Medical Service Corporation International (MSCI) is an international health and development company incorporated in Washington, D.C. in 1973.  MSCI has worked in over 60 countries for numerous private and public clients including the United States Agency for International Development (USAID), the Department of State, The World Bank, the Inter-American Development Bank, the African Development Bank, the Asian Development Bank, Exxon-Mobil Corporation, and CIBA-GEIGY.

MSCI's corporate goal is to improve health services worldwide through the use of appropriate technology, modern management systems, and quality advisory assistance.  The firm is a recognized leader in the design, implementation, and management of projects focusing on medical care and treatment adherence, human health resources development, infectious disease control, the delivery of primary health care, and hospital services, and health systems strengthening.

MSCI's ability to manage complex health programs is based upon a 34 year history of successful implementation of numerous health-related programs in Africa, Latin America, Asia, the Middle East and Eastern Europe.  It has strong professional working relationships with leading health educational institutions in the U.S. including Harvard University School of Public Health, Tulane University School of Public Health and Tropical Medicine, The University of Pittsburgh Health Sciences Center, and Vanderbilt University.

MSCI has delivered humanitarian assistance and basic health services in transitional and post-conflict states such as Hungary, Bulgaria, Georgia, Poland, Somalia, and Sudan. It has also provided disaster relief after earthquakes and hurricanes in El Salvador and medical support following the Chernobyl nuclear disaster in Ukraine.

MSCI maintains overseas offices in Tbilisi, Georgia; Batumi, Georgia; Dar Es Salaam, Tanzania; Maputo, Mozambique; Lilongwe, Malawi; and Port-au-Prince, Haiti.  

MSCI’S AREAS OF EXPERTISE INCLUDE:

Health Systems Strengthening

- Health Policy Development
- Health Systems Reform
- Information, Education and Communications
- Human Resource Development
- Health Care Finance
- Continuing Medical Education

Health Services Delivery

 - Diagnosis, Treatment and Control of Infectious and Vector Borne Diseases
- Maternal and Child Health
- Treatment Adherence and Compliance

 Monitoring and Evaluation

- Health Management Information Systems
- Performance Monitoring
- Program Assessment and Evaluation

SELECTED CURRENT ACTIVITIES

Tuberculosis Treatment and Control Program (TTCP):
Republic of Georgia

Under a USAID-funded program, MSCI is supporting the Government of Georgia's efforts to improve the diagnosis and treatment of tuberculosis through the implementation of Directly Observed Therapy – Short Course (DOTS).  TTCP serves as a key support mechanism for the country’s National Tuberculosis Program (NTP) and has effectively increased the rate of successful treatment outcomes in Tbilisi, Poti, and Adjara Region.  During the past four years, the Program has improved clinical and laboratory services by training:

• 12 DOTS instructors (six TB doctors, three TB nurses and one PHC doctor);
• all 37 outpatient TB doctors and all 8 laboratory technicians at all five  of the specialized dispensaries in Tbilisi;
• all 66 doctors, 77 nurses and 9 laboratory technicians from the TB Hospital in Tbilisi;
• all 63 DOTS outreach nurses serving the Tbilisi outpatients;
• 22 doctors and 10 nurses of the Ministry of Justice who are working in the prisons;
• five TB doctor and one DOTS coordinator who were sent to the TB Training Center on MDR TB in Latvia, Riga;
• all four of the TB doctors and all 6 TB nurses of Poti;
• all 16 of the TB doctors of Adjara;
• all 33 of the PHC doctors of Poti;
• 293 PHC doctors of Tbilisi (out of 350);
• 77 PHC doctors of Batumi (out of 120);
• seven PHC nurses serving Poti outpatients in neighboring villages;
• all 20 of the DOTS nurses serving Batumi outpatients; and
• 27 physicians from Military Hospital.

 Additionally, 41 journalists were given a special course to increase their awareness of TB, and eight doctors from Tbilisi dispensaries were instructed on TB record keeping and reporting standards.

