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From 2011-2016, ASH produced over 175 technical resources across key technical areas. Use the categories on the right sidebar to navigate to each technical area, or scroll down on this page.
ASH's Synthesis Series - Click below to view e-updates highlighting resources across key themes.  Addressing the Rise of Non-Communicable Diseases in Africa Through Improved Regulation of Medical Products Non-communicable diseases (NCDs) are a growing cause of death and disability in Africa, reducing individual and collective productivity and increasing health care costs. This brief, developed for the 2016 African Growth and Opportunity Act Forum, discusses the rise of NCDs in Africa, the importance of strengthening regulatory mechanisms for improved access to medicines and medical devices to address them, and the role of trade in improving these processes. [Download] French Version [Download] Portuguese Version [Download]  A Corridor of Contrasts: On the Road from Abidjan to Lagos, Urbanization Offers Risk and Opportunity, Hardship and Hope The West African transport corridor crosses five countries through a densely populated urban setting from Abidjan, Ivory Coast to Lagos, Nigeria. Rapid economic growth and urbanization associated with trade along the road have the potential to help pull people out of poverty and improve populations’ health. However, without proper management, this growth can also lead to the expansion of informal settlements, increased pollution, and crime. A Corridor of Contrasts documents the multi-faceted issues affecting the health of people living in urban areas along the corridor, and the recommendations for improving services for those living and working along the corridor. English Version [Download] French Version [Download] Watch the video: Meeting the Needs of Urban Youth  Inequity, Fertility, and Economic Opportunity: Family Planning Makes a Difference This technical brief presents analysis of the impact of differential fertility decline among wealth quintiles on population age structure in four African countries, the trajectory of these trends through 2050, and the impact on access to economic opportunity. Produced in collaboration with Avenir Health and the Health Finance and Governance project, findings suggest that if fertility decline is not accelerated across wealth quintiles, the resulting inequities could limit the realization of economic benefits for the country as a whole. Fertility decline should be considered a critical element of inclusive and sustained economic growth in Africa. [Download]  Ebola and Other Disease Outbreaks: Implications for Economic Growth and Trade This brief discusses the impact of disease on trade, economic growth and commerce, with particular reference to the recent outbreak of Ebola Virus Disease in West Africa. It examines the impact of disease on different economic sectors and discusses the importance of global health security and the strengthening of systems to reduce risk factors that amplify the spread of infectious diseases and debilitate sustained economic stability. There is a need to understand the role of regional and international cooperation mechanisms and policies, especially the role of trade agreements such as the African Growth and Opportunity Act (AGOA), in promoting economic trade and growth to assist in preventing the spread of various diseases. [Download] Summary of key points in French [Download]  Health, Economic Development and Trade: Technical Brief Africa is the fastest growing continent in the world— with a projected average economic growth rate of 6 percent from 2013-2015. Health is becoming increasingly important as economies grow. This brief, developed for the health session at the 2013 U.S.-Sub-Saharan Africa Trade and Economic Cooperation Forum, (also known as the AGOA Forum), explores the relationship between health, economic development and trade in Sub-Saharan Africa by reviewing available evidence taken from published research and data. [Download]  Trends in Digital Health in Africa Technical Brief Over the last five years, the ASH project, in support of USAID/Africa Bureau priorities, has engaged with thought leaders, innovators, and implementers on cutting-edge issues to build capacity and advance collaboration in the use of digital technology to improve health outcomes. This brief, informed by work throughout the life of ASH, shares key findings from a consultation with experts working on digital health at the national, regional, and global levels. It outlines trends, barriers, and opportunities to scale digital health in Africa. [Download]  Infographic: mHealth Compendium The six volumes of the mHealth Compendium contain 167 profiles of mobile health programs. This infographic summarizes program characteristics including locations, health areas addressed, and target end users across the series. [Download]  mHealth Compendium Special Edition 2016: Reaching Scale The mHealth Compendium series has expanded the body of knowledge and increased access to the most current information on mobile technology solutions for health. The mHealth Compendium Special Edition 2016: Reaching Scale features in-depth profiles of ten programs that have grown in scale over time. The case studies include details of the process, challenges, and lessons learned in growing an mHealth program. English [Download] French [Download] Portuguese [Download] Browse the mHealth Database  Regional Actors Addressing Digital Health in Africa: Comparative Advantages, Challenges and Opportunities Source: African Strategies for Health In recent years, there has been a growing trend toward regionalization on the African continent, as integrated and cooperative efforts have created positive impact in political, economic, and social sectors. In Africa’s health sector, regional actors have become active contributors to development and health agendas. The growth of information communication technology (ICT) and particularly the rapid expansion of access to mobile phones and networks in Africa have opened opportunities to use these new technologies to improve the health