A strong, resilient health system is the key to achieving sustainable improvements in health and health care in any country. A health system is made up of many layers of institutions and individuals that, together, contribute to the availability, quality and affordability of preventative, curative and palliative health services.  

Since 2006, IMA World Health has built and supported integrated, holistic and sustainable health systems that increase access to quality health care in fragile countries. IMA supports health systems at the national, subnational (i.e. district) and community levels, providing tailored assistance and capacity strengthening that boosts engagement, capability and investment at all levels of a country’s health system.  

Our approach encompasses the World Health Organization’s building blocks of health systems strengthening (HSS):   

1. Improved health service delivery 

We address the human, financial, social and physical capital needs of a health system to improve its service delivery and universal access at scale with an emphasis on women and youth.  

2. Health workforce development  

We strengthen the capacities of a country’s health workforce through trainings, mentoring, and the provision of equipment and other resources.   

3. Information systems  

We help governments and health facilities utilize human resources and reporting software to manage their health workforce more effectively as well as make data-driven decisions to improve their health service delivery.  

4. Access to essential medicines  

We strengthen national medicine distribution systems, establishing a pull system that gives each health facility a line of credit to purchase low cost, high quality medicine based on their patient intake. The funds from the sales of medicine replenish the credit line and go towards building a facility’s financial reserves for future medicine procurement. This pull system also reduces medicine stock outs, ensuring availability to those who need the medicine.  

5. Health system financing  

We work at all three levels in a health system – government, providers, and recipients – to ensure people have access to essential services and are protected from financial hardship. We do this by creating efficiencies in use of resources, promoting transparencies and accountabilities from all stakeholders, and ensuring access to essential services while striving towards affordable and accessible health coverage for all.   

6. Leadership and governance   

We support health facility leadership in strengthening their management capacities and utilizing the information systems they need to be effective. In addition to leadership training programs, we promote the use of community scorecards to help leadership understand the experiences of both health providers and users in their facilities, monitor whether their facility’s services are improving, and engage the community and health providers in joint decision-making and planning.  

IMA World Health is dedicated to preventing and treating diseases that primarily affect poor and vulnerable people. IMA targets a variety of diseases through specialized disease control projects, as well as through integrated health systems strengthening and service delivery programs.

CORONAVIRUS (COVID-19)

Building on our experience with Ebola, and in anticipation of local or widespread transmission of the coronavirus on the African continent, IMA World Health is seeking to improve preparedness of non-governmental Christian Health Associations and other faith-based health care networks in Sub-Saharan Africa for COVID-19 outbreak response. IMA is working through a collaborative partnership with the Africa Christian Health Associations Platform (ACHAP) -- a membership organization of 43 CHAs in 32 countries in Africa. Learn more.

NEGLECTED TROPICAL DISEASES

As a global leader in NTD control and elimination, IMA specializes in the control and elimination of five NTDs—lymphatic filariasis, onchocerciasis (known as River Blindness), trachoma, schistosomiasis and soil-transmitted helminthes or worms. Our primary work involves managing mass drug administration in Haiti, Tanzania and the Democratic Republic of Congo. IMA uses a combination of evidenced-based strategies to map and scale-up NTD control in partnership with governments and civil society partners, and through funding from the United States government and other donors. IMA also provides morbidity management interventions to manage the debilitating symptoms of these diseases, such as surgery to relieve pain and prevent blindness for those suffering from trachoma. Learn more about our projects.

EBOLA

IMA World Health’s work on the front lines of strengthening health care systems often brings us in contact with new infectious disease outbreaks. One such disease is Ebola, a deadly virus with a case fatality rate of up to 90 percent. It is highly contagious and spreads easily and rapidly through human contact. IMA’s experience in containing Ebola outbreaks began in 1995 in the Democratic Republic of Congo. Our work has involved providing personal protective equipment and other supplies, raising disease awareness, supporting health facility prevention and control measures and more. Learn more.

NON-COMMUNICABLE DISEASES

Through longstanding relationships with local hospitals in Tanzania, IMA supports the diagnosis and treatment of a set of non-communicable diseases that often go undiagnosed and untreated in communities that lack resources that are common in developed countries. IMA trains health workers on screening and treatment methods as well as provides supplies to support low-cost screening and treatment for cervical cancer, the leading cause of cancer death in Tanzania. IMA has also supported the diagnosis and treatment of Burkitt’s Lymphoma, an aggressive but treatable childhood cancer, for over a decade, primarily by training health workers to promote early detection and by providing the essential chemotherapy drugs. Learn more.

HIV AND AIDS

Since 2004, IMA World Health has implemented and strengthened a full range of community- and facility-based interventions to prevent and treat HIV and AIDS in sub-Saharan Africa. One of our core approaches is strengthening the capacity of local health facilities to provide testing, care and treatment. This includes training health workers and supporting sites to improve and scale up Prevention of Mother-to-Child Transmission, HIV testing and counseling, antiretroviral therapy and care and support services. Learn more about our projects.

