This report provides an analysis of women’s sexual and reproductive health, their perception of and access to maternal health care services in Khost province, Afghanistan. MSF-OCB is focusing on women with direct obstetric complications to achieve a reduction in sexual and reproductive health related mortality and morbidity among the population of Khost province.

This review was commissioned by the International Board of MSF to reflect on the lessons learned for Movement governance from the early months of the MSF response to the recent Ebola crisis in West Africa. It focuses on the first six months of the Ebola outbreak (from April to September 2014), and on Movement governance issues only. The findings are based on analysis of relevant records, minutes of platform meetings, and interviews with a cross-section of the key people involved in Movement governance during this period.

The review aimed to capture learnings from this difficult exit process in South Sudan and provides an overview of the root causes identified. Some external factors are linked to the context and the position of the authorities and they must be considered as hard to influence. The internal lessons identified can be addressed by OCB. The two key areas are the communication and working relation with South Sudanese staff and use of the (existing) know-how in OCB in regards to exiting a project.

Despite a 5 day SIAs by MOH in 2014, a new outbreak began in Katanga/DRC and spread throughout 2015. A comprehensive, integrated “3 headed” response was chosen by MSF-OCG in 3 Health Zones (HZ) of Tanganyika, including preventive and curative activities (for measles, malaria, and malnutrition): although quite ambitious given available HR resources, this was relevant given these “three” on-going emergencies in Tanganyika.

Measles epidemics occur in Katanga (KTA)/DRC, challenging early response strategies for outbreak control. In 2015, despite MOH delay in declaring the epidemic, OCP present in KTA, showed good reactivity in 5 Health Zones (HZ) of Ht Lomami with a so called “vertical” response (focused on measles: vaccination and case management). However, malaria and malnutrition should have been better considered (OCG chose a “3 diseases strategy”). The 6 to 8 weeks long vaccination campaigns were efficient as the ZS outbreaks stopped after a few weeks.

Since Kyrgyzstan is one of the 27 high multidrug-resistant tuberculosis (MDR-TB) burden countries listed by the WHO, MSF started a drug-resistant tuberculosis project in Kara Suu District in 2012. A qualitative study was undertaken to understand the perception of TB and DR-TB in order to improve the effectiveness and acceptance of the MSF intervention and to support advocacy strategies for an ambulatory model of care.

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Family and Sexual Violence in PNG is pervasive and widespread, centered within the family and the extended family (wantok), and manifests itself as physical or emotional abuse, sexual abuse, and social isolation. There is also a stigma attached to young survivors making it difficult to report. The endemic nature and high rates of violence within the family impact women and children the most in PNG.    

sierra leone

The objective of this review was to assess the response of OCG, focusing on the Freetown Prince of Wales Ebola Treatment Centre, Sierra Leone (open Dec 2014 to end of Feb 2015) and to reflect on the ability to incorporate “real time lessons learned” during the ongoing management of the outbreak. The evaluation focused on operational infrastructure management (including laboratories), medical & nursing care management, epidemiological control measures, community engagement & mobilisation, capacity building, relationship with other actors and research. 

MSF OCB commissioned an extensive multi-sectoral critical review of its Ebola intervention. The summary report highlights key findings from all specific reports and draws global conclusions. Lessons have been identified both, for future large scale emergency responses as well as for a next Ebola response. Many of lessons identified are not entirely new, but their importance has been strongly accentuated by the extremity of this health crisis. Priority recommendations are listed in the summary report, while specific recommendations are made in the respective reports.

L'évaluation fait partie de l'accord de financement avec le bailleur. En outre, étant donnés les changements que le projet a vécu récemment, le moment est opportun pour évaluer les stratégies mises en place afin de fournir de nouvelles recommandations pour la mise en œuvre du projet en Guinée. L'évaluation englobe aussi le renforcement des structures de santé périphériques.

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