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World Lung Foundation Announces Health Systems Strengthening Grant

WLF funds supported the construction of this on-site residence for Assistant Medical Officers. These residences help to ensure that qualified medical personnel are present when patients come for care

The World Lung Foundation is pleased to announce a $752,000 grant to the Ndela Youth Development Center in Tanzania. Funds will be used to train health workers and to undertake essential capital improvements in rural Tanzanian hospitals as part of the implementation of an innovative strategy to substantially reduce mortality stemming from lack of access to emergency services. The strategy, which is monitored and evaluated on an ongoing basis by a team of African medical experts, the Karolinksa Institute, and Columbia University, is currently being implemented in Tanzania, Mozambique, and Malawi.

Health systems in much of the developing world are in crisis. Acute shortages of health workers mean that many of those with life threatening illnesses cannot even benefit from existing equipment - there is no one to treat them. University trained medical doctors are in short supply and, if they don't disappear with the "brain drain" to developed countries, they are reluctant to leave the cities where there is much better potential for private practice.

The World Lung Foundation grant supports training and infrastructure improvements to mitigate this crisis. The Foundation is funding additional training and support for Assistant Medical Officers, who provide most of the life-saving surgical and other emergency care in under-served rural areas. Acquiring new skills will help Assistant Medical Officers to better address some of the chief causes of death in rural Tanzania, such as trauma, acute abdominal conditions, and maternal mortality. WLF is also supporting other improvements that will enable hospitals - and the communities they serve - to better benefit from these professionals, such as on-site residences for Assistant Medical Officers, in-patient ward expansion, construction of new operating theaters, and the upgrade of peripheral health centers to give them surgical capacity.

The use of Assistant Medical Officers for emergency care is a key element of an overall strategy for decreasing mortality in rural areas. These Officers are not doctors, but have been trained from existing pools of lower level health workers to provide desperately needed surgical and emergency services. Existing evidence shows that they can provide care of the same quality as medical doctors without requiring the same financial inputs. As such, the use of Assistant Medical Officers might lessen health system financial crises and shockingly high mortality rates prevailing almost all over sub-Saharan Africa. Indeed, project implementers intend to increase emergency obstetric coverage from 22% to 50% of all at-risk deliveries in the catchment area, and to increase the number of patients treated for trauma and acute abdominal emergencies by at least 200%.

This project requires little additional governmental investment, but it will have sustainable health system improvements. It thus has enormous potential to be scaled up to countries similarly struggling. WLF is accordingly going to support Africa-wide sharing of concrete program information and lessons learned, such as detailed morbidity and mortality data, hospital development plans, and training curricula.