Gretchens Klage aus Faust / Otto Ludwig

GRETCHENS KLAGE AUS FAUST / OTTO LUDWIG Gretchens Klage aus Faust / Otto Ludwig (1) Noten (1

Institutionalizing community-focused maternal, newborn, and child health strategies to strengthen health systems: A new framework for the Sustainable Development Goal era

Abstract Background Stronger health systems, with an emphasis on community-based primary health care, are required to help accelerate the pace of ending preventable maternal and child deaths as well as contribute to the achievement of the Sustainable Development Goals (SDGs). The success of the SDGs will require unprecedented coordination across sectors, including partnerships between public, private, and non-governmental organizations (NGOs). To date, little attention has been paid to the distinct ways in which NGOs (both international and local) can partner with existing national government health systems to institutionalize community health strategies. Discussion In this paper, we propose a new conceptual framework that depicts three primary pathways through which NGOs can contribute to the institutionalization of community-focused maternal, newborn, and child health (MNCH) strategies to strengthen health systems at the district, national or global level. To illustrate the practical application of these three pathways, we present six illustrative cases from multiple NGOs and discuss the primary drivers of institutional change. In the first pathway, “learning for leverage,” NGOs demonstrate the effectiveness of new innovations that can stimulate changes in the health system through adaptation of research into policy and practice. In the second pathway, “thought leadership,” NGOs disseminate lessons learned to public and private partners through training, information sharing and collaborative learning. In the third pathway, “joint venturing,” NGOs work in partnership with the government health system to demonstrate the efficacy of a project and use their collective voice to help guide decision-makers. In addition to these pathways, we present six key drivers that are critical for successful institutionalization: strategic responsiveness to national health priorities, partnership with policymakers and other stakeholders, community ownership and involvement, monitoring and use of data, diversification of financial resources, and longevity of efforts. Conclusion With additional research, we propose that this framework can contribute to program planning and policy making of donors, governments, and the NGO community in the institutionalization of community health strategies

Knowledge and practices for preventing severe malaria in Yemen: the importance of gender in planning policy.

OBJECTIVE: In Yemen, morbidity and mortality due to malaria is high. We explored malaria-related treatment seeking, prevention practices and knowledge of transmission amongst parents in order to inform health education strategies. Yemen is culturally very distinct from most malaria-endemic countries. We aimed to identify beliefs which may be barriers to malaria prevention and treatment, and hypothesized that household gender relationships might impact on practice. METHODS: Focus group discussions amongst women and men in urban, semi-urban and rural areas, followed by questionnaire interviews with parents or guardians of children with severe malaria, mild malaria, and healthy children from the community. FINDINGS: Recognition of malarial symptoms was good but delays in seeking medical treatment after symptom onset were common, with 78% of parents reporting delay. Delays primarily related to financial constraints, but also to difficulties with treatment seeking when male family members were not available. When contact with a health worker occurred prior to admission to the hospital, the treatment was potentially inappropriate in 29% and ineffective in 57%. There were distinct differences between men and women in their perspective on malaria. Knowledge of malaria transmission was vague and mosquitoes were not emphasized, particularly amongst mothers. Bednets were reported to be used rarely and without insecticide treatment, and some beliefs such as that malaria is transmitted by breastfeeding were potentially harmful. CONCLUSIONS: Some beliefs were potential barriers to malaria prevention strategies. The different beliefs and roles identified between men and women need to be taken into account in health promotion messages