SA is working towards reducing the high cost of private healthcare and ensuring public healthcare is of quality. But it won’t happen overnight…..more

WONCA E-Update

Friday 4th September 2015

WONCA News – September 2015

The latest WONCA News, containing the usual mix of WONCA news, views and events, is available via the WONCA website. 

From the President – the new Sustainable Development Goals (SDGs)

“2015 is a landmark year in global health as we come to the end of the Millennium Development Goals. In September 2015, the United Nations will be asked to adopt the 17 new Sustainable Development Goals. There is only one health specific goal, number 3: [“Ensure healthy lives and promote well-being for all at all ages”] but each of the 17 goals has an impact on global health and the health of individuals and communities.”

Professor Michael Kidd uses part of this month’s column to discuss the new SDGs.  He has been working especially hard on WONCA’s behalf in liaising with various UN agencies to ensure the voice of family medicine is heard in the implementation and monitoring of these goals, and will no doubt report on progress in future columns.   

WONCA Conference photographs

2015 has been a big year for WONCA conferences – and with WONCA Europe in Istanbul still to come.  Karen Flegg has compiled albums of the various conferences so far – click on the link and scroll through the various albums and relive the memories.

World Mind Matters Day

Today (4th September) our colleagues in the World Psychiatric Association (WPA) are launching World Mind Matters Day.   This is part of a global campaign that aims to achieve a FAIR DEAL in mental healthcare across the world and focuses on the following priorities:

• Fairness and equity in funding, resources, outcomes and research
• Accessibility to effective services
• Integrating physical and mental health
• Reducing discrimination and stigma
• Dignity and equality for all
• Education of public and stakeholders
• Alliances and advocacy with patients and carers
• Links with organisations and across specialties

Also being launched is the report of the Presidential Taskforce on migrant and refugee mental health, which is of special interest to the WONCA Working Party on Mental Health and the WONCA SIG on Migrant Care, International Heath and Travel Medicine.

WONCA Direct Membership

A reminder to everyone that significant discounts on delegate registration are available at all WONCA conferences to WONCA Direct Members.  Brazil is offering particularly generous discounts to WONCA Direct Members so now would be an excellent time to consider taking out this individual membership. 

Direct Membership is normally available for three years, for $140, but with a discount for anyone from less developed countries.  Even better value is:

Life Direct Membership which is to support the work of WONCA through a one-off donation, currently $750.  For this Life Direct Members, as well as supporting the work of WONCA, also get a special certificate, a unique lapel pin and their name is entered onto the Roll of Honour on the WONCA website.  

Further details about Direct Membership and Life Direct Membership can be found here, Or contact Arisa, our Membership Officer, on admin@wonca.net

Soon, soon’ – the complexity of radically transforming the health system underlies the snail’s pace of the National Health Insurance (NHI) White Paper’s development, but a lot is happening to improve the quality of public health in preparation for one universal health system. Kerry Cullinan reports for Health-e News.

MEC for Health Magome Masike recently hosted a farewell function for the prospective medical students in Orkney. He and previous graduates of the free Nelson Mandela / Fidel Castro Medical Training Programme made their expectations of the youth clear. Masike told the students that the ability to adapt would be important to their success in Cuba. He urged students to stay strong and focused…..more

Traditional health practioners should be regulated say some Northern Cape traditional healers as the Department of Health looks to integrate healers into HIV, tuberculosis (TB) and chronic illnesses programmes….more

The Department of Health’s controversial plans to limit medical schemes’ responsibilities for paying prescribed minimum benefits (PMBs) were never intended to leave patients footing part of their bills, a senior official claimed on Wednesday. Draft amendments to regulation 8 of the Medical Schemes Act, published for comment two weeks ago, propose limiting medical schemes’ financial liability for PMBs, a move critics say leaves patients exposed to potentially massive bills if a doctor or hospital charges more than a scheme is willing to pay….more

THE Council for Medical Schemes has added its voice to the confusion surrounding proposed amendments to the regulations governing how schemes pay for prescribed minimum benefits, and assured consumers they will not face co-payments if they stick to designated service providers. Prescribed minimum benefits are a set of 270 serious health conditions, 25 chronic diseases and emergency conditions that medical schemes must cover for every member, regardless of which benefit package the member buys…..more

MEDICAL schemes’ expenditure on specialists and private hospitals soared last year, rising 12% and 11.6% respectively, according to the Council for Medical Schemes’ (CMS) latest annual report. This above-inflation trend has been observed for the past decade, and is one of the reasons why the Competition Commission is currently conducting a market inquiry into the private healthcare sector…..more

CITATION: A framework on the emergence and effectiveness of global health networks

Jeremy Shiffman, Kathryn Quissell, Hans Peter Schmitz, David L. Pelletier, Stephanie L. Smith, David Berlan, Uwe Gneiting, David Van Slyke, Ines Mergel, Mariela Rodriguez, Gill Walt.

