News and stories

Group of healthcare workers on the hypertension screening team

How One Healthcare Worker Team Uses Digital Health to Perform More Hypertension Screenings During COVID-19

Aug, 2020

The global COVID-19 pandemic has posed a threat to essential health services around the world. Despite this, healthcare workers at a hospital in Tanzania (pictured above) have continued providing services to pregnant and postpartum women in the community using digital technology to record and track screening data. Not only that, they have increased the number of monthly hypertension screenings.

 

Frontline healthcare workers are at the forefront of ensuring quality maternal healthcare in Tanzania. The healthcare workers at Sengerema Council Designated Hospital, serving a population of over 650,000, play a crucial role in keeping women and babies safe by screening for hypertension at prenatal and antenatal care visits. Hypertensive disorders are among the leading causes of death for pregnant women in Tanzania, and so diagnosis and treatment are key to reducing maternal deaths. A team of nine healthcare workers at the hospital have screened over 10,500 women since 2019, when they joined AstraZeneca Pharmaceuticals’ Healthy Heart Africa (HHA) program implemented by Touch.

 

Mr. Makala, an RN in the HHA program, reported that with increased precautions, COVID-19 did not influence their screening capabilities. In fact, the hospital team increased its screening numbers per month by at least 150 since the pandemic began, now screening over 1,000 women every month. When asked why this might be, Mr. Makala explained that the care the healthcare workers provide from beginning to end continues to foster trust throughout the community, making more women feel comfortable to visit and get screened.

 

Digital health has promoted ease and efficiency in these screening services. The healthcare workers record results and other key data on tablets, which are synced to an online dashboard. Mr. Makala explains that the tablets are easier to use than paper forms, prompting answers to skipped questions and saving time with typing ease.

 

What’s more, the use of digital technology has fostered strong communication between the healthcare workers on the frontline and Touch Foundation’s program team, which has been indispensable given limited travel opportunities during COVID-19. The tablets help the program team at Touch support the healthcare workers from afar, track screening progress, and continue collecting data to study the prevalence of hypertension in the Lake Zone of Tanzania.

 

Working together with AstraZeneca and healthcare worker teams like Mr. Makala’s throughout the region, we will educate, screen, and refer for treatment 50,000 pregnant women and 1,800 healthcare workers over three years.

 

To hear from another nurse delivering maternal hypertension screening and care on the frontlines, click here.

Frontline Healthcare Workers Save Pregnant Women’s Lives with RHD Prevention and Care

Jun, 2020

For the last five years, Touch Foundation, with the generous support of Medtronic Foundation, has worked to address Rheumatic Heart Disease (RHD) in the Lake Zone of Tanzania. As we come to the end of the program, we celebrate the powerful role that frontline healthcare workers can have in RHD prevention and care. Touch volunteer, based in Mwanza, Tanzania, Madison MacLean writes about one of those healthcare workers, Mercy, who is committed to ensuring excellent prenatal care.

 

RHD develops from untreated strep throat and ultimately results in permanent heart damage, which can be very dangerous, especially for pregnant women. Because of this danger, screening, early diagnosis, and treatment are critical to saving lives and our program addressed the ways in which these can be integrated into standard care procedures in Tanzania. Now, upon completion of the program, we are taking the time to reflect on the program and celebrate the people who helped define it. One of those people is Mercy, a sonographer at Kambarage Health Center, who participated in Touch Foundation’s training series for healthcare workers on RHD prevention.

 

Mercy is the only sonographer at Kambarage Health Center (KHC) and feels strongly about providing prenatal care. Her passion for her work stems in part from her own experiences. As part of another Touch Foundation program supported by AstraZeneca Pharmaceuticals, Healthy Heart Africa, Mercy was screened and found to be hypertensive early on in her pregnancy. She was able to receive the proper treatment, and she and her unborn child remained safe. She thus knows both firsthand and through her professional work the importance of providing services that will lead to early detection and care for others too.

“It is important to screen women and children for Rheumatic Heart Disease because then we are able to know in the early stages and get treatment earlier.”

There are very few cardiologists who can do these screenings, especially in rural areas. Many of these services are only available at the larger referral hospitals. We supported the training of Mercy and other healthcare workers to screen pregnant women and children during routine prenatal visits at the clinic. She now has the knowledge and equipment to screen and identify issues in pregnant women, increasing early detection and referring those patients before their conditions become severe.

“If more healthcare workers could be trained and upskilled like I have, it will have a big impact. It can improve the services and we can increase care for people living in remote areas and refer them in the first stages of an issue.”

The RHD training has shown first-hand that providing frontline healthcare workers like Mercy with the training and equipment to implement an early screening system can save lives.

“We met a pregnant mama yesterday, she used to come to the clinic because she had high blood pressure. We found out yesterday she has a problem with her heart. We were able to give her a referral to the regional hospital to get treatment. This is a good thing for us!”