and well-being of people across the continent. [Download Technical Brief] [In French] Visit the online database to browse through more than 120 regional organizations working in health in Africa. >>Database  mHealth Opportunities and Lessons Learned for Family Planning Programming To ensure universal access to sexual and reproductive health services, a range of systems and service delivery interventions, identified as high impact practices (HIPs), help family planning programs focus their efforts and maximize resources to achieve broadest reach and greatest impact. The growing ubiquity of mobile technology offers numerous opportunities to support and augment the successful implementation of HIPs. This brief presents themes and lessons learned from across the five volumes of the mHealth Compendium from programs which addressed family planning. It is intended to provide policymakers and program implementers with a resource on potential areas for integration of mHealth into family planning programming, as well as emerging lessons from a range of example case studies. [Download]  Harnessing the Power of Digital Health Summary Presentation The ASH project with USAID/Africa Bureau hosted a talk-show style panel "Harnessing the Power of Digital Health: Lessons and Opportunities for Family Planning Programs" at the International Conference on Family Planning, Indonesia January 2016. The interactive session brought together three experts to discuss practical experiences and key issues which have emerged in implementing digital health solutions for family planning. This presentation summarizes key points from the discussion. [Download]  mHealth Compendium Fifth Edition Volume 5 of the mHealth Compendium series compiles 41 case studies submitted by implementing partners primarily in Africa, but also in other regions of the world. These applications have been used for tasks including the monitoring and implementation of health interventions; making electronic payments for services; and informing local communities about potential outbreaks of disease. English Version [Download] French Version [Download] Portuguese Version [Download]  mHealth Compendium Fourth Edition Mobile and wireless technologies assist health projects in accurately assessing the needs of a target population, collecting and disseminating relevant information, and delivering cost effective health services. This fourth volume of the mHealth compendium, published in October 2014, is a collection of 31 case studies. Several feature mHealth tools that have great potential for contributing to strengthening health systems and supporting the response to disease outbreaks, such as the Ebola outbreak in West Africa. English Version [Download] French Version [Download] Portuguese Version [Download]  mHealth Compendium Third Edition This volume was published in November 2013 and is the third edition in the series. It contains 24 new case studies which document mHealth innovations, many of which seek to contribute to USAID’s two overarching objectives of eliminating preventable maternal, newborn and child deaths and achieving an AIDS free generation. English Version [Download] French Version [Download] Portuguese Version [Download]  mHealth Compendium Second Edition The second volume of the mHealth Compendium was published in May 2013 and contains 27 case studies which document a range of mHealth applications being implemented mainly throughout Africa. Case studies have been organized within five programmatic areas: Behavior Change Communication, Data Collection, Finance, Logistics and Service Delivery. English Version [Download] French Version [Download] Portuguese Version [Download]  mHealth Compendium First Edition The first edition of the mHealth Compendium, published in November 2012, contains 35 case studies which document a range of mHealth applications being implemented across the world. To improve access to relevant mHealth information, this compendium offers project descriptions, publication references, and contact information for making further inquiries. [Download]  Landscape Analysis and Business Case for mHealth Investment in Angola With more than 13.3 million mobile users in Angola, there are unparalleled opportunities to use mHealth solutions to improve quality of care, access to health services, and health outcomes. USAID/Angola commissioned the USAID-funded African Strategies for Health Project to conduct a landscape analysis of mHealth in Angola and develop a business case to determine opportunities and barriers for USAID investment. This report lays a foundation for the development of a national mHealth strategy. [Download in English] [Download in Portuguese]  Africa Regional Meeting on Digital Health: Meeting Report From May 12-15th 2015, over 150 government, private sector, and donor participants came together in Lilongwe, Malawi at the Africa Regional Meeting on Digital Health for Overcoming Barriers to Ending Preventable Child and Maternal Deaths and Achieving Universal Health Coverage to exchange ideas and information on how to adopt and expand digital health technology. Co-hosted in collaboration with the Government of Malawi by the USAID and the UN Foundation, the meeting brought together country teams led by government representatives with a goal of strengthening and expanding opportunities for public-private partnerships in digital health across Africa. The event achieved unprecedented participation by the private sector. [Download]  Use Of Technology In The Ebola Response In West Africa: Technical Brief The 2014 epidemic of Ebola Virus Disease in West Africa is the largest in history. This brief provides a summary of Information and Communication Technologies (ICT) tools, including eHealth and mHealth, which have been used to optimize the Ebola response. It also provides recommendations for policy makers and program managers seeking to deploy ICT tools in outbreak settings that are applicable beyond the 2014 Ebola crisis. English Version [Download] French Version [Download]  Investing in Technology and Innovations for Human Development in Africa: Meeting Report This report documents key topics