Health Policy and Planning 2015;1–14

doi:10.1093/heapol/czu046

ABSTRACT

Since 1990 mortality and morbidity decline has been more extensive for some conditions prevalent in low- and middle-income countries than for others. One reason may be differences in the effectiveness of global health networks, which have proliferated in recent years. Some may be more capable than others in attracting attention to a condition, in generating funding, in developing interventions and in convincing national governments to adopt policies. This article introduces a supplement on the emergence and effectiveness of global health networks. The supplement examines networks concerned with six global health problems: tuberculosis (TB), pneumonia, tobacco use, alcohol harm, maternal mortality and newborn deaths. This article presents a conceptual framework delineating factors that may shape why networks crystallize more easily surrounding some issues than others, and once formed, why some are better able than others to shape policy and public health outcomes. All supplement papers draw on this framework. The framework consists of 10 factors in three categories: (1) features of the networks and actors that comprise them, including leadership, governance arrangements, network composition and framing strategies; (2) conditions in the global policy environment, including potential allies and opponents, funding availability and global expectations concerning which issues should be prioritized; (3) and characteristics of the issue, including severity, tractability and affected groups. The article also explains the design of the project, which is grounded in comparison of networks surrounding three matched issues: TB and pneumonia, tobacco use and alcohol harm, and maternal and newborn survival. Despite similar burden and issue characteristics, there has been considerably greater policy traction for the first in each pair. The supplement articles aim to explain the role of networks in shaping these differences, and collectively represent the first comparative effort to understand the emergence and effectiveness of global health networks.

KEY MESSAGES

1. Global health networks — webs of individuals and organizations linked by a shared concern for a health condition—now exist for most high-burden health problems that low- and middle-income countries face. However, scholars have paid them scant attention, so we know little about their origins and the influence they have in global health.

2. These networks vary in their capacities to attract attention, generate funding, develop interventions and convince national governments to adopt policies and carry out programmes. This variance may help explain why mortality and morbidity have declined more rapidly for some conditions than others.

3. The emergence and effectiveness of global health networks can be understood by considering three categories of factors: features of the networks and actors that comprise them, their policy environments and particular characteristics of the issues they address.

The final feature is ‘framing strategy’ (Factor 4) (Snow et al. 1986; Benford and Snow 2000; McInnes and Lee 2012; McInnes et al. 2012): how network actors publicly position an issue in order to attract attention and resources. Networks may differ in their capacities to discover frames that work. HIV/AIDS communities have been particularly adept at this: when HIV/AIDS was understood as a public health problem afflicting only certain population groups it had difficulty attracting resources; when advocates reframed it as an exceptional disease that posed an existential threat to humanity, politicians began to pay attention (Prins 2004; Harris and Siplon 2007).

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Best wishes, Neil

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org  

‘Presumptive treatment of uncomplicated malaria remains an ingrained behaviour that is difficult to change’, say the authors of a new study from Nigeria. In the conclusion of the full text, they say: ‘Given the challenges we have outlined, it will be particularly important to consider whether it is cost-effective for the government to support the roll-out of RDTs in the private sector and we would recommend further investigation of this issue.’

This is an interesting point: Whether to abandon RDTs (rapid diagnostic tests) on the basis that it is too difficult to persuade healthcare providers to use them appropriately, or to continue to seek better ways to encourage such use. Are HIFA members aware of examples of successful introduction of RDTs in Nigeria or other malaria-endemic countries?