MALARIA

IMA works to prevent and treat malaria in some of the most insecure and challenging areas of South Sudan and the Democratic Republic of Congo. Here, IMA ensures that pregnant women access intermittent preventive therapy, or IPTp, to prevent malaria during pregnancy and that they and their young children sleep under long-lasting insecticide-treated nets, or LLINs. IMA uses both proven and innovative solutions to distribute and track LLIN installation to ensure adequate coverage and usage. Learn more about our projects.

IMA World Health’s projects highlight the role of water, sanitation and hygiene, or WASH, interventions in promoting health and well-being.

Billions of people, most of whom live in developing countries, lack access to clean, safe drinking water and adequate sanitation facilities, and the health consequences are dire. The two leading causes of death globally for children under 5 years of age—diarrheal disease and acute respiratory infections—along with other health problems like childhood stunting are linked to poor WASH practices. Contaminated drinking water and poor household hygiene behaviors sicken millions of children and adults, contributing to debilitating illnesses and premature mortality. The economic impacts are also significant. Children, girls especially, may miss school because they lack private sanitation facilities or must fetch water for their families. Adults miss cultivating food for their families because they are sick.

IMA has integrated WASH interventions into broader primary health care delivery and health systems strengthening projects for over a decade. In the Democratic Republic of Congo, WASH interventions are a critical component of the Access to Primary Health Care project, which aims to increase access to basic health care to a population of 8.9 million people. Focusing its WASH work primarily on building and/or improving the water and sanitation infrastructure at health centers, IMA has provided more than 300,000 people with access to safe drinking water and nearly 250,000 with adequate sanitation.
In Haiti, IMA targets healthy WASH behaviors at schools, ensuring students have access to clean drinking water, adequate latrines, handwashing stations and education on the importance of handwashing and other healthy WASH practices. Through these simple but powerful measures, school officials have noted that absences due to illness have declined. Our WASH work supports our larger efforts in Haiti to control and eliminate neglected tropical diseases, which disproportionately affect those who lack access to clean water and sanitation. These, plus healthy hygiene practices like proper hand washing, can prevent the spread of some NTDs like soil transmitted helminthes or intestinal worms.

Each of our WASH-related projects includes a strong education component to build the capacity and buy-in of local health workers and officials to maintain and repair WASH infrastructure, as well as training on the importance of handwashing with soap and other critical hygiene behaviors.

OUR PROJECTS

Access to Primary Health Care (ASSP): In the rural areas of the DRC where ASSP supports primary health care, estimates suggest that only 32 percent of the population has access to potable water and just 17 percent benefit from suitable water and sanitation devices. In alignment with the DRC National Framework of Clean Schools and Villages Program, IMA is committed to sustainably promoting better hygiene and sanitation practices and increasing clean drinking water availability in assisted communities. With funding from the U.K.’s Department for International Development, ASSP has increased access to and use of potable water and hygienic sanitation by constructing water infrastructures, such as community rainwater collection cisterns at health centers, new protected water points and wells with solar water pumps. ASSP has also distributed toilet tiles for latrine construction to improve access to sanitary elimination.

Healthy Schools, Successful Children: With funding from Episcopal Relief & Development, IMA worked to improve students’ health, school participation and academic success through WASH interventions in the South, Southeast and Grand Anse departments of Haiti. Here, 74.5 percent of schools lack running water for sanitation, and 84 percent lack treated drinking water. Fewer than 60 percent of schools have functional toilets or latrines. In alignment with the Ministry of Education’s hygiene-friendly school model, the project was designed to improve WASH infrastructure in 60 schools; improve WASH behavior among students, teachers and communities; and institutional frameworks for sustaining interventions among schools and other local stakeholders.

Sexual and gender-based violence is a public health crisis around the world. The World Health Organization estimates that as many as 1 in 3 women globally are affected by physical or sexual violence, and a lack of empowerment, autonomy, education and opportunity for women and girls negatively affects both their health and that of their children and families.

IMA World Health has integrated SGBV interventions and behavior change communication around women’s empowerment into broader health programs for more than a decade, focusing primarily in the Democratic Republic of Congo.

IMA is the lead implementer of the United States Agency for International Development’s Tushinde Ujeuri: Comprehensive Services to Address GBV Project in Eastern Congo, where years of insecurity and conflict alongside deeply rooted gender inequities and harmful cultural practices have contributed to high rates of SGBV. These, in turn, cause severe medical, psychological, economic and social suffering for survivors, their families and communities. Tushinde Ujeuri is a comprehensive community-based program designed to help communities respond to and prevent SGBV. In Swahili, its name means “We Overcome Violence.”

Tushinde Ujeuri builds on the highly successful USAID Ushindi Project (2010-2017), through which IMA provided SGBV prevention and response activities in highest risk areas of Eastern Congo. IMA’s holistic approach to addressing SGBV incorporates social and financial recovery, in addition to medical care and psychosocial support. Ushindi directly assisted nearly 30,000 survivors of SGBV from 2010 to 2017.