presented and discussed at the first ever ministerial-level stakeholders meeting “Investing in Technology and Innovations for Human Development in Africa” held on 14th October 2014 in Rabat, Morocco. The meeting, convened by the African Development Bank, USAID and ASH, enabled high-level dialogue on the importance of collaboration between the health and science and technology sectors, making the case that investments in digital infrastructure and tools such as (mobile) broadband Internet, electronic payments and electronic records can fast-track development of the continent’s economic and social sectors, including health. [Download]  Scaling Up Mobile Technology Applications for Accelerating Progress on Ending Preventable Maternal and Child Deaths Report This report documents key points presented and discussed at the regional meeting “Scaling Up Mobile Technology Applications for Accelerating Progress on Ending Preventable Maternal and Child Deaths” held November 10, 2013 in Addis Ababa, Ethiopia on the fringes of the third International Conference on Family Planning. [Download]  Using Mobile Technology to Improve Family Planning and Health Programs This report documents the lessons learned from the regional meeting on “Using Mobile Technology to Improve Family Planning and Health Programs” held in Dar es Salaam, Tanzania from November 12-16, 2012. The meeting was sponsored by the Bureau for Africa’s (AFR) Office of Sustainable Development and the Bureau for Global Health’s (GH) Office of Population and Reproductive Health of the United States Agency for International Development (USAID), USAID/East Africa and USAID/Tanzania. [Download]  Infographic: mHealth Compendium Case Studies, Volume 1, 2 & 3
This summary synthesizes and highlights case study materials in Editions One, Two and Three to help identify and access information contained within the Compendiums. English [Download] French [Download]  Regional Actors Addressing Health Financing in Africa: Comparative Advantages, Challenges and Opportunities The African continent has seen pronounced movement toward regionalism in recent years to catalyze development and strengthen African integration and unity. Successful health financing systems are critical for achieving health targets and reaching Universal Health Coverage, a widely supported development goal. Thus, sustainable health financing is now at the forefront of development dialogue. African leaders have demonstrated strong political commitment through endorsing measures such as the Abuja Declaration of 2001 on increasing government funding for health, and the Monterrey Consensus of 2002 that established a set of guiding principles enabling developing countries to address the challenges faced in mobilizing sufficient financing for their economic development. [Download Technical Brief] [In French] Visit the online database to browse through more than 120 regional organizations working in health in Africa. >>Database  Health Care Financing Country Profiles Source: African Strategies for Health The African Strategies for Health project and Management Sciences for Health participated in the Financial Protection and Access to Care Workshop, held in Accra, Ghana from February 15-19, 2016. Convened by Ghana's Ministry of Health, the National Health Insurance Authority, the World Health Organization (WHO), and the United States Agency for International Development (USAID), the meeting brought together participants from nine African countries and representatives from the Bill & Melinda Gates Foundation, WHO's Africa Regional Office, the West African Health Organization (WAHO), the Joint Learning Network for UHC, the World Bank, the Mexican Ministry of Health, and various NGOs and private sector organizations. The country profiles were developed for discussion at the workshop, and provide an in-depth perspective on the health financing situation in each of the nine countries in attendance (Benin, Côte d’Ivoire, Ethiopia, Ghana, Nigeria, Rwanda, Senegal, Togo, and Uganda).
Additional workshop materials including background documents, agenda, and presentations from each of the sessions, are available on the workshop website here. Additional Health Financing and Macro-Fiscal country profiles, developed by the PEPFAR- and USAID-funded Health Policy Project are available here.   Rwanda Health Private Sector Engagement Assessment Source: African Strategies for Health As Rwanda looks to sustain and build on its hard-earned gains in health, it faces a few vital constraints. Donor funding is declining and the Health Sector Strategic Plan III (HSSP III) is underfunded with a likely gap of $372- $697 million. Private sector investment, which could potentially help fill this gap, is only 1.7 percent. The Government of Rwanda’s goal of increasing this investment to 5 percent (or approximately $260 million/year) would cover almost 50 percent of annual total health expenditure. The Government of Rwanda, its development partners, and key stakeholders recognize the importance of increasing private sector engagement (PSE) as a means to accessible, equitable, efficient, and improved health services. In order to support the government to assess the landscape, identify potential opportunities and key obstacles, and develop a framework or roadmap toward increased and sustained PSE in health, USAID/Rwanda commissioned ASH to carry out the Rwanda Health PSE Assessment. [Download the Full Assessment Report] [Read the Summary Brief]  Community Health Worker (CHW) Incentives in Malawi: Lessons Learned Source: African Strategies for Health In order for governments and organizations to adopt, implement, and scale up community health programs, knowledge of the wide typology of CHW models and their associated incentive mechanisms is critical. It is equally important for policy makers and program implementers to understand the impact of program design factors, like incentives, and how they may contribute to optimal CHW performance and the achievement of sustained health impact. To better understand the impact of financial and non-financial incentives on CHW performance and retention in Africa, the