Organizational Overview and Strategy: updated for the March 2016 to June 2016 quarter

1. Organizational Overview
and Strategy
March 2016
Global Health Innovations
and Action (GHIA)
Foundation

2. Organizational Description
Founded in 2013, the GHIA-Foundation was
established to contribute to improved health outcomes
for women in the Sustainable Development Era and
beyond (post-2015 Millennium Development Goals);
GHIA-Foundation will support selected developing
countries to deliver quality essential health package
including cervical and breast cancer screening and
treatment, within a strengthened health system using
the maternal health platform—antenatal, intrapartum
and postnatal—as an entry point, beginning with sub-
Saharan Africa.

3. Organizational Vision
“A world where
women in developing
countries live longer,
healthier lives”

4. Organizational Mission
“To reduce morbidity and mortality
among women in developing
countries by strengthening health
systems to deliver high-quality,
comprehensive health services
whenever a woman accesses care”

5. Statement of Need: Overview
 Every year, approx. 300,000 women die from
complications of pregnancy and childbirth;
 73 countries—mostly developing countries—account
for 96% of global maternal mortality, yet have less
than 42% of the world’s healthcare workers;
 AIDS-related deaths among adolescents have
increased 50% between 2005 and 2012;
 Non-communicable diseases including breast and
cervical cancer, are killing more women than HIV,
TB, malaria, and maternal conditions combined.

6. Statement of Need: Breast Cancer
 Breast cancer is the most common cancer and the
leading cause of cancer death in women globally;
 1.7 million women receive a diagnosis of breast
cancer every year;
 It kills over 500,000 women annually;
 About 60% of these deaths occur in developing
countries; and
 Majority of the women in developing countries
present with advanced stage disease when
treatment offers very little hope.

7. Statement of Need: Cervical Cancer
 Approx. 500,000 women are diagnosed with cervical
cancer every year, and some 270,000 die as a result;
 Every two minutes, a woman dies from cervical cancer,
mainly in the reproductive years of life;
 85% of cervical cancer deaths occur in low and middle
income countries (LMICs);
 In LMICs, a woman is 5 times as likely to develop
cervical cancer as a woman in the United States (in
Malawi: 12 times);
 HIV-positive women are 4-5 times more likely to
develop cervical cancer than HIV-negative women due
to increased vulnerability to human papillomavirus
(HPV) infection.

8. Areas of Focus
1. Maternal health: antenatal, intrapartum and postpartum
care;
1. Prevention, screening, early detection, and management of
non-communicable diseases: specifically breast and cervical
cancer;
1. Innovative approaches to capacity building and skills
development of health workers at pre-service & in-service
levels for improved outcomes for women;
1. Research to better understand women’s health; and
1. Innovations to improve efficiency e.g. point-of-care
diagnosis and treatment.

9. Long-Term Goals
By 2020, in countries where we work, we will support
national governments to:
 Raise public awareness and increase visibility of women’s
health;
 Build midwifery capacity to reduce maternal deaths by 5%
annually;
 Reduce deaths from cervical cancer by promoting prevention,
early detection, screening and treatment;
 Increase capacity of health workers and empower them to
screen for and treat cervical pre-cancer through training and
equipment;

10. Long-Term Goals
 Increase capacity of health workers to downstage breast
cancer through early detection of disease and empower them
to promptly refer women with abnormalities;
 Promote public-private partnerships between national
governments and in-country stakeholders to strengthen
health systems in support of women’s health;
 Increase adoption of innovative strategies and technologies
including for maternal health, breast and cervical cancer for
improved quality of care.

11. Guiding Principles
Guiding
Principles
Country
leadership
&
ownership
Partnership
s
Accountability
Sustainability
Evidence-
based
approach
Health
systems
strengthening

12. Unique GHIA-Foundation Strategies
Sets Us Apart from Others
 Leveraging the maternal health platform—antenatal,
intrapartum and postpartum—as an entry-point for cervical
and breast cancer screening and treatment, to reduce missed
opportunities for care;
 Increasing health worker capacity and skills through preservice
and inservice training to improve quality of care;
 Exploring point-of-care detection and treatment approaches to
provide comprehensive essential health package to women
whenever they access care;
 Applying innovative cost-effective approaches and technologies
to training (e-learning), to early detection and diagnosis, and
messaging (mobile technology) to improve efficiency.

13. Key Interventions
Develop/review national policies,
strategies and programs for women’s
health to strengthen maternal health,
cervical and breast cancer components
Train and equip health workers on basic
and comprehensive emergency obstetric and newborn
care (BEmONC, CEmONC)
Train and equip health workers to screen and treat
women for cervical pre-cancer using simple, low-cost
methods and innovative approaches on point-of-care
diagnosis & treatment;

14. Key Interventions
Develop innovative approaches, such as mobile
technology and tele-medicine, to reach adolescents &
women with appropriate messaging and health programs;
Teach women about dangers in pregnancy and childbirth,
breast and cervical cancer and how to speak out and
demand prevention and treatment services;
Build strong partnerships for greater impact;
Mobilize resources from governments, foundations, and
corporations to support countries and GHIA-Foundation
activities at all levels.

15. Country Selection Criteria
Developing countries, beginning with sub-Saharan Africa;
Country leadership and demonstrated commitment to
improving women’s health (essential);
Prioritization of women’s health: maternal health, HIV or
family planning services (very important);
Existing cancer prevention and treatment infrastructure
(important);
 Data on maternal health, breast/cervical cancer (very
important);
National stability/security (very important).