In the E&E Weekly Report to the USAID Administrator (January 11, 2007), MSCI’s Tuberculosis Treatment and Control Program (TTCP) in Georgia was described as follows: Since 2003, USAID’s Tuberculosis Treatment and Control Program has helped strengthen diagnosis of tuberculosis and the implementation of the Directly Observed Treatment Short-Course (DOTS) program in Georgia.  As a result of the program, the quality of TB diagnosis testing has improved by 80%, and the positivity rate of TB has increased by over 40%.  In response to these results, the National Reference Laboratory is replicating the USG-funded intensive coaching approach in all 37 smear exam laboratories in Georgia.   

Promoting Integrated ABC/VCT/Treatment Programs for HIV/AIDS: Malawi, Mozambique, Haiti, Swaziland, Ethiopia and Guatemala

This USAID-funded Program has been providing small subgrants to 19 community and faith-based organizations (C/FBOs), all of which are based in high HIV/AIDS prevalence regions of Malawi, Mozambique, Haiti, Swaziland, Ethiopia and Guatemala.  The Program supports the work of C/FBOs in:

The Program’s C/FBO partners comprise an extensive network of community leaders, facilities and volunteers and have a deep commitment and close ties to the local communities they serve.  During the five years of MSCI’s Integrated ABC/VCT/Treatment Program, the C/FBO subgrantees have made major contributions to preventing the spread of HIV/AIDS.  Further, these subgrantees have made significant cost share contributions totaling approximately 30% of the Program’s budget. 

The Program is now focusing on involving the C/FBO community on providing treatment adherence support at the community level for host government funded ART care efforts.  This is important because host governments frequently do not have the capacity for community outreach activities such as those supported by C/FBOs.

Consultancy Services for District Hospitals Medical/Technical Needs Assessment Study: Tanzania

Recently, the World Bank awarded MSCI a contract to conduct a situational analysis and needs assessment of the medical and technical equipment requirements of 93 district hospitals, designated hospitals, and regional hospitals that provide Level I services in Tanzania.  This Study will prepare plans of action for improving service delivery and training of staff for the Tanzania Health Sector and local Government Reform programs. In addition, the MSCI Consultant Team will develop a set of recommendations to strengthen the procurement system (and ensure its transparency) and an investment plan for the acquisition and/or replacement of medical equipment in priority service areas.

Technical Assistance Support Contract 3 (TASC3) IQC

MSCI, and its HealthStar Consortium, has been awarded a USAID TASC3 Global Health Indefinite Quantity Contract (IQC.  HealthStar is a diversified group of 21 organizations working in the international health field.  The IQC mechanism allows USAID Missions and Bureaus, as well as other USG agencies to access comprehensive technical assistance and support for health related programs in developing countries.  The six Global Health Functional Areas for which HealthStar partners have qualified are: 1) service delivery; 2) health policy reform; 3) community mobilization and individual behavior change; 4) monitoring and evaluation; 5) capacity building; and 6) commodities systems management [more...]

PAST PROGRAMS

Chornobyl Childhood Illness Program: Ministry of Health, Government of Ukraine, Kiev, Ukraine

Under a USAID-funded cooperative agreement, MSCI managed a four-year, US$4 million effort that addressed the medical and psychosocial effects on children of the Chornobyl nuclear disaster.  Using five mobile units of ultrasonographers and psychologists, the program screened 116,000 children for thyroid cancer and psychosocial problems (e.g., suicidal ideation) in the five regions of Ukraine most affected by nuclear contamination.  Technical advisors from MSCI and its collaborating institutions (the University of Pittsburgh Medical School, Children's Hospital of Philadelphia) provided staff training and consultant assistance to Ukrainian counterpart organizations on the screening, identification, and the medical/psychosocial management of children who were found to have developed radiation related conditions.

New Partners Initiative (NPI) Outreach Workshops Task Order and Task Order Extension

Under a USAID funded TASC2 IQC Task Order, MSCI recently assisted USAID and the Office of the U.S. Global AIDS Coordinator (OGAC) to implement the New Partners Initiative (NPI) of the President’s Emergency Plan for AIDS Relief (PEPFAR).   This work included:

  ● Implementing Outreach Workshops to Identify New Partners.