African Strategies for Health (ASH) project undertook a literature review and in-depth studies in two countries, Malawi and Madagascar. Malawi was selected as one of the two countries because of its national cadre of government-funded CHWs, as well as the array of incentives currently being used by community health programs. This technical brief presents key findings and recommendations based on research conducted in Malawi. Technical Brief [Download] Full Malawi Report [Download] Technical Brief in French [Download]  Community Health Worker Incentives in Madagascar: Lessons Learned Source: African Strategies for Health In Madagascar, CHWs play an essential part in improving access to quality health services in the context of a weak public sector and a severe shortage of trained healthcare workers. This technical brief presents key findings and recommendations based on research conducted in Madagascar, and may be useful for countries that are considering introducing, modifying or scaling up a community health program. Technical Brief [Download] Full Madagascar Report [Download] Technical Brief in French [Download]  Cost-Effectiveness of Reproductive Health Vouchers and Community-Based Health Insurance in Uganda Source: African Strategies for Health When planned and used appropriately, financial incentives have proven effective in improving utilization and quality of maternal and child care. This technical brief, based on a study examining the cost-effectiveness of reproductive health vouchers and subsidized community-based health insurance programs in Uganda, provides an overview of the study findings as well as key policy options and recommendations for researchers, policymakers, and program managers. [Download] Action Brief [Download] To ensure that study findings and recommendations are translated into practice, Management Sciences for Health in Uganda and ASH partnered with the Ministry of Health and the USAID Mission in Uganda to convene a dissemination meeting and workshop in Kampala. The workshop, held on October 29th, 2015, provided a platform to share study findings and to discuss the use of RHVs and CBHI in Uganda. [Read the workshop report]  A Review of Health-Related Corporate Social Responsibility in Africa Source: African Strategies for Health Increasingly a part of corporations' business strategies, corporate social responsibility (CSR) is an expression of the business desire to create value for both the corporation and the community in which it operates. In an effort to understand the potential for leveraging the contributions of private companies to the health sector in Africa, the African Strategies for Health (ASH) project conducted a review of health-related CSR across the continent. The multi-country study focused on identifying the business incentives, main approaches, and coordination efforts currently practiced for CSR. The report provides a snapshot in time in an industry that is constantly evolving and becoming increasingly institutionalized and aims to provide a better understanding of existing CSR for health in Africa and opportunities for ministries of health and USAID missions to leverage CSR activities. Recommendations are intended to facilitate the development of meaningful relationships with local and international companies interested in investing in health programs in Africa to sustainably contribute to the improvement of health outcomes. Full Report [Download] Technical Brief [Download]  Health Care Financing Reform in Ethiopia: Technical Brief
Source: African Strategies for Health The Second Global Symposium on Health Systems Research (HSR) took place in Beijing, China, on October 31 - November 3, 2012, and was dedicated to evaluating progress, sharing insights and recalibrating the agenda of science to accelerate universal health coverage (UHC). UHC is understood here in its broader sense of health service type, accessibility and financial risk coverage. This brief, developed for a USAID-hosted satellite session, describes the experience of Ethiopia in reforming health care financing and the resulting transformation of the health sector. [Download]  Integrated Pediatric HIV and Child Health Services in Sub-Saharan Africa: Discussion Brief There is a growing recognition of the need for greater alignment between HIV testing and treatment and existing maternal, newborn, and child health (MNCH) services to achieve the dual goals of ending pediatric AIDS and improving child survival. In many countries, the integration of pediatric HIV and child health platforms and interventions is already happening, and while the existing evidence-base is limited, several studies and reviews suggest that HIV and MNCH service integration is feasible and can improve various health and behavioral outcomes. In order to enhance understanding of current efforts to deliver integrated pediatric HIV and child health services, USAID's Africa Bureau and the ASH project conducted research to produce a mapping of existing initiatives in Sub-Saharan Africa. [Download]  Regional Actors Addressing HIV in Africa: Comparative Advantages, Challenges and Opportunities Source: African Strategies for Health Regional bodies are active contributors to the development of Africa’s health sector. In the region that is home to more than 70% of all people living with HIV, they have a particularly important role to play in supporting global HIV initiatives such as the U.S. Government’s call for an AIDS-Free Generation, the Global Plan to Eliminate New HIV Infections in Children and Keeping their Mothers Alive, and Ending Preventable Child and Maternal Deaths. Understanding how regional actors engage in HIV-related work, as well as their comparative advantages and challenges, will enable governments, policymakers, donors, implementers, and civil society to partner with them effectively to end preventable child and maternal deaths and prevent new HIV infections. [Download Technical Brief] En français [Les Acteurs Régionaux Face au VIH en Afrique: Avantages comparatifs, défis et opportunités] Visit the online database to browse through more than 120 regional organizations working