‘Invest in health, build a safer future’
A healthy population is critical to economic growth and poverty reduction. MCC investments strengthen the ability of institutions, policies, and households to provide health practices and services that improve and prolong lives and result in a more productive workforce. In other areas, such as road infrastructure, MCC works to ensure that health and safety considerations are identified early in the project cycle all of MCC investments and integrated into the project design and implementation process.
Making Health-Wise Investments
All MCC investments aim to foster a healthier and more productive workforce. When selecting country partners, MCC looks not only at indicators on public expenditures on health and, immunization rates, but also on natural resources management to understand the country’s efforts to provide adequate health care and healthy living conditions to its citizens.
In addition, the MCC Environmental Guidelines establish a process to ensure identification and mitigation of the potential health and safety impacts of MCC investments. On roads projects, for example, MCC utilizes a multidisciplinary approach to identify roads safety concerns early in the project development cycle and to integrate appropriate mitigation measures into road design and construction. Irrigation development and other water infrastructure activities, such as rehabilitation of water drainage systems, include review and mitigation of health impacts, including malaria and other water-related diseases.
Along with mitigating health risks, MCC investments in different sectors often include efforts to address health issues. Community-driven development activities, such as those funded in Burkina Faso, Ghana, El Salvador, and the Philippines, have included development of local health and education services. Roads and other infrastructure activities often result in improved access to health services and hospitals for poor people.
Examples of MCC’s Health Projects
Maternal and Child Health and Nutrition (MCHN)
A compact with Indonesia included a $134.2 million community-based project that integrated sanitation, health, and nutrition interventions to support the Government’s efforts to reduce stunting in children − leading to higher wages, lower healthcare costs and a more productive workforce nationwide. The consequences of stunting in children under the age of two are irreversible. It leads to higher infant and child mortality, increased susceptibility to infection and illness, and impaired cognitive abilities, all of which result in long-term economic losses to individuals, families and society. MCC’s Indonesia Compact raised much needed public awareness about stunting and built the capacity of the Indonesian Ministry of Health to reduce stunting by improving nutrition, sanitation, and health among vulnerable groups. The project, which included partnership with the private sector, targeted 5,700 villages across 11 of Indonesia’s 34 provinces.
Preceding the Indonesia Compact, MCC threshold program with Indonesia included a $20 million project to support the Government of Indonesia in reaching immunization targets. The project ensured the availability of quality vaccine supplies and provided training for health-care providers on epidemiology, immunization and surveillance, mid-level management, financial sustainability, integrated health planning, and budgeting.
HIV/AIDS Prevention and Treatment
Forty percent of MCC’s compact with Lesotho was designed to strengthen the delivery of essential health services, including HIV/AIDS prevention and treatment. The $144 million health project was targeted to improve maternal and child health services, and HIV/AIDS, Tuberculosis and other communicable and non-communicable disease prevention and treatment. This was achieved through health systems strengthening — human resources, health information and management systems, and health care waste management investments — and health infrastructure rehabilitation. The project placed special emphasis on systems and infrastructure needed to scale up HIV counseling, testing, and anti-retroviral treatment. The program partnered with the President’s Emergency Plan for AIDS Relief (PEPFAR) and the U.S. Agency for International Development, the Centers for Disease Control and Prevention, and other donors.
An MCC threshold program with Kenya included $5.9 million in activities to strengthen transparency and accountability in the health sector to reduce corruption in the provision of essential services—largely targeted at maternal and child health activities. MCC funding aimed to strengthen procurement capacity and accountability, improve supply chain management of public health resources, and establish capacity within the Ministry of Health to monitor procurements and assess compliance.
Non-communicable Disease and Injury (NCDI)
As part of MCC’s first compact with Mongolia, $42 million was utilized to strengthen the national program for prevention, early diagnosis and management of non-communicable diseases and injuries. Mongolia’s death rates from premature heart disease, stroke, diabetes and pedestrian traffic accidents had risen precipitously preceding the compact. This MCC-funded public health intervention expanded and strengthened Mongolia’s national program for prevention, early diagnosis, and treatment of NCDI’s. The program included clinical guideline development, health worker training, and national screening programs for hypertension and cervical cancer.
Water and Sanitation
Unimproved sanitation is a leading risk factor for chronic malnutrition in developing countries and requires interventions focused on improving living environment and nutrition at the household level. Diarrhea remains the second leading cause of death, after respiratory illnesses, for children in developing countries. Poor access to safe drinking water and sanitation is the main cause of many of these deaths.
Many of the economic benefits from water and sanitation activities accrue from reduced illness and improved health, particularly for the poor. MCC’s first compact in El Salvador invested nearly $16.6 million to provide access to potable water systems and sanitation services to benefit 90,000 people in the poorest region of the country. MCC also included water and sanitation projects in compacts with Lesotho, Mozambique, Ghana, Jordan, Zambia, Liberia and Sierra Leone.
Recognizing the link between sanitation and nutritional status, the nutrition (CBHN) project in Indonesia invested in a Community Led Total Sanitation (CLTS) campaign targeting 1,600 villages. The CLTS approach involves teams of health workers and volunteers “triggering” their communities by facilitating discussions around open defecation, contamination of food and drinking water, and sanitation solutions. To meet the demand for sanitation services and products that this effort generates, local members of the private sector were trained as a corps of “sanitation entrepreneurs” to provide appropriate sanitation technologies like latrines, grey water disposal methods, and hand washing stations.
In Sierra Leone, the Water Sector Reform Project improves access to reliable and safe water and sanitation (WASH) services through water sector reform, improved utility management and efficiency, and improved WASH practices at the household level. Increased productivity related to lower direct and indirect health costs for firms and households is targeted to increase economic growth.