MSCI organized and conducted workshops in Philadelphia, Atlanta, Denver, Los Angeles, and Washington D.C. to orient potential new partners to the global HIV/AIDS situation, the PEPFAR Program and its technical components, the President’s New Partners Initiative (NPI), and the U.S. Government grant assistance and application processes.  More than 2000 organizations were contacted, and a total of 400 organizations, represented by 709 individuals, participated in the six workshops.

  ● Provision of Technical Assistance Support to the NPI Awardees.

MSCI conducted site visits to 22 newly funded NPI grantees.  This was done through needs assessment workshops that yielded extremely valuable insights regarding the capacity of these organizations to successfully implement their grants.  After the completion of the site visits, MSCI held a debriefing for USAID, OGAC, and DHHS on the main findings of the needs assessment, lessons learned and recommendations for future technical support to the NPI grantees.  Most important, the needs assessments resulted in a clear articulation of the urgent steps and technical assistance needed to remediate the weaknesses uncovered and strengthen the capacity of these organizations.

The Vector Biology and Control Projet (VBC): USAID Office of Health, Bureau of Science and Technology, Washington, D.C.

MSCI implemented this USAID-funded project for the control of malaria, schistosomiasis, river blindness, Guinea worm disease and more than 20 other insect and snail borne diseases in Africa, Asia, Latin America and the Middle East.  With the help of several hundred consultants, the 13 VBC staff members completed over 250 individual assignments in 43 USAID assisted countries.  The VBC Project also involved four university subcontractors – Harvard University School of Public Health, Tulane University School of Public Health and Tropical Medicine, Johns Hopkins University School of Hygiene and Public Health, and the Jackson Foundation which represented the Uniformed Services University of the Health Sciences.

Originally conceived as a quick response technical assistance project to meet the health priorities of USAID supported countries around the world, MSCI's VBC staff went on to design disease control initiatives, establish training programs, test new technologies, and develop surveillance programs that are the backbone of the disease control strategies for several countries.

To support the technical needs of the Project's scientists and consultants, VBC established a state-of-the-art Information Center that was unequaled for the depth and relevance of its data.  In addition, MSCI utilized a network of 1,200 worldwide consultants which included specialists in entomology, epidemiology, parasitology and medicine.

Among the many accomplishments of the VBC Project were:

• the initiation of an internship training program to give opportunities to new graduates of disease control programs who wanted to devote their careers to vector borne disease control;
• the design and development of integrated malaria control programs for several countries;
• preparation of contingency plans to manage outbreaks of potentially fatal dengue hemorrhagic fever for four Latin American countries;
• development of ivermectin distribution and monitoring programs for the prevention of blindness due to onchocerciasis in Africa and Central America;
• development of community-based approaches for the control of Guinea worm disease in Central and West Africa in collaboration with the Carter Foundation and Global 2000;
• creation of a major housing improvement project to limit exposure of Bolivian villagers to the vectors of Chagas' disease; and
• development of integrated disease control alliances between ministries of health and agriculture for more rational use of insecticides and other resources in Latin America, Asia, Africa and the Middle East.

The VBC Project staff collaborated with virtually every U.S. and international disease control organization including the U.S. Centers for Disease Control (CDC), WHO, the Pan American Health Organization (PAHO), the Carter Foundation, the Environmental Protection Agency (EPA), Helen Keller International, The International Eye Foundation, ORSTROM, African Medical Research Foundation (AMREF), United Nations Children's Fund (UNICEF), the U.S. National Institutes of Health (NIH), as well as the staff members of more than 25 universities and foundations. 

Health Manpower Training/Health Services Administration Project: Institute of Health Science, Ministry of Health, Mbabane, Swaziland

Under a six-year USAID-funded contract, MSCI employed technical advisors to the MOH and its Institute of Health Science to improve Swaziland's training and clinical service delivery capabilities in three areas:

• training of nurses and other health workers in primary healthcare, maternal and child health, family planning, and child survival technologies;
• the delivery of rural health services; and
• administrative and logistics systems for the nation's four regional hospitals.

