Tag Archives: health systems

Small Innovations, Big Impacts _Key to Strengthening Health Systems

With  the growing failure to deliver safe  and affordable treatment and daunting increase in number of deaths of  men, women and children. Innovations in health products, practices, and technologies have the potential to revolutionize global health.

I came across this article through Karen Grepin’s Blog and thought how amazing this tradition was , a 75 yr old tradition of gifting new mothers a maternity kit as they leave the hospital and how mothers choose them over the cash. My eyes lit up when I saw the contents of the box and wait –it  costs less than $180. Bravo ! I  couldn’t help but relate this to the low infant mortality rate in Finland and thought about how many mothers in low income settings would find it appealing with strategies/innovations like this to seek care and  deliver in health care facilities.

Fig 1: Maternity Box,Finland and its contents  & Image Courtesy-BBC



Joy Teni is a newly appointed midwife in a primary health care center in South Sudan. After taking charge in the only PHC in this northern region , she realized that women only opted to use the natural family planning –Lactational Amenorrhea Method ( LAM ) and believed that modern methods would prevent them for giving birth in future. In an attempt to change this situation , Joy created a visual display of family planning methods which she used  during antenatal care visits, as well as with post-natal mothers and husbands. Briefly after doing this she noticed a change in pattern of using the modern family planning methods. And how much did this cost ?Zero. Marketing an old idea into a new one is also innovation and What a simple and effective way to address the problem!

Fig 2: Modern Family Planning Methods, Display-South Sudan & Image Courtesy:MSH


Do I think we can address serious issues within health systems by simple innovations? Yes.

What’s stopping countries with limited funding to take advantage of innovations like this?If critics consider that these innovations are contributing to the problem of healthcare funding, it only seems reasonable to argue and show how successfully they can contribute to a solution.


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The Rise of the Midwives

Often in public-private partnerships it is seen as private companies and NGOs entering into local populations to assist where public health care systems have not prevailed. This can lead the direction of health systems toward the drives of the private entities. Yet this is also neglects the influence that the public sector has on current private companies and people that exist already in the community settings. While with the best of intentions, foreign agencies often unknowingly direct funds and resources away from culturally sensitive practitioners, yet a current change exists by some organizations. They have realized this issue and changed their programs. A prime example of this is midwives in different countries.

Many people in various countries use midwives for birthing due to cultural sensitivities. This issue has been shown in many countries such as Afghanistan and Uganda. Countries such as these and Ecuador use midwives to assist in birth especially in rural settings. Midwives often use complementary and alternative medicine as a complement for health practices. These methods are based in historically practiced treatments and integration into a health system has been scientifically proven to be effective[1]. An example of an excellent program that is being established in with CARE, public health centers and midwives in Ecuador.

Currently, CARE is funding the transportation of midwives in rural parts of Ecuador to attend training sessions with local obstetricians in order to improve clinical knowledge. These midwives then return to the rural sector to use these new practices in conjunction with traditional methods during the pre-natal, birth and post-partum stages of childbearing.

This method incorporates diagonal implementation, which has been shown to be one of the most effective program styles because it uses a well-established framework[2]. It uses outside funding to pass on knowledge, which is sustainable and can be passed down through midwives. Additionally, it gives many women the security of being treated by a known community member who keeps with local customs and practices as well. Finally, this system supports a communication between local traditional health-practitioners and clinical professionals.


[1] Camurdan, C, Gül, A (2013) Complementary and alternative medicine use among undergraduate nursing & midwifery students in Turkey. Nurse Education in Practice. 13(5): 350-354

[2] Reich, MR, Takemi, K, Roberts, MJ, Hsiao, WC. (2008) “Global action on health systems: a proposal for the Toyako G8 summit.” Lancet 371: 865-869.

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