Prof. G. L. Monekosso
WHO Regional Office for Africa
28/04/08 Ouagadougou, Burkina Faso
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Outline of the Presentation
1.Background
2.Performance of Health Systems in theAfrican Region
3.Rationale for revitalization of PHC
4.Actions for revitalization of PHC andstrengthening Health Systems
5.Roles and Responsibilities ofstakeholders
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Background
Progress in health before and afterAlma Ata
Strengths, weaknesses, opportunitiesand challenges over 30 years
Summary of achievements of countriesbetween Alma Ata and the MillenniumConference
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Performance of Health Systems
Achievements
Creation of health districts
Partnership with non-public healthproviders
Integrated community programmes
Community health workers/resourcepersons
Built health training institutions andproduced appropriate cadres
Essential medicine lists
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Performance of Health Systems
Challenges
Decreasing expenditure of health
Increasing cost of services includingtraining
Human resources for health crisis
Weak capacity at the decentralized levels
Heavy burden of disease – HIV/AIDS,Malaria, Tuberculosis
Move from community participation andinvolvement to empowerment.
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Rationale for revitalization of PHC
PHC is central to delivering on
Equity
Social justice
Solidarity
Universality
Accountability
Responsiveness
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Actions for revitalization of PHCand strengthening Health Systems
Stewardship
Set equity goals monitored throughregular surveys, oversight and leadership.
Strengthen regulatory frameworks
Institutional framework for communityempowerment and development
Governance – efficient and effective useof resources
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Actions for revitalization of PHCand strengthening Health Systems
Health financing
Fairness in financing – benefit-incidenceanalysis
Increasing allocation to health – directedtowards priorities
Social protection from catastrophicexpenditures through health riskssharing.
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Actions for revitalization of PHCand strengthening Health Systems
Service delivery
Building managerial capacities at the districtand sub-district levels
Evidence-based HRH policies for multiskilled,motivated, equitably distributed HRH
Procurement and supply chain management toensure availability of essential medicines andsupplies
Strengthening health information management
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Roles and Responsibilities
Empowered communities capable of providingoversight
Accountable governments committed toupholding health as a basic human right
Partners committed to increasing the level,predictability, flexibility and effectiveness of aidfor health activities to facilitate the achievementof the MDGs.
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MDG 1 ERADICATE EXTREME POVERTY AND HUNGER
MDG 4 Child Survival
Neonatal care, breastfeeding, weaning diets, growth monitoring, control ofdiarrhoeal disease and respiratory infections and malaria; vitamin A and iodinedeficiency, day nursery care, school health
MDG 2UniversalPrimaryEducation
MDG 3GenderEqualityEmpowerWomen
Curative Care, Maternal CareDisease Control, Basic ImmunizationsReproductive Health, Essential DrugsHealth Literacy, Food SecurityWater and Sanitation
MDG 5 Safe Motherhood
Maternal risk screening., Control of malaria and aneamia.Tetanustoxoid immunization. Pre-natal hospital beds, blood transfusion,Basic obstetric surgery. Cancer screening. Ambulance services
MDG 6 Healthy WorkforceAccident, violence, substance abuse prevention,mental/adolescent health, food safety Prevention ofHIV/AIDS, MALARIA, TUBERCULOSIS, other chronic noncommunicable diseases, healthy housing, rehabilitation,health insurance.
PRIMARY HEALTH CARE
MDG 7 ENSURE ENVIRONMENTAL SUSTAINABILITY
MDG 8 A GLOBAL PARTNERSHIP FOR DEVELOPMENT
THE MILLENNIUM GOALS – COMPLEMENTARY TO PRIMARY HEALTH CARE
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CENTRALLEVEL
1
INTERMEDIATELEVEL
2
INTERMEDIATELEVEL
2
COMMUNITYDIALOGUE
4
DISTRICTLEVEL
3
DISTRICT LEVEL
3
1- National health conference
2- Provincial health forum
3- District health meetings
4- Community health dialogue
ACHIEVING A CONTINUING
CONSENSUS FOR COMMUNITY HEALTH POLICIES
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The way forward
Explicit policies and plans
Complementary roles of communities,governments and partners
Involvement of civil society and theAfricans in the Diaspora
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THANK YOU
