People's Stories Wellbeing

The arrival of the health team has made a huge difference to our community
by Action Against Hunger, agencies
Aug. 2017
When a local health post was established in her community, life changed for Namusa Nomoga, mom of four in Mali.
Namusa Nomoga, mother of four children in southwestern Mali, grows lettuce, tomatoes and onions in her little vegetable garden. Her husband works as a seasonal farmer.
A few months ago, her son, two-year-old Samakoun, suffered from life-threatening malnutrition. “I noticed that something was wrong with Samakoun when he developed a temperature. He was very hot. He wasn’t able to keep his food down and then he stopped eating altogether. He usually smiles a lot and he likes to play, but suddenly he became very weak.”
“As a mom, you worry about your children. When they’re sick, your mind cannot be at ease until they are better again,” says Namusa. She took Samakoun to a local health post, established by the innocent foundation and Action Against Hunger.
“Kindiaba, the local health worker who moved to our village a few months ago, weighed and measured Samakoun, and took his temperature. She told me that he was ill with undernutrition and that he needed special treatment. She asked me to feed him Ticadekeni [a ready-to-use therapeutic food used to treat malnourished children] and to come back for follow-up treatment once a week. After just a few weeks, Samakoun had recovered.”
“It used to be very difficult for families here to access health care,” explains Kindiaba Sidibe, who was deployed to Namusa’s village to provide children with access to basic healthcare. “The national health structure exists, but at a community level, many people cannot access treatment for their children when they fall ill.”
Together with the innocent foundation, Action Against Hunger is changing how malnourished children are diagnosed and treated within their communities, paving the way for health workers to reach all malnourished children, no matter where they live.
By empowering community health workers to diagnose and treat children at home—instead of asking parents to walk as many as 25 miles to the nearest health clinic for treatment—we are supporting action to tackle hunger and malnutrition head on.
Action Against Hunger’s program aims to empower community health workers not only to help save lives, but also to partner with mothers like Namusa and other caregivers to spot the warning signs of malnutrition and get early treatment to prevent children from becoming seriously ill in the first place.
“Before Kindiaba arrived, we had to walk for many hours to get to Tambaga [where the nearest health center is located] to seek treatment for our children when they were ill,” says Samakoun. “It’s really far and it meant we had to leave children behind for a long time. Even when we managed to go there, we still weren’t able to prepare a meal for our other children or fetch water from the well to water our garden.”
The results from our research project promise to be a gamechanger in the fight against child hunger. The initial findings from our study are very promising: in the villages where we implemented the program, community health workers were able to double the number of children who received treatment for severe acute malnutrition.
“After one year of implementation, we’ve found that there is massive engagement with the project within local communities. People have welcomed the health workers and there’s been great demand for their services,” explains Franck Ale, who coordinates the project for Action Against Hunger and the innocent foundation. “We’ve found that there’s been a significant increase in the number of children who are accessing treatment and survive.”
For mothers like Namusa, the project has changed her family’s life already: “I want my children to move forward. My dream is for him to be able to study and do well in life. The arrival of the health team has made a huge difference to our community. Children in the village no longer die from disease. They recover when they’re ill. And I feel more at ease. I’m less worried for my children now.”

