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Public Health Informatics in Action in Malawi: Making life easier for healthcare workers and patients while improving quality through an innovative national Electronic Medical Record System

Categories: child health, global health security, HIV/AIDS, women's/maternal health

Instituting an Electronic Medical Record System reduces the need to manage and store growing volumes of patient charts, a major challenge in resource-limited settings.

Instituting an Electronic Medical Record System reduces the need to manage and store growing volumes of patient charts, a major challenge in resource-limited settings.

Denise Giles, M.P.H., Health Scientist, CDC-Malawi

Denise Giles, M.P.H., Health Scientist, CDC-Malawi

Keeping track of even one patient undergoing treatment for HIV/AIDS can be complicated enough.

Doing it for over 472,865 patients when you’re a low income country coping with high demand and a sputtering economy magnifies the complexity.

Which is why Malawi’s story – and its solution – is attracting attention and praise. It’s a story of how Electronic Medical Record System (EMRS) technology is being used and the foresight needed to bring it to reality.

You don’t have to look far to see the positive results.

Preventing Maternal Deaths in Africa

Categories: HIV/AIDS, women's/maternal health

 Healthy mothers and babies

Maternal health has improved in most regions of the world, with far fewer women dying during pregnancy and childbirth than 20 years ago. 

Isabella Danel, MD, MS, CDC Division of Reproductive Health

Isabella Danel, MD, MS, CDC Division of Reproductive Health

Progress in sub-Saharan Africa, however, has been much slower. HIV and complications of childbirth are the leading causes of death among reproductive age women around the world, but above all in this region. Being pregnant in sub-Saharan Africa is often a dangerous medical condition. In Zambia, women who have given birth are often greeted with a Bemba expression of relief and surprise: “Mwapusukeni.” Translated it means, “You have survived!”

That greeting is becoming more commonplace these days, which is another way of illustrating a basic truth: positive change can happen quickly when the right actions are taken to improve maternal health.

Strengthening Global Health Security Protects Americans

Categories: flu, global health security, HIV/AIDS, infectious disease, malaria, parasitic diseases

 

This blog was originally posted on CNN.com on February 13, 2014.

 

The 5 Ways Diseases in Other Countries Can Kill You

The world is smaller and people are more mobile than at any time in history. This makes it easier than ever for what’s happening anywhere on the globe to harm Americans’ health. 
 
Here are five ways diseases in other countries pose a threat:

1) The flu could threaten millions. Even in a mild year for flu, in the United States alone, there are thousands of deaths, hundreds of thousands of hospitalizations, and billions of dollars in productivity losses.
 
In a pandemic, millions of people worldwide could be killed. H7N9 influenza, also known as bird flu, is spreading in China, though fortunately it has not mutated to become an infectious disease outbreak that could threaten the health of people around the world.

CDC Director Dr. Tom Frieden

CDC Director Dr. Tom Frieden

2) Antibiotic resistance is on the rise. Antibiotic resistance just might be the most urgent health threat facing us now.

The nightmare strain of bacteria known as CRE, carbapenem-resistant Enterobacteriaceae, arose abroad and was introduced to one state in the United States. Now it’s in at least 44 states. It can resist all or almost all antibiotics, kills many of the people who get it in their blood, and spreads its resistance capabilities to other bacteria.

The World Health Organization estimates multidrug-resistant tuberculosis already has infected a half a. million people across the globe.

CDC Collaborations with the Ministry of Health in Dominican Republic Result in Measurable Public Health Gains

Categories: health systems strengthening, HIV/AIDS, malaria, tuberculosis (TB)

CDC Global Health Director Tom Kenyon (right), CDC Global AIDS Director Deborah Birx (second from right), and CDC-Dominican Republic Director Oliver Morgan (second from left) meet with Dr. Miguel A. Gerardino (left), Director of the Juan Pablo Pina Hospital in San Cristobal, Dominican Republic, January 2014.

CDC Global Health Director Tom Kenyon (right), CDC Global AIDS Director Deborah Birx (second from right), and CDC-Dominican Republic Director Oliver Morgan (second from left) meet with Dr. Miguel A. Gerardino (left), Director of the Juan Pablo Pina Hospital in San Cristobal, Dominican Republic, January 2014.

For a relatively small country where CDC established a full-time country office only five years ago, the Dominican Republic is suddenly drawing attention.

