It was a day of learning about global health. The United States Agency for International
Development (USAID) and George
Washington University held the Global Health
Mini-University on September 14. The Global Health Mini-U is an
annual forum for best practices and the latest health information
from around the world.
No one can do it alone
The importance of collaborations and how commercial partnerships
are helping build emerging health markets was a hot topic. One
highlighted project was the Social Marketing for Change/Commercial
Market Strategies projects to promote family planning in Morocco by
increasing the use of the contraceptive pill. This model involved
engaging pharmaceutical companies, researching pricing, lowering
product prices, training pharmacists, and conducting market
research from USAID.
Partnerships allow professional associations to reach key
opinion leaders in both public and private sectors and build
support among critical influencers. Partnerships work best
- There is a close collaboration between private and public
- There is close collaboration on the marketing plan
- Companies are willing to independently produce high quality and
- All parties can see mutual benefits
Monitoring and evaluating community
How do programs report? What are communities being asked to
report? What resources do these communities have available? Are
community programs providing the data necessary to establish
accountability and guide program management? These questions are
extremely important for measuring and evaluating global health. The
President's Emergency Plan for AIDS Relief reporting indicators are
commendable, but are they viable given the realities in the field?
Usually, a community worker is a volunteer or low paid staff, with
low literacy, who lives in the community, and who is responsible
for data collection using lengthy forms and record keeping.
Community programs also are expected to provide comparable data to
facility-based programs but without comparable physical
infrastructure and human resources. This leads to poor data
quality, low data use, and program burnout.
The challenge is to ensure that frontline volunteers/staff are
not overextended. It does not make sense for frontline workers to
collect all the information that the cooperating agencies require
for monitoring and evaluation purposes. The reality is that
adequate financial resources are needed to obtain data. An
alternative approach would be to develop a community roster for
supervision, simple forms for case management, semi-annual or
annual cluster sample surveys to track coverage, and
population surveys to measure outcomes and impact in project
areas. Although this approach requires well-designed baselines,
follow-up surveys, and data triangulation, it is feasible.
The future of global health
Challenges facing the future of global-and how to address those
challenges-were also discussed at the conference. Among those are
the number of people dying of non-communicable diseases; population
growth; vulnerable women and girls; resistance to drugs; health
funding; diagonal programming; and how civil societies, private
individuals, government, and multilaterals work better together. To
address the gaps in maternal health, a better job must be done to
integrate family planning services and maternal and child health.
We need to more deeply understand the barriers and cultural
considerations. In some cultures, for example, it is important to
target the gatekeepers when designing programs for women.
Implications of urbanization
Countries are facing water scarcity and inadequate
infrastructure to meet the needs of the population, lack of focused
attention, and investments to find solutions that work in urban
areas and can be scaled up, as well as attention to the health
needs of the young adolescents.
Strengthening of health systems is also a challenging issue in
global health. A health system should deliver high quality care, be
accessible, and be well financed. Countries find themselves without
resources once funding ends and are unable to keep the
infrastructure. They have to start looking internally to determine
how they will finance their own health systems, and, especially in
emerging economies like India, they need to explore how to create
models that can produce profits and be sustainable.
Participants in the Global Health Mini-U for sure had a day of
learning, but also of fun. The day ended with a fun activity where
students from George Washington and George Mason University were tested
in their knowledge of global health. For everybody's satisfaction
there was a tie!