Policy & Systems



New ILO Report: The World Needs More Rural Health Workers, a Lot More

On April 27, a new report released by the United Nations International Labor Organization (ILO) made a distressing finding: without adequate numbers of health workers, especially in rural areas, more than half of the world’s rural population—and more than three-quarters of the rural population in Africa—will go without access to effective health care in 2015.The report, entitled Global Evidence on Inequities in Rural Health Protection, was the ILO’s response to observable trends in economic disinvestment and neglect in rural health systems around the world.More than half the world’s rural population will go without effective health care in 2015. Now, with this report indicating that nearly 56% of the world’s rural population—and 83% of Africa’s rural population—live without critical health care access, the ILO has provided powerful evidence to demonstrate why strengthening the rural health workforce is imperative to filling this gap.According to the report, inadequate numbers of rural health workers is one of most crippling determinants of poor access to health services in rural areas across the globe. While approximately half of the world’s population resides in rural areas, only 23% of the health workforce is stationed here.This amounts to a deficit of approximately 7 million health workers in rural areas, comprising the vast majority of the ILO’s estimated 10.3 million global health worker deficit.*“Health workers are a prerequisite for access to health care. Without skilled health workers, no quality health services can be delivered to those in need,” asserts this report.So what do the recorded health workforce shortages mean for people’s access to life-saving health services?ILO research provides a grim response to this question: precisely because of these health workforce deficits, 50% of rural areas and 24% of urban areas lack access to the essential health services they need. 77% of Africa’s rural residents lack essential health coverage.

Alejandro Cerón serving at a community health house. San Miguelito, Guineales, Sololá

Neo-Colonial Epidemiology in Guatemala: An Interview with Alejandro Cerón

I recently had a chance to talk with Alejandro Cerón, an Assistant Professor of Anthropology at the University of Denver. Cerón trained as a physician Read More


The Lancet Commission on #GlobalSurgery Report

Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development Watch Live The Lancet Commission on Global Surgery Report.


Let’s Eradicate Obstetric Fistula and Restore Dignity for Women

Every day, some 326 babies are born in North Carolina. Those babies and their mothers are fortunate—we live in a state with a strong health care system, and we have the benefit of first-rate hospitals, medical research, and pharmaceutical development right in our back yards.For every 1,000 babies born in North Carolina, seven will die in infancy. This is seven too many, but in a global sense, we are far more fortunate than many other countries. In Mali, for instance, 78 of every 1,000 babies die before they reach their first birthdays.And far too often, mothers fare little better than their lost children. Many women die in childbirth or suffer life-altering disabilities.Imagine for a moment: After many long months of looking forward to the birth of your child, you suffer a prolonged, excruciating labor, and give birth to a stillborn baby

We Can Help Restore Dignity for Thousands of Women in Mali

Diarahi, 27, is hopeful about her life. Her tenacious spirit has wavered over the last twelve years, but somehow has never broken—not when she suffered from more than three days of obstructed labor and mourned the loss of her baby, not when weeks later she realized she could no longer control her bladder, and not when her husband shunned her. Not even when the grandmother who took her in passed away shortly thereafter. Diarahi used to be among the two million women and girls worldwide who suffer from a devastating childbirth injury called obstetric fistula. Fistula is a preventable, treatable condition caused by prolonged, obstructed labor that leaves women with chronic incontinence of urine, feces, or both.

World HTN Day— High blood pressure, also known as hypertension, has become a global crisis

hypertension blood pressure wiki

In the United States, about 70 million or 1 in 3 adults have high blood pressure (>140/90 mmHg) , and only about half of these adults have their condition under control. Worldwide, high blood pressure is estimated to cause 9 million preventable deaths, and is expected to increase. Commonly referred to as the “silent killer” because it often has no warning signs or symptoms, hypertension is a leading risk factor for cardiovascular diseases, such as heart attack and stroke. The Centers for Disease Control and Prevention has created the Million Hearts® initiative to address this challenge within the United States.  Launched in 2011, it set an ambitious goal to prevent 1 million heart attacks and strokes by 2017.

ODI Report Examines International Public Financing, Poverty Eradication Goal

Humanosphere: Status quo won’t end extreme poverty by 2030, think tank says Humanosphere reporter Tom Murphy discusses findings and recommendations from an Overseas Development Institute report, writing, “The report says that the key to changing the way development is done starts with providing enough money to finance basic social services including health care, education, and…More

Yemen’s Tenuous Temporary Ceasefire Allows For Delivery Of Humanitarian Aid To Civilians

Agence France-Presse: Situation in Yemen ‘catastrophic,’ warns U.N. food agency “The U.N.’s food agency warned Wednesday that the situation in Yemen was ‘catastrophic,’ as aid agencies rushed to take advantage of a temporary ceasefire to help desperate civilians…” (5/13). U.N. News Centre: Yemen: U.N. welcomes ceasefire as ‘lifesaving’ humanitarian relief begins to arrive “The top…More

Take Care

It’s interesting to note the emergence of two strands of discussion in the public space around humanitarian aid and development. One is the issue of chronic and/or traumatic stress and accompanying PTSD among humanitarian workers. In an earlier post I pointed out this article in The Guardian, and then a more recent offering in the […]

