaron elaborated on how sharing knowledge brings different viewpoints to the table. “AAP shares information on pediatric health, from child survival to NCDs and chronic care. Other partners such as maternal health experts including the American College of Gynecologists, share complementary information that helps to tell a fuller story. Together we are able to add to each other’s credibility.”

Lisa Schechtman, Director of Policy and Advocacy, at WaterAid, who sits on the Steering Committee for the MNCH Roundtable and is also the co-chair for WASH Working Group, said, “Sharing information allows roundtables and individual organizations to be strategic and current in advocacy issues that organizations work on.” Lisa continued, “For smaller teams like WaterAid, and [as] one of the few organizations that work in the WASH space, having these spaces allow us to amplify our contribution as few WASH advocates are able to do that.”

Builds a Collective Voice

Roundtables build a collective voice around global health issues, bringing multiple focuses together to create stronger messages to send to Congress and the administration. Aaron emphasized this point, “Diverse voices show consensus around global health issues and allow us to validate programmatic evidence from different perspectives. There is not necessarily a national constituency for global health so it is important that roundtables allow for coordination, for members to come together and present evidence to policy makers and agencies to reinforce global health agendas.”

Lisa reinforced the power of collective voice and that “we are stronger together.” WASH is one example of this. Lisa added, “WASH focuses on the outcomes of providing services and most of these outcomes are linked directly to the goals of the MNCH Roundtable. The MNCH Roundtable helps to provide context to do what we do and MNCH-focused groups can learn from WASH and consider our inputs and strategies. This gives us credibility for the health benefits of WASH and our position in the global health community doing advocacy on WASH.”

Comprehensive Holistic Approach

Roundtables provide a space for points of integration and create holistic approaches to global health agendas. Aaron explained, “For the Reach Every Mother and Child Act (Reach Act), the child survival groups needed buy-in from the maternal health groups to create a strong message to legislators. Bringing diverse voices to policy makers shows that we are united around this issue. For NCDs, we serve as a bridge for maternal and child health; without the NCD voice, global maternal and child health policies and interventions would not necessarily include chronic illness, and without the maternal and child health voice NCD policies have not adequately addressed the unique needs of children and youth.”

On WASH integration, Lisa said, “Integration was the original reason we joined the MNCH Roundtable several years ago. Although members of the Roundtable do WASH service delivery there was almost no health organization working on WASH advocacy. WASH underlies the success of the MNCH and Nutrition community which builds more WASH champions and raises opportunities and issues.” By being a part of the MNCH Roundtable, Lisa said that “WASH is now at the table for the MNCH annual appropriations process.”

Moving Forward

To move global health forward, is to move together. Roundtables allow the global health advocacy community to come together, find areas of integration and collaboration, and build a collective voice. Lisa discussed this benefit and used WASH integration as an example. “Being a member of the Roundtables and of Global Health Council has worked hand in hand.” Lisa emphasized, “Both memberships increase the profile of WASH as a health issue and create new partnerships, in addition to the opportunity to work with Global Health Council staff.”

Looking forward, the global health advocacy community’s collective voice is now more important than ever. Aaron added, “We work in different spaces but we recognize that there is a shared agenda and vision to help and maintain the role of America as a trusted leader and partner for global health issues.”

Global Health Council works with the Roundtables to support information sharing, coordinate advocacy efforts, and be a part of the collective voice of the global health community. If you are interested in attending roundtable meetings or would like to find out more information please email advocacy@globalhealth.org.

Toolkit: Advancing Women Leaders in Africa

ACCESS THE POLICY TOOLKIT

In March 2017, Her Excellency Dr. Joyce Banda, former President of Malawi and Founder of the Joyce Banda Foundation, launched her paper, “From Day One: An Agenda for Advancing Women Leaders in Africa” as the crux of her research while serving as a Distinguished Fellow at the Woodrow Wilson Center. To achieve this end, Dr. Banda published “From Day One: An Agenda for Advancing Women in Africa” which details the history of women’s leadership in Africa and some of the challenges and opportunities women face on their leadership journey. The paper includes five key recommendations for promoting women’s leadership in Africa:

1) Enhance political will to empower girls, and appoint qualified women to leadership positions

2) Mobilize rural leadership, families, and communities to promote the change of mindsets and behavior around women and girls

3) Strengthen networks between current and emerging leaders

4) Allocate resources towards data collection and analysis, and research around women and leadership

5) Create the legal environment to advance women in positions of leadership

In the second phase of her research, Dr. Banda spearheaded the creation of a toolkit to provide actionable steps to implement the recommendations.

