Organizational Overview and StrategyMarch 2016

Global Health Innovations and Action (GHIA) Foundation

Organizational Description

Founded in 2013, the GHIA-Foundation was established to contribute to improved health outcomes for women in the Sustainable Development Era and beyond (post-2015 Millennium Development Goals);

GHIA-Foundation will support selected developing countries to deliver quality essential health package including cervical and breast cancer screening and treatment, within a strengthened health system using the maternal health platform—antenatal, intrapartum and postnatal—as an entry point, beginning with sub-Saharan Africa.

Organizational Vision“A world where women in developing

countries live longer, healthier

lives”

Organizational Mission

“To reduce morbidity and mortality among women in

developing countries by strengthening health systems to

deliver high-quality, comprehensive health services whenever a woman accesses

care”

Statement of Need: OverviewEvery year, approx. 300,000 women die from complications of pregnancy and childbirth;73 countries—mostly developing countries—account for 96% of global maternal mortality, yet have less than 42% of the world’s healthcare workers;AIDS-related deaths among adolescents have increased 50% between 2005 and 2012;Non-communicable diseases including breast and cervical cancer, are killing more women than HIV, TB, malaria, and maternal conditions combined.

Statement of Need: Breast Cancer

Breast cancer is the most common cancer and the leading cause of cancer death in women globally;1.7 million women receive a diagnosis of breast cancer every year;It kills over 500,000 women annually;About 60% of these deaths occur in developing countries; and Majority of the women in developing countries present with advanced stage disease when treatment offers very little hope.

Statement of Need: Cervical Cancer

Approx. 500,000 women are diagnosed with cervical cancer every year, and some 270,000 die as a result;Every two minutes, a woman dies from cervical cancer, mainly in the reproductive years of life;85% of cervical cancer deaths occur in low and middle income countries (LMICs);In LMICs, a woman is 5 times as likely to develop cervical cancer as a woman in the United States (in Malawi: 12 times);HIV-positive women are 4-5 times more likely to develop cervical cancer than HIV-negative women due to increased vulnerability to human papillomavirus (HPV) infection.

Areas of Focus

1. Maternal health: antenatal, intrapartum and postpartum care;

2. Prevention, screening, early detection, and management of non-communicable diseases: specifically breast and cervical cancer;

3. Innovative approaches to capacity building and skills development of health workers at pre-service & in-service levels for improved outcomes for women;

4. Research to better understand women’s health; and

5. Innovations to improve efficiency e.g. point-of-care diagnosis and treatment.

Long-Term Goals

By 2020, in countries where we work, we will support national governments to:Raise public awareness and increase visibility of women’s health;

Build midwifery capacity to reduce maternal deaths by 5% annually; Reduce deaths from cervical cancer by promoting prevention, early detection, screening and treatment;

Increase capacity of health workers and empower them to screen for and treat cervical pre-cancer through training and equipment;

Long-Term Goals

Increase capacity of health workers to downstage breast cancer through early detection of disease and empower them to promptly refer women with abnormalities;

Promote public-private partnerships between national governments and in-country stakeholders to strengthen health systems in support of women’s health;

Increase adoption of innovative strategies and technologies including for maternal health, breast and cervical cancer for improved quality of care.

Guiding Principles

Guiding Principles

Country leadership

& ownership

Partnerships

Accountability

Sustainability

Evidence-based

approach

Health systems

strengthening

Unique GHIA-Foundation Strategies Sets Us Apart from OthersLeveraging the maternal health platform—antenatal,

intrapartum and postpartum—as an entry-point for cervical and breast cancer screening and treatment, to reduce missed opportunities for care;

Increasing health worker capacity and skills through preservice and inservice training to improve quality of care;

Exploring point-of-care detection and treatment approaches to provide comprehensive essential health package to women whenever they access care;

Applying innovative cost-effective approaches and technologies to training (e-learning), to early detection and diagnosis, and messaging (mobile technology) to improve efficiency.

Key Interventions

Develop/review national policies, strategies and programs for women’s health to strengthen maternal health, cervical and breast cancer components

Train and equip health workers on basic and comprehensive emergency obstetric and newborn care (BEmONC, CEmONC)Train and equip health workers to screen and treat women for cervical pre-cancer using simple, low-cost methods and innovative approaches on point-of-care diagnosis & treatment;

Key InterventionsDevelop innovative approaches, such as mobile technology and tele-medicine, to reach adolescents & women with appropriate messaging and health programs; Teach women about dangers in pregnancy and childbirth, breast and cervical cancer and how to speak out and demand prevention and treatment services;Build strong partnerships for greater impact;Mobilize resources from governments, foundations, and corporations to support countries and GHIA-Foundation activities at all levels.

Country Selection Criteria

Developing countries, beginning with sub-Saharan Africa;

Country leadership and demonstrated commitment to improving women’s health (essential);Prioritization of women’s health: maternal health, HIV or family planning services (very important);Existing cancer prevention and treatment infrastructure (important); Data on maternal health, breast/cervical cancer (very important);National stability/security (very important).