2020 Virtual Asante Supper Marks Leadership Change

May, 2020

Members of the Touch Foundation community gathered virtually on May 18, 2020 to honor our Founder and President for the past 15+ years, Lowell Bryan, for his profound leadership and dedication to saving lives and relieving human suffering. Due to the COVID-19 pandemic, we re-imagined the event and held it online. If you missed it live, not to worry! You can view the event on demand here.

 

Rik Kirkland, Director of Publishing at McKinsey & Co., moderated our Asante celebration and interviewed Lowell on the urgency COVID-19 adds to the need to address Africa’s infectious disease burden and the potential to deploy digital health at scale to catalyze change in African health systems. The discussion was inspired by a white paper on this topic, which Lowell wrote and which we released during the event.

 

In the paper, entitled Early Thoughts on Potential of COVID-19 to Promote Digital Health in Africa, Lowell discusses the ways in which digital health has the potential to expand access to healthcare and decrease the infectious disease burden throughout the African continent. You can read the white paper on our website here.

 

This particular Asante was bittersweet as we honored Lowell for his tireless commitment to Touch Foundation as he stepped down from his position as Touch Foundation’s President. With that, we also welcomed Celia Felsher, longtime board member, who has taken his place. We are thrilled both that Celia has taken on the President role and that Lowell is not going far: he will remain active as Chairman of the Board and on several board committees.

 

After looking back at our impact over the years and exploring the gravity felt around the world with the COVID-19 pandemic, we ended the night by looking with determination to the future. As Celia said in her closing remarks,

“As has been made abundantly clear from the current COVID-19 pandemic, we are all, regardless of where we live, interconnected, and the strength of healthcare systems everywhere is necessary to ensure the health of all of us. Touch’s work is, therefore, more important than ever.”

 

You can view the online event here and read more about our programs and Lowell’s history with Touch here.

Notes from a Nurse: The Importance of Screening Mamas for Hypertension

Feb, 2020

“We introduced them to the program, explained the importance of screening for hypertension, and took their vitals. After this they say, ‘Thank you, thank you very much Nurse.’”

 

These words come from Byera Kwesiga, a nurse and site coordinator at Kahama Hospital in the Lake Zone of Tanzania, as she describes her work to protect mamas from the adverse effects of hypertension. As manager of the hospital’s Healthy Heart Africa Program, Byera organizes staff in the Reproductive and Child Health department and ensures that pregnant and postpartum women are properly screened for hypertension.

 

Hypertension, or high blood pressure, is among the leading causes of death in Tanzania and is especially dangerous for mothers and their babies. High blood pressure in pregnancy can develop into preeclampsia and eclampsia, which are both life-threatening, especially when left untreated. That’s why Touch Foundation is partnering with AstraZeneca’s Healthy Heart Africa program to screen pregnant and postpartum women in Tanzania.

 

Byera was among the nearly 150 Tanzanian Lake Zone health workers we trained in 2019 on the adverse effects of hypertension and how to conduct detailed screenings and diagnose pregnant and postpartum women. By December 2019, they had performed over 10,000 screenings! The information they collect during these screenings is not just helping them provide better care to patients: the data also helps us better understand the prevalence of hypertension in pregnant and postpartum women in the Lake Zone.

 

Byera is saving lives by ensuring mothers are screened during their antenatal and postnatal clinic visits. Before the program began, Byera says that she and other health workers often only discovered hypertensive cases during or right before labor and delivery, which didn’t give the opportunity to protect mothers from the life-threatening effects of high blood pressure. Now, screening during clinic visits allows Byera and her colleagues to diagnose hypertensive cases early, allowing more preventative measures to be taken. Byera remembers a pregnant patient whose blood pressure was approaching dangerously high levels during an antenatal screening. Because the nurses at Kahama Hospital caught it early, they were able to provide her with the proper medications and monitor her to ensure that she remained healthy and her baby was born safely.

 

At Touch, we’re excited to continue working with nurses like Byera, particularly in 2020, the Year of the Nurse and Midwife, who are leading the way in improving maternal health around sub-Saharan Africa.

Reflecting on 2019: Story from a Volunteer with Touch in Tanzania

Jan, 2020

Written by Juliana Andrade, a lawyer living in Brazil who volunteered with Touch in Tanzania for nine weeks, supporting our M-Mama program and providing legal expertise.

     

After building a career in profit oriented businesses, I decided to volunteer in projects that aim to solve critical development challenges in our world. This decision, fortunately, brought me to Touch Foundation, where I was able to use my professional expertise to contribute to projects that are saving lives and improving healthcare in Tanzania. Touch’s unique data-driven vision, in which sustainability and purpose walk together and guide day-to-day decisions, was the perfect fit for me. I have found Tanzania to be so beautiful and welcoming. There are development challenges and failures in health systems resulting in inadequate access to healthcare. So, being part of an organization with vast experience with the local environment and stakeholders enabled me to feel supported and stay focused on working at my optimal level. Touch’s commitment to innovative solutions and sustainable results enhanced my belief that people who have experience in the business world can play an important role in solving the challenges faced by our global community. I am so thankful for this experience, which has changed who I am and what I want to achieve in the next chapter of my professional life.

