Management Sciences for Health: Poised to Deliver on Access to Affordable Healthcare in Hard-to-Reach and Underserved Communities in Africa
Colbert Gwain in Kigali
Bainwi Joy had lived a joyous life with her aunt, Mrs. Fulai Rose, in Bamenda, Cameroon’s North West Regional capital, until her 12th-grade year in college in late 2022, when suddenly she developed a strange malaise that kept her constantly moving in and out of hospital. One year after Joy’s birth in her native village kaleidoscope, Abuh, in Fundong District in the Boyo Division of the North West Region, Mrs. Fulai Rose had opted to take the young promising little queen to the city where she could have easy access to the many amenities that the village completely lacked such as education, good nutrition, potable water and, above all, health facilities.
Some 17 years after, it was judged that she reconnect and spend a vacation with the family back in Abuh village. It was all rosy and joyous as the family was excited to see what Joy had grown up to become, and how she was full of ambition to reach for her life’s dreams. Weeks into her fulfilling vacation, she developed a strange malaise that made her unable to sleep, and cry uncontrollably. Upon hearing of the situation, her aunt made special transportation arrangements for her to be brought back for consultation at the Bamenda Regional Hospital where the Region’s best health experts are concentrated.
She was then diagnosed with intussusception, a medical emergency involving obstruction of the intestine, or the intestine telescoping into itself, and making the concerned to scream uncontrollably out of sheer pain. Bainwi Joy was quickly placed on medication and weeks after, the situation was brought under control, with the aunt heaving a sigh of relief. She could once more return to Abuh village to continue her vacation, hoping to come back to Bamenda to complete her 12th grade and enroll in the University.
A few weeks later, the health condition deteriorated with immense intensity but Joy’s immediate family kept the news away from the aunt on the pretext she had outstretched to mobilize the financial resources for her treatment in Bamenda and hoped that the available health facilities in the village could provide a solution for the ailment. Things only got worse as the health system in that community lacked everything that others elsewhere take for granted–medical doctors, trained health personnel, and laboratories. When Joy’s aunt got wind of how bad the situation had become, she forced them to send her back to Bamenda for better medical attention. But before they could mobilize available transportation to Fundong, and then to Bamenda, Joy had given up the ghost.
It is in a bid to correct such dysfunctional health systems and to make sure health services are not only accessible but also affordable to all (including in hard-to-reach and underserved communities like Abuh), that Management Sciences for Health, MSH, have been sounding off not only on the road covered so far but also on their dogged determination to make sure everyone (especially women and girls) do not die (like Bainwi Joy) of treatable diseases.
As a commitment maker at the just ended Women Deliver 2023 (WD2023) conference in Kigali, Rwanda, that took place from July 17-20, 2023, Marian Wentworth, CEO and President of Management Sciences for Health was resolute on the fact that as the leading international health insurance provider, MSH was dedicated to building accessible and affordable healthcare systems across the world that work for everyone, particularly the disadvantaged populations.
While pledging her support to women’s leadership at the Women Deliver conference, Dr. Mirian Wentworth regretted the fact that while 75% of workers around the world (especially in the healthcare delivery system) are women, they occupy less than 25% of leadership positions. This was suggestive of the fact that the healthcare system around the world (and especially in Africa) would have been better if more women were in decision-making positions. As a key decision-maker in MSH, which is one of the leading International organizations in the health reform sector, Dr. Marian stressed her unwavering commitment to deepening her organization’s work in the area of strengthening the healthcare system so it works for everyone, especially in disadvantaged communities.
It is a core belief at MSH that when health systems are strengthened, better health outcomes are achieved, as already obtained in areas where MSH works. MSH does this by addressing key health challenges, working towards achieving universal health coverage, and improving health systems functioning through policy and practice changes that increase access, coverage, quality, and/or efficiency of the health services, leading to better outcomes in all the 49 countries they work in.
To avoid a situation where health services work in the city centers in Africa and are dysfunctional in the local communities like Abuh where Bainwi Joy lost her life earlier this year, MSH believes strong health systems must be designed, led, and managed locally by the people, for the people, and from the community through the district to regional and national level. It is apparently in line with this philosophy that Dr. Marian Wentworth, in responding to an ask by The Colbert Factor at the Women Deliver Conference, was rather appalled by the fact that although a majority of clinical trials around the world were carried out on the African continent, none of the drug manufacturing industries was in Africa. This, according to her was a clear indication that the drugs were not meant for Africa, even as the bulk of the world’s health challenges today were in Africa. She wished that more clinical trials on alternative medicine be done in Africa.