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Do we want our fellow citizens to die because they are poor
by Tedros Adhanom Ghebreyesus
Director-General of the World Health Organization (WHO), agencies
July 2017
All roads lead to universal health coverage and this is our top priority at WHO. For me, the key question of universal health coverage is an ethical one. Do we want our fellow citizens to die because they are poor? Or millions of families impoverished by catastrophic health expenditures because they lack financial risk protection? Universal health coverage is a human right.
At least 400 million people have no access to essential health services, and 40% of the world''s population lack social protection.
Think about the human reality behind these numbers: the young mother who dies in childbirth in a fragile state because she lacks access to health care; a young child dropping out of school due to family impoverishment caused by health expenses; and an adult living in inner city of a middle-income country suffering from chronic non-communicable diseases and not getting treatment.
I know from personal experience that it is possible for all countries to achieve universal health coverage, including key public health interventions.
The paper in this issue of The Lancet Global Health by Karin Stenberg and colleagues shows that, even at low levels of national income, countries can make progress. Many countries at different levels of economic development have achieved universal health coverage, showing this to be more a political than an economic challenge.
The world has agreed on universal health coverage. Sustainable Development Goal 3.8 sets the following target by 2030: achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality, and affordable essential medicines and vaccines for all. How should WHO help countries to achieve universal health coverage?
Universal health coverage is ultimately a political choice. It is the responsibility of every country and national government to pursue it. Countries have unique needs, and tailored political negotiations will determine domestic resource mobilisation. WHO will catalyse proactive engagement and advocacy with global, regional, and national political structures and leaders including heads of state and national parliaments.
Countries will also need to know where they stand on universal health coverage, benchmarked against others. WHO will develop a measurement system based on Sustainable Development Goal 3.8 indicators to benchmark countries on their attainment of universal health coverage.
Beyond benchmarking, countries learn from their peers, especially those they see as having similar political or economic contexts. WHO will document best practices in universal health coverage at the country level.
Some countries might be doing better on quality service coverage while others might be doing better on financial protection. Within service coverage, countries might prioritise one category (eg, reproductive, maternal, and child health) while others might be doing better on non-communicable diseases or mental health.
Countries take different paths using either public or private providers although public finance will always be needed to provide social protection for the poor to improve equity and so no one is left behind.
Once this learning has occurred, countries may request technical assistance. WHO should be prepared to provide technical assistance to countries based on their specific needs, across the full range of health-related Sustainable Development Goals.
It should work to sustain and build upon recent successes including polio, HIV/AIDS, neglected tropical diseases, and maternal and child health.
Because access to appropriate medicines, vaccines, and diagnostics is an important component of universal health coverage, WHO''s activities on expedited prequalification of vaccines and essential drug and diagnostics lists are important.
Moreover, universal health coverage includes not just heath care but also health promotion and prevention and a broader public health approach. A strong primary health care platform with integrated community engagement within the health system is the backbone of universal health coverage.
Universal health coverage and health emergencies are cousins; two sides of the same coin. Strengthening health systems is the best way to safeguard against health crises.
Outbreaks are inevitable, but epidemics are not. Strong health systems are our best defence to prevent disease outbreaks from becoming epidemics. WHO will continue to implement the International Health Regulations and conduct Joint Evaluation Exercises with countries - of which 70 will be completed by the end of 2017.
Achieving universal health coverage will require innovation. Also, what is measured is managed so data matters. Based on evidence and data, WHO will track progress on how the world is meeting the health-related Sustainable Development Goal indicators. Universal health coverage is not an end in itself: its goal is to improve the other health-related Sustainable Development Goals.
We have a historic opportunity to make transformational improvement in world health. Let''s use the opportunity at the next UN General Assembly in September 2017 to make universal health coverage a reality for many more people.
* Access the link below for more Lancet coverage, also UN WebTV:
17 July 2017
Health services, especially vaccines, must ‘reach the unreached,’ stress UN agencies.
Globally, nearly 13 million infants – almost one in ten – did not receive any vaccinations last year, putting them at serious risk of potentially fatal diseases, the United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO) said today, urging greater efforts to extend the reach of health services.
“Every contact with the health system must be seen as an opportunity to immunize,” stressed WHO’s Director of Immunization, Dr. Jean-Marie Okwo-Bele, noting that most of those who remained un-immunized were also the same as the ones missed by health systems. “These children most likely have also not received any of the other basic health services. If we are to raise the bar on global immunization coverage, health services must reach the unreached,” he added.
According to WHO and UNICEF estimates, 6.6 million children received their first dose of diphtheria-tetanus-pertussis (DTP) vaccines but did not complete the full, three dose DTP immunization regimen (DTP3).
Full completion of the vaccination series doses is critical to ensure the highest level of protection against those diseases.
Furthermore, according to the UN agencies, since 2010, the percentage of children who received their full course of routine immunizations has stalled at 86 per cent (116.5 million infants).
Of the estimated 10 million children, in 64 countries out of 194 WHO member States which have not achieved this target, 7.3 million live in fragile situations or in humanitarian emergencies, including countries affected by conflict.
Four million of them also live in just three countries – Afghanistan, Nigeria and Pakistan – where access to routine immunization services is critical to achieving and sustaining eradication of diseases such as polio.
Similarly, Central African Republic, Chad, Equatorial Guinea, Nigeria, Somalia, South Sudan, Syria and Ukraine recorded less than 50 per cent coverage for DTP3, last year.
In the battle against measles, 85 per cent of children globally received the first dose by their first birthday but only 64 per cent received the second dose.
Additionally, concerted effort is required in the progress against rubella (which can cause hearing impairment, congenital heart defects and blindness and other life-long disabilities), which has seen global coverage increase from 35 per cent in 2010 to 47 per cent last year.
Furthermore, global coverage of more recently-recommended vaccines are yet to reach half the world’s children. These include vaccines against major killers of children such as rotavirus, a disease that causes severe childhood diarrhoea, and pneumonia.
Vaccination against both these diseases has the potential to substantially reduce deaths of children under five years of age, a key target of the Sustainable Development Goals (SDGs).
Inequities in immunization coverage
According to WHO-UNICEF data, many middle-income countries still lag behind in the introduction of newer and more expensive vaccines and disparities persist within countries, implying the need for more work to reduce inequalities related to household economic status, mother’s education as well as those living in rural and urban areas in many countries.
Stressing the importance of immunization as one of the most “pro-equity” interventions currently available, Robin Nandy, Chief of Immunizations at UNICEF, stated: “Bringing life-saving vaccines to the poorest communities, women and children must be considered a top priority in all contexts.”
Immunization currently prevents between 2-3 million deaths every year, from diphtheria, tetanus, whooping cough and measles. It is one of the most successful and cost-effective public health interventions.

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