MSH Spotlights Fragile States at Women Deliver

(Photos by Willow Gerber/MSH)

by Filmona Hailemichael

Filmona Hailemichael (Photo credit: R. Hassinger/MSH)

Filmona Hailemichael (Photo credit: Hassinger/MSH)

On Tuesday, May 28, MSH brought together fragile states staff from Democratic Republic of the Congo (DRC), Haiti, and Afghanistan to share their field experiences with congressional staffers in Malaysia for the Women Deliver conference. The dinner panel, “Delivering Maternal, Newborn, and Child Health (MNCH) in Fragile and Post-Conflict States,” featured Philippe Tshiteta of MSH DRC, Sandra Guerrier of MSH Haiti, and Dr. Mushfiq of MSH Afghanistan, and also Sandra Krause, the director of sexual and reproductive health at Women’s Refugee Commission, and Paola Cirillo, the Syria and Middle East program officer at Italian NGO AIDOS.

The five panelists shared vivid stories of the major barriers to and strategies for delivering MNCH and reproductive health services in the difficult contexts in which they work.

Despite many challenges, the common emergent theme was that simple, low cost interventions—such as having skilled birth attendants, immunizations, and proper hand washing—can have powerful impacts on effectively saving lives and improving the health of women and children even in post-conflict and post-disaster settings. The event left attendees with a better sense of the on-the-ground realities that MNCH health workers face in fragile states and an improved understanding of the need for improvements to health systems infrastructures in these environments.

Read more about MSH’s work in fragile states.

Filmona Hailemichael is a manager of policy and advocacy at MSH.

Against all odds: Meeting maternal, newborn, and child health needs in the DRC

Kristin Cooney. (Photo courtesy K. Cooney)

Kristin Cooney. (Photo courtesy K. Cooney)

by Kristin Cooney

I had the pleasure of presenting stories and results from a successful DRC project on Tuesday, May 28, day one of Women Deliver 2013.

The USAID-funded Integrated Health Project (IHP) in the Democratic Republic of Congo (DRC), implemented by Management Sciences for Health, the International Rescue Committee and Overseas Strategic Consulting, Ltd, is creating better conditions for, and increasing the availability and use of high-impact health services, products, and practices in 80 health zones in four provinces (Kasaï Occidental, Kasaï Oriental, Katanga, and Sud Kivu.

IHP addresses three major bottlenecks hampering the performance of health services: (1) poor availability of medicines and essential inputs related to supply chain management; (2) limited availability of qualified human resources to implement high-impact interventions for the health of the mother and the child; and (3) low quality of care.

Audience members participate in a Q&A with the panelists. (Photo: R. Hassinger/MSH)

Audience members participate in a Q&A with the panelists. (Photo: R. Hassinger/MSH)

Although working in a fragile state where instability persists, IHP applies a development approach that demonstrates that, even against many odds, health programs can achieve results in challenging settings—they just need to be innovative and persistent to achieve their goals.

Using a range of high-impact practices and approaches in maternal, neonatal, and child health and family planning that were selected through careful analysis, including use of the Lives Saved Tool (LiST)—such as integrated services, Leadership Development Programs, fully-functional service delivery points, and a range of behavior change communication approaches (i.e. mHealth and Champion Communities)—IHP has achieved impressive results in fistula care, family planning, rates of assisted delivery, and active management of the third stage of labor, among other health indicators.


An important focus of the program is counseling women and families on healthy timing and spacing of pregnancies at health center and community level. Community-based distribution of family planning methods is improving contraceptive security and promoting a range of modern contraceptive methods and includes training and supporting community workers to deliver family planning and to refer and accompany couples to health centers to choose a contraceptive method.

Selected findings include:

  • Couple years of protection as of March 2013 was 122,523, which is 111% of the target of 110,000.
  • New acceptors of family planning as of March 2013 was 136,302, or 113% of the target of 120,728.
  • As of December 2013, the percent of women receiving Active Management of the Third Stage of Labor, at 84%, was 105% of the target of 80%.

IHP is getting the right commodities into the right, competent hands at the right time to produce impressive results, against all odds.

Kristin Cooney is a director, country portfolio, at MSH.