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Are Complex Global Health Partnerships Worth It? In Peru, a Resounding “Yes.”

This blog was cross-posted from Chemonics and written by Ellen Eiseman

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This week at the World Health Assembly in Geneva, the Global Health Council, FSG and Chemonics hosted a session addressing the question: Are Complex Global Health Partnerships Worth It?

Before the audience got comfortable and the speakers took their seats at the front table, I noticed Peru’s Minister of Health, Dr. Anibal Veláquez Valdivia, had joined us, and felt a jolt of excitement. I had worked extensively on the Peru Quality Healthcare (QHC) program—a five-year initiative that emphasized partnerships in order to improve service delivery. Now, two years after that project closed, I wondered what the minister would say about the approach to partnering that the QHC program took.

chemonicsblog2My colleague, Dr. Oscar Cordon, was the first to speak. He talked about standardizing health care processes (through PIM, the Performance Improvement Methodology), the institutionalization of these processes through government, academia, and civil society alliances, and the development of national strategies and policies. He shared our results: consistent delivery of quality services, increased capacity of the health workforce, more local  engagement, and improved health outcomes.

And he emphasized how none of this would have been possible without the collaboration, coordination, and commitment of all levels of the health care system—and trust. Trust, he said, had been built among and between the members of the QHC program team and the ministry of health. The ministry was fully engaged, and by the end of the program, they took over the entire process as their own.

Sound too good to be true? It might have been easy for Oscar to paint a better or more successful picture than what had really happened. After all, how often do these complex partnerships really work?

Again, I wondered about the minister, even as he stepped to the podium. But when Dr. Veláquez began to speak, he validated the good relationships that had been established and the success of working towards a common goal. In addition, he shared the news of the advances they had made since the program closed:

  • chemonicsblog3The tools used in Performance Improvement Methodology (PIM) were adjusted and transferred to the Ministry of Development and Social Inclusion to design checklists for other social programs, including a) senior citizen welfare b) social conditional cash transfers and c) the First 1000 Days nutrition program for children under 3 years.
  • The checklist for assessments were incorporated into the National Survey of Health Care Facilities. These will be conducted on an annual basis under the direction of the National Institute of Informatics and Statistics, meaning they are fully institutionalized at the national level.
  • The experience achieved in Peru has allowed them to establish South-to-South collaboration and the minister himself has also provided technical assistance to the Ministry of Development in Guatemala. They have also shared their experience with other countries in the region and some of them are coming to visit and learn more about it.

This was news to me. As I translated for the minister, I knew I was smiling. When he said that they were providing technical assistance to other countries, sharing what we were able to do in Peru, I just had to stop and say, “wow!” in front of the entire auditorium. After I got over the embarrassment (and the minister stopped laughing), he concluded his remarks.

Dr. Veláquez had to leave shortly after, but all this week at the World Health Assembly, his words have stayed with me.

Now, when someone asks me, “are complex global health partnerships worth it?” I think about how Peru’s Ministry of Health owns performance improvement processes. I think about how it’s no longer a formula, but a mindset shared with the social security sector, the private sector, NGOs, and the community. I think about all the people that are getting better quality health care than they were before. Most importantly, I think about how working together for a common goal, creating a win-win situation, and treating one another with respect means anything is possible.

With no hesitation, I answer that question with a resounding “yes.”

Ellen Eiseman is a director in Chemonics’ health practice. This week, she was part of a delegation representing the company at the World Health Assembly in Geneva, Switzerland.

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Citizens Hearings Come to World Health Assembly

This guest post was provided by White Ribbon Alliance and written by Brigid McConville

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Watch a short film about the Citizens’ Hearings.

“We’ve got a gap of political accountability in the global process of the World Health Assembly. We can shine a light on what they are doing.”

Thus spoke Richard Horton, Editor-in-Chief of The Lancet and Co-Chair of the iERG (Independent Expert Review Group on Information and Accountability for Women’s and Children’s Health), when interviewed by White Ribbon Alliance Citizen Reporters during the UNGA last September.

And this week we did shine that light. Our ground breaking Global Dialogue between citizens and governments took place on May 21st at Geneva’s Palais de Nations. This is the first time citizens have ever been heard in this way during any World Health Assembly.

Richard Horton chaired the event, which featured citizens from Indonesia and Tanzania. Responses came from a number of government representatives, as well as from WHO’s Flavia Bustreo and Betsy McCallon from White Ribbon Alliance who also Chairs the NGO Constituency of PMNCH.

The Global Dialogue brought to Geneva the recommendations of Citizens Hearings which have now taken place in some 30 countries in numerous communities and districts, as well as at national level.

In this truly remarkable movement for citizen led accountability, tens of thousands of people, including health care providers, district leaders, and elected officials have met together to discuss what isn’t working and to come up with practical solutions.

Faridah Luyiga Mwanje from White Ribbon Alliance Uganda presents the Joint Statement of partners in the Citizens Hearings to Ban Ki-moon in New York, May 14th 2015.

