This discussion paper argues for the development of an advocacy agenda to promote comprehensive health systems development in developing countries. It aims to promote discussion amongst health policy experts and civil society organisations (CSOs) about the need for and content of a health systems advocacy agenda. This document is intended to stimulate discussion and is accompanied by a pro-forma document to facilitate your comments, opinions and recommendations in shaping the content of a health systems development agenda and the way forward for appropriate health care systems development.
Equitable health services
A health systems development agenda for developing countries: Time to be clear and visionary
Global Health Watch
Demand for health care services in Uganda: Implications for poverty reduction
Sewanyana S, Nabyonga JO, Kasirye I, Lawson D: World Institute for Development Research (WIDER), 2006
Using the 2002/3 Uganda National Household Survey data, this study examines the nature and determinants of individuals' decisions to seek care on condition of reporting illness. A nested logit model, which captures correlations among health care provider alternatives, is used to estimate a behavioural model for health care demand. The three options in the model are: no-care, and formal care (public or private health care).
Essential Health Services workshop in South Africa
Oxfam International, August-September 2006
This two-day gathering begun with participants noting their concerns and expectations about the state of essential services in general, as well as the workshop itself. Oxfam said the purpose of the workshop was to welcome participants’ input in shaping Oxfam’s thinking on essential services, and though Oxfam chose to focus on health, education and water internationally, participants should point the report in the right direction.
Access to vaccines: Obstacles and solutions
Arnodei I: Geneva Health Forum, 31 August 2006
More than 2,600,000 deaths have been prevented in 2003 thanks to the Hepatitis B vaccine currently available. This is only one impressive example of the benefits of good vaccination and immunisation programmes. Although vaccination programmes are very cost-efficient, costing as less than 1,000 USD per life saved, the world still faces over 100,000 neonatal tetanus deaths and over 400,000 deaths from measles per year. The international community has a very ambitious plan: to completely eradicate diseases which are preventable by global vaccine coverage. How can such a goal be accomplished?
Breathing life into DRC's sick hospital
Winter J: BBC News International, 8 August 2006
This story describes the experience of Professor Stanis Wembonyama as director of the main hospital in Democratic Republic of Congo's second city, Lubumbashi, last year. Gecamines, the state-owned mining monopoly used to be in charge - theoretically - of the Jason Sendwe Hospital, but the institution had been left to rot. Most of the beds had been either stolen or stripped down and sold as scrap metal. Doctors and nurses had not been paid their salaries for five years and so they earned their living by demanding cash before treating their patients. The story outlines the steps to clean up the hospital and instil management discipline.
Critical view on the role of hospitals in increasing access to health
Krebs V: Geneva Health Forum, 1 September 2006
Hospitals have always played a pivotal role in the global healthcare system. They have power, authority and professional competences in both the rich and poor worlds. But what if we all begin to re-think the mission of hospital care and re-design the way we deliver it in order to increase access to health? The moment has arrived for reform in order to achieve optimal care, to learn from examples of real innovation and disseminate this knowledge, sharing ideas as well as best practices. For example one speaker at this session of the August 2006 Geneva Health Forum noted that the mission of hospitals has shifted from delivering specialized care to our patients; to responsibility for the care in our region; to promoting health to all our citizens.
Disease control programmes: Undermining comprehensive care?
Krebs V: Geneva Health Forum, 1 September 2006
What is the best way to address the health care needs of an underserved population? Is it through disease prevention or is it through a more comprehensive and coordinated approach? According to a session of the August 2006 Geneva Health Forum integration of the two approaches is the key to a successful health care delivery system, providing wider access to a greater number of the population. The vertical approach is disease-centred, while the horizontal approach is patient-centred. The use of resources in a vertical approach is dictated by a centralized authority, while the horizontal approach encompasses area-wide planning at the centre with final decision-making devolved to the local or district level. Experiences reported from Uganda and Tanzania indicated limitations of the vertical approach and the better results provided by the adoption of a horizontal approach.
Ensuring access to health care for migrants
Berry S: Geneva Health Forum, 31 August 2006
The fifth largest nation in the world does not have sufficient access to health. Indeed if migrants were seen as a country, they would represent a significant nation in terms of population. How can we explain that so many people do not have access to health care? The focus of this symposium, chaired by Angela Davies from the International Organization of Migration (IOM) and Sandro Cattacin from the University of Geneva, was on the unequal provision of health services for migrants.
Improving health, connecting people: The role of ICTs in the health sector of developing countries
Chetley A: InfoDev, 31 May 2006
This framework paper is aimed at policy makers who are involved in the development or management of programmes in the health sector in developing countries. It provides a ‘snapshot’ of the type of information and communication technology (ICT) interventions that are being used in the health sector, and the policy debates around ICTs and health. It draws from the experience of use in both the North and South, but with a focus on applicability in the South to identify the most effective and relevant uses of ICTs.
How can food security interventions be improved to protect livelihoods in the Greater Horn of Africa?
Humanitarian Policy Group, ODI: Eldis , 2006
This Briefing Note reviews the extent of emergency livelihoods responses during the most recent drought and resulting food crisis in the Horn of Africa. Drawing on secondary data and interviews with national and international actors in affected areas, it asks why accurate and timely early warning did not lead to a rapid and appropriate response to mitigate the drought’s effects, and highlights how inadequate contingency planning, limited capacity in livelihoods programming and inflexible funding mechanisms resulted in delays and deficiencies in livelihoods interventions, and the predominance of food assistance in the emergency response.