The imbalance in the healthcare system, according to MSH, is because for far too long, global health development has been led by the Global North, International Non-Governmental Organizations, INGOs, and by vested political interests from abroad. It is probably because these programs are designed without Africa and local communities in mind, that Bainwi Joy’s situation couldn’t be addressed by the weak and poorly designed healthcare system in Abuh. MSH is committing to doing a better job going forward, by partnering with the hard-to-reach and underserved African communities through the strengthening of the local system with their leadership and vision. MSH’s work in the over 20 African countries that they are already in, is a testimony to this fact.
Management Sciences for Health Work in Rwanda has helped to enhance the resilience of the Rwandan health system, including bringing health insurance to more than 80% of the Rwandan population. As a long-time technical partner to the Rwandan government (and especially with the introduction of Performance-based Financing, PBF), person-centered, locally-led primary healthcare is flourishing in Rwanda, thanks to MSH. With MSH’s new project launch in Rwanda called H-Access Net, which would work at different levels of providing universal health coverage, including health financing, leadership management and governance, and human resources for health, healthcare delivery in Rwanda would be taken to the next level.
MSH and Herd Immunity:
Dispelling constant disinformation around the introduction of new vaccines, especially the HPV vaccine, Dr. Marian Wentworth challenged that people rather be worried about the emergent disease that threatens the lives of children, women, and men than just about the safety of vaccines. She stressed how safe and effective the vaccine has been in over 150 countries around the world after it had been tested in adolescent girls and boys and other categories of the population.
The Human Papilloma Virus (HPV), which helps prevent the risk of cervical cancer and other HPV-caused infections, is estimated to be 80% effective and efficient and even prevents genital warts. The World Health Organization (WHO) recommends the HPV vaccine as part of routine vaccination in all countries, along with preventive measures. With the defenses of the vaccine guaranteed and with available data attesting to a decreased rate of HPV infections in populations that have taken the required doses, herd immunity benefits are assured. MSH believes vaccines can be used in strengthening health systems.
Access to Health as Human Right:
Joy died because of a lack of access to healthcare. MSH believes in access to healthcare for everyone, including in disadvantaged communities like Abuh, is a fundamental human right. And, according to Amnesty International, ‘Too many people are unable to access life-saving care because of cost’. To show the importance of access to health as not only a human right but more importantly a public good, this notion was enshrined in the Universal Declaration of Human Rights and the International Covenant on Economic, Social, and Cultural Rights.
Achieving access to health in disadvantaged communities in Africa would have to go with access to WASH programs for women and girls, transportation services, digitalization, and above economic empowerment of such disadvantaged members of the community. These are areas that Management Sciences for Health, MSH, needs to step up engagement in.
Decolonizing the Healthcare System:
The one way Management Sciences for Health (MSH) could assist the African continent to achieve self-determination in the Healthcare sector by freeing their minds from the colonial ideology, enabling investment in modernizing the rich African traditional pharmacopeia. The decolonization process may be challenging, yet not impossible. This would involve what the U.S.-based National Center for Biotechnology Information refers to as ’embedding community participation through policies that incentivize historically marginalized and excluded groups to better disperse decision-making power which is a consequential first step in truly achieving self-determination’ in the healthcare sector.
MSH could begin this too-important assigned task by encouraging cross-referencing (after critical research and benchmarking) between conventional medicine and African traditional medicine in the first place and, in the second place, materially and financially encouraging clinical trials, packaging, conservation, and large-scale marketing of African traditional medicine.
Management Sciences for Health which was founded in the 60s by Dr. Ron O’Connor (after having been introduced to a poem ‘The Tao of Leadership’), functions on the core values of Respect, Accountability, Equity, and Impact; while working shoulder-to-shoulder with countries and communities to save lives and improve the health of the world’s poorest and most vulnerable people by building strong, resilient and sustainable health systems.
MSH owes this commitment to Bainwi Joy, those who have gone before her, and those in other parts of Africa who are likely to die because the healthcare system designed by the Global North offers few opportunities for complete adaptation by communities in the Global South.
Colbert Gwain is a digital space immigrant, author, radio host, and content creator @TheColbertFactor. He is also a Commitment Maker at @UN Women Generation Equality Action Coalitions. He describes himself as an African Citizen merely living in Cameroon (by virtue of his support for the Africans Rising campaign for a #borderless Africa). The Colbert Factor is a nonprofit news organization. Our coverage relies on your financial support. If you value analytical write-ups like the one you are reading right now, give today at 677852476…And you would have supported a free press.