Oliver Morgan, MSc PhD FFPH, CDC Country Director for Dominican Republic

Oliver Morgan, MSc PhD FFPH, CDC Country Director for Dominican Republic

It’s easy to see why. The Dominican Republic is a popular vacation destination with 1.4 million Americans visiting each year. The country has a unique relationship with its neighbor, Haiti, the poorest country in the Western Hemisphere, where CDC also supports many programs. 

Earlier this month, Dr. Tom Kenyon, Director of CDC’s Center for Global Health and Dr. Debbi Birx, who leads CDC’s Division of Global HIV/AIDs visited the Dominican Republic to review, with Dominican authorities, CDC programs to protect public health. Kenyon and Birx are the highest level CDC officials to visit the DR since CDC’s country office officially opened in 2009.

Reflections on the Fight Against HIV in Malawi

Categories: child health, HIV/AIDS, women's/maternal health

 

CDC Malawi Laboratory Advisor Dr. Abdoulaye Sarr reviews a CDC supported HIV program during a site monitoring visit

CDC Malawi Laboratory Advisor Dr. Abdoulaye Sarr reviews a CDC supported HIV program during a site monitoring visit.

This year, my staff and I have had the opportunity to spend considerable time in health facilities that our HIV-funded partners support throughout this beautiful country. Some of these facilities are on back-country roads; others are on forest-covered hills, while others sit on the shores of Lake Malawi. For CDC-Malawi, making these trips every quarter has been critical to strengthening our partnership with the Malawi Ministry of Health, ensuring quality in our programming, keeping our technical discussions grounded and practical, and helping ensure each of us is aware of the challenging realities faced by health workers and patients on a daily basis.

Sundeep Gupta, MD, MPH, Director, CDC-Malawi

Sundeep Gupta, MD, MPH, Director, CDC-Malawi

It has also highlighted how, against enormous odds, Malawi has been a leader in achieving remarkable successes in the fight against HIV, despite being one of the poorest countries in the world, ranking 181 of 187 countries in GDP per capita. In Malawi, almost one in every four adult urban women are infected, child and maternal deaths remain elevated due to the epidemic, and almost every family in the country has a profound story to tell about how they have been personally affected by this disease.

I find it thrilling that in the next two months, Malawi is set to reach the milestone of 500,000 persons (one of every 30 Malawians) alive and on antiretroviral treatment, something that was simply inconceivable when the program started a decade ago.

Celebrating a Decade of Progress Fighting Global HIV/AIDS

Categories: child health, HIV/AIDS, women's/maternal health

Deborah Birx, MD, Director, Division of Global HIV/AIDS, CDC Center for Global Health

Deborah Birx, MD, Director, Division of Global HIV/AIDS, CDC Center for Global Health

This World AIDS Day, CDC and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) commemorate a decade of success in fighting global HIV/AIDS. Ten years ago, this modern-day plague was devastating the health and wellbeing of millions of individuals in communities across Africa and in other resource-poor countries around the world. Today, we celebrate the extraordinary progress we have made in reducing new HIV infections and providing life-saving care and treatment to those who are living with HIV/AIDS.

With resources available through PEPFAR, we have provided antiretroviral drug treatment (ART) to millions and increased life expectancy rates in much of Africa. HIV-infected patients have returned to the workforce, enabling them to provide for themselves, their families, and communities; and AIDS-related deaths are declining worldwide. In June, Secretary of State John Kerry announced the joyous news of the millionth baby born HIV-free thanks to life-saving PEPFAR-funded programs to prevent mother-to-child transmission (PMTCT) of HIV. New pediatric HIV infections have dropped by nearly 50% since PEPFAR began. 

The Value of CDC’s Work in Thailand

Categories: global disease detection, global health security, health systems strengthening, HIV/AIDS, infectious disease, noncommunicable diseases (NCDs), refugee health, tuberculosis (TB), violence and injury

 

Thai monk

 

When I became country director in 2013 the relationships between Thailand’s public health officials and CDC were already strong and well established.

Mitch Wolfe, MD MPH, Director, CDC-Thailand

Mitch Wolfe, MD MPH, Director, CDC-Thailand

That wasn’t surprising. CDC’s collaboration with the Ministry of Public Health, after all, began 30 years ago and the partnership has been prospering  – and expanding – ever since. And there is a strong history between the two countries – this year Thailand and the US are celebrating 180 years of Friendship.

The reasons are well established too. And numerous.

Last summer, while visiting family, I was asked by a U.S. border guard, “Why is America working abroad for public health?” I was happy to get this question, as it was an opportunity to deepen understanding for why CDC works abroad – to protect Americans from health threats, to build important relationships with strategic partners, and to learn lessons that can be expanded to other parts of the world.

