ADVANCING GLOBAL HEALTH .

Despite great medical leaps over the last decades, medical care as a contributor to health is far outweighed by the many larger, overriding societal factors that are often weakly addressed or sometimes dismissed because they are not direct health care. MSI’s contributions respond to requirements embedded in the definition from the World Health Organization that presuppose interventions far beyond preventive and curative medicine and health care delivery.

Our core competencies empower our partners to promote robust, effective, efficient and transparent health care delivery systems alongside other key pillars of sustainable growth and development. MSI and Coffey International Development, of which we are a part, have implemented long-term projects, analyses, evaluations and assessments in the health sector worldwide. Our combined capabilities during the last 30 years have reached 89 countries and all continents.

Working with governments, public sector institutions, implementation agencies, private enterprises and civil society organizations, our projects include health systems strengthening, integration of good governance principles, primary health care, women’s and children’s health, HIV/AIDS, nutrition, reproductive health and family planning, and communicable and vector-borne diseases.

MSI addresses bottlenecks to achieving the MDGs dependent on health systems that are too fragile and fragmented to deliver the volume and quality of services needed. We work at the very intersections where health care delivery either succeeds or becomes impeded by surrounding structural and societal factors. MSI’s contributions include strategic planning, management and policy implementation. Our extensive experience in anti-corruption, rule of law and economic growth also enables us to bring varied approaches to health systems strengthening in a holistic manner.

OVERVIEW

In 1946, the World health organIzatIon defIned health as “a state of complete physIcal, mental, and socIal Well-beIng and not merely the absence of dIsease or InfIrmIty.” thIs assertIon, tested through much subsequent dIscussIon, remaIns the gold standard statement on health. Its sWeep underpIns the foundatIons for the vIsIon and approach applIed by msI In provIdIng technIcal assIstance and guIdance In loW-resource settIngs.

SELECTED EXPERIENCE • IRAQ

MSI implemented the USAID-funded National Capacity Development project, applying our tools and techniques to the health sector. MSI’s work with the Ministry of Health contributed to establishment of a new strategic framework, assistance in the implementation of the Ministry’s strategic plan, application of software to develop activity tracking systems, and assistance in improving efficiency in the capital investment budget and operational budget performance.

• FEDERATED STATES OF MICRONESIA Coffey is working to improve health and educational outcomes in three of the four states. Health advisers have been essential to many facets of health care service delivery, including building capacity of the national and state governments to implement health reform strategies in a decentralized political structure, installing health service management and delivery systems and updating health workforce plans.

• ZAMBIA MSI is helping to implement the USAID-funded Local Partners Capacity Building project to improve the overall capacity of 100 local NGOs, faith-based organizations and other partners to ensure scaling up of quality HIV/AIDS services. The project is strengthening the management, financial, technical, and monitoring and evaluation capacities of organizations and recruiting talented local development professionals for the project.

• PAPUA NEW GUINEA Coffey provided management to examine the capacity of the PNG health system to independently provide specialist for clinical and surgical services. It also assisted with reviewing project performance, assessing management of the project for ways to improve and reviewing collaborative work between AusAID and the Government of PNG in surgical and clinical service delivery and improvements.

• HIV/AIDS COMPLIANCE MONITORING PROJECT MSI helped USAID to streamline the implementation and monitoring of HIV/AIDS programs worldwide. It focused on assessing, developing, and implementing plans for monitoring compliance with all requirements applicable to HIV/AIDS interventions among injection drug users. Actions included promoting communication and dissemination of user-friendly monitoring materials.

STRENGTHENING HEALTH SYSTEMS As awareness of the centrality of strengthening health systems has grown in recent years, MSI has applied increased resources to improve the functioning of the six building blocks of actual health systems – Service Delivery, Health Workforce, Health Information, Leadership/Governance, Procurement and Management of Medical Equipment, Commodities and Supplies, and Health Care Financing. MSI’s strongest contributions to international health lead to improving four of these six building blocks while partnering with national institutions. Our most frequent point of entry is at the intersection of health, and democracy and governance. We build local capacity, create enabling environments, develop anti-corruption strategies and engage citizens. MSI focuses on the collection and utilization of data to inform, guide and fine-tune policies, development approaches and interventions, collaborating within available resources to scale up successful ones.

HEALTH SERVICES – CAPACITY BUILDING & ORGANIZATIONAL DEVELOPMENT MSI assists programs and organizations to become more productive, accountable, results-oriented and creative. Our organizational development and capacity-building techniques elicit and generate increased governmental and non-governmental collaboration and support. The ensuing benefits enable Ministries of Health, community-based organizations, local NGOs, private and faith-based health service providers and other civil society organizations to expand programs and increase efficiency of service delivery and management systems.

HEALTH POLICY CHANGE It is essential that countries allocate their resources strategically, equitably, effectively and efficiently. MSI assists clients to design, modify and convert policies into action. We have developed particular approaches for policy changes that are organizationally or politically difficult to implement and for situations where enhanced transparency and public participation are priorities.

SELECTED EXPERIENCEMSI’s HIV/AIDS Toolkit is based on eleven years of experience managing USAID’s Implementing Policy Change (IPC) Project and other policy change efforts in the health, population and HIV/AIDS fields. We provided hands-on assistance, training, process consulting and facilitation in more than 40 countries, conducted applied research on policy reform and implementation issues, and developed and tested tools for policy planning. The toolkit includes a framework for managing the six key tasks involved in policy change; a series of tools to help policymakers, NGOs, donors, and activists carry out each of these tasks; case examples; and more than 100 active links to other relevant documents and websites.