Devex Examines World Bank President Jim Kim’s ‘Science Of Delivery’ System

Devex: Inside Jim Kim’s ‘science of delivery’ “…Kim’s emphasis on delivery and systematically sharing knowledge can be traced at least back to his time at the World Health Organization from 2003 to 2006. It was at the WHO where Kim noticed that policymakers and health care workers with access to similar resources achieved different health…More

The mHero Story

The Ebola outbreak of West Africa didn’t hit overnight like a tsunami or earthquake—rather, the disaster gradually took over the region beginning in December 2013, really gaining speed in late summer of 2014.  Along the way, weaknesses in health systems, including support to frontline health workers, were exposed, accelerating the spread of the virus. Like many in the field of global health and development, my colleagues and I at IntraHealth International wanted to find a way to help. For over 35 years, IntraHealth has focused on supporting health workers and health systems.One of the organization’s niche areas is health information systems, in particular the open source health worker information system (iHRIS) that helps ministries of health and other stakeholders to collect, analyze, and use data on their health workforces.mHero uses simple SMS and interactive voice response technology on mobile phones. With this commitment to health workers, expertise in technology, and desire to collaborate with partners to respond to the Ebola outbreak in West Africa, IntraHealth, along with UNICEF, created mHero, a two-way communication platform to support dialogue between ministries of health and health workers. This tool supports health worker training, flash surveys to gather information in real time, and other communications using simple SMS and interactive voice response technology on mobile phones.mHero: The BeginningCreating new technologies takes significant time and a lot of committed resources—none of which were readily available as Ebola spread through the streets of Monrovia and the hills of Sierra Leone.

Dissatisfaction Growing Over Russia’s State-Run Health Care System, Bloomberg Reports

Bloomberg Businessweek: In Putin’s Russia, Universal Health Care Is for All Who Pay “…Russia [has] slashe[d] health care services to plug budget gaps left by lower oil prices. That has provoked labor unrest by medical workers — some have even staged hunger strikes — and alarm among patients and their families as one government agency…More

Enhancing public health practice through a capacity-building educational programme: an…

Background: The Post-Graduate Diploma in Public Health Management, launched by the Govt.

Kenya’s Nurses Can Empower Women through Family Planning

For many women in rural Kenya, deciding how and when to start family planning is not an easy one. Cultural practices, religion, and other factors often stand in the way of women making choices about their reproductive lives.In Mombasa County, many members of the Mijikenda, the dominant ethnic group in the area, tend to marry off girls at an early age and believe in large families. Illiteracy and poverty are high, particularly among women. Poor women in particular are not presented with many contraceptive options. Since the various methods of family planning have different side effects for different users, options are key. Linnet Nyakora, a nurse at Mbuta Model Health Centre is helping women overcome these obstacles.During a training course in contraceptive technology use, Linnet learned how to provide and use methods such as intrauterine devices, implants, and injectables.

Emerging doctors call for action on global epidemic: non-communicable disease

This week, special guest-bloggers and Australian doctors-in-training, Rebecca Kelly and Tim Martin of the Australian Medical Students’ Association, call for greater focus, discussion and action on the world’s leading causes of death. In March this year, the Australian government released the 2015 Intergenerational report revealing a prediction of the economic and social trends over the next 40 years. There’s some fantastic news; children born in the middle of this century are projected to live greater than 95 years. Importantly, this increase in life expectancy will involve an improved quality of life and Australians will be more prosperous in real terms. However, the report comes with a warning.

WHO Failed To Engage Local, International Partners In Ebola Response, Independent Panel Reports

Cynthia GoldsmithThis colorized transmission electron micrograph (TEM) revealed some of the ultrastructural morphology displayed by an Ebola virus virion. See PHIL 1832 for a black and white version of this image.Where is Ebola virus found in nature?The exact origin, locations, and natural habitat (known as the "natural reservoir") of Ebola virus remain unknown. However, on the basis of available evidence and the nature of similar viruses, researchers believe that the virus is zoonotic (animal-borne) and is normally maintained in an animal host that is native to the African continent. A similar host is probably associated with Ebola-Reston which was isolated from infected cynomolgous monkeys that were imported to the United States and Italy from the Philippines. The virus is not known to be native to other continents, such as North America.

News outlets discuss the first report of the WHO’s Ebola Interim Assessment Panel, released on Monday. Agence France-Presse: Experts denounce WHO’s slow Ebola response “A U.N.-sponsored report on Monday denounced the World Health Organization’s slow response to the Ebola outbreak and said the agency still did not have the capacity to tackle a similar crisis…”…More

Building Resilient Health Systems Vital To Preventing Future Outbreaks

New York Times: Ebola-Free, but Not Resilient Judith Rodin, president of the Rockefeller Foundation, and Bernice Dahn, minister-designate of health for Liberia “…A resilient health system combines active surveillance mechanisms, robust health care delivery system, and a vigorous response to disease. … When a resilient system is in place, cities and countries alike are prepared…More

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