Organizational Description and Capabilities of Management Sciences for Health (MSH)
MSH is a nonprofit international organization, founded in 1971, that works in 40 countries to improve
access to and quality of health services. Our mission is to save lives and improve the health of the
world’s poorest and most vulnerable people by closing the gap between knowledge and action in
public health. We apply our expertise in maternal, newborn and child health (MNCH), infectious
diseases, management and leadership, pharmaceutical and laboratory management, human
resources for health, and health policy reform and financing to strengthen health systems and build
the capabilities of public and private health institutions and personnel at all levels of the health
system, across the continuum of care. Since 1983, we have partnered with USAID through the
PRITECH and BASICS child survival projects as well as many other country projects to scale up the use
of effective interventions to reduce maternal, infant, and childhood morbidity and mortality in
developing countries. Although our approach has been integrated—newborn health is a core
component in these projects.
The following examples are illustrative, not comprehensive and illustrate our experience in large scale
implementation and policy in MNCH. Newborn health was championed by and through the decade
of work performed through BASICS II and III.
Through the USAID-funded REACH (Rural Expansion of Afghanistan’s Community-based Healthcare)
Project, MSH bolstered the capacity of national and local partners to dramatically expand
community-based care, especially key MCH indicators. In the 13 REACH provinces, access to basic
health services increased from a half million Afghans in 2003 to 7.5 million in 2006. From 2004 to
2006, the rate of births attended by skilled providers doubled, from 12% to 23%, the number of
children immunized increased from 15% to 37%, and the use of modern contraceptives rose from
16% to 26%. These achievements were facilitated by the training of 6,300 community health workers
(half of whom are women) and more than 800 midwives and an innovative program to educate 8,500
women in health-oriented basic literacy. Newborn health was an integral part of the community
curriculum.
Between 2003 and 2007, the USAID-funded Reducing Child Morbidity and Strengthening Health
Care Systems Program in Malawi helped achieve marked reductions in newborn and childhood
mortality and illness by strengthening the health system, especially at the district level. Results: The
Pediatric Hospital Initiative improved emergency care and treatment of newborns, infants and
children admitted to (or born in) hospitals, lowering the number of under-five child deaths
significantly; the program expanded HIV testing and counseling, reaching 243,775 people and
establishing 48 sites for PMTCT services; MSH supported development of a national IMCI policy and
five-year plan and trained more than 300 people in the use of IMCI; we increased community-based
care for child malnutrition through 60 sites in five districts; and we addressed high rates of malaria by
introducing periodic antimalarial therapy for pregnant women.
In South Africa, MSH’s Integrated Primary Health Care Project is strengthening a network of PHC
facilities to deliver quality HIV & AIDS prevention, care, and treatment services, in part by increasing
health workers’ competence in planning, implementing, and evaluating these services. We have
included a special emphasis on early infant diagnosis and pediatric HIV/AIDS care and treatment. An
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earlier USAID-funded project, EQUITY, worked to strengthen equitable access to high-quality health
services for South Africans in the Eastern Cape Province through emphasis on essential services,
community structures, and development of district management teams. The project developed
checklists and guidelines for the management of obstetric emergencies and care for high-risk
pregnancies and a series of easy-to-read booklets for health workers on priorities in newborn and
child health. The project increased the availability of vaccines, injectable contraceptives, and essential
medicines to treat infant and childhood illnesses, TB, and STIs. Quality improvement in hospitals
included intensive attention to following protocols and guidelines for newborn care. Results:
Throughout the Eastern Cape, immunization rose from 58% in 1998 to 69% in 69% in 2002. Services
were integrated so that, by 2002, 92% of clinics provided basic child care services (including FP) five
days a week. At Delmas Hospital, perinatal mortality fell from 42.6/1,000 live births in 2001 to 25.9 in
2002. In 2003, 403 VCT and 157 PMTCT sites were operational, reaching 55% of the provincial
population, compared to just 54 VCT and PMTCT sites in 2001. EQUITY also improved the use of DOTS
for TB and increased in collection of sputa specimens by 88%.
The Senegal Maternal Health & Family Planning Program (2000–06) included among its
achievements increasing the availability of postabortion care (the percentage of service delivery
points with at least one provider trained in postabortion care increased from 39% to 100% from 2003
to 2005) and expanding PMTCT and malaria prevention among pregnant women. In Guinea, the
PRISM Project contributed to increasing the use of FP, MNCH, and STI/AIDS services. Results: The
contraceptive prevalence rate doubled (from 6.8% in 2003 to 13.0 in 2006) in the target areas. The
number of women who had at least one prenatal consultation rose from 84% to 90% over the same
period, as did the number of children fully vaccinated against TB (62% in 2003 versus 79% in 2005).