     

Getting Health Workers To Where HIV/AIDS Clients Need Them Most With POA

Nov, 2019

Written by Liz Pavlovich, MScPH, Business Development Manager at Touch Foundation. She recently traveled to Mozambique, where Touch Foundation is working with HRH2030 on a health workforce analysis.

 

HIV/AIDS services start with the health professional. Yet healthcare workers are often in short supply in sub-Saharan Africa – the region of the world most affected by the epidemic. Another major constraint is the limited amount of funding available. Finally, while some advances have been made in collecting and using data on the health workforce providing HIVAIDS services, it is often still challenging to get current, reliable data when needed. Yet, this data can power how the global health community most effectively reaches those impacted by HIV/AIDS to ensure that people are tested, and initiated and retained on treatment.

 

For 15 years, Touch Foundation has developed innovative and data-driven solutions to the training and deployment of the health workforce in Tanzania and elsewhere. Two major health workforce considerations are the skills mix and the geographic distribution. Five years ago, a representative of the Government of Tanzania revealed to us that they had several tens of thousands of requests from districts for new healthcare workers at facilities across the country, but only a fraction of that to deploy, given the low budget available for staffing and modest number of graduates. A solution was needed to make the time-consuming and challenging process of prioritizing these requests easier. With support from USAID and PEPFAR, Touch Foundation created the POA (Prioritization and Optimization Analysis) methodology in 2015 to guide this decision-making process using data on the actual need and real-world budget and healthcare worker shortages.

 

Recently, we utilized POA, with PEPFAR funding under the USAID HRH2030 Program, to help inform health worker staffing allocations for HIV service delivery in Mozambique. Working with partners, including USAID and CDC, we set out to help stakeholders use data to determine the need and priority of each and every health worker providing HIV/AIDS services at each PEPFAR-supported facility in all provinces of the country. The ultimate goal was to improve the provision of client-centered HIV/AIDS services to achieve epidemic control in Mozambique, a country with one of the world’s highest prevalence rates at 12.6%[1] and lowest health workforce densities.[2]

 

The POA methodology is simple, yet the results are powerful.  Novel to stakeholders involved in health workforce planning, POA begins by assessing the total number of healthcare workers needed to deliver HIV/AIDS services. To do this in Mozambique, we mapped—from a client-centered perspective—the different types of healthcare workers involved in the clients’ care and the amount of time required from each healthcare worker. For example, a clinically stable client on antiretroviral therapy (ART) will be seen by a pharmacist at a health facility for 5 minutes every 3 months in order to collect their ART refills. They are also seen by a clinical officer for 10 minutes twice a year for adherence counseling, monitoring of their health, and lab services. If the number of stable clients on treatment served by that health facility goes up, so too does the need for pharmacists and clinical officers. A clear picture of who is involved in the care continuum for HIV/AIDS clients enabled us to quantify the total number of the various cadres of healthcare workers needed. Since we also had data on the current health workforce, we could ascertain the health worker shortage by cadre and facility.

 

Figure 1. Overview of the POA methodology applied in Mozambique for determining the need for healthcare workers providing HIV/AIDS services, and prioritizing and assigning them based on the budget constraints.

 

The real innovation of POA is that it prioritizes and recommends assignments for all the needed healthcare workers, taking into the account the limited budgets available to cover their salaries. The needed healthcare workers are ranked so that the top priority assignment is the one that is the most ‘overworked’. For example, imagine a situation where one laboratory technician in a busy facility in Mozambique is struggling to keep up with the viral load testing demands of thousands of clients on treatment, a job for several lab techs. Adding another lab tech at this facility would be much higher priority than a lab tech at a different facility with fewer patients. POA goes through this calculus for tens of thousands of needed healthcare workers to produce a comprehensive ranked list.

 

While in Mozambique in November, I worked with Touch Foundation staff to orient PEPFAR and CDC stakeholders on how to use the recommendations from POA to decide where to deploy healthcare workers across 595 health facilities. The recommended assignments would cover nearly half of the overall shortage of 18,000 healthcare workers, especially among lay cadres like community and facility counselors. Using POA, implementing partners can more efficiently plan, budget, and staff programs delivering critical HIV/AIDS services.

 

Through this approach, we improve HIV/AIDS service provision where it’s most needed, by staffing facilities with the optimal quantity and skill mix in order to test, initiate treatment, and retain clients. Data-driven decision-making can bring us closer to controlling the epidemic.

 

This post originally appeared on the HRH2030 website here.

 

[1] UNAIDS; 2018 for adults (15-49 years). www.unaids.org/en/regionscountries/countries/mozambique

[2] CIA World Factbook; 2017 physician density. https://www.cia.gov/library/publications/the-world-factbook/fields/359.html

The Powerful Impact of the M-Mama Emergency Transport System in Rural Tanzania

Sep, 2019

Sub-Saharan Africa accounts for 2 out of 3 global maternal deaths related to complications from pregnancy and childbirth. Our M-Mama program is changing that with its Emergency Transport System (EmTS)–an innovative solution that uses digital technology to triage a patient remotely 24/7 and dispatch an ambulance or community driver to bring the patient to a health facility, a process that takes an average of two minutes.

