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Collective action for better health outcomes
Strengthening the Humanitarian,
Development & Peace Nexus:
Fostering collaboration between the
emergency response programming and
health systems development
Collective action for better health outcomes
Humanitarian-Development Nexus in the news
Collective action for better health outcomes
Photo: WHO/C. Haskew
The Humanitarian-Development Divide
Humanitarian Principles/ IHL
Humanitarian Development
Substitution/parallel
Outlook
Coordination/Leadership
Planning Frameworks/Tools
Legal Frameworks
Types of Settings
Culture/Approach
5-10 years 6-12 months*
System-led: clusters
HRP/HNO
Sovereign Law, Aid effectiveness principles
Stable/Willing Fragile/ Unwilling
UNDAF/ CCA, NHP&SP, NAPHS
Government-led; IHP+/UHC2030
Complementarity
Humanitarian Principles/ IHL
Collective action for better health outcomes
Photo: WHO/C. Haskew
New Way of Thinking: 2016 Global Processes
Agenda for Humanity
“Reduce risks and vulnerabilities”
“leave no-one behind”
Agenda 2030
Collective action for better health outcomes
Photo: WHO/C. Haskew
Bridging the Hum-Dev Divide in Health
Joint Analysis
Define Collective Outcomes
Joint Planning
Life Saving
Assistance and
protection
Integration in
National Health
System
UHC & resilience:
Health System
Strengthening and
preparedness
Humanitarian Development
‘Joined Up’ Programming
Collective action for better health outcomes
Photo: WHO/C. Haskew
A new way of working
•Humanitarian interventions should apply early recovery approaches in the response, and seek integration with existing health services and transition of governance to local authorities
•Development oriented workstreams should target fragile and conflict affected areas in a more operational manner, addressing key bottlenecks in health system performance that also constrain the humanitarian response, with more flexibility in contracts and adapted management of risks.
•Fostering the interface between them through connections in analysis, planning and coordination
Collective action for better health outcomes
Photo: WHO/C. Haskew
HDPN for health
1. Collective outcome:
•SDG3: As overarching goal Universal Health Coverage: ensuring that people can use essential services when they need them without suffering financial hardship
•Preparedness of the health system and communities for shocks.
Collective action for better health outcomes
Collective outcome: UHC
Collective action for better health outcomes
Photo: WHO/C. Haskew
HDPN for health
2. Joint analysis: bringing together
•humanitarian assessments (MIRA/HNO/HeRAMS, etc),
•health sector performance/bottleneck/capacity assessment
•all hazard risk analysis (STAR, VRAM, PHRA, etc)
•context analysis
Collective action for better health outcomes
Photo: WHO/C. Haskew
HDPN for health 3. Joint operational planning at national & subnational level:
•Integrating where possible both humanitarian and development support in the operational plans.
•Multi Year HRP, using the health system analysis framework to identify priorities and opportunities for early recovery to connect with longer term health system recovery and resilience
•National Health Strategic Plan that prioritises areas and populations in most need, and preparedness for all hazards.
Collective action for better health outcomes
Photo: WHO/C. Haskew
HDPN for health Give example how humanitarian partners can support
health system strengthening for the HDN
1.Service delivery
2.Health workforce
3.Information
4.Medical products
5.Financing
6.Leadership/governance
See chapter on early recovery of the health cluster handbook
Collective action for better health outcomes
Humanitarian/emergency coordination, EOC Health development partner coordination (IHP+, etc)
Registration and mapping of all health partners Coordination for the recovery assessment and planning
Sub national emergency coordination Core functions and capacities for district health management
Accountability to Affected Populations People-centred and integrated health services
Focused capacity building of DHMT to supprt life saving functions Guidance for district, community and village health committees
Decentralisation policies
Humanitarian Response Plans National Health Strategy/policy planning (JANS)
Emrgency preparedeness and contingency planning Disaster Risk Management, IHR 2005
(selected) Morbidity surveillance IDSR
EWARNS EWARNS
HeRAMS SARA
Selected HIS indicators HMIS
Restore life saving services Restore basic services, and improve for access and performance
Essential Packages of (life saving) Health services Package of health services
Patient safety, and IPC
Progressive expansion of coverage and quality Universal Health Coverage
List of core life saving pharmaceuticals Essential medicine lists, by level of health facility
Drug and equipment donation guidelines Essential medical equipment lists, by level of health facility
Quality control of drugs procured by international partners Prequalification of suppliers
Standardised remuneration/incentives HRH policies and plans
Task shifting Staffing standards by level of health facility
Scaling up community outreach programs/CHWs Standard post descriptions
Training curricula for types of health workers
CHW policy
Services free at point of delivery Health financing policies, public funding, reduce OOP, PBF
(temporary) waiving of user fees Financial protection from catastrophic health expenditures
Recovery and Health System resilience
Coordination
Governance
HIS
Service delivery
Pharmaceuticals
and equipment
Financing
HRH
Response and Early Recovery
Collective action for better health outcomes
Photo: WHO/C. Haskew
Implementing HDPN for health
1. Focus on service delivery:
•Progressively expand access, coverage and quality of an Essential Package of Health Services (EPHS)
•Health financing with social & financial protection
•Address health system constraints for its implementation, and
•Address barriers to access services from HH/community perspective
Collective action for better health outcomes
Photo: WHO/C. Haskew
Implementing HDPN for health
2. Preparedness for acute emergencies
•Preparedness and risk management for all hazards, including health security and IHR core capacities
• Strengthen national EWARS, investigation, control and response capacities (including for example scaling up epidemic related treatment centres)
•Health system strengthening for preparedness: ensure integration in NHSP, and respective policies for health system components
•Essential Public Health Functions in fragile contexts
Collective action for better health outcomes
Photo: WHO/C. Haskew
3. Governance & partnership:
• Coordination architecture that provides links between humanitarian and development partners, as well as intersectoral connections
• Maintaining health governance, in particular at subnational level: District Health Management & community engagement
• Platform for policy dialogue, based on joint analysis, planning and monitoring
• Conflict sensitive programming, Health as a Bridge for Peace
• Commitment to humanitarian principles & principles for Aid Effectiveness
Implementing HDPN for health
Collective action for better health outcomes
HEALTH
programme EMERGENCIES
A new way of working
Funding and financing:
•Increased public funding and local resources
•Predictable and flexible humanitarian and development funding to support HDPN
•Avoid the humanitarian development funding gap
•Create dedicated emergency pooled funds for health (e.g. to reimburse loss of revenue due to user fee waiver policies, subsidise access to medicines, scale up service delivery for epidemics, etc)
•Pilot different provider payment mechanisms in protracted emergencies, complemented by demand side financing