Advancing Primary Health Care in Egypt, Ethiopia and Mozambique

A cross section of delegates at the working group on 'Advancing Primary Health Care in Egypt, Ethiopia and MozambiqueOn May 7, the Corporate Council on Africa (CCA) in partnership with the USAID’s flagship Maternal and Child Survival Program (MCSP), hosted a Health Working Group on “Advancing Primary Health Care in Egypt, Ethiopia and Mozambique.” Moderated by Dr. Jeffrey Sturchio, CCA’s Chairman, MCSP representatives from the three countries discussed the key drivers to maternal healthcare problems in their respective countries, followed by their current or proposed solutions.Dr. Issam el-Adawi, Chief of Staff for MCSP Egypt, began the discussion with an overview of maternal healthcare in Egypt. He cited four key issues that affect maternal healthcare in Egypt including: female genital mutilation (FGM), early marriage, governorates, and the limitations imposed by the mother-in-law. According to Dr. el-Adawi, these factors significantly hinder a woman’s ability to obtain adequate health care across the country. To address these issues, there have been several solutions with varying degrees of effectiveness. On one hand, law advocacy gives agency and representation to girls who undergo FGM, however this minimizes and does not inhibit the continuation of the practice. On the other hand, civil society organizations have managed to penetrate the community with health education advocacy and increase awareness on best practices and quality health care.Dr. Abeba Bekele, Newborn Health Advisor in Ethiopia’s MCSP also discussed how power dynamics and gender norms are rigorously followed within rural communities in Ethiopia. He noted that newborn survival is affected by religious beliefs, with communities relying on religious interventions instead of medical care. Dr. Bekele advocated for the continuation of health extension workers – health care workers who are mobilized into rural communities to bridge the gap towards better maternal health care. Due to the impact of extension workers, there has been a visible shift in power dynamics and gender norms. Men are more willing to be included in the conversation and assist in the proliferation of improved maternal care. Equally important, the survival rate of newborn children has increased due to a shift from religious reliance to medical resource availability.In Mozambique, the issue of child marriage creates challenges to accessing health care. Dr. Stelio Dimande, a Community Health Technical Director for MCSP Mozambique, highlighted best practices and solutions that address the issue. To advance primary healthcare in Mozambique, the MCSP in collaboration with the government has been strengthening community platforms and improving engagement. MCSP has been active in strengthening the referral system especially in rural communities. Through the referral system women can be treated in a timely manner without major complications. In addition, Dr. Dimande proposes that there be a focus on multisector collaboration across the different ministries. For example, infrastructure and education affect access and health knowledge; therefore, respective ministries should collaborate for successful outcomes. The healthcare implications of the high child marriage rate have been countered by manual guides that address adolescents and first-time mothers and give them direction over measures and steps to take.Overall, all three countries, through collaboration with USAID, have seen a profound shift from traditional barriers to access to solutions that are more reflective of the needs of women and children.