CITATION: Effectiveness of Provider & Community Interventions to Improve Treatment of Uncomplicated #Malaria, Nigeria

Obinna Onwujekwe, Lindsay Mangham-Jefferies, Bonnie Cundill, Neal Alexander, Julia Langham, Ogochukwu Ibe, Benjamin Uzochukwu, Virginia Wiseman

Published: August 26, 2015DOI: 10.1371/journal.pone.0133832

@PLOSONE http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0133832

ABSTRACT

The World Health Organization recommends that malaria be confirmed by parasitological diagnosis before treatment using Artemisinin-based Combination Therapy (ACT). Despite this, many health workers in malaria endemic countries continue to diagnose malaria based on symptoms alone. This study evaluates interventions to help bridge this gap between guidelines and provider practice. A stratified cluster-randomized trial in 42 communities in Enugu state compared 3 scenarios: Rapid Diagnostic Tests (RDTs) with basic instruction (control); RDTs with provider training (provider arm); and RDTs with provider training plus a school-based community intervention (provider-school arm). The primary outcome was the proportion of patients treated according to guidelines, a composite indicator requiring patients to be tested for malaria and given treatment consistent with the test result. The primary outcome was evaluated among 4946 (93%) of the 5311 patients invited to participate. A total of 40 communities (12 in control, 14 per intervention arm) were included in the analysis. There was no evidence of differences between the three arms in terms of our composite indicator (p = 0.36): stratified risk difference was 14% (95% CI -8.3%, 35.8%; p = 0.26) in the provider arm and 1% (95% CI -21.1%, 22.9%; p = 0.19) in the provider-school arm, compared with control. The level of testing was low across all arms (34% in control; 48% provider arm; 37% provider-school arm; p = 0.47). Presumptive treatment of uncomplicated malaria remains an ingrained behaviour that is difficult to change. With or without extensive supporting interventions, levels of testing in this study remained critically low. Governments and researchers must continue to explore alternative ways of encouraging providers to deliver appropriate treatment and avoid the misuse of valuable medicines.

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Best wishes, Neil

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org  

The news item below is forwarded from K4Health. Reading this, together with the 78 million dollar Mobile Hub announced recently, suggests an explosion of global mHealth programmes backed by hundreds of millions of dollars. Are all these programmes competing with one another or are they truly cooperating? Meanwhile it is essential that more funding is made available for those organisations that produce and distribute actionable mHealth content for citizens, such as Global Health Media Content, Medial Aid Films, Hesperian, HealthPhone and many others represented on HIFA. (See our article in The Lancet Global Health: http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(15)00054-6/fulltext )

Meeting Report: Africa Regional Meeting on Digital Health for Overcoming Barriers to Ending Preventable Child and Maternal Deaths and Achieving Universal Health Coverage

‘K4Health participated in the “Africa Regional Meeting on Digital Health for Overcoming Barriers to Ending Preventable Child and Maternal Deaths and Achieving Universal Health Coverage” in Malawi, May 12-15, 2015. The meeting was convened by the U.S. Agency for International Development (USAID) and the United Nations Foundation (UNF) with collaboration from the Government of Malawi. With more than 150 government, private sector, and donor participants, the event aimed to strengthen and expand opportunities for public-private partnerships in digital health across Africa. K4Health’s Director of ICT and Innovation, James BonTempo, led a knowledge café session on mHealth Knowledge http://www.mhealthknowledge.org/ a portal providing access tools and resources in mhealth, mHealth Evidence https://www.mhealthevidence.org/ a portal housing the world’s literature on mHealth, and the mHealth Working Group website https://www.mhealthworkinggroup.org/ an international community with more than 1,900 members represennting more than 500 organizations in 78 countries. For more information, access the meeting report.’

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org  

The news item below is forwarded from K4Health. Further information here:

http://www.globalhealthlearning.org/

“Join the network and start making free calls to your fellow medical practitioners.”

‘The Global Health eLearning Center (GHeL) is now available to a growing number of health workers in Tanzania via their mobile devices free of charge. Earlier this month, GHeL was included as a free domain to members of the Health Network Programme. Members of this network can now take GHeL courses?critical resources for continuing professional developmentt?on their mobile devices without incurring data charges. The Healthh Network Programme makes it easier for health workers to seek advice, refer clients, and improve patient care nationwide. When doctors, assistant medical officers, and clinical officers in Tanzania join this network they can call and text each other and access select websites for free. The network facilitates collaboration among geographically dispersed health workers—particularly those working in isolated or remote areas. The Health Network Programme was created in close partnership with Vodacom, the Ministry of Health & Social Welfare, the Medical Association of Tanzania and Switchboard, acquired recently by IntraHealth International.’