 

In July, members of Touch Foundation’s Board of Directors visited Usanda dispensary, a small rural health facility located within Tanzania’s Shinyanga region. They spoke directly to women who had experienced life-threatening complications during labor and needed the EmTS to reach quality care. We met their healthy children and also the taxi drivers who responded to the dispatcher’s call and transported them to safety.

 

Anna shared her experience during her prolonged labor. The healthcare workers at Usanda dispensary determined that Anna was facing an obstructed labor and would need an emergency C-section to save her life and her baby’s life. Through the EmTS, healthcare workers connected Anna with a community driver who transported her—by that point unconscious—to Shinyanga Hospital, where she immediately underwent surgery and delivered a healthy baby girl.

 

Agnes was similarly transported to Shinyanga Hospital for an emergency C-section due to a prolonged labor. When Agnes awoke from surgery, she was shocked to learn that she had been pregnant with twin boys! Such surprises are not uncommon when access to healthcare, like prenatal services and ultrasound scans, is limited.

 

The taxi drivers shared a different perspective and reinforced how the EmTS is a market-based solution. According to one driver, before the EmTS, taxi drivers were sometimes called for medical transport and at times, would not be able to negotiate a reasonable rate with the patient. But that has changed with the implementation of the EmTS. Now, pre-negotiated rates are paid directly to the drivers upon completion of their trips and at no cost to the patient. Trips are often long distances, and the average taxi rate is $45.

 

Today, M-Mama is up and running in all six districts of Tanzania’s Shinyanga region, providing life-saving emergency care to 90,000 pregnant and post-partum women and their newborns. Since inception, M-Mama has transported more than 8,500 women and newborns and in two years, this cost-effective program will be fully adopted by the Tanzanian Government. Furthermore, based on the demonstrated success of M-Mama, the government is interested in expanding the innovative program throughout the country. And, excitingly, we are also expanding M-Mama to Lesotho as part of a sub-Saharan Africa expansion plan with Vodafone Foundation.

 

A special thanks to Pathfinder International, an integral M-Mama partner, for organizing the meeting at Usanda dispensary.

Why hospital medical equipment maintenance is so critical to saving lives, as told by one of Tanzania’s few female biomedical engineering technicians

Mar, 2019

“When you say that you’re an engineer some people say ‘really?’ or they look at how you look physically and say ‘can you really be an engineer?’”

 

Those are words from Nziza Pachal Rufutu, a 28-year-old woman working as a biomedical engineering equipment technician at Bugando Medical Centre (Bugando) in Mwanza, Tanzania. She is responsible for installing medical equipment and performing preventive maintenance and repairs at one of the largest and most specialized hospitals in the country. Nziza’s role is critical in ensuring equipment is functioning properly so that the hospital can provide quality healthcare services.

 

From a young age, Nziza excelled in science classes. After finishing her A-levels (similar to the Advanced Placement programs in the US), Nziza considered a career in engineering. Her brother, who was at University studying to become an engineer himself, introduced her to the field of biomedical engineering. She realized that this field would allow her to link her interests in biology and medicine with engineering principles to help others.

 

Upon graduating, Nziza applied for a job at Bugando and has worked there since 2016. Nziza oversees the engineering side of the sterilization department at Bugando and, together with other engineers, works closely with the operating theatres to ensure that all equipment is in good working condition for surgeries. She explained that “Engineers provide oxygen and other medical equipment services in operating theaters. If the equipment performance is poor, then the doctors and other medical personnel can’t provide good healthcare services to the patients.”

 

One of her primary challenges working in the male-dominated field of engineering is others’ perceptions of herself and her capabilities. “They may undergrade you and think you can’t do more like men do. So maybe there are some tasks that you are not sent to do because they think you cannot do it.” Reflecting on this issue, Nziza added “they just don’t understand that it’s only a matter of hard work and having knowledge and skills, a committed mind, and a desire to learn more.”

 

Nziza embodies these attributes, and has been committed to improving Bugando since she first joined the hospital. For example, she worked with the engineering department and the Touch team to provide guidance on the equipment needed to enhance cardiology services at the hospital. After this initial project with Touch, Nziza became a member of Touch’s Healthcare Technology Management Improvement team in May.

 

Through the Healthcare Technology Management program, Nziza has taken on the role of Key Performance Indicator (KPI) Champion at Bugando. If measured on a regular basis, KPIs can help engineers understand when large machines are not functioning as intended. In her role as a KPI Champion, Nziza connects with her colleagues stationed at Bugando’s large machines (i.e. Oxygen Plants, Generator, Incinerator), and monitors the KPIs for each machine. This allows her to respond immediately to any issues, before equipment downtime can affect the quality of care at the hospital.