16. Monitoring and Evaluation
 Measurable evaluation metrics and an evaluation protocol will
be developed and adopted prior to implementation in any
country;
 Quarterly reports will track major metrics including the
number of women screened and treated for cervical/breast
cancer, number of girls vaccinated against HPV infection,
number of health facilities providing comprehensive package
of services to women through maternal health and other
platforms, and providers trained;
 A final report will be produced that synthesizes challenges and
lessons learned from implementation to make sure that
strengths are capitalized upon and pitfalls avoided during
scale-up in existing countries and replication in subsequent
countries.

17. GHIA-Foundation Structure
Foundation Board
Chief Executive
Officer
Chief Operating
Officer
Program/Ad
min Officer
Program/Ad
min Officer
Patrons/Matrons

18. Update on GHIA-Foundation Flagship
Programs: Liberia Model MNH Program
Funded by Chevron, and
implemented at the Benson
Hospital, Paynesville, Liberia
Started in July 2015 for one year
Goal:
Contribute to accelerate the
reduction of maternal &
neonatal mortality
in Liberia

19. Liberia Model MNH Program
Objectives
 Provide quality antenatal care to 20,000 patients and 500 in-
patients deliveries in one year;
 Train 10 nurses and 5 midwives on Basic Emergency Obstetric &
Newborn Care; & 5 doctors on Comprehensive Emergency
Obstetric & Newborn Care through coaching and E-learning;
 Provide specialized quality neonatal & child care to reduce
neonatal mortality rate and Under-5 mortality rate by 5%
annually;
 Use innovative & strategic community outreach approaches to
promote clinic utilization & community health interventions;
 Establish & train 4 staff members on the use of electronic data
record & management system

20. Liberia Model MNH Program:
Achievements – July 2015– Mar. 2016
 Antenatal clinic attendance: 3,812
women
 Number of deliveries: 380 deliveries
 Number of Cesarean sections: 166
(that is, 43% CS rate)
 Number of health workers trained:
- 10 nurses and 7 midwives trained on BEmONC;
- 6 doctors and 1 project manager trained on C-
EmONC;
- Post-test significantly higher than the pre-test
results;
- 4 staff members trained on electronic data
management system.
Training of nurses/midwives on Emergency Obstetric & Newborn Care
Source: Benson Hospital, Paynesville, Liberia

21. Antenatal clinic attendance over
three quarters (July ‘15 – March ‘16)
125
168
307
90
373
547
0
100
200
300
400
500
600
Number of patients who attended the
facility for antenatal care in both first
and second quarters.
612
716
870
0
100
200
300
400
500
600
700
800
900
1000
January February March
Number of patients who attended the
facility for antenatal care in the
third quarter

22. Liberia Model MNH Program:
Achievements – July ‘15 – March ‘16
 The program procured new
resuscitation equipment
 Trained health workers are
capable of resuscitating
asphyxiated newborns
 Nurses provide routine
immunization and deliveries free
of charge.
 Hospital staff are reaching
communities adjacent to and
behind the facility with messages
on free and quality antenatal care
and through radio jingles and
outreach
Newborn delivered after mother ruptured uterus due to prolonged labor, was resuscitated and survived; nurses/midwives trained on EmONC
Source: Benson Hospital, Paynesville, Liberia

23. Lessons Learned:
Liberia Model MNH Program
 Trained and equipped nurses and
midwives can effect a rapid
change in the quality of care in the
antenatal, intrapartum and
postpartum period
 Lives of newborns can be saved
with appropriate skills and
equipment
 Capability for Cesarean section is
critical to saving women’s and
newborn’s lives
 Maternal care needs to extend
beyond the four walls of the
hospital to the surrounding
communities to increase facility
utilization
Apneic newborn without heart beat, was resuscitated and survived
Source: Benson Hospital, Paynesville, Liberia

24. Liberia Model MNH Program
Next Steps
 Quarterly supervision by
facilitator continues for on-
the-job training & skills
improvement
 Community outreach to
increase women’s utilization
of facilities
 Resource mobilization to
continue and expand the
program beyond one year and
beyond Benson Hospital
 Establishment of electronic
data management system
 Continuous quality
improvement measures
Apneic newborn without heart beat, was resuscitated and survived
Source: Benson Hospital, Paynesville, Liberia

25. Update on GHIA-Foundation Flagship Programs:
Swaziland Cervical and Breast Cancer Program
 Scoping Mission conducted in March 2015 to explore
partnership with the Ministry of Health and rapidly analyze the
health systems response, including in-country stakeholders to
cervical and breast cancer
 Ministry of Health and partners expressed interest in
collaborating with GHIA-Foundation
 Draft Memorandum of Understanding and Program Proposal
developed and shared with MoH
 At the request of the MoH, chemotherapy protocol created and
shared with the MoH
 Resource mobilization efforts in progress to build capacity for
cervical/breast cancer screening, early detection and treatment

26. Conclusion
 Considering the triple-burden of diseases to which
women are exposed, a comprehensive approach that
allows partnership with national government to
strengthen health systems and accelerate service
delivery to the most vulnerable is a best buy;
 Empowering women and girls and increasing
knowledge and skills among health care workers at
pre-service and in-service levels will promote
prevention, early detection, and treatment of maternal
conditions and improve health outcomes for women in
the Sustainable Development Era and beyond.

27. Contact Us
www.ghia-foundation.org
ghiafceo@gmail.com
ghiafcoo@gmail.com