Monitoring and Evaluation

Measurable evaluation metrics and an evaluation protocol will be developed and adopted prior to implementation in any country; Quarterly reports will track major metrics including the number of women screened and treated for cervical/breast cancer, number of girls vaccinated against HPV infection, number of health facilities providing comprehensive package of services to women through maternal health and other platforms, and providers trained; A final report will be produced that synthesizes challenges and lessons learned from implementation to make sure that strengths are capitalized upon and pitfalls avoided during scale-up in existing countries and replication in subsequent countries.

GHIA-Foundation Structure

Foundation Board

Chief Executive

Officer

Chief Operating

Officer Program/Admin Officer

Program/Admin Officer

Patrons/Matrons

Update on GHIA-Foundation Flagship Programs: Liberia Model MNH Program

Funded by Chevron, and implemented at the Benson Hospital, Paynesville, Liberia

Started in July 2015 for one year

Goal: Contribute to accelerate the reduction of maternal & neonatal mortality in Liberia

Liberia Model MNH ProgramObjectives Provide quality antenatal care to 20,000 patients and

500 in-patients deliveries in one year; Train 10 nurses and 5 midwives on Basic Emergency

Obstetric & Newborn Care; & 5 doctors on Comprehensive Emergency Obstetric & Newborn Care through coaching and E-learning;

Provide specialized quality neonatal & child care to reduce neonatal mortality rate and Under-5 mortality rate by 5% annually;

Use innovative & strategic community outreach approaches to promote clinic utilization & community health interventions;

Establish & train 4 staff members on the use of electronic data record & management system

Liberia Model MNH Program:Achievements – July 2015– Mar. 2016

Antenatal clinic attendance: 3,812 women

Number of deliveries: 380 deliveries

Number of Cesarean sections: 166 (that is, 43% CS rate)

Number of health workers trained: - 10 nurses and 7 midwives trained on

BEmONC;- 6 doctors and 1 project manager trained

on C-EmONC;- Post-test significantly higher than the pre-

test results;- 4 staff members trained on electronic data

management system.

Training of nurses/midwives on Emergency Obstetric & Newborn CareSource: Benson Hospital, Paynesville, Liberia

Antenatal clinic attendance over three quarters (July ‘15 – March ‘16)

July

Augu

st

Septe

mber

Octobe

r

Novem

ber

Decem

ber

0

100

200

300

400

500

600

125168

307

90

373

547

Number of patients who attended the facility for antenatal care in both first and second quarters.

January February March0

100200300400500600700800900

1000

612 716

870

Number of patients who at-tended the facility for antenatal

care in the third quarter

Liberia Model MNH Program:Achievements – July ‘15 – March ‘16

The program procured new resuscitation equipment

Trained health workers are

capable of resuscitating asphyxiated newborns

Nurses provide routine immunization and deliveries free of charge.

Hospital staff are reaching communities adjacent to and behind the facility with messages on free and quality antenatal care and through radio jingles and outreach

Newborn delivered after mother ruptured uterus due to prolonged labor, was resuscitated and survived; nurses/midwives trained on EmONC

Source: Benson Hospital, Paynesville, Liberia

Lessons Learned: Liberia Model MNH Program

Trained and equipped nurses and midwives can effect a rapid change in the quality of care in the antenatal, intrapartum and postpartum period

Lives of newborns can be saved with appropriate skills and equipment

Capability for Cesarean section is critical to saving women’s and newborn’s lives

Maternal care needs to extend beyond the four walls of the hospital to the surrounding communities to increase facility utilization

Apneic newborn without heart beat, was resuscitated and survivedSource: Benson Hospital, Paynesville, Liberia

Liberia Model MNH Program

Next Steps Quarterly supervision by

facilitator continues for on-the-job training & skills improvement

Community outreach to increase women’s utilization of facilities

Resource mobilization to continue and expand the program beyond one year and beyond Benson Hospital

Establishment of electronic data management system

Continuous quality improvement measures

Apneic newborn without heart beat, was resuscitated and survivedSource: Benson Hospital, Paynesville, Liberia

Update on GHIA-Foundation Flagship Programs: Swaziland Cervical and Breast Cancer ProgramScoping Mission conducted in March 2015 to explore partnership with the Ministry of Health and rapidly analyze the health systems response, including in-country stakeholders to cervical and breast cancer

Ministry of Health and partners expressed interest in collaborating with GHIA-Foundation

Draft Memorandum of Understanding and Program Proposal developed and shared with MoH

At the request of the MoH, chemotherapy protocol created and shared with the MoH

Resource mobilization efforts in progress to build capacity for cervical/breast cancer screening, early detection and treatment

ConclusionConsidering the triple-burden of diseases to which women are exposed, a comprehensive approach that allows partnership with national government to strengthen health systems and accelerate service delivery to the most vulnerable is a best buy;Empowering women and girls and increasing knowledge and skills among health care workers at pre-service and in-service levels will promote prevention, early detection, and treatment of maternal conditions and improve health outcomes for women in the Sustainable Development Era and beyond.

Contact Us

www.ghia-foundation.orgghiafceo@gmail.comghiafcoo@gmail.com