in health in Africa. >>Database  Regional Minimum Standards and Brand for HIV and other Health Services along the Road Transport Corridors in the SADC Region Source: Southern African Development Community Expanded mobility and cross-border trading are significant drivers in the transmission of communicable diseases and have contributed to increased HIV prevalence rates among key populations and communities living in Eastern and Southern Africa. To support a strengthened and coordinated response to the unique public health challenges this presents, the Southern African Development Community (SADC), approved and released the Regional Minimum Standards and Brand for HIV and other Health Services along the Road Transport Corridors in the SADC Region (RMSB) in November 2015. The RMSB outline a minimum package of services and standards for service delivery to more effectively target high-risk geographic areas and key populations, such as long distance truck drivers and sex workers. The RMSB define roles, responsibilities, and management mechanisms to improve the quality and reach of current prevention and health services for HIV and other important health conditions, including tuberculosis, sexually transmitted infections, malaria, hypertension, diabetes, and sexual and reproductive health services including family planning. The standards are endorsed by Member State Ministries of Health and Transport, and represent collaborative partnership through a highly consultative process involving key stakeholders and technical experts from Member States, development partners, United Nations agencies, regional transport federations, worker groups, regional and national associations of sex workers, and implementing partners that provide health services to long distance truck drivers, sex workers, and communities living along road transport corridors in the region. Catalytic technical and financial support was provided in partnership by USAID's Africa Bureau and their project African Strategies for Health (ASH), and USAID's Regional HIV/AIDS Program and their project, Building Local Capacity for Delivery of HIV Services in Southern Africa (BLC), both implemented by Management Sciences for Health. Download the RMSB [in English] [French] [Portuguese] Executive Summary [Download] Innovative HIV Prevention Practices and Programmes for Long Distance Truck Drivers and Sex Workers: Global Lessons and Opportunities in the SADC Region [Download] Visit the SADC Website  Reducing Maternal Mortality for HIV-Infected Pregnant and Postpartum Women Source: African Strategies for Health This technical brief summarizes the findings of three systematic reviews on interventions to reduce maternal mortality in HIV-infected pregnant and postpartum women, individual and contextual barriers and enablers for ART use among this key population, and the health system barriers and enablers for ART use by these women. The brief outlines select recommendations made in the systematic reviews for leveraging interventions to reduce maternal mortality and to address individual, contextual, and health system factors that influence ART initiation, adherence, and retention. [Download]  A Systematic Review of Interventions to Reduce Maternal Mortality among HIV-Infected Pregnant and Postpartum Women Source: African Strategies for Health HIV-related maternal mortality is high in populations with high prevalence rates and HIV-infected pregnant and postpartum women experience increased mortality compared to their uninfected peers. Scaling up HIV-related treatment options and expanding program reach for these women is likely to decrease maternal mortality. This systematic review synthesizes evidence from interventions which directly reduce mortality among this population. [Download]  A Systematic Review of Individual and Contextual Factors Affecting ART Initiation, Adherence, and Retention for HIV-Infected Pregnant and Postpartum Women Source: African Strategies for Health; Published in PLoS ONE This systematic review synthesized evidence of individual and contextual factors that inhibit or enable antiretroviral therapy (ART) initiation, adherence, and retention among HIV-infected pregnant and postpartum women. Factors in the Individual, interpersonal, community, and structural levels of influence are identified and areas of intervention needs for this population are suggested and discussed. [Download]  A Systematic Review of Health System Barriers and Enablers for ART for HIV-Infected Pregnant and Postpartum Women
Source: African Strategies for Health; Published in PLoS ONE HIV-infected pregnant and postpartum women are among those most consistently engaged with the health system, yet more than one third of this population does not receive treatment. This systematic review synthesized evidence on health systems factors that affect ART initiation, retention in care, and long-term adherence in HIV-infected pregnant and postpartum women. Key health system barriers and enablers of ART are categorized into five themes (models of care, service delivery, resource constraints, patient/health system engagement, and interventions to improve maternal ART outcomes) and key knowledge gaps and research priorities are identified. [Download]  Regional Actors Addressing Maternal, Newborn, and Child Health in Africa: Comparative Advantages, Challenges and Opportunities In recent years, there has been a growing trend toward regionalization on the African continent, as integrated and cooperative efforts have created positive impact in political, economic, and social sectors. Intergovernmental partnerships and cross-border collaboration add value to the fight to save the lives of mothers and children. In an environment with a multiplicity of MNCH policies and programs at national, regional, and global levels, and a pool of donor assistance for health that is shrinking, strengthening partnerships and coordination to collaboratively address MNCH across the continent is critical. [Download Technical Brief] [In French] Visit the online database to browse through more than 120 regional organizations working in health in Africa. >>Database  Demand-Side Determinants to Integrated Community Case Management Care-Seeking: Lessons from DRC Integrated community case management (iCCM) is an effective, equity-based strategy that aims to train, equip, and supervise community health workers to treat children for malaria, diarrhea, and pneumonia. Despite the potential for iCCM services to lead to significant reductions in child mortality, its utilization by care-seekers remains low. This study was conducted in the Democratic Republic of Congo (DRC) and Senegal to enhance understanding of demand-side factors that influence the use or non-use of iCCM services and identify strategies to address them. Technical Brief [Download] Full DRC Report [Download] Technical Brief in French - Coming Soon!  