1. Faith, Healthcare And Technology, Faith, Healthcare And Technology, Christian Connections for International Health 2009 Conference 2009 Conference Sarla Chand Buckeystown, MD May 23, 2009

2. Overview This presentation will provide a brief overview of the role Christian health organizations play in providing healthcare especially to the poor and marginalized and thereby assisting their national health sector in reaching those that the government is unable to

3. Various Approaches - 4 Case Studies ApproachEmphasis CSSC, Tanzania FBO strengthening national health sector by strengthening its own health information system CMC Vellore, India Continuing to follow the Biblical mandate and on the cutting edge of medical technology ECC,IMA- DR Congo FBO/MoH collaboration to deliver healthcare in a weak national infrastructure UPMB, CHAK CHAs incorporating evidenced based interventions in maternal/newborn health Care in member service delivery

8. Christian Medical College & Hospital, Vellore, India

9. CMC & H, Vellore Ida Scudder opened a one-bed clinic in Vellore, India in 1900. Two years later, in 1902, she built a 40-bed hospital, the forerunner of today's 2234-bed medical center. In 1909, she started the School of Nursing, and in 1918, a medical school for women was opened under the name Missionary Medical School for Women. With the training of these women as doctors and nurses, Indian women began to have access to health care professionals. The medical school was upgraded into a university affiliated medical college granting the degree of M.B.B.S. in 1942, under the name Christian Medical College. Men were admitted to this college in 1947, ten in a class of 35.

10. CMC & H, Vellore Contd… CMC & H, Vellore Contd… Today, there are 3,000 outpatients per day, 1,000 inpatients, 55 operations, 22 clinics, and over 30 births every day. Ten bible classes are held each day and 350+ patients are visited by a chaplain. In addition, there is the work of CHAD, CONCH, and RUHSA, which go out to the villages and rural areas bringing methods of disease prevention, health care and community empowerment to tens of thousands more.

11. CMC is unique in being both a centre attending to the needs of the disadvantaged a leading referral tertiary care hospital. CMC fosters wholeness of healing and integrates physical and spiritual care combines technical competence and care relevant to the needs of people and their environment principal achievement is hundreds of health care personnel

12. CMC is unique in being Cont… engages in cutting edge research (gnome) leads in cutting edge procedures (mismatched blood kidney transplant) major emphasis on training in Community Medicine, includes living in a village for several weeks, designed to provide practical knowledge and experience related to the life and health of rural people. consistently ranked among the best medical colleges in India, 2 nd only to All India Institute of Medical Sciences

13. Faith-based Health Networks in Uganda Faith Based Networks provide  50% of health care services  60% of Pre-service Education in Uganda Uganda Catholic Medical Bureau (UCMB) Uganda Muslim Medical Bureau (UMMB) Uganda Protestant Medical Bureau (UPMB)

14. Malaria in pregnancy  1.35 million pregnancies each year  Malaria is the leading cause of death and illness in Uganda  1998- MIP Policy adopted  IPT (only 33.8% -- CDC data )– Target- 85%  ITNs  Case Management  Addressing MIP through ANC  91% of pregnant women attend at least one ANC visit

15. Overview 2003 - Uptake of IPT1 - 35%; IPT2 - 27%; (2006 IPT1 - 49.8% and IPT2 – 16.6%) ; ITN use-5% Antenatal care good platform to address prevention and treatment of MIP WHO - 3 pronged approach for MIP: –IPT –ITNs –Early diagnosis, prompt and appropriate treatment. CORPS IN CLASS WITH CHILDREN

16. Objectives Objectives Increase uptake of IPT using DOT Method Increase ITN use among Pregnant Women Improve capacity among providers to deliver focused ANC services Increase number of pregnant women coming in early trimester

17. Approach Upgrade FANC/MIP/PMTCT knowledge of * FBO Health Networks * Providers * CORPS (Community Owned Resource Persons) and * Religious Leaders Strengthen ANC service delivery with FANC, MIP – DOT, Job Aids, Birth Plan Form

18. Tools & Processes Tools & Processes Orientation Package for service provider and CORPs Job Aids-FANC,MIP,PMTCT (Birth plan form in 3 languages- UPMB) Tools for baseline, support supervision and end line Training and Supportive Supervision

19. Achievements Key Program IndicatorBaselineEnd line % of ANC clinic staff trained in MIP in past 6months2%100% % of women received/purchased ITNs during ANC0%27% # of CORPS trained in MIP0%25% # of Religious Leaders sensitized0%10% ANC Attendance in first semester0%5% ANC Attendance once during pregnancy93%98% % of Pregnant women receiving IPT1 using DOT43%94% % of Women who received IPT2 using DOT63%76%

20. Faith-based Co-managed Health Zones and Umbrella Projects in DR Congo

21.  In DR Congo, the role of FBOs extends beyond health service provision to include health system co-management. This is very different from other countries:  FBOS played a key role in the development of the health zone concept in DR Congo  202 of Congo’s 515 Health Zones are currently co-managed (formally or informally) by FBOs or NGOs. Health Zone System Development and Management Health Zone System Development and Management

22. 40% of health zones are co-managed by FBOs/NGOs

23. A Typical Health Zone of Congo Ref. Hospital, BCZS & Health Centers

24. Achievements of Health Zone System SANRU’s integrated and systems strengthening approach resulted in major achievements in maternal & newborn care: Prenatal Care increased to 80% www.sanru.org Assisted births increased from 45% to 65% SANRU’s health system strengthening program strengthens PHC interventions and encourages co-management of health zones via FBO health networks.

25. Thank You