What Does Health System Strengthening Mean?
We talk a lot about health systems and the technical side of providing quality primary health care for all, but what does that look like in the lives of real people? Through our work, we see just what a stronger health system means for people living with HIV, mothers trying to raise healthy children, and even the health workers and Ministry of Health officials trying to meet community needs. Here are two stories of individuals who highlight how HAI's work with government health systems has impacted them.
Edith
Edith lives in Bouaké in Côte d'Ivoire, where HAI has been working with the Ministry of Health since 2007 to expand HIV testing and treatment into routine prenatal care. Before then, women had to visit up to 8 different sites to get HIV testing, find out their results, come in for follow up, and get regular prenatal exams. Even then, there were few facilities that offered treatment. Edith describes:
"It was very hard for us because many people came for care and waited long hours at a clinic. We got up at 4am to be sure to see the doctor, who could only see 10 out of the 50 people waiting each day. I was a little bit lucky to live in town, because many people had to travel from far away. Some women didn't come for prenatal care, even though they wanted to, because they didn't have the money to travel so far to the clinic."
"Now, we have care in every health facility. It is easy to get tested and there are many more doctors available. I have all the care I need, and I can get my medications for three months at a time. I feel better, and I have gained back the 88 pounds I lost [when I was sick]. My daughter was born healthy without HIV, although I know others whose babies are sick and need medicine."
Women at a prenatal clinic in Côte d'Ivoire
Edith participates in a women's support group run by an HAI partner, Bouaké Eveil. She hopes that one day, a cure for AIDS can be found. Until then? "I hope more people will learn about HIV and the ways it is transmitted. People are not well informed and women are sometimes afraid to talk to their husbands, like I was. I stay positive for myself, and help my friends to be optimistic."
Dr. Rui de Araujo
Another example is Dr. Rui de Araujo, who was the first Minister of Health for the newly independent Timor-Leste. He has been a champion of building up the health system, especially focusing on services for women and children. Dr. Rui, as he is called, and HAI forged a partnership as the Timorese Ministry of Health sought to take responsibility for services that NGOs had stepped in to provide during the conflict surrounding Timor's independence from Indonesia.
The Timorese government has made great progress in health--in 2008, 82% of pregnant women living in districts where HAI works received at least one prenatal care visit, up from only 50% in 2003.
You can read more about Dr. Rui, our work in Timor, and the impact of stronger health systems on real people in the 2008 annual report.
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