Faridah Luyiga Mwanje from White Ribbon Alliance Uganda presents the Joint Statement of partners in the Citizens Hearings to Ban Ki-moon in New York, May 14th 2015.

Their collective recommendations call for citizens to be included in health planning, decision making and monitoring – at local level as well as at top table. Also key is how people can hold politicians to account for their rights to better reproductive health services – for women, newborns, children and young people.

Family planning, reproductive rights, adolescent health, budgets, emergency obstetric care – these are high on the citizens’ agenda and have already been shared with Ban Ki-moon as he updated the game changing 2012 Global Strategy for Women’s, Children’s & Adolescent’s health.

Meanwhile, accountability has emerged as THE buzzword at this year’s WHA, with increasing recognition that citizens have an immense role to play in making sure governments keep their promises to their people.

Citizens are not only calling on governments to account for their delivery on the Millennium Development Goals 4 and 5, but are now pushing for a strong accountability framework in the latest Global Strategy for Women’s, Children’s & Adolescents’ Health and within the Sustainable Development Goals. Citizens and civil society are ready to be part of progress into the future; we look to our leaders to respond.

 


Co-sponsored by the Governments of Bangladesh and Sweden, the Global Dialogue at the WHA68 was co-organised by White Ribbon Alliance, Save the Children, World Vision and IPPF.

It is the first of a series of Global Dialogue events focusing on citizen accountability in the context of RMNCAH, allowing space for a constructive dialogue between community representatives and their respective Member States.

A report from all the Hearings will be delivered to leaders this July before September’s UN General Assembly (UNGA) in New York, where the second ‘Global Citizens’ Dialogue’ event is planned.

More information and reports from the Citizens’ Hearings, including statements from Citizens, children, district leaders and politicians: http://www.citizens-post.org/

 

About the White Ribbon Alliance

Healthy mothers make a healthy world. White Ribbon Alliance unites citizens to demand the right to a safe birth for every woman, everywhere.   The Alliance formed because the voices of women at risk of dying in childbirth were not being heard. It rapidly grew as thousands of people and groups joined the network and is now the world’s biggest citizen-led coalition for maternal health   campaigning nationally and globally to persuade Heads of State to keep their promises and deliver on their commitments to maternal health.  The White Ribbon Alliance mobilise citizens and provide a platform for women and men to demand change.  More information:  www.whiteribbonalliance.org, Facebook.com/whiteribbonalliance, @WRAGlobal, #CitizensPost

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SIXTY-EIGHTH WORLD HEALTH ASSEMBLY PLENARY SESSION: BUILDING RESILIANT HEALTH SYSTEMS

This guest post was written by Gillian Franklin, MD, MPH, PhD, Yerby Postdoctoral Fellow, Harvard T.H. Chan School of Public Health.

May 18, 2015: The excitement filled my heart as I walked into the Palais des Nations wide-eyed and ready for the opening of the first day of the Sixty-eighth World Health Assembly (68th WHA). Of particular interest to me were the WHO Director-General Dr. Margaret Chan’s opening speech, and the invited speaker Angela Merkel, Chancellor of the Federal Republic of Germany address to the Assembly.

Chancellor Merkel addressed the Assembly, calling for a new plan to cope with issues such as the Ebola outbreak. She emphasized the urgent need for collaboration and a new action plan to respond swiftly in emergencies like the Ebola outbreak. She also stressed the importance of having well-designed, efficient infrastructures in place in such global emergencies.

Dr. Chan’s focus later in the day was on WHO reform as a result of lessons learned from the recent Ebola outbreak. She discussed developing and overseeing of a new program that will be faster and more flexible in addressing health emergency operations. In her words, “the world was ill-prepared to respond to an outbreak that was so widespread.”

On the second day of the 68th WHA I attended the plenary hearing where honorable delegates from various countries specified their quest for building resilient health systems in their respective countries, outlined goals, and emphasized their progress towards improving their country’s public health infrastructure in light of the Ebola outbreak. Some of the countries along with quotes from their honorable delegates included: Portugal (“…focus on health promotion and disease prevention…”), Chile (“…adapt and respond to disasters, such as tsunamis, landslides, forest fires, earthquakes…”), Poland (“…affordable drugs and vaccines…”), Malaysia (“…life course perspective…”), Islamic Republic of Iran (“…capacity building and the importance of a paradigm shift…”), Kenya (“…comprehensive plan to guide Ebola response…”), Spain (“…comprehensive health care and building health information systems…”), Slovakia (“…integrated health system model…”), and Haiti (“…coordinated responses and action plans…”).

It was an honor to meet the honorable delegate from Malaysia Datuk Seri Dr. S. Subramaniam, Minister of Health after he spoke about the consequences of the Ebola outbreak, and the lessons his country learned from observing this crisis in countries with poor health systems. Dr. Subramaniam further discussed the need for, and outlined the following seven components that he felt were of importance for building a resilient health system:

  1. Must have evidence based public health policies in place
  2. Must have proper linkages in the system
  3. Must have proper infrastructure and foundations to be able to respond
  4. Must have strong and interactive communications
  5. Must be adaptive and quick to respond
  6. Must have the ability to predict and respond to crisis
  7. Must have regular drills to test out these systems

Plenary session on Tuesday, 19 May 2015, day two of the 68th WHA as the honorable delegates address the Assembly.