MSI implemented the Reproductive Health Compliance assignment plan to develop stronger systems to implement U.S. policy and legislation regarding family planning programs (Mexico City Policy, the Helms Amendment, and the Tiahrt Amendment) and to monitor compliance. MSI provided technical assistance to USAID’s Bureau for Global Health/Office of Population and Reproductive Health and Missions to monitor and strengthen compliance. It coordinated assessments of systems, made recommendations, and trained staff on compliance measures.

Country case studies in Ghana and Sierra Leone equipped African governments for relationships with vertical health funds to maximize health outcomes and promote compliance with the Paris Declaration. These include funds sponsored by bilateral and multilateral donors and private foundations that typically target narrowly defined objectives. They often work independently of one another, both inside or outside of government, and consequently vary in policies and program approaches, increasing the need for coordination among governments and vertical health funds across Africa.

CITIZEN PARTICIPATION & ANTI-CORRUPTION Good governance, civil society involvement and corruption-free public health institutions build strong foundations for sustainable growth and development. The MSI Center for Governmental Integrity is recognized for its innovative work in combating corruption. MSI’s Center has developed diagnostic assessments, public-private partnerships, a local government training package, sector-by-sector strategies, and indicators for performance measurement. We have also helped to establish citizen advocate offices for legal protection of corruption victims.

SELECTED EXPERIENCEMSI developed USAID’s Corruption Assessment Handbook. It provides a common framework and methodology for USAID Missions worldwide. Our multidisciplinary and multi-method analysis of both the legal-institutional framework and the political-economic dynamics in a country focuses attention on the underlying root causes of corruption, rather than on just its symptoms.

MSI performed a detailed and comparative analysis of corruption vulnerabilities in health care delivery for the USAID Africa Bureau’s Office of Sustainability Development in Benin, Mozambique and Tanzania, and developed practical recommendations to improve efficiency, transparency and accountability in health care services.

MSI’s Rwanda Health Sector Corruption Assessment analyzed corruption vulnerabilities and corruptive practices in six areas of the health sector, providing guidelines to USAID/Rwanda for integrating good governance techniques and anti-corruption safeguards into health sector programs.

MSI worked in Colombia to increase access to quality health care by improving citizen knowledge of alternative service providers, by improving the transparency of the choices made regarding service providers, and increasing the role of citizens and local authorities in the social audit of health care providers. We provided training at the local level to formulate, execute, monitor and evaluate health policies to improve outcomes.

SCALING UP MSI’s scaling-up activities create a sustainable institutional environment for significantly expanding programs and advancing the scaling up of especially promising health programs. These activities function to advance the scaling up of viable projects in maternal health, sexual and reproductive health and interventions targeted to reduce maternal mortality and morbidity associated with post-partum hemorrhage.

SELECTED EXPERIENCEWith grants from the MacArthur Foundation since 2003, MSI has assisted India, Mexico and Nigeria to utilize grantee models and policy ideas to scale up activities for reproductive health programs targeting women and marginalized populations. MSI developed a framework, conducted field trials to target specific programs for successful inclusion and collaborated in disseminating papers and findings at international workshops and conferences.

MONITORING & EVALUATION MSI’s Monitoring and Evaluation (M&E) approach assists clients to sharpen their focus and increase their use of performance information and minimize collecting unnecessary data. We have utilized this M&E and assessment expertise to develop and implement plans for monitoring compliance with HIV/AIDS intervention requirements and U.S. policy and legislation regarding family planning programs. MSI provides systematic analysis to improve health and HIV/AIDS activities with up-to-date, balanced and multi-disciplinary assessments for country teams in Africa on sector-level improvements.

SELECTED EXPERIENCEUSAID’s Office of HIV/AIDS (OHA) contracted MSI to improve its performance monitoring and information system (supporting treatment, care and prevention services to people living with or affected by HIV/AIDS). OHA delivers technical assistance to assess, develop, and implement plans for monitoring compliance with all requirements regarding injection drug users, the establishment clause with faith-based organizations and prohibition of sex trafficking.

MSI improved overall performance and management through the Monitoring and Evaluation Management Services Project for USAID/Uganda. The project used a variety of consultations, trainings, workshops and field assessments. Six special studies,

focusing on health and HIV/AIDS programs, provided USAID and its implementing partners with improved knowledge of activities and programming for better informed management decisions.

MSI conducted a study in Zimbabwe to examine the relationship between participation in microfinance programs and the ability to mitigate HIV/AIDS. The assessment results indicated that households of micro-entrepreneurs affected by HIV/AIDS, in comparison to households of other micro-entrepreneurs, had lower income levels and were less likely to seek necessary medical attention. The assessment also documented ways that microfinance helped households affected by HIV/AIDS cope with the negative economic impacts.

The U.S. Department of Labor engaged MSI to work with the Internal Labor Organization’s Global Program on HIV/AIDS and the World of Work to develop templates of strategic planning and performance measurement instruments that could be used across projects in the ILO/AIDS portfolio. ILO/AIDS then contracted directly with MSI to provide technical assistance to its project teams to develop strategic planning and performance monitoring systems.

GEOGRAPHIC EXPERIENCEthIs map hIghlIghts the range and spread of countrIes Where both msI and coffey Id have Implemented health projects.

ghana

uganda

zambIa

malI

rWanda

mozambIque

tanzanIa nIgerIa

senegal

cameroon

sIerra leone benIn

mexIco

bolIvIa

Iraq bangladesh

vIetnam

IndIa

phIlIppInes

papua neW guInea

cook Island

east tImor IndonesIa

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