Service Delivery Programs

The Department is actively involved in providing high-quality health care to the residents of the communities around the School of Public Health: Washington Heights, Inwood, and Harlem, and to communities in Africa, Asia, and Latin America.

Our programs address a wide range of health issues, from early childhood interventions at the Head Start Programs, to STI/HIV education and prevention at the Young Men's Clinic and the Family Planning Center, to averting maternal death in communities abroad.

Health services are incorporated into local schools, community based organizations, and the New York-Presbyterian Hospital/Columbia University Medical Center, as well as at freestanding clinics. The network of health care services created by the department allows us to contribute to our neighborhood, and beyond. It also directly informs the education we provide. Research and education projects are carried out within the clinics, where many Heilbrunn students complete their practica, through which they learn valuable skills, while assisting clinics/projects to design, evaluate, or deliver services.

Currently, the programs of the Heilbrunn Department of Population and Family Health include:

	Center for Community Health and Education
	Family Planning Center
	The Young Men's Clinic
	In Your Face Teen Pregnancy Prevention Program
	Tobacco Prevention and Cessation Programs
	Columbia University Head Start and Early Head Start
	Averting Maternal Death and Disability Project
	Reproductive Health Access, Information and Services in Emergencies (RAISE) Initiative
	International Family AIDS Program
	Community Health Worker Network of NYC
	Tanzania Ghana Health Partnership
	Ghana Health Information System Development
	Northern States Maternal, Newborn, and Child Health Program

Tanzania Ghana Health Partnership

Tanzania and Ghana are at the forefront of health development in sub-Saharan Africa. Tanzania is on target to achieve the Millennium Development Goal (MDG) of reducing childhood mortality by two thirds from 1990 to 2015. Although these two countries have demonstrated successful health systems development and have been highly lauded within the international development community, a variety of bottlenecks have prevented their programs—as well as other proven, low-cost interventions—from realizing their full potential. These bottlenecks include problems with manpower, communications, logistics, resources, and leadership. The Tanzania-Ghana Health Partnership will demonstrate the feasibility and impact of assembling and implementing a comprehensive package of proven interventions for strengthening health systems in Ghana and Tanzania. The project will also add components that are missing from existing health systems in order to develop a new and cost-effective paradigm for health system development across national borders. In preparation for this work, we will implement a six-month planning process to:

Through such efforts, the planning process will develop a proposal for promoting total “Health Systems Development” in Ghana and Tanzania using a framework created by the World Health Organization. In Tanzania, the project will build new capabilities into the country’s existing EMPOWER initiative, which mobilizes health system strengthening at all points of care, while also integrating Ghana’s strategies for providing community-based health services. In Ghana, the project will add Tanzania’s systems for strengthening the management of district-level health systems into its existing CHPS programming in order to accelerate the scale up of such programs. This program will be known as the Ghana Essential Health Interventions Program. All of these planning efforts will be coordinated between the two countries in order to foster the sharing and transfer of information, strategies, plans, and research. This project is currently in the planning phase with a grant from the Doris Duke Charitable Foundation, and is in the process of developing a proposal for implementation.

Ghana Health Information System Development

In 2000, the government of Ghana reformed its health care system by decentralizing the planning and management of health services from the national to the district level. By doing so, the government aimed to foster a system of health care management that could be more responsive to local needs and particular burdens of disease. In addition, the government made a national commitment to scaling up community-driven health care services that had proven effective in some of the country’s most remote and impoverished communities. This program was known as Community-based Health Planning and Services, or CHPS. In 2006, the government launched a National Health Insurance (NHI) program to make health care more affordable for its people.

Although these reform efforts have generated international recognition, the new strategies have not yet achieved their full promise. For example, while CHPS is a highly laudable initiative, this program currently reaches only 10 percent of the country’s population. More importantly, however, the District Health Information Management System (DHIMS) that was developed to support decentralization of Ghana’s health care system is inadequate to the country’s needs.

The Ghana Health Information System Development project will test whether the adaptation of existing mobile phone technology can help address these problems by 1) significantly easing information capture for community-based health care workers, and 2) providing a mechanism for critical communication between front-line health care workers and their supervisors. The GHISD project is truly cutting edge: Little is known about the feasibility of utilizing mobile phone technology for reforming routine health information operations and even less is known about the use of information systems as a tool for reforming community health care worker efficiency and health service effectiveness. Filling these critical knowledge gaps, the project will seize upon the momentum that has been created through the promising health care reform efforts to date in Ghana; set the stage for the completion of such efforts; and test whether promising technology can strengthen the community-based health care services that are increasingly being implemented throughout the developing world. This project was made possible with a grant from the Bill and Melinda Gates Foundation.

Northern States Maternal, Newborn, and Child Health Program

Together with partners including Health Partners International, Save the Children-UK, and GRID Consulting, the Mailman School of Public health is a partner in the the Nigeria Northern States Maternal Newborn and Child Health (MNCH) program, an initiative that aims to achieve the following objectives:

• To leverage operations research to redefine the institutional relationships, organizational alignment, and basic decision-making processes necessary for the MNCH program to succeed;
• To spark the transformation associated with evidence becoming the principle criterion for decision-making to drive change in organizational practices and align resources to needs necessary to get MNCH in Northern Nigeria on track; and
• To ensure that the adoption of the practices and norms associated with evidence-based or knowledge culture play a key role in strengthening health system stewardship and improving health service uptake and delivery.

By the end of the program, it is expected that:

• The state ministries of health will engage in operations research, including through a demographic surveillance system, to inform policy, systems and services development;
• Key opinion leaders in Northern Nigeria will have become part of the larger health systems research agenda, such as the INDEPTH Network of demographic surveillance sites, that is driving progressive development throughout sub-Saharan Africa; and
• Operations research will have become the publicly recognized organizing principle for systems development among state and other development partners.