The Honorable Delegate from Malaysia Datuk Seri Dr. S. Subramaniam, Minister of Health on day two of the 68th World Health Assembly, Tuesday, 19 May 2015

The 68th WHA was fertile ground for addressing the reforms needed, especially after the Ebola outbreak. A common theme from several countries included lessons learned form the recent Ebola health crises in countries with no or poorly built public health infrastructure. Countries set goals for improving their current public health infrastructure, and outlined priorities for building more resilient health systems for efficient disaster response in the future.

I look forward to the rest of the week’s 68th WHA events.

Full transcripts and videos of the Sixty-eighth World Health Assembly Speeches are available and can be viewed.

Harvard T.H. Chan School of Public Health: To advance the public’s health through learning, discovery, and communication.

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World Health Assembly: Civil Society and the Sustainable Development Goal (SDG) on Health

This blog was cross-posted from Leadership, Management & Governance Project and written by Jason Wright, Project Director

I am pleased to be in Geneva for the 68th World Health Assembly (WHA). On May 18 (Monday), I attended a workshop entitled Moving the Health Goal Forward: Civil Society Action on Indicators, Measurement, and Accountability sponsored by:

(I co-chair the GHC Board Membership and Development Committee, and I previously served as U.S. Director of the International HIV/AIDS Alliance.)

GHC Executive Director Christine Sow and AIDS Alliance Policy Manager Marielle Hart introduced the workshop.  They showed an AfGH video on Making Universal Health Coverage (UHC) a Reality.

Marielle chaired a first panel including:

Jennifer discussed the Summit on Measurement and Accountability for Results in Health:  A Common Agenda for the Post-2015 Era on June 9-11, 2015, in Washington.  She noted that global health leaders at the summit will endorse a Roadmap for Health Measurement and Accountability and a Five-Point Call to Action to:

  1. Increase the level and efficiency of investments by governments and development partners to strengthen the country health information systems in line with international standards and commitments
  2. Strengthen country institutional capacity to collect, compile, share, disaggregate, analyze, disseminate, and use data at all levels of the health system
  3. Ensure that countries have well-functioning sources for generating population health data, including civil registration and vital statistics systems, census, and health survey programs tailored to country needs, in line with international standards
  4. Maximize effective use of the data revolution, based on open standards, to improve health facility and community information systems including disease and risk surveillance, financial, and health workforce accounts, empowering decision-makers at all levels with real-time access to information
  5. Promote country and global governance with citizens’ participation for accountability through monitoring and regular inclusive transparent reviews of progress and performance at facility, subnational, national, regional, and global levels, linked to the health-related Sustainable Development Goals (SDGs)

Ties discussed developments in increasing measurement and accountability including the Health Metrics Network (HMN) and the Commission on Information and Accountability for Women’s and Children’s Health.  He noted that we have achieved a digital revolution but not yet a data revolution.  He cited the U.S. Government as the largest investor in health information and the Demographic and Health Survey (DHS) Program in particular.

Tim stated that “there is a lot of jargon around the results agenda.”  He noted interest in rationalizing and systematically investing in the agenda.  He also cited the U.S. Government as the largest investor in health information and stated that “we would be lost” without the DHS Program.

Marielle asked about the monitoring framework for UHC.  Ties noted that the framework was published last year and the first global monitoring report will be launched on June 12 in New York.

AfGH Coordinator Tim Roosen and CHESTRAD President Lola Dare discussed civil-society consultations on measurement and accountability.

Tim stated that “what we measure, we treasure.”  He discussed an AfGH technical meeting on April 23 and 24 in Brussels. An outcome document makes recommendations regarding:

  • Post-2015 global health indicators
  • National UHC monitoring
  • International public financing for health
  • Meaningful engagement of all stakeholders
  • Accountability of health providers

Lola noted that there are 27 accountability platforms and 21 reproductive, maternal, newborn, child, and adolescent health (RMNCAH) engagement platforms or programs.  She presented the results of One Voice Coalitionconsultations in six technical areas.  Her themes included:

  • Measure or perish
  • Lead, own, and tell
  • More money, better results

She noted the creation of a Youth Development Index.

Christine and Lola presented a draft Civil Society Statement on Measurement and Accountability for Health.  They indicated that there will be civil society meetings before and after the Summit on Measurement and Accountability for Results in Health on June 8 (Monday) in the afternoon and June 11 (Thursday) in the afternoon.

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GHC Submits Statements to the Sixty-Eighth World Health Assembly (WHA)

This year, GHC submitted seven statements to the WHA in collaboration with a member organizations. These statements can be found below (corresponding to their agenda items). All submitted statements will be recorded in the WHA’s final record.

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