Demand-Side Determinants to Integrated Community Case Management Care-Seeking: Lessons from Senegal Senegal has a long history of treating illness at the community level. The full package of iCCM services was introduced in 2003 and has since been expanded to cover all of Senegal’s 14 regions and 72 of 75 health districts. The aim of this study was to identify demand-side drivers of the use or non-use of iCCM services across four districts and eight community sites in Senegal. The findings and recommendations may be relevant for countries that are considering introducing, modifying, or scaling up an iCCM program at the community level. Technical Brief [Download] Full Senegal Report [Download] Technical Brief in French - Coming Soon!  Misoprostol Policy and Scale-up for the Prevention of Postpartum Hemorrhage in Madagascar, Mozambique, and Nigeria: A Synthesis Brief Postpartum hemorrhage (PPH) is the leading cause of maternal mortality in low-income countries. Over the past decade, the use of misoprostol for the prevention of PPH in developing countries has gained attention as an effective strategy in settings where skilled birth attendance is low, particularly at the community level. Despite a growing body of evidence, few countries in Africa have adopted national policies or service-delivery guidelines for the introduction and scale-up of this intervention. To better understand and inform the processes behind doing so, ASH conducted a review of experiences from Madagascar, Mozambique, and Nigeria. [Download Synthesis Brief]  Misoprostol Policy and Scale-up for the Prevention of Postpartum Hemorrhage in Madagascar: Country Report This study identifies a number of facilitators, enablers, and challenges in Madagascar’s support for community distribution of misoprostol for the prevention of PPH and its subsequent implementation. While no formal policy has been established, gains in policy adoption are reflected in a ministerial note, which authorizes the procurement and roll-out of misoprostol at the community level for the prevention of PPH. [Download]  Misoprostol Policy and Scale-up for the Prevention of Postpartum Hemorrhage in Mozambique: Country Report A range of factors were cited as influential in the development, adoption, and subsequent implementation of Mozambique’s policy for community-based distribution of misoprostol for PPH. A critical determinant was cited as the engagement and leadership from the MOH. However, government support alone was not sufficient for policy adoption; the availability of local research as well as broad-based support from national and international stakeholders was also important to bring about the necessary policy and regulatory decisions for the effective adoption and subsequent implementation of the policy. [Download]  Misoprostol Policy and Scale-up for the Prevention of Postpartum Hemorrhage in Nigeria: Country Report This study demonstrates that a number of facilitators, enablers, and challenges have contributed to Nigeria’s support for community distribution of misoprostol for PPH and its subsequent implementation. While the policy development process was described as long and arduous, a strong facilitator for its adoption was the availability of local evidence highlighting the safety, feasibility, and acceptability of this intervention in the most challenging areas of Nigeria. [Download]  Meeting the Health Needs of Five to Nine Year Olds In Africa Significant global investment in preventative and life-saving interventions for children under five years of age has greatly contributed to the reduction of the global mortality rate by nearly half from 1990 to 2013. Given that more children are surviving into primary school age and beyond, and that today’s generation of young people is the largest in history, health investments in the youth population (ages 10-24) have also increased. However, this investment often excludes five to nine year olds, creating a gap in the health continuum of care that should extend from birth through adulthood. This discussion brief aims to raise awareness about the health issues affecting five to nine year olds and initiating dialogue on potential opportunities for health programming directed toward this cohort. [Download]  Maternal Death Surveillance and Response (MDSR) Case Studies A 2011 Bulletin of the World Health Organization advocates for low-income countries to adopt maternal death surveillance and response (MDSR) systems that include maternal death identification, reporting, review, and response to provide the essential information to stimulate and guide actions to prevent future maternal deaths and improve the measurement of maternal mortality. To enhance cross-country learning around MDSR, ASH developed two country-specific case studies which document MDSR implementation experiences in Burkina Faso and Malawi. These case studies were developed for inclusion in the WHO Global MDSR Implementation Report and can be accessed on the WHO website. Burkina Faso Case Study [Download] Malawi Case Study [Download]  2014 Status Report on Maternal, Newborn and Child Health Source: African Union Commission As part of the African Union’s Campaign on Accelerated Reduction of Maternal Mortality in Africa (CARMMA), the African Union Commission launched the 2014 Status Report on Maternal and Child Health, at the 2015 CARMMA Week Commemoration held in Nairobi, Kenya on November 18-19, 2015. Developed with support from the African Strategies for Health project, the Status Report is part of the African Union's contribution to enhancing MNCH on the continent. This is the third in a series of Status Reports prepared since 2012. The report details the status of MNCH in Africa over the last five years and makes recommendations for focusing efforts on ending preventable maternal and child deaths by 2030. [Download]  African Leadership for Child Survival Meeting Report
