The community is the center of the health system.
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MSH Global Health Impact
April 2016

Communities: Key to Strong Health Systems

Democratic Republic of the Congo. [Photo: Rebecca Weaver/MSH]
Photo: Rebecca Weaver/MSH

This issue highlights community health and community health workers, and presents a glimpse of MSH's work at the community level, in partnership with national ministries of health, civil society organizations, the private sector, and more.

The community is the center of the health system in developing countries. 

Throughout sub-Saharan Africa, community health workers, often volunteers, represent the foundation of the health system, addressing priority health areas ranging from maternal and newborn health to family planning and infection prevention. The community health worker (known by different names in different countries) is the fundamental frontline promoter, provider of services and medicines (through integrated community case management), and the one who refers and links beneficiaries with more complex health needs to facilities. Not only do community health workers extend access to health services for the underserved and those living in hard-to-reach or conflict-ridden areas, they help countries accelerate certain health outcomes and achieve the Sustainable Development Goals and related targets for universal health coverage.

But community health workers cannot be successful in achieving these health outcomes alone: Successful service delivery and effective human resources for health require that other aspects of the health system are bolstered and well-functioning.

Are you working at the community level? How is your country responding to these challenges? Read and comment on these stories on


Beyond the Facility Walls: Community Health Workers Need Support

by Sarah Johnson
[A community health worker in Togo.] {Photo: Katy Doyle/MSH}
Photo: Katy Doyle/MSH

The community health system extends far beyond the four walls of the health facility, and, is as important to saving lives, blogs MSH's Sarah Johnson. 

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Study: How Do Incentives Affect Community Health Worker Performance in Madagascar and Malawi?

[A community health volunteer in Madagascar demonstrates how to provide Depo-Provera.] {Photo: Colin Gilmartin/MSH}
Photo: Colin Gilrmartin/MSH

Through USAID’s African Strategies for Health project, MSH studied the impact of financial and non-financial incentives on community health worker performance and retention and service delivery in Madagascar and Malawi. [In this photo, a community health volunteer demonstrates how to provide Depo-Provera, a modern contraceptive method.]

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Ending Preventable Child Deaths with Integrated Community Case Management: Stronger Pharmaceutical Systems for Healthier Communities

by Jane Briggs
Ending Preventable Child Deaths {Photo credit: Brooke Huskey/MSH}
Photo: Brooke Huskey/MSH
The USAID-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program, led by Management Sciences for Health (MSH), supports community health workers and integrated community case management programs by helping governments strengthen five elements of the pharmaceutical system: governance, information management, service delivery, human resources, and financing.

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Nigeria: Community-Based Health Insurance Saves Baby Rosemary’s Life

Nigeria: Chief Ntuen, his wife, and baby Rosemary. [Photo: MSH staff]
Photo: MSH staff
“If not for community-based health insurance, I would have lost my little baby, Rosemary, to cholera,” says Chief Victor Joseph Ntuen in Akwa Ibom State. Chief Ntuen bought community-based health insurance in 2015, but says he didn’t understand its importance until his youngest child got seriously ill--and he and his wife couldn't afford treatment.

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Expanding HIV and TB Services in Eastern Uganda with Community Outreach and Performance-based Financing

Uganda: Kasifa and her baby. [Photo: MSH staff]
Photo: MSH staff
Esther Nyende, 45, is a member of her village health team and a community leader in Uganda’s eastern Pallisa District. Supported by community-based organizations through performance-based financing grants, village health team members, such as Nyende, are helping save lives, such as Kasifa (pictured above with her baby) and Beatrice, who are now receiving antiretroviral therapy (ART).

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Strengthening Medicines Management Systems to Fight Malaria in Guatemala

Guatemala: Strengthening Medicines Management Systems [Photo: USAID SIAPS]
In Guatemala, a network of community volunteers who diagnose and treat malaria in their communities are mainstays of the Ministry of Health’s malaria strategy to ensure timely access to appropriate treatment. USAID's SIAPS Program, led by MSH, is providing technical assistance to the Ministry of Health’s malaria program for a nationwide rollout of interventions to improve management of malaria commodities at all levels of the health system.

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After Ebola: Ensuring Better Water and Sanitation for Health in Liberia

Liberia: Photo essay.  [Photo: Cindy Shiner/MSH]
Photo: Cindy Shiner/MSH
An effective water supply is critical not only during disease outbreaks, but also for day-to-day health service delivery. Through the US Agency for International Development (USAID) Collaborative Support for Health (CSH) program, MSH and partners are assisting the Liberian government to strengthen Liberia’s health system, including working with the Ministry of Public Works to improve management of its infrastructure, such as water wells in rural areas.

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Good Governance Improves Women's Health in Afghanistan: One Village’s Story

Afghanistan: Good governance improves women's health  [Photo: Afghan Eyes]
Photo: Jawad Jalali/Afghan Eyes
Governance training empowered a community health council (known as a shura) in Nangarhar Province, Afghanistan, to intervene and improve the health of women in their village.

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More News

Gabon Launches New Program and Partnership with MSH to Make Modern Health System Accessible to All

On Friday, April 8, the Gabon Ministry of Health launched a technical assistance agreement with Management Sciences for Health (MSH) that will help reform Gabon’s health sector, with a particular focus on improving maternal and child health outcomes.

Join MSH on LeaderNet: May 24-26

Why does organizational capacity building matter in local health organizations? How do you optimize the impact of interventions, and measure if they are working? Explore these questions and more in a free, online seminar, Capacity Building of Local Health Organizations: Balancing Demand & Supply, May 24 through 26. Join the free, global LeaderNet community to participate.

Zika or Ebola? The Danger of False Choices

“The recent announcement by the White House to transfer $600 million in yet unspent Ebola funds to address the Zika virus is not a solution to the current funding deficit for Zika, and risks increasing our collective vulnerability to future outbreaks,” blogs No More Epidemics Campaign Director, Dr. Frank Smith.


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Saving lives and improving health
of the world’s poorest and most vulnerable people
by closing the gap between knowledge and action in public health.
We envision a world where everyone has the opportunity for a healthy life.
Management Sciences for Health (MSH) uses proven approaches developed over 40 years to help leaders, health managers, and communities in developing nations build stronger health systems for greater health impact. We work to save lives by closing the gap between knowledge and action in public health. Since its founding in 1971, MSH has worked in over 150 countries with policymakers, health professionals, and health care consumers to improve the quality, availability, and affordability of health services.

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