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org  

‘Benefits of data sharing have been widely recognized – transparency and cooperation, reproducibility of research, cost-efficiency and preventing redundancies, acceleration of discovery and innovation, and saving lives through more efficient and effective public health programs…’

‘The simultaneous effect of multiple interacting barriers ranging from technical to intangible issues has greatly complicated advances in public health data sharing’, concludes a paper in BMC Public Health (with thanks to Isabelle Wachsmuth-Huguet and HIFA-EVIPNet-French). This has negative consequences for decision-making by public health agencies (ranging from international health agencies to ministries of health to local institutions), and also obstructs their use in academic research and technology development.

Below is the citation and abstract. The full text is available here: http://www.biomedcentral.com/1471-2458/14/1144

It is notable that the current study (like many reviews, and for obvious reasons) is limited to English-language studies only.

CITATION: A systematic review of barriers to data sharing in public health

Willem G van Panhuis, Proma Paul, Claudia Emerson, John Grefenstette, Richard Wilder, Abraham J Herbst, David Heymann and Donald S Burke

van Panhuis et al. BMC Public Health 2014, 14:1144

ABSTRACT

Background: In the current information age, the use of data has become essential for decision making in public health at the local, national, and global level. Despite a global commitment to the use and sharing of public health data, this can be challenging in reality. No systematic framework or global operational guidelines have been created for data sharing in public health. Barriers at different levels have limited data sharing but have only been anecdotally discussed or in the context of specific case studies. Incomplete systematic evidence on the scope and variety of these barriers has limited opportunities to maximize the value and use of public health data for science and policy.

Methods: We conducted a systematic literature review of potential barriers to public health data sharing. Documents that described barriers to sharing of routinely collected public health data were eligible for inclusion and reviewed independently by a team of experts. We grouped identified barriers in a taxonomy for a focused international dialogue on solutions.

Results: Twenty potential barriers were identified and classified in six categories: technical, motivational, economic, political, legal and ethical. The first three categories are deeply rooted in well-known challenges of health information systems for which structural solutions have yet to be found; the last three have solutions that lie in an international dialogue aimed at generating consensus on policies and instruments for data sharing.

Conclusions: The simultaneous effect of multiple interacting barriers ranging from technical to intangible issues has greatly complicated advances in public health data sharing. A systematic framework of barriers to data sharing in public health will be essential to accelerate the use of valuable information for the global good.

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The authors say ‘more research is needed to expand the evidence base of these barriers. As knowledge on these barriers will increase, so will opportunities for solutions’.

Best wishes, Neil

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org  

Source: http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001847

Abstract

Background: Despite growing recognition of neglectful, abusive, and disrespectful treatment of women during childbirth in health facilities, there is no consensus at a global level on how these occurrences are defined and measured. This mixed-methods systematic review aims to synthesize qualitative and quantitative evidence on the mistreatment of women during childbirth in health facilities to inform the development of an evidence-based typology of the phenomenon.

Methods and Findings: We searched PubMed, CINAHL, and Embase databases and grey literature using a predetermined search strategy to identify qualitative, quantitative, and mixed-methods studies on the mistreatment of women during childbirth across all geographical and income-level settings. We used a thematic synthesis approach to synthesize the qualitative evidence and assessed the confidence in the qualitative review findings using the CERQual approach. In total, 65 studies were included from 34 countries. Qualitative findings were organized under seven domains: (1) physical abuse, (2) sexual abuse, (3) verbal abuse, (4) stigma and discrimination, (5) failure to meet professional standards of care, (6) poor rapport between women and providers, and (7) health system conditions and constraints. Due to high heterogeneity of the quantitative data, we were unable to conduct a meta-analysis; instead, we present descriptions of study characteristics, outcome measures, and results. Additional themes identified in the quantitative studies are integrated into the typology.

Conclusions: This systematic review presents a comprehensive, evidence-based typology of the mistreatment of women during childbirth in health facilities, and demonstrates that mistreatment can occur at the level of interaction between the woman and provider, as well as through systemic failures at the health facility and health system levels. We propose this typology be adopted to describe the phenomenon and be used to develop measurement tools and inform future research, programs, and interventions.

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Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org  

Sharing individual-level data in low and middle income settings – special issue and online eLearning course

A Special issue of the Journal of Empirical Research on Human Research Ethics http://jre.sagepub.com/content/10/3 , launched today, focuses on the ethical implications of sharing health research data in low and middle income settings. To accompany the special issue, Bioethics, Research Ethics & Review has launched an online resource (https://bioethicsresearchreview.tghn.org/research-data-sharing/) which brings together resources about ethical best practices for data sharing, policies and processes for data curation and data sharing, and links to repositories for data sharing.  The online resource includes a new eLearning Course (https://globalhealthtrainingcentre.tghn.org/ethics-and-best-practices-sharing-individual-level-data-clinical-and-public-health-research/) on Ethics and Best Practices in Sharing Individual-level Research Data. The special issue, online resource and eLearning course are all free to download and use, and your contributions to the online resource are welcomed.

