Prof. G. L. Monekosso WHO Regional Office for Africa.

Prof. G. L. MonekossoWHO Regional Office for Africa

28/04/08 Ouagadougou, Burkina Faso 2

Outline of the Presentation

1. Background

2. Performance of Health Systems in the African Region

3. Rationale for revitalization of PHC

4. Actions for revitalization of PHC and strengthening Health Systems

5. Roles and Responsibilities of stakeholders

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Background

Progress in health before and after Alma Ata

Strengths, weaknesses, opportunities and challenges over 30 years

Summary of achievements of countries between Alma Ata and the Millennium Conference

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Performance of Health SystemsAchievements Creation of health districts Partnership with non-public health

providers Integrated community programmes Community health workers/resource

persons Built health training institutions and

produced appropriate cadres Essential medicine lists

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Performance of Health SystemsChallenges Decreasing expenditure of health Increasing cost of services including

training Human resources for health crisis Weak capacity at the decentralized levels Heavy burden of disease – HIV/AIDS,

Malaria, Tuberculosis Move from community participation and

involvement 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 PHC and strengthening Health Systems

Stewardship Set equity goals monitored through

regular surveys, oversight and leadership. Strengthen regulatory frameworks Institutional framework for community

empowerment and development Governance – efficient and effective use

of resources

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Actions for revitalization of PHC and strengthening Health Systems

Health financing Fairness in financing – benefit-incidence

analysis Increasing allocation to health – directed

towards priorities Social protection from catastrophic

expenditures through health risks sharing.

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Actions for revitalization of PHC and strengthening Health Systems

Service delivery Building managerial capacities at the district

and sub-district levels Evidence-based HRH policies for multiskilled,

motivated, equitably distributed HRH Procurement and supply chain management to

ensure availability of essential medicines and supplies

Strengthening health information management

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Roles and Responsibilities

Empowered communities capable of providing oversight

Accountable governments committed to upholding health as a basic human right

Partners committed to increasing the level, predictability, flexibility and effectiveness of aid for health activities to facilitate the achievement of 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 of diarrhoeal disease and respiratory infections and malaria; vitamin A and iodine deficiency, day nursery care, school health

MDG 2 Universal Primary Education

MDG 3 Gender Equality Empower Women

Curative Care, Maternal Care Disease Control, Basic Immunizations Reproductive Health, Essential Drugs

Health Literacy, Food Security Water and Sanitation

MDG 5 Safe Motherhood

Maternal risk screening., Control of malaria and aneamia.Tetanus toxoid immunization. Pre-natal hospital beds, blood transfusion, Basic obstetric surgery. Cancer screening. Ambulance services

MDG 6 Healthy Workforce Accident, violence, substance abuse prevention, mental/adolescent health, food safety Prevention of HIV/AIDS, MALARIA, TUBERCULOSIS, other chronic non communicable 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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CENTRAL LEVEL

1INTERMEDIATE

LEVEL

2

INTERMEDIATE LEVEL

2

COMMUNITY DIALOGUE

4

DISTRICT LEVEL

3

DISTRICT LEVEL

3

1- National health conference

2- Provincial health forum

3- District health meetings

4- Community health dialogue

ACHIEVING A CONTINUINGCONSENSUS 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 the Africans in the Diaspora

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THANK YOU