As part of Committing to Child Survival: A Promise Renewed, a global effort to stop children from dying of causes that are easily prevented, ASH supported the Government of Ethiopia, USAID and UNICEF to convene the African Leadership for Child Survival Call to Action meeting in Addis Ababa, Ethiopia, from January 16-18, 2013. The focus of the meeting was on:
UNICEF’s Committing to Child Survival: A Promise Renewed: 2013 Progress Report [Download] provides an update on global progress to date.  Strengthening IPTp Service Delivery through Facility Initiated Supervision: Lessons from a Quality Improvement Approach in Uganda Malaria contributes significantly to maternal mortality and morbidity in Sub-Saharan Africa. Preventing malaria among pregnant women is an important strategy for reducing mortality and adverse maternal and neonatal health outcomes. The World Health Organization recommends intermittent preventive treatment for pregnant women (IPTp) at each scheduled antenatal care visit starting early in the second trimester as a key strategy for prevention. This study, conducted in two districts in Uganda, explored service delivery practices, missed opportunities, and barriers at the facility level that impede IPTp service provision. Technical Brief [Download]  Facility Level Factors Influencing the Uptake of Intermittent Preventative Therapy for Malaria in Pregnant Women: Report on a Formative Assessment Conducted in Uganda Reducing the burden of malaria in Uganda is a priority for The National Malaria Control Program. While significant strides have been made, some components have not progressed to the same extent, including malaria in pregnancy. This assessment was undertaken by the ASH project to assess facility-based factors that influence the coverage of IPTp among pregnant women. Full Report [Download]  Financial Incentives to Improve Malaria Case Management: A Review of the Evidence Malaria remains a significant burden to health systems, especially in Sub-Saharan Africa, which accounts for 90 percent of malaria-related deaths worldwide. Not all patients are able to access timely and quality malaria case management services. A key strategy to enhance the utilization, provision, and quality of malaria services is the use of both demand-side and supply-side financial incentives. To understand how financial incentives may be structured to improve malaria case management, this technical brief presents an evaluation of findings, associated recommendations, and considerations for future operations research. [Download]  Regional Actors Addressing Malaria in Africa: Comparative Advantages, Challenges and Opportunities
Regional bodies involved in malaria-related work often have specific roles and act in complementarity to one another. Past success in addressing the high malaria burden in the region has been brought on by their strategic engagement with governments and international donor agencies. Understanding just how these regional actors operate, as well as their comparative advantages and challenges, will ensure that governments, policymakers, donors, and implementers more effectively partner with them and leverage their full potential to end malaria in Africa. [Download Technical Brief] [In French] Visit the online database to browse through more than 120 regional organizations working in health in Africa. >>Database  Childhood Tuberculosis and Nutrition: Opportunities for Integrated Programming Community platforms; maternal, newborn, and child health; and nutrition programs play an integral role in ensuring TB in children is identified and treated early; however all too often children with TB remain undiagnosed, uncounted, and untreated. Good nutrition is promoted as an essential element of TB treatment and weight gain is used to monitor children's progress during treatment. However, nutrition programs provide limited references to screening malnourished children for TB. This brief in meant to inform National TB Programs, nutrition programs, and providers how to capitalize on existing nutrition programs to identify children with TB. [Download]  The Policy and Practice Divide for Childhood Tuberculosis in Africa: A Landscape Analysis In recent years, progress has been made to combat childhood TB. The emergence of policies and guidelines across Africa that incorporate childhood TB, coupled with innovative treatment and child-friendly medicine, have moved us closer to tackling one of the oldest and most persistent diseases in the world. However, this analysis shows that in African countries, a persistent divide between policy and practice threatens progress gained for addressing childhood TB across the region. This brief presents the landscape of childhood TB programming in 12 countries in Africa and suggests three focus areas critical for moving the dial on this intractable issue. [Download]  Closing the Implementation Gap Between Policy and Service Delivery for Childhood TB To improve the status of childhood TB service delivery, a focus on policy and practical implementation support is needed. Download the diagram to better understand the issue. [Download]  Strengthening Guidelines for Childhood Tuberculosis to Accelerate Diagnosis and Treatment While many countries in Africa have developed national strategies to address childhood TB, implementation of these strategies in practice lags. National guidelines for the management of childhood TB can strengthen health service delivery and improve diagnosis and treatment. Because sick children frequently present to Maternal and Child Health (MCH) services, it is critical that MCH and TB services are linked and leveraged by clear guidance on the optimal interaction between these services. To better understand whether childhood TB guidelines can inform the roles and responsibilities of MCH providers and to identify opportunities for strengthening them and related tools, USAID and the ASH project assessed existing childhood TB guidelines in 13 countries in Africa. This brief provides a summary of findings and makes recommendations for revising outdated guidelines and strengthening them to improve service delivery and reduce the burden of TB in children. [Download]