With the globalization of biomedical research and growing concerns about possible pandemics of diseases such as HIV, SARS, and Ebola, international data-sharing practices are of growing interest to the biomedical science community. But what are the advantages and disadvantages of sharing data in low and middle-income settings? What challenges stand in the way for researchers in countries such as India, Kenya, and Vietnam?

The special issue of JERHRE publishes research funded by the Wellcome Trust, on behalf of the Public Health Research Data Forum. The special issue outlines the views of researchers and gatekeepers of biomedical research in five developing countries – India, Kenya, South Africa, Thailand, and Vietnam – on the possibility of expanding the sharing of their individual-level biomedical research data.

“Data sharing enables researchers worldwide to build on the efforts of others in a cost-effective way. Base-line data will be in place when epidemics strike. The political, scientific, and economic problems of understanding and stopping new diseases will be vastly reduced when an infrastructure and baseline data are readily available to scientists,” Sieber wrote. “Each discipline raises its own set of challenges, risks, and benefits of data sharing, but with ingenuity, the risks can be overcome.”

Author: Dr Susan Bull

Tamzin Furtado

Project Manager

The Global Health Network

I see an open access point-of-care medical summary as having the potential to do for medicine what open access journals have already done for science. I have published in PLOS Medicine a call out to all those who believe in the goal of health information for all to seriously consider moving their content to an open license (note not the same as free access) http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001868

PLOS has also indicated their desire to be involved in this initiative. http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001870 If all those in the field of getting high quality information out to those who need it most work together we can accomplish this goal.

—

James Heilman

MD, CCFP-EM, Wikipedian

The Wikipedia Open Textbook of Medicine

www.opentextbookofmedicine.com

United Nations Sustainable Development Summit 2015 – Outcome document: Transforming our world: the 2030 Agenda for Sustainable Development

[PAHO/WHO Equity list & Knowledge network]

Contribution from our valuable members. Thank you!!

United Nations Sustainable Development Summit 2015

Outcome document: Transforming our world: the 2030 Agenda for Sustainable Development

25 – 27 September  2015

The United Nations summit [https://sustainabledevelopment.un.org/post2015/summit] for the adoption of the post-2015 development agenda will be held from 25 to 27 September 2015, in New York and convened as a high-level plenary meeting of the General Assembly.

Preamble:

This Agenda is a plan of action for people, planet and prosperity. It also seeks to strengthen universal peace in larger freedom. We recognise that eradicating poverty in all its forms and dimensions, including extreme poverty, is the greatest global challenge and an indispensable requirement for sustainable development.

All countries and all stakeholders, acting in collaborative partnership, will implement this plan. We are resolved to free the human race from the tyranny of poverty and want and to heal and secure our planet. We are determined to take the bold and transformative steps which are urgently needed to shift the world onto a sustainable and resilient path. As we embark on this collective journey, we pledge that no one will be left behind.

The 17 Sustainable Development Goals and 169 targets which we are announcing today demonstrate the scale and ambition of this new universal Agenda. They seek to build on the Millennium Development Goals and complete what these did not achieve. They seek to realize the human rights of all and to achieve gender equality and the empowerment of all women and girls. They are integrated and indivisible and balance the three dimensions of sustainable development: the economic, social and environmental.

Keywords / Palabras clave: Sustainable Development; Millennium Development Goals (MGDs); Inequalities; Universal Health Coverage; Global Health; United Nations

How to obtain this report / Como obtener este informe: click here.

https://sustainabledevelopment.un.org/content/documents/7891Transforming%20Our%20World.pdf

Visit the Portal/Blog of the PAHO/WHO Equity List & Knowledge network : http://equity.bvsalud.org/

Visite el Sítio/Blog de la Lista de Equidad y Red de Conocimiento: : http://equity.bvsalud.org/es/

For additional information of the Equity List or contributions please contact Mrs. Eliane P. Santos, Advisor, Library and Information Networks – KBR/ Pan American Health Organization, Regional Office of the World Health Organization – pereirae@paho.org

Pan American Health Organization, Regional Office of the World Health Organization for the Americas

Office of the Assistant Director

Area of Knowledge Management, Bioethics and Research (KBR)

http://www.paho.org

(with thanks to Communication for Development Network)

[forwarded from http://globalhandwashing.org/resources/global-handwashing-day-social-media-toolkit/ ]

Blue Raise a Hand

Updated for 2015, this social media toolkit has sample messages, blog ideas, and resources to help celebrants and handwashing champions spread the word about Global Handwashing Day.