In Nicaragua, MSH has contributed since 1994 to significant increases in MNCH indicators, most
recently in eight PROSALUD Project districts where one million people live. Results: Household
surveys conducted in 2000 and 2002 demonstrated that DPT coverage increased 19.8% (versus a
3.7% increase nationally), fully vaccinated two-year-olds increased 3.9% (versus a 9.5% decrease
nationally), and prenatal care increased 18.7% (versus 4.0% nationally). FP coverage in rural villages
covered by the project increased 5%, while exclusive breastfeeding increased by almost 20%.
MSH has been a managing partner in the Partnership for Child Health Care (which implements the
BASICS child survival project), as well as a member of the Partnership for Maternal, Newborn and
Child Health, and the US Coalition for Child Survival.
As a leading partner in the USAID-funded BASICS Project, the following summarizes our Global
Technical Leadership role in the area of newborn health 1 .
Activities to support newborn health were initiated by USAID/BASICS II around 1999. Products were
developed with partners or technical inputs were provided to partners at global level for tools to
support program implementation and for advocacy to focus attention on key issues.
1
Newborn Survival and Health, BASICS II final report, pg. 2-6
2
BASICS II (1999 - 2004)
Tools to support program implementation
Selected Annotated Bibliography (PAHO),
Components of Essential Newborn Care (ENC)
Safeguarding investment in PMTCT with quality ENC
Birth Attendants with Relevance to the Newborn
BASICS III (2004 – 2009):
Adaptation of tools to support MNH programs
E-Learning module on Neonatal Infections
Guidelines for Feeding the Low Birthweight Infant (WHO)
Home to hospital continuum of care (ACCESS)
Home based care (ACNM, ACCESS)
Community Mobilization (ACCESS, CORE), and
“Helping Babies Breathe” a simplified training tool for resuscitation (AAP, WHO)
Regional Activities
BASICS was active with partners such as USAID, WHO, UNICEF, Save the
Children/Saving Newborn Lives, ACCESS, URC/HAI, and Catalyst in all three geographic regions
as noted below. Activities and products focused on advocacy and establishment of
guidelines, strategies and action plans to promote newborn health in the three regions.
Asia Regional Initiative
Regional Strategy for Newborn Health (with WHO)
“MotherNewborNet” – a network for sharing of experiences, tools and newsletters. Topics
included postpartum care, birth asphyxia, key activities to support maternal and newborn
health (MAMAN), community case management (CCM) and kangaroo mother care (KMC)
Africa Regional Activities
Advocacy to promote newborn health through participation in regional meetings and
workshops such as those related to the Child Survival Forum, African Road Map, PMNCH
“Opportunities for Africa’s Newborns”- an advocacy document linking newborn health with
existing programs
LAC Regional Activities
Establishment of the LAC Newborn Health Alliance to support the region
Development of a Regional Strategy and Plan of Action for Newborn Health
Innovative expansion by BASICS to support country programs for prevention and treatment
of infection, a leading cause of mortality, through the regional umbrella
Support at Country Level
The major focus for BASICS has been country level technical support. Programmatic
experiences commenced in one district in Senegal and expanded not only within the
country, but also into 13 other countries in the three regions (Senegal,
Madagascar, DR Congo, Rwanda, Mali, Swaziland, India, Timor Leste, Cambodia,
Dominican Republic, Honduras, El Salvador and Bolivia. The key components promoted in the various
country programs are shown below in Table 1.
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Table 1 Component of Essential Newborn Care Promoted/Implemented in Countries
Components in all countries
Components in selected countries
Antenatal Period
• ANC (at least 4 visits)
• Tetanus toxoid
• Iron & folate
• Iodized salt
• Birth preparedness
• Delivery with skilled birth attendants
• Counseling for early and exclusive
breastfeeding
• Identification and careseeking/referral
for maternal danger signs
Birth and Postnatal Period
• Clean delivery practices,
• EPNC (Essential Preventive Newborn
Care)
– Hygiene including hand
washing
– Temperature maintenance
– Cord & eye care
– Breastfeeding
– Extra care for low birth weight
babies including KMC
– Identification and referral for
danger signs
• Early focused postnatal contact/visit
within 2-3 days and preferably near
end of 1st and later between 4 – 6
weeks
Promotion of IPT and ITNs for
prevention of malaria during the
antenatal period in Senegal, DR
Congo,
Madagascar and Swaziland
Integration of other selected
components of MNCH and
Nutrition
o Nutrition and primary
immunization (India)
o MNH, FP, PMTCT - Swaziland
o AMTSL, postpartum/postnatal
care of the mother and baby –
DR Congo
o IMCI. HIV and family
planning - Rwanda
Resuscitation for birth asphyxia
Senegal, DRC, Madagascar, Mali,
El
Salvador (in BASICS II)
Treatment of sepsis
o Full treatment – Dominican
Republic, El Salvador
o Partial T/T -1st dose
antibiotics + referral - Senegal,
DRC, Madagascar, Mali,
Honduras
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