The video was produced by the USAID-funded African Strategies for Health (ASH) project, led by Management Sciences for Health (MSH). It features commentaries from global and African regional experts in childhood TB including representatives from the World Health Organization’s Regional Office for Africa, UNICEF, the TB Alliance and USAID.  Regional Actors Addressing Tuberculosis in Africa: Comparative Advantages, Challenges and Opportunities
Due to the resurgence and new status of TB as the leading infectious killer in the world, combined with the fact that the African region bears the highest TB and TB/HIV co-infection rates in the world and continues to struggle with multi-drug resistant TB (MDR-TB), a large number of African regional actors have scaled up their efforts to combat the disease. They play specific and often complementary roles and have established a range of relationships with governments and donor agencies. Understanding how these actors operate, as well as their comparative advantages and challenges, will ensure that governments, policymakers, donors, and implementers partner with them effectively to prevent new TB infections and end preventable deaths. [Download Technical Brief] [In French] Visit the online database to browse through more than 120 regional organizations working in health in Africa. >>Database  Pan-African Parliament Champions Evaluation Across the Continent Source: African Strategies for Health In partnership with USAID's ASH project and its South African partner, Khulisa Management Services, members of the Pan-African Parliament (PAP) joined a global campaign calling for increased attention and leadership for health evaluation in Africa. Led by the Global Parliamentarian Forum for Evaluation, the Global Parliamentarians for Evaluation Campaign, promotes the use of and demand for high-quality evaluation capacities, essential for delivering progress in health and development across the continent. [Download] [Also in French, Portuguese, and Arabic] Videos: A series of videos were released as part of the global campaign, highlighting how evaluation has been used for evidence-based policy making over the course of their mandate at the Parliament of their home country. The five African parliamentarians featured in the series include Hon. Muntaka Mubarak (Ghana), Hon. Roger Nkodo Dang (Cameroon), Hon. Rachel Shebesh (Kenya), Hon. Shitaye Minale (Ethiopia) and Santosh Vinita Kalyan (South Africa).
 Strengthening the Capacity of African Evaluators to Conduct High Quality Health Evaluations
Source: African Strategies for Health This report documents the proceedings of the 7th International Conference of the African Evaluation Association in Yaounde, Cameroun from March 3 -7, 2014. [Download]  Regional Economic Communities Results from a Landscape Analysis of Regional Health Sector Actors in Africa: Comparative Advantages, Challenges, and Opportunities The African continent has perhaps seen the most pronounced movement towards regionalism. In Africa’s health sector, regional bodies—such as regional economic communities and inter-governmental institutions, as well as regional professional associations and regional networks —have become active contributors to the development and health agendas during the last 10-15 years. The following paper discusses regionalization as a critical trend in Africa and presents findings and conclusions from a landscape analysis of key regional organizations in the African health sector. It contributes to a greater understanding of the relationships, power dynamics, limitations, and strategic advantages of regional bodies in Africa. [Download]  Regional Networks and Associations Results from a Landscape Analysis of Regional Health Sector Actors in Africa: Comparative Advantages, Challenges, and Opportunities Despite the growing international trend towards increased regional multilateralism, integration, and cooperation in health and other sectors, there is a limited body of literature examining the relationships, power dynamics, limitations, and strategic advantages of regional bodies. To enhance understanding of the contributions and role of regional bodies engaged in health in Africa, the ASH project undertook a study to compile the evidence on regionalization and the relationships, limitations, and strategic advantages of regional actors. This study contributes to the similar but larger scale landscape analysis commissioned by Harmonizing for Health in Africa (HHA) with support from the Norwegian Agency for Development Cooperation (NORAD). [Download] Visit the online database to browse through more than 120 regional organizations working in health in Africa. >>Database Regional Actors Addressing Health in Africa Technical Briefs Download a series of technical briefs outlining the role of regional actors and their comparative advantages, challenges, and opportunities for addressing key health issues:
Strengthening Regional Collaboration for Health: A Session at the World Health Assembly As African countries adopt the Sustainable Development Goals and prepare to meet the ambitious targets for 2030, strong regional cooperation will become increasingly important to ensure commitments become action. USAID and the ASH project, led by MSH, led a side session alongside the 69th World Health Assembly to discuss the role of regional actors in the African health sector and opportunities to leverage greater collective impact on health outcomes through strengthened collaboration and partnership between global, multilateral, regional, and country-level stakeholders. [Watch the video recording] |