Kenya’s progress towards sustainable health

Categories: global disease detection, HIV/AIDS, tuberculosis (TB)

 

Dr. Tom KenyonRecent events in Nairobi have understandably focused the world on security challenges in Kenya. In that context it is important to recognize inspiring public health advances that represent innovative collaboration between CDC and our Kenyan partners to increase health security for Kenya and the global community. I made a two-day trip to visit our CDC-Kenya programs – a quick stop before commissioning the new CDC Global Disease Detection Center in Dhaka, Bangladesh. While I have previously worked as CDC Country Director in Ethiopia and had a general idea of what to expect, visiting Kenya reminded me that each of our CDC country offices has developed unique programs and solutions to address public health issues affecting local populations.

Fresh Voices From the Field: HIV in the Caribbean

Categories: HIV/AIDS

 

This is the fifth in our ongoing “Fresh Voices From the Field” series, where we hear from ASPPH (Association of School and Programs of Public Health) Global Health Fellows working throughout the world. Global Health Fellows are recent Master of Public Health or Doctoral graduates placed in CDC global health offices in Atlanta and abroad. They work on a range of priority public health issues and bring a fresh perspective to CDC’s efforts in the field. (See other “Fresh Voices” blogs.)

 

Samantha Dittrich, MPH

Samantha Dittrich, MPH

While the Caribbean is thought of as a paradise, with images of white sand beaches, blue seas, and tropical drinks inevitably coming to mind, the day-to-day situation for its inhabitants can be quite different. As the only ASPH Fellow assigned to the CDC Caribbean Regional Office, I have seen firsthand varying levels of poverty and fragile social infrastructures that most people know little to nothing about. CDC’s Caribbean Regional Office (CDC CRO), formed in 2002, serves 11 countries—this includes the English-speaking Caribbean and Suriname. CDC CRO’s mission is to improve the health of Caribbean people by supporting national governments and their partners to effectively respond to the HIV/AIDS epidemic and to use our office as a platform to address other urgent public health problems.

Fresh Voices From the Field: The Value of Our Global Health Work

Categories: child health, health systems strengthening, HIV/AIDS, noncommunicable diseases (NCDs), violence and injury, water, women's/maternal health

 

Chelsey Beane is pictured near the home of a traditional healer in Andruvu Village, in the Arua District of Uganda.

Chelsey Beane is pictured near the home of a traditional healer in Andruvu Village, in the Arua District of Uganda.

This is the fourth in our ongoing “Fresh Voices From the Field” series, where we hear from ASPPH (Association of School and Programs of Public Health) Global Health Fellows working throughout the world. Global Health Fellows are recent Master of Public Health or Doctoral graduates placed in CDC global health offices in Atlanta and abroad. They work on a range of priority public health issues and bring a fresh perspective to CDC’s efforts in the field. (See other “Fresh Voices” blogs.)

 

Chelsey Beane, MSPH, ASPH Fellow

Chelsey Beane, MSPH, ASPH Fellow

Working at CDC headquarters in Atlanta is an amazing experience. And yet, sometimes, you can feel disconnected from the real world impact of the science that we spend all day discussing, refining, communicating, and implementing. So I was extremely grateful to have the opportunity recently to travel to Uganda to assist the CDC country team with preparation for a visit by CDC Director Dr. Thomas Frieden.

Although I had read the statistics, knew about our programs, and had become familiar with the major health issues in the country, I left impressed and humbled by what I experienced. I visited a rural village that had a recent outbreak of plague, where I met a small girl who had been diagnosed with diabetes, desperately in need of care and treatment, but miles from the nearest health facility. I was welcomed into the home of a family living in a tiny enclosed hut, filled with smoke from a cooking fire by which two toddlers quietly sat, and truly understood the urgent need for clean cookstoves. I saw people living in rural villages, without access to clean water. But I also saw how efforts by CDC and its partners are making a huge impact, not just for the health system as a whole, but for individuals whose lives have been changed. I saw the implementation of growing laboratory systems in the country, that are improving diagnoses of diseases, such as early infant diagnosis of HIV, and more accurate diagnosis for tuberculosis. I heard the story of a young woman who was raped and became infected with HIV, but who later had two children, both of whom were born healthy. I saw an eRanger, or motorcycle ambulance, rush into a maternal health clinic, carrying a pregnant woman whose delivery would be attended by skilled health workers.

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