Resource Attachments:

http://globalhandwashing.org/wp-content/uploads/2015/03/Global-Handwashing-Day-2015-Social-Media-Toolkit.pdf

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Best wishes,

Neil

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org  

This year in particular has seen the profile of hand hygiene raised to new levels across the globe.

On 5 May 2015, one part of WHO’s SAVE LIVES: Clean Your Hands campaign was a very successful social media campaign with #safeHANDS photos posted from people all over the world.

http://www.who.int/gpsc/5may/EN_PSP_GPSC1_5May_2015/en/

Based on the Ebola outbreak response, the collaboration between WASH and health care infection prevention strategies has been enhanced including in support of hand hygiene action and this week (world water week #wwweek) saw numerous messages posted emphasising this important link.

Whatever the day to raise awareness to hand hygiene, collaboration and learning from easily accessible years of activities/experience will serve the public and health care communities well.

Thank you

Claire.

The tippy-tap is a brilliant solution: a hands free way to wash hands in places with difficult access to running water.  It can be made from simple salvaged materials and is operated by a foot lever.  It uses very little water for each hand wash: only 40 ml of water compared to 500 ml using a mug.  

This website shows examples, including how to build one: http://www.tippytap.org/wp-content/uploads/2011/03/How-to-build-a-tippy-tap-manual.pdf

warm regards,

Deb

What a wonderful initiative to celebrate the Global Handwashing Day. I want to share with you a very appropriate animation on handwashing:

http://sawbo-illinois4.org/Handwashing

Sincerely,

Julia Bello Bravo, PhD

Assistant Director

Center for African Studies (CAS)/Illinois Strategic

For the month of September, the One Million Community Health Workers (1mCHW) Campaign and mPowering Frontline Health Workers are supporting HIFA to hold an in-depth exploration around the need for improved data on community health worker (CHW) programs, and how we can meet these needs in the post-2015 era.

You can read more about this discussion here:

http://1millionhealthworkers.org/data-for-decision-making/

CHWs deliver vital health education and life-saving interventions. They have made an important contribution to the major reductions in child and maternal mortality in middle- and low-income countries over the past 10 years. Several countries, including Ethiopia, Rwanda and, more recently, Ghana, have supported national scale-up of CHWs. There is agreement that further expansion of CHWs is needed globally.

Currently, information on CHWs -­ including demographics, deployment details, services provided, and service delivery – is inconsistently collected in parallel by multiple actors. There is clearly massive

duplication and wasted effort, which leads to inaccurate data collection and utilization. This is the next challenge that we must work together to overcome.

Recently the 1mCHW Campaign and mPowering interviewed 8 senior decision-makers, academics, and program managers in a blog series about CHW data for decision making.

To each we asked three core questions:

1. What are the most pressing challenges in the development of scale-up of CHW programs today?

2. Why is data on frontline health workers, particularly CHWs, important?

3. In your opinion, what are the largest gaps in data on frontline health workers, particularly CHWs, right now?

and invited them also to answer one or more supplemental questions:

4. In what ways is your organization using innovative solutions to collect data on frontline health workers?

5. With better information and data, how could NGOs and governments overcome these challenges to improve CHW programs and programmatic decision-making?

6. How can we begin to close data gaps?

You can read their responses here:

http://mpoweringhealth.org/category/data-for-decision-making-series/

On September 1st we shall open the discussion on HIFA around the same questions. We hope to solicit perspectives from the full range of stakeholders represented on HIFA: ministries of health, CHW managers, individual NGOs, and INGOs; frontline health workers, policy makers, information professionals, publishers, researchers, and more.

The results of this discussion, combined with the interviews, will be compiled into a short report and disseminated by the 1mCHW Campaign and mPowering. This multi-stakeholder input will help inform the post-2015 era of global CHW scale-up and we look forward to engaging your views in the discussion.

Please do forward this message widely to your contacts and colleagues and invite them to join the discussion via the HIFA website: www.hifa2015.org

Thank you,

Cindil, Carolyn, & Neil