 

According to Nziza, “the Healthcare Technology Management program has improved the skills of the engineers as well as working facilities, and other people in the hospital have begun to see the importance of the engineering department and that we are critical to the hospital functioning well. They see that when equipment is improved, people are provided with better services.”

 

Moving forward, Nziza wants to focus on skills training for the engineering department as well as equipment training for all healthcare workers at the hospital. She is proud to be a leader in our Healthcare Technology Management program and work together with other biomedical engineers to provide better healthcare services day-to-day to Bugando’s patients. After all, the hospital can’t function without equipment that is well maintained.

Combating Noncommunicable Diseases Starts with Providing Quality Preventative Care for Young People

Sep, 2018

Dr. Bazil Kavishe can easily recall figures and statistics from projects and publications he completed over a decade ago related to how noncommunicable diseases impact Tanzanians. It’s impressive given the breadth of his career as a senior research scientist at the National Institute for Medical Research (NIMR), the largest public health research organization in Tanzania.

 

Dedicating himself and his career to improving people’s quality of life has always been Dr. Bazil’s plan, though not as a research scientist initially. While completing a clinical internship at Muhimbili National Hospital in Dar es Salaam after medical school, he was inspired to pursue a profession dedicated to noncommunicable disease (NCD) research and prevention efforts. “I thought, instead of working at the hospital and treating people who are experiencing complications [from various NCDs], it would be a good opportunity for me to join a public health team and work on interventions and operational research that may improve the prevention aspects of these conditions.” The evidence he collects ultimately informs health programs and policies with the goal of eliminating the need for hospital care through effective prevention strategies, including public education, screening, and early diagnosis.

 

In Tanzania, NCDs account for about one-third of all deaths, of which cardiovascular diseases are the leading cause. NCDs are a very real threat to Tanzanians of all ages, even more than HIV/AIDS or malaria at this point. Because of this, Dr. Bazil argues, “There is a need to focus resources on the younger population because chronic diseases are setting in at a very young age. If you don’t intervene during early childhood or adolescence, you are likely to have an increasingly high prevalence of NCDs during adulthood.”

 

Early on, Dr. Bazil and his team conducted a study to establish the burden of selected NCDs and HIV in Mwanza, Tanzania. Their research uncovered a higher prevalence of hypertension and diabetes among adults than previously thought (Read the full article). Surprisingly, they also discovered that a significant number of people aged 18-44 already had hypertension, a disease most often found in older populations. Concerned about these findings, Dr. Bazil led an independent research project to further explore the prevalence of hypertension in adolescents and children. In collaboration with colleagues in Uganda he conducted a survey in secondary schools and higher learning institutions in Mwanza and in Entebbe, Uganda.

 

Touch Foundation worked closely with NIMR and Dr. Bazil on the needs assessment for our Rheumatic Heart Disease (RHD) program. His team worked in Tanzania’s Sengerema district in 2016 to determine the prevalence of sore throats and the availability of drugs and equipment needed to treat and diagnose strep throat. Screening those who recently suffered from a sore throat can help identify strep throat cases, which, if left untreated, can damage heart valves and result in Rheumatic Heart Disease later in life. This nearly entirely preventable NCD is the most commonly acquired heart disease among young people under 25 and is particularly dangerous to pregnant women. Using this research, Touch is strengthening the health system by upgrading equipment (i.e. ultrasound machines), providing supplies, and training healthcare workers.

 

Hypertension is another dangerous and widely prevalent cardiovascular condition in Tanzania. Our Healthy Heart Africa program, is addressing hypertension in pregnancy, which is responsible for 16% of maternal deaths and many newborn deaths. Dr. Bazil sees Healthy Heart Africa as an important opportunity to educate more women on NCDs, the importance of preventative care, and lifestyle risk factors like diet. He also   believes it is critical to train healthcare workers on how to provide high quality care. Through this program and our RHD program, we will screen 50,000 pregnant women for high blood pressure and heart conditions like RHD and connect them to treatment.

 

This September, the 73rd session of the UN General Assembly brings together governments, civil society, and the private sector for the third High-Level Meeting to discuss the progress and action needed on NCDs. We believe that high quality research led by top Tanzanian organizations like NIMR as well as robust multidisciplinary partnerships are critical to addressing the burden of NCDs. Together, we can support health systems to better prevent, diagnose, treat, and manage NCDs so that all people­­—and especially youth­­—live long, productive lives.

Perspectives of a young adult living with Type 1 Diabetes on incorporating patient voices into the NCD agenda

Jul, 2018

On July 5, 2018, Touch Foundation participated in the UN Interactive Hearing on Non-Communicable Diseases (NCDs), held as part of the preparatory process for the UN high level meeting on NCDs this coming September during the UN General Assembly. Dhishana Kidambi, Bard Globalization and International Affairs summer intern at Touch’s New York office, shares some reflections on the hearing and her personal experiences living with Type 1 Diabetes.

