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Dr. Gupta is Shifting Healthcare Systems in Resource-Poor Settings to Address NCDs

Dr. Neil Gupta, BWH Division of Global Health Equity.

By: Brittany Stopa

Ms. Stopa is a Clinical Research Regulatory Coordinator in the BWH Department of Neurosurgery, and holds a Masters of Public Health in Global Health. She is a contributor to the BWH Global Health Hub.

Dr. Neil Gupta is a physician in Brigham and Women’s Division of Global Health Equity (DGHE) who is working to strengthen healthcare systems by addressing the growing problem of noncommunicable diseases in low-income countries. I sat down with Dr. Gupta to discuss the scope of his work and the landscape in which he conducts these critical system-strengthening efforts.

Ms. Stopa:       Thank you for joining me, Dr. Gupta. I want to talk to you today about noncommunicable diseases (NCDs) and your work in addressing them. I read in the World Health Organization (WHO) report in 2015 that 70% of the world’s 56 million deaths were caused by NCDs1. And so, as somebody that works in that field, do you see NCDs emerging as the focus of public health? Is this the direction the field is moving?

Dr. Gupta:       NCDs are definitely an emerging focus in global health and are increasingly recognized as a critical issue that we need to address. NCDs, to give you an overview, are a diverse group of chronic illnesses that include cardiac conditions, cancers, respiratory diseases, diabetes, blood disorders, kidney diseases, liver cirrhosis, congenital diseases, and many other conditions. It can also include mental disorders and injuries, which may require surgical, rehabilitation, or palliative care services.

In the global health community, NCDs are set apart from more traditional infectious diseases, which have historically been a major focus in global health. Infectious diseases cause a huge number of deaths, but luckily many can now be prevented or treated with adequate tools and resources. Addressing large-scale infectious epidemics, as well as basic maternal and child health services, was the first goal of emerging health systems in lower income countries globally. But now, as health systems and coverage of health services have improved in those areas, the area of NCDs is being increasingly recognized as the next step for maturing health systems.

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Better Counting Preterm Babies: BWH authors’ new review examines what works, and what’s next globally

Anne CC Lee, Lian Folger, Lauren Schaeffer, Pratik Panchal, Hannah Blencowe, Joy E Lawn
Nov 17, 2017 is World Prematurity Day. The authors publication on diagnostic accuracy in neonatal assessment was released today in Pediatrics.

On World Prematurity Day, findings from a new study will be published in the journal Pediatrics.1 This systematic review examines the accuracy of different newborn assessments to determine gestational age and identify preterm babies.

WHY THE EARLY IDENTIFICATION OF PRETERM BABIES IS IMPORTANT

Each year, 15 million babies are estimated to be born preterm (before 37 completed weeks gestation), with the vast majority born in low- and middle-income countries (LMICs).2 Preterm birth complications are the leading cause of under-5 child mortality globally3—accounting for 1 million neonatal deaths each year.4

Preterm babies are more likely to die in infancy or become ill with conditions that could be effectively treated if identified early, such as breathing problems, infections, or low body temperature.   The early identification of preterm babies enables health workers to offer these babies special care, including better monitoring and the timely delivery of potentially life-saving interventions, such as continuous positive airway pressure or kangaroo mother care. Furthermore, accurate determination of gestational age is needed to identify growth-restricted infants, who also carry increased risk of mortality and morbidity in infancy and beyond.

In order to save lives of premature and growth-restricted infants in LMICs, these high-risk infants need to be accurately identified as early as possible and targeted for interventions.
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BWH Global Health Equity faculty and PIH colleagues unveil toolkits for costing and mentored quality improvement in resource limited settings

The original version of the article was posted by Partners in Health

In 2009, BWH faculty in the Division of Global Health Equity began a journey with colleagues in Rwanda, at Partners In Health and at HMS, to strengthen community health across the globe. That journey culminated this fall, with the publication of dynamic toolkits on MESH-QI and District Costing Methodology that will allow the impact of this work to endure. Funded by the Doris Duke Charitable Foundation’s Africa Health Initiative, this ambitious work is coming to a successful conclusion and culminating with numerous publications, notably including two powerful toolkits that will allow this work to be replicated at many sites for years to come.

Dr. Lisa Hirschhorn and Dr. Peter Drobac were principal investigators on the Population Health Implementation Training project, which sought to make significant improvements to WHO health system building blocks. The project also worked to fulfill MOH priorities such as improving the quality of health center-based care, strengthening monitoring and evaluation, and enhancing community health worker networks.

Out of this grant and the vision of these leaders, Partners In Health has developed a model for mentoring health care workers. The model is gaining broad attention after improving quality of care in Rwanda and elsewhere for several years. The team also has developed a new guideline—along with a separate, cost-analysis toolkit—that describes how health centers and systems can implement the model, combat the global shortage of quality health care staffing and plan budgets across a range of services.

“Building a culture of high-quality care delivery processes and systems is almost impossible, especially in resource-limited settings,” said Anatole Manzi, director of clinical practice and quality improvement for PIH, who worked closely with Drs. Hirschhorn and Drobac on this project.

“This guide provides invaluable help to organizations and governments preparing to implement MESH-QI as a model for Health Systems Strengthening,” Anatole Manzi, director of clinical practice and quality improvement for PIH.

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