Building Community Capacity to Fight Pneumonia and Save Children’s Lives

This blog post was written by Amy Sarah Ginsburg, MD, MPH, Senior Advisor in International Programs at Save the Children U.S.A, and Kurabachew Abera, MD, MPH, Health and Nutrition Team Leader for Save the Children Ethiopia. Save the Children believes every child deserves a future. In the United States and around the world, they give children a healthy start in life, the opportunity to learn and protection from harm. Save the Children is a Global Health Council 2017 member.

 

“We are living in the midst of a pneumonia pandemic. No disease kills more children.”
 – Kofi Annan, former United Nations Secretary-General

As we mark World Pneumonia Day this month, we reflect on our progress in the fight against pneumonia as well as the work ahead. A Save the Children report, Fighting for Breath, shows child mortality rates are at an historic low, however even this “good news” means 5.6 million children died in 2016 before their 5th birthday.

Why are millions of children still unable to access life-saving nutrition, vaccines, and medicines? How can we ensure all families have access to the health care they need to protect their children from pneumonia and other illnesses? The answer is simple: we need to reach the unreached. The reality, however, is one of the most daunting global health challenges we have yet to face.

Today’s global health landscape has greater complexity than we encountered in past decades. We have made remarkable progress by addressing a then-universal challenge of developing countries – the lack of access to basic health care interventions such as antiretrovirals, vaccines, and contraception. Aggressive strategies, developed by global institutions and skillfully implemented by countries, began to close – though not eliminate – the access gap between industrialized and impoverished countries. This global approach, coupled with significant economic gains in many African and Asian countries, yielded dramatic results. By employing a largely “one size fits all” approach, we succeeded in saving millions of lives.

The success of this approach has fundamentally changed the challenges ahead. As is widely acknowledged, the communities untouched by global advancements are often the poorest of the poor, war-torn, geographically remote, mobile/pastoralist and/or historically underserved. Inequities in communities’ abilities to access basic health care are not only between rich and poor countries, there are often significant disparities within countries. Our continued progress is dependent on our ability to understand, navigate and influence these diverse communities.

Ethiopia’s experience illustrates this point. Nationally, the country has demonstrated remarkable progress in expanding access to health care, reducing hunger and undernutrition, and improving its economy. Since 1990, Ethiopia has reduced its child mortality rate by more than 75% from 203 to 58 per 1,000 livebirths. The success is largely due to increased use of tools and approaches made possible by the health extension program, a home-grown innovative community health program that increased access to basic health care.

Though Ethiopia has made significant headway, analysis shows this progress is uneven. The more remote areas of the country, such as the developing regional states of Somali and Afar, have made relatively few health gains. Many of these communities have weak linkages to the overall health system, which is inadequately resourced and often inaccessible. Cultural factors inhibit appropriate health practices, and there are few sources of accurate health information. Not surprisingly, there is poor uptake of the life-saving reproductive, maternal and child health interventions that are responsible for the dramatic health gains in other regions. As a result, the child mortality rate in these regions remains stubbornly high at nearly twice the national average.

In Afar and Somali, as in so many other communities around the world, cultural, geographic, political and economic forces converge at the community level and serve as complex barriers to improved health. Unfortunately, there is no “one size fits all” strategy to reach the unreached. We need careful analysis of local facilitators and barriers and community engagement to determine the best way forward.

Save the Children is developing country advocacy initiatives to strengthen the capacity of countries to address their complex health challenges. In Ethiopia, we are working in Afar and Somali regions to identify significant health system gaps, and engaging communities and policymakers to develop ways to close them. Our current work in Ethiopia focuses on maternal, newborn and child health including prevention and treatment of childhood pneumonia, the leading infectious cause of death for children. Save the Children is working with the Ministry of Health of Ethiopia to ensure universal access to quality neonatal and child health services. To this end, improving quality and scaling up integrated community case management and community-based newborn care as part of the package of the health extension program in Afar and Somali regions are priorities. Coupling community-based advocacy with efforts to improve child health, allows us to drive change by promoting health interventions -including immunization, nutrition, and access to care- that can reverse persistently high rates of child mortality.

Our work in Ethiopia recognizes that countries are both innovators and implementers – to shape and sustain change we need to strengthen the work of in-country stakeholders, leaders and partners. We must find new ways to provide catalytic investments, build government and community capacity, and to foster evidence-based and systems innovations that can save lives. This means listening to, empowering and holding accountable, governments and stakeholders closest to the most difficult problems.

Our global vision of achieving the ambitious Sustainable Development Goals requires us to find new ways to improve the health of families in the poorest and most remote regions of the world. As we evaluate the global health community’s annual progress and consider priorities for the year ahead, high among them should be increased support for country advocacy. This is complex, incremental and important work. It is the path we must travel to meet our global goals and save children’s lives.