 

“Eat three chapatis (wheat cakes) for dinner, and give yourself six units of insulin. As long as you are at 180 before bed, you should be good to go!” I hardly felt any of my endocrinologist’s optimism; cutting portions seemed like an impossible proposition to make to a 12-year-old living in India.

 

A few years later, I was at a friend’s house when I was introduced to Dr. Anjana, a pediatric endocrinologist trained and working in New York, who was appalled by the advice my endocrinologist had given me: “You calculate your insulin sensitivity, count the carbs in your food, and then give yourself a dose based on how much you eat. That way, you can eat whatever you want as long as you dose yourself correctly!”

 

When I later asked my local doctor about carb-counting, he laughed and said, “good luck trying that with a bowl of dal makhani! Carb-counting is impossible to do with Indian foods.” Despite being trained to advocate a carb-counting methodology, he believed, and my experience showed, that it simply could not be practiced in India.

 

As someone living with a NCD in the Global South, I can say that it is this clash of absolutes between the technical knowledge created and disseminated by multilateral organizations in the Global North and the realities of living in the Global South that make the management of NCDs so challenging. NCDs are often highly individualistic, and the most effective management techniques arise from the integration of lived insight with technical experience.

 

As part of the preparatory process towards the third High-Level meeting of the General Assembly on NCDs, the interactive hearing consisted of several panel discussions that offered an opportunity to deliberate on the best way to manage NCD care between various stakeholders in resource constrained communities. The agenda of the hearing was to discuss the role of five different areas that will need to be addressed: scaling up action against NCDs, financing, promotion of multi-sectoral partnerships, political leadership, and accountability.

 

The panels addressed many important issues that could improve action against NCDs, ranging from the need for catalytic funds, massive technology building, a skilled workforce, and multi-sectoral partnerships between the public and private sectors. While panelists recognized that the ultimate goal is to empower people with NCDs to take charge of their health, most consideration is given to political actions that require the cooperation of powerful global actors, highlighting the conflicts between the private and public interests that need to be resolved.  As someone living with a NCD, it felt as though the narratives of people with NCDs, and the value of their insight, needed a more prominent position.

 

Since its inception, Touch Foundation has focused on strengthening local health systems. This approach recognizes that there are too few healthcare workers and too many breakdowns in national health systems.

 

The health systems approach taken at the interactive hearing recognized various actors (infrastructure, drugs, regulation, healthcare workers, etc.) as separate entities, rather than a single system in which bonds could be strengthened. Panelists in the sub panel titled “Engaging people with NCDs” maintained that this approach does not effectively recognize sustainability and continues to place people living with NCDs on the sidelines and creates difficulties for people from different cultural backgrounds to navigate the health system.

 

Creating a system that implements a locally informed approach on a global scale remains an important aspect of addressing NCDs. In this context, Touch Foundation makes important contributions to creating a more holistic health system that is patient-centric. The comprehensive systems approach adopted through programs like Treat & Train offer an effective model to treat NCDs. By optimizing healthcare facilities with the goal of developing local leadership, Touch is able to effectively prioritize all aspects of the healthcare system. This offers a useful framework to resolve the challenges that people with NCDs face, and include the crucial voices of patients that have been missing in the global response.

Celebrating the future of healthcare in Tanzania at our 2018 Asante Supper

Jun, 2018

On May 10, 2018, Touch Foundation’s staff, board members, and guests enjoyed a wonderful evening at the Morgan Library & Museum in New York City learning about the future of healthcare in Tanzania while celebrating Vik Malhotra and McKinsey & Company’s enduring commitment to Touch’s work.

 

We were honored to host the former President of Tanzania, Jakaya Kikwete (pictured here alongside Touch President Lowell Bryan & Honoree Vik Malhotra), at this year’s Asante Supper. While serving as President of Tanzania from 2005 to 2015, Mr. Kikwete made healthcare a national priority, greatly expanding the government’s investment in the training of healthcare workers and the expansion of healthcare facilities nationwide.

 

Mr. Kikwete has been a longtime friend of Touch: his leadership enabled us to enter into a Public Private Partnership with the Tanzanian government and the US government, which remains in place to this day. We were delighted to share our accomplishments and vision for the future of healthcare in Tanzania with Mr. Kikwete, who continues to be a dedicated maternal and child health advocate through his partnership with The Access Challenge’s One By One: Target 2030 campaign, which is aimed at promoting universal health access in Africa.

 

Sean Ryan, a partner in McKinsey’s Health Care Strategies practice and Touch Foundation’s newest board member, took the stage during the dinner program to share a surprising discovery that resulted from the McKinsey engagement he led in Tanzania’s Lake Zone last November:

 

“It turns out that making doctors better business-people can help transform medical care. The practices they build will expand access to healthcare in Tanzania, free up capacity at public hospitals, and create new opportunities for doctors across the country.”

 

The program also included a Q&A session featuring Dr. Isidor Ngayomela, entrepreneur and orthopedic surgeon in Tanzania, who shared how opening his own health facility–Kamanga Medics Hospital–has allowed him to treat more patients while employing more doctors:

 

“I used to see 100 patients in a day at Bugando, which is a reason why we also started Kamanga. Because the patients were overflowing…some patients will be benefiting from Kamanga because they will be attended to quickly and go back into their working places. And so, in a way, you de-bulk these other government hospitals and so share the patients as well.”