IMA World Health also serves as the founding organization and secretariat of We Will Speak Out U.S., a coalition of faith-based organizations working together to empower faith communities to speak out against SGBV. In 2014, IMA, on behalf of the coalition, partnered with Sojourners to release Broken Silence, a report based on a Lifeway Research survey of 1,000 U.S.-based Protestant pastors on their understanding of and response to SGBV in their congregations and communities. The report found that pastors often underestimate the prevalence of SGBV, speak infrequently about it and have even responded to disclosures of violence in ways that may inadvertently do more harm than good.

IMA deepened this research through a partnership with the Science, Religion, and Culture Program at Harvard Divinity School. After a year-long qualitative study of seven Boston-area congregations and three chaplains from two local universities, IMA and HDS released the “Interrogating the Silence” report in 2015. This study confirmed that religious leaders have little support and little training in dealing with issues related to SGBV and concluded that, while religious leaders are a powerful resource for victims and survivors of SGBV, they need more training on the available tools, gender relations, and the social mechanisms that contribute to violence.

OUR PROJECTS

Tushinde Ujeuri, Comprehensive services to address GBV
USAID | 2017-2022

USAID in partnership with an IMA World Health-led consortium of local and international partners has been on the forefront of countering sexual and gender-based violence (SGBV) in eastern DRC through the Tushinde Ujeuri, Counter Gender-Based Violence Project. This comprehensive, 5-year project implemented in five health zones in North and South Kivu provinces works to strengthen community-based prevention of and response to SGBV, reduce SGBV incidence, and improve the quality of and access to holistic care for survivors, particularly among vulnerable groups including LGBTI. The USAID Tushinde project has and continues to help reintegrate survivors of SGBV successfully within their communities through holistic medical, psychosocial, legal, and socio-economic support, while disrupting the broader cycle of SGBV. The project adopts an integrated approach to prevention, response, and reintegration of SGBV survivors and has reached 19,940 survivors to date with SGBV services. To date, 18,416 survivors have received psychosocial services, 6,351 survivors have received medical care, and 5,696 survivors have received legal counseling. The Tushinde projects continues to reach communities with SGBV prevention messages, with 1,183,083 individuals having received messages to date and more planned for the fifth and final year of the project. Through this project, IMA has developed a unique expertise in advocating for protection through a human rights-based approach for marginalized groups including LGBTI individuals. Eighty-two LGBTI community members have been reached with SGBV prevention and response awareness to date with more outreach planned in the coming year. Of the project's supported groups, 126 members were sensitized on LGBTI rights in the last year, totaling 150 reached since the beginning of the project.

Support of Provision of Reproductive Health and Gender-Based Services in Bor State Hospital and Mingkaman Protection of Civilians Sites (RH and GBViE)
United Nations Population Fund | 2016-2021

This project is a grant from the United Nations Population Fund to support the provision of Reproductive Health and Gender-Based Violence in Emergencies (GBViE) Services in Bor State Hospital and Mingkaman Protection of Civilians Site. The focus is on ensuring delivery of a Minimum Initial Service Package (MISP) of services. Activities include training of service providers on components of MISP service delivery focusing on sexual and reproductive health support and sexual and gender-based violence (SGBV) prevention and care, information and services, and coordination and program management to promote sexual and reproductive health and combat gender based violence. Project staff also provide Dignity Kits and psychosocial support to survivors of SGBV. The project has established a One Stop Center in Bor State Hospital and a Youth-Friendly Space in Mingkamen, where project staff work with youth to combat stigma and norms that may contribute to SGBV.

Post-Exposure Prophylaxis (PEP) Kit Procurement in DRC
USAID/BHA | 2018-2022

IMA has procured and distributed Post-Exposure Prophylaxis (PEP) Kits in the DRC since 2018. IMA's current running PEP Kit project, funded by USAID/BHA, responds to the PEP Kits needs in 10 provinces most affected by humanitarian crisis and SGBV issues across the DRC. IMA World Health employs a multipronged supply and distribution strategy which increases access, reduces stock-out, and reduces cost per Kit through a cost-effective local kitting solution. Through this holistic approach, IMA improves the PEP Kit supply and utilization in DRC and supports redistribution of PEP Kits based on demand level data, which reduces stock out and loss. Through these various USAID/BHA supported projects, access to PEP Kits has significantly increased in targeted provinces where 96% of survivors of sexual violence who arrived at a health facility within 72 hours of assault received a PEP Kit. These projects have cumulatively purchased, kitted, and distributed 93,569 PEP Kits, trained a total of 1,386 health care professionals in clinical management of rape, including PEP Kit administration and sexual exploitation and abuse (SEA), improving the quality medical care of SGBV survivors while also preventing SEA. These USAID/BHA-funded projects have been instrumental in the response efforts to SGBV issues in the country in the last three years as they have been the main source of PEP Kits without which SGBV survivors in the targeted areas would have not been able to access these essential lifesaving drugs.