Posted by: afedorova | 09/10/2009

Welcoming a comprehensive, integrated approach

GHC Policy Communications Coordinator Vince Blaser is traveling in Zambia and Tanzania to visit member programs and report on policy connections. This is the seventh of his reports.

DAR ES SALAAM, Tanzania – From the grassroots to the large organizations here in Tanzania or in Zambia, the answers have been similar: an integrated, coordinated, comprehensive and, most especially, flexible approach to global health by a major donor such as the United States is welcome.

The embodiment of what the Obama Administration is trying to do in many ways can be found in the overarching goals of the African Medical and Research Foundation (AMREF), a GHC member. Started in 1957 by three surgeons as Flying Doctors Service of East Africa, AMREF now implements projects here in Tanzania, as well as Kenya, Ethiopia, Uganda, Tanzania, Southern Sudan and South Africa, as well as providing training and consulting support to 30 additional African countries. The three overarching themes of the organization – community partnering for better health, capacity building, and health systems and policy research – match up to the major themes of some of the mulitlaterals (e.g. the World Health Organization’s major emphasis on primary health care this year) as well as the U.S. Global Health Initiative.

Speaking with program staff at AMREF’s main office, they reiterated to me some of the themes I’ve seen around the country this week – challenge of reaching the rural areas, health workforce shortages and adaptation of messages to reach the variety of cultures here. The organization through its 26 projects with multiple partners and funders has responded to some of these challenges in both in implementation – such as creating “post-testing clubs” to address a lack of psycho-social support for people living with HIV – and in advocacy – such as successfully convincing the Tanzanian Ministry of Health that some non-lab health workers can perform HIV tests.

The organization has many new projects and components coming into force in gender and youth empowerment, maternal health and family planning. Dr. Florence Temu, deputy country director, said that AMREF Tanzania keeps those three main themes in mind with all of their programs with the realization that all of the funding streams and issue areas in global health often boil down to how they all are given to one child by one health worker. Staff at AMREF said the Tanzanian government has solid policies but might not always have the resources they need to fully implement them.

As director of the grassroots organization (and GHC member) Global Vision Tanzania, Dr. Joel Samson Ruvugo has quite a different position than Dr. Temu. However, in a meeting with him today he reiterated for comprehensive and flexible support that better enables organizations such as Global Vision – which conducts counseling in HIV, TB and malaria.

Of course to enable everyone’s goal of better health outcomes, solid hospitals and laboratories are a must. Tomorrow I will end my two weeks here in Africa by looking at labs and hospitals supported by the Abbott Fund.

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