 

To learn more about Touch’s accomplishments and vision for the future of healthcare in Tanzania, we invite you to watch our Asante Supper video.

School Heart Screenings are Saving Young Lives in Rural Tanzania

Apr, 2018

Zacharia Masatu, a 12-year-old from Tanzania’s Sengerema district, is the second youngest of nine children born to two farmers. Zacharia is in 6th grade at the Bukirigulu Primary School and had never seen a doctor before a Touch-supported heart screening at his school.

 

At the age of four, Zacharia’s parents started to notice that their son was not a healthy young boy. Zacharia had difficulty breathing and always seemed to have a cough. His parents did not think it was a serious disease, though, and took him for local herbal treatment. Although this did not seem to be working, Zacharia’s parents were not able to take him to see a doctor because hospital services were not financially or physically within their reach.

 

As part of our efforts to decrease cardiovascular disease, our partners at Bugando Medical Centre, with support from Touch and Medtronic Foundation, have screened over 3,000 school children in the Sengerema and Buchosa districts. The pediatric cardiologist at Bugando, Dr. Glory, performed an echocardiogram on Zacharia and immediately realized the 12-year-old was in grave danger. His eldest sister came to his school at once and the two traveled five hours to Bugando in Mwanza, a ferry and several hours away from Zacharia’s home in Sengerema, to seek life-saving treatment. Zacharia was diagnosed with a serious heart condition called Ebstein Anomaly and had surgery the following day. After just over 2 weeks, he was discharged, feeling better than ever before.

 

Unfortunately, the surgical team was unable to perform the corrective surgery Zacharia needed for complete valve repair because of Tanzania’s limited capacity for cardiovascular surgery. Instead, they drained his heart of fluid and administered medication that will allow him to better manage his condition going forward. As a result, Zacharia will never lead a completely normal life. He will not be able to play sports or become a farmer like his parents, and he will have to take medication and receive monthly checkups to manage his heart disease.

 

School heart screening projects targeting specific diseases (in this case, rheumatic heart disease) are often one-off endeavors, but Touch’s systems thinking and decades of experience in the region ensure that bedside ultrasound diagnostic capacity becomes embedded in district level health systems. Without bedside ultrasound diagnostic capacity reaching a school in rural Tanzania, Zacharia’s life threatening heart condition would not have been diagnosed, and Zacharia would not have had the chance to reach adulthood. Zacharia’s story is just one example of the ripple effect of impact that endures long beyond the life of Touch’s support for health system improvements.

Caroline Mtani is fierce about helping mothers and babies

Feb, 2018

“I have devoted most of my work to serving the disadvantaged, pregnant women and children under the age of five.” Working in an under-resourced facility, Caroline Mtani is often exhausted by her day’s work. But she still finds herself spending any free moment she has in the maternity ward; “When I see the baby is drinking and is active, I feel happy. No one has the spare time to spend with the babies, but I enjoy it.”

 

Caroline Mtani is boundlessly energized by her work at Sengerema Designated District Hospital (SDDH), a rural hospital in Tanzania. Caroline has worked at SDDH for her entire medical career, spanning nearly three decades. For the first twenty years, Caroline worked as a nurse midwife. After the birth of her second child, and with support from her husband, Caroline decided to get her Assistant Medical Officer (AMO) diploma from the Catholic University of Health and Allied Sciences (CUHAS) in Mwanza, Tanzania. The AMO diploma allowed her to provide the full spectrum of maternal care, including C-sections. Deciding to pursue the advanced diploma was not an easy choice as it required her to leave her two young children and husband and move to Mwanza for two years of challenging studies. Caroline succeeded in obtaining her diploma and returned to work with SDDH to provide care to mothers, newborns, and other patients in this underserved area.

 

Touch first partnered with SDDH in 2013. Tanzania continues to face a severe shortage of healthcare workers like doctors, nurse midwives and AMOs. Touch’s Treat & Train program tackles this gap in Tanzania’s health system. The Treat & Train Network connects hospitals and training facilities so that medical and nursing students can gain valuable hands-on experience during clinical rotations while also helping to provide better care to patients in under-resourced health facilities. With her wealth of knowledge about the Lake Zone’s medical facilities as well as a drive to bring impassioned healthcare workers to SDDH and the surrounding area, Caroline, the Co-coordinator of the program, is essential to the success of Treat & Train.

 

Four years after Treat & Train began at SDDH, Caroline continues to pursue her goal of bringing positive change to her community through better healthcare. She is the National Facilitator for the Helping Babies Breathe training program at SDDH as well as the clinician in charge of maternal issues and the Supervisor of the Mobilizing Maternal Health Program.