MSCI's six member team of three nurses, a nurse-midwife, a nurse family practitioner, and a hospital administrator was responsible for evaluating and revising Swaziland's training curricula to accommodate the expanded role of nurses in a public health system that has few physicians.  The Project emphasized classroom teaching with hands-on practical training.  MSCI field staff developed educational materials, evaluated the effectiveness of the training programs, and helped integrate primary healthcare nurses into the country's health institutions at both the urban and rural levels.  When the project ended, over 200 nurse practitioners and a cadre of new teachers had been trained.

USAID staff rated the Swaziland Manpower Training/Health Services Administration Project as one of the Fifty Best in USAID's history. 

Schistosomiasis Research Project: Ministry of Health, Government of Egypt, Cairo, Egypt

The Egypt Schistosomiasis Research Project (SRP) was the largest project ever devoted to research on the control of this disease which affects 200 million people in 74 countries.  Funded by USAID, this 10-year Program conducted key research on the epidemiology, treatment, and diagnosis of schistosomiasis infections; the training of public health personnel for dealing with this disease; the social aspects of disease control; and the development of a vaccine for preventing the disease.  The SRP also assisted Egyptian medical educational institutions to conduct a practical training and biomedical research program.

MSCI also coordinated the research efforts of 62 participating organizations, including U.S. and Egyptian universities.  This involved providing training to Egyptian health professionals on research methodologies, project design, the development of grant applications, and the monitoring of research project results.  To implement this aspect of the SRP, MSCI created technical assistance, financial,  and procurement systems for the Egyptian Government which included the establishment of:

• U.S. and international training for Egyptian scientists;
• steering and technical review committees;
• a management information system;
• peer review teams;
• documentation systems for 62 grants;  and
• systems for the administration of grant funds.

Three Regions Health Study: Tanzania

Under this African Development Bank funded program, MSCI provided the Government of Tanzania with documents, plans, and budgets for health reform activities in three underserved Regions of the country.  The focus of the Program was on the preparation of action plans that will result in sustainable health sector improvements.  A major part of the Program involved identifying the human resource, physical facility, equipment, and material requirements of the Government's health system in three rural and underserved regions.

Partnership in Healthcare Programs: USAID, Sofia, Bulgaria

Under the USAID Partnerships in Healthcare Program in Bulgaria, MSCI worked to improve the management of cardiovascular diseases and to reduce childhood mortality and morbidity from traumatic injuries through two projects:

• Improving the Management of Cardiovascular Disease Project, a collaborative effort between MSCI, Saint Ekaterina Hospital of Sofia, and Michigan State University.  The program involved the training of Bulgarian physicians and other healthcare professionals, the establishment of CME programs, and the development of appropriate cardiac disease prevention programs; and
• Reducing Trauma in Children Project, a program focused on improving the capability of Bulgarian health professionals to reduce morbidity and mortality from trauma in children.  Through collaboration with the N.I. Pirogov Emergency Medical Institute of Sofia and the Children's Hospital of Philadelphia, MSCI staff conducted training in:  (a) state-of-the-art children's trauma care; and (b) management of patient evaluation, intervention, and treatment.

 Both projects involved:

• designing and implementing CME programs for healthcare professionals throughout Bulgaria;
• conducting training programs in basic and advanced life support which taught medical emergency teams the latest techniques of patient assessment, triage and modern life-saving practices;
• establishing a computer-based Learning Resource Center at two major hospitals in Sofia;
• developing a model community awareness and health education campaigns using radio and printed material in conjunction with the American University of Bulgaria;
• developing a Young and Experienced Scientists Research Program which included training seminars on the design, management, and evaluation of medical research projects; and
• the funding of over 30 research projects.

As an integral part of these projects, MSCI established:

• a model triage/resuscitation unit at the Pirogov Emergency Medical Institute in Sofia;
• two pediatric emergency clinics in Varna and Plovdiv; and
• a cardiac emergency unit in Varna.

For each of these clinics, MSCI was responsible for implementing training programs for clinic staff, introduction of computerized management systems for the clinics, and procurement and installation of medical equipment and supplies.