 

Caroline reflected that “Touch is like family”. These deep, trust-based relationships with our local partners are the heart of what we do at Touch and key to sustainable change. Caroline has facilitated a meaningful partnership between Touch and SDDH out of a personal drive to empower her own patients and her fellow healthcare workers. She continues to strive towards the goal of creating an ever stronger SDDH and Tanzanian health system, a goal we can proudly say we share and are working together to achieve.

Restituta achieved her dream of helping other women

Dec, 2017

Working as a dispatcher in Touch’s Mobilizing Maternal Health program, Restituta helps women in labor reach emergency care. 

 

Restituta Mabilla Limbe is a determined 34-year-old woman who always dreamed of helping women and young girls in her community. Growing up in Sengerema, a rural town in north-west Tanzania, Restituta noticed a pattern of inequality between the women and men in her community. In spite of having four siblings, she was the only child expected to work, because she was the only woman. Her younger brothers were free to do as they pleased, while she and her mother carried all of the family’s responsibilities. To Restituta, women unjustly had more difficult lives since traditional norms required them to work hard day and night.

 

Inspired by the inequality she witnessed as a child, she dreamed of a way to help other women in her community. Her dream had to be put on hold due to her family’s lack of finances at the time she was enrolling in University, a rare accomplishment for Tanzanian women. Restituta was obligated to study Information Technology because it was the only course she could receive funding to complete.

 

After several years of studying and then working as a graphic designer in another part of the country, Restituta moved back to Sengerema to be closer to her family. One day, she saw an advertisement for an open dispatcher position as part of Touch Foundation’s Mobilizing Maternal Health program. Holding the flier in her hand, Restituta felt certain this position would allow her to realize her dream of helping women.

 

Today, Restituta is the top dispatcher at Sengerema District Hospital. Her typical day at the referral center, which is open 24/7, involves taking calls and arranging emergency transport via a mobile application for pregnant women and newborns so women can safely deliver at health facilities in the care of skilled providers. She has even earned the position of Team Leader because of her hard work and commitment leading her peer dispatchers. However, this is not Restituta’s only role. She is also the mother of two young boys, a four year old and one year old. With the support of her mother, Restituta is able to leave her children at home and go into work every day to save mothers and newborns.

 

Restituta’s job is often challenging due to cultural barriers. Traditionally women in Tanzania are accustomed to delivering in their own homes. With nearly half of all Tanzanian women giving birth at home without the care of a skilled healthcare worker, there is a high risk of birth complications. One of Restituta’s greatest challenges is convincing family members that their loved one is in grave danger and needs to be transported to the hospital immediately. Through Touch’s Mobilizing Maternal Health program, Restituta has been a key player in reducing maternal mortality by 27% in her community.

 

Restituta has achieved her dream of helping women in her community, but her work is far from finished. Her interest in the health field has grown immensely and she hopes to return to school and earn her nursing degree in order to continue helping vulnerable women and young girls.

The benefits of mentoring in health education

Nov, 2017

Tanzania is one of 57 countries identified by the WHO as facing a human resources for health (HRH) crisis with an estimated shortage of 181,100 healthcare workers in the country. Currently in Tanzania, there are fewer than 4 nurses and midwives per 10,000 people, compared with the WHO optimal ratio of 16 per 10,000 people.

 

Mentorship is a novel technique to address systemic problems in health education such as poor morale and strenuous working conditions. Primary healthcare personnel play an important role in increasing the accessibility of healthcare, specifically in low- and middle-resourced communities. One of the best ways to enhance primary healthcare in vulnerable areas, such as rural Tanzania, is by creating mentorship programs for nurses and midwives. Finding ways to improve healthcare worker training has always been among the major priorities of Touch Foundation’s approach.

 

In alliance with WHO guidelines, Touch Foundation views training, clinical mentoring and supportive supervision of nurses and midwives as an effective strategy for improving the retention of healthcare workers and improving the overall strength of the Tanzanian healthcare system. Dr. Renae Stafford, Touch’s Program Director of Academic and Clinical Services, co-authored two articles, (http://ow.ly/Mrsj30gCtbf) (http://ow.ly/hrOM30gCteK), highlighting the great potential in clinical mentorship of midwives and nurses. Our Treat & Train program incorporates mentoring and preceptorship as a means to enhance clinical safety and promote professional communication, problem solving and crisis management. This will allow communities to achieve sustainable results when improving health and providing quality health services.

 

The training and mentoring of midwives and nurses is particularly beneficial in assuring antenatal, delivery, emergency obstetric and post-natal services to improve maternal and newborn health in low-resource settings, like the Lake Zone of Tanzania. With nearly half of all Tanzanian women giving birth at home without the care of a skilled healthcare worker, maternal and newborn death is all too frequent. In fact, a woman in Tanzania is 80 times more likely to die from pregnancy-related causes than a woman in the United States. Through our Treat & Train program, we have trained maternal healthcare workers in Emergency Obstetric and Newborn Care. Well-trained healthcare workers form an important link to our Mobilizing Maternal Health program, where emergency transport has led to a 27% decrease in maternal deaths.