HIV/AIDS Prevention in Asylums, Orphanages, and Villages: El Salvador 

Supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria, (GFATM), supported project to MSCI’s non-profit foundation, Seraphim, trained 196 persons in basic HIV prevention, family planning and reproductive health.  In addition, 224 health workers were trained in HIV/AIDS bio-safety for management of hazardous waste/contaminated products; 271 health workers and volunteers were trained in pre- and post-test counseling and support to home health care providers. Assessments were conducted of foster homes, orphanages, and housing for the elderly.

In a related project, Guide to Life: Program for the Prevention of HIV/AIDS, Seraphim/MSCI provided HIV information and prevention services to prostitutes, truck drivers, and women selling food from road side stands.  Services included counseling, testing, provision of condoms, antiseptics and referrals to medical facilities.

Malaria Control Project: Ministry of Health, Government of El Salvador, San Salvador, El Salvador

MSCI provided planning, training, and epidemiological expertise to the Salvadoran Government's Malaria Control Program. This included technical assistance to the MOH in vector control and malaria case management, support for the development of an action plan to dengue hemorrhagic fever epidemics, and training for volunteer collaborators in malaria control.  As a result of these efforts, a significant decline in the incidence of malaria in El Salvador was observed within three years.

Technical School of Tirana: Ministry of Education, Tirana, Albania

MSCI was instrumental in re-establishing a private, non-profit U.S. foundation, The Harry T. Fultz Albanian American Educational Foundation, to assist with educational reform in Albania.  The Foundation wished to renew sponsorship of the American-founded Technical School of Tirana which had been interrupted since World War II.  MSCI worked with the Ministry of Education to assess the training capacity, management structure, physical facilities, and funding requirements for the School's renovation.  In addition, MSCI designed the School's Business Development Center (BDC), a key component of its educational program.

Technical Health Institute: Government of The Syrian Arab Republic, Damascus, Syria

In this USAID sponsored five-year project, MSCI assisted the Syrian Technical Health Institute (THI) to make the transition from a didactic pedagogic institution to an advanced training facility with state-of-the-art teaching equipment and an updated curriculum.  THI's educational curricula and training materials in radiology, public health, pharmacy, and prosthetics were revised and updated.  Modern teaching laboratories were established with the capability to produce training materials in Arabic and seminars for the Arabic speaking healthcare community.

Syrian health educators were sent to the U.S. to receive intensive technical training in the allied health sciences.  In the interim period, Arabic speaking U.S. training advisors were assigned by MSCI in Syria to provide technical assistance in human resource planning and curriculum development and to conduct student training programs.

Primary Healthcare Training Program: Ministry of Health, Government of Poland, Warsaw, Poland

Through World Bank funding, MSCI assisted the Ministry of Health and Social Welfare (MOHSW) to improve primary healthcare delivery by training Polish professionals from the MOHSW and three health consortia on methods for decentralizing services, utilizing resources more effectively, and implementing information systems and cost recovery mechanisms.  This project involved a study tour in the United States during which the Polish healthcare experts received intensive briefings on various U.S. healthcare training programs, management systems, and clinical practices.

Medical Equipment Maintenance and Repair Skills Training Project (MEMRST): Pan American Development Foundation (PADF), Central America and the Caribbean Region

MSCI's biomedical engineer was a member of a Pan American Development Foundation (PADF) evaluation team which conducted an assessment of a USAID-sponsored training course for biomedical equipment instructors in six Central American countries.  The evaluation team concluded that in spite of an extremely complicated and problem-laden environment, the local training for the maintenance and repair of biomedical equipment had been a success.

Environmental Capacity Building in Africa: The World Bank, Washington, D.C.

MSCI's International Center for the Environment and Health (ICEH) participated in The World Bank's "Environmental Capacity Building in Africa" Program in Washington, D.C.  ICEH was responsible for developing a manual and teaching a course on the role of risk assessment in pollution management for African environmental health professionals.  In addition, ICEH organized and conducted field trips and site visits to provide participants with experience about real pollution problems and solutions.

Maternal and Child Health Services: El Salvador

With funding from the Inter-American Development Bank, MSCI and its non-profit partner organization, the SERAPHIM Foundation, provided earthquake relief services.  They also established high quality community-based maternal and child health services in six regions of El Salvador.