Making Lemonade Out of Lemons

CORE GHPC 2015 Closing Plenary

April 17, 2015

Janine Schooley, PCI

Gillian McKay, GOAL Global

How to Optimize Health System Strengthening instead of Running from One

Crisis to Another

For Your Consideration For the Next 90 Minutes

Let’s Think “Recommissioning” not “Decommissioning”

Plan

Context

Case Study

Recap of Key Issues

Group Discussion

Presentation of Highlights from Discussion

Lemons by Themselves: Pretty Sour

In thinking about the Ebola Response, we are at risk of:

Withering away the momentum

Neglecting to integrate new healthcare workers into the Health Care System

Allowing new infrastructure (like ETCs) to rot away

Continuing to allow the Health System to omit Communities

Perpetuating parallel health care systems

Might as well just sit and wait for the next crisis!

Ebola in Sierra Leone: A Case Study

A World Before Ebola

Health System Community

EBOLA

Stage 1: Health Systems Medicalized Approach

Step 2: Social Mobilization & Community Engagement

Are We Making Lemonade in Sierra Leone? Government is Leading on Early Recovery

Prioritization with Partner Support:

Restoration of Health Services and Build a Resilient Health System

Reopen Educational Facilities

Enhance Food Security Initiatives

Expand WASH

Increase Private Sector Participation

Expand Social Protection Services

Close the Deficit

GREAT PRIORITIES, no question! But is this enough? How do we mitigate the backlash?

Some LemonAID…

Keen Donor and NGO engagement for long term recovery efforts

But much remains Top-Down

Medicalized Approaches

Infection Prevention & Control

WASH

Triage

“Core” ETCs

Emergency Obstetric Care

Surveillance/Social Mobilisation Efforts

Communicable-disease preparedness

Immunisation programming

Data Collection and Analysis

A Voice from the Field “I think it would be of great benefit if the current structures are maintained. In the first place, it encourages involvement of local people in decision making as well as the use of local resources in addressing problems. I strongly believe that one of the key reasons why we initially struggled to contain the Ebola outbreak was because local people felt left out in the response. Once that was rectified we have increasingly seen the power held by tribal, local, religious leaders, youths and women at the ward level to solve problems. I would love to see biweekly meetings at ward level even after Ebola to address any other problems or spikes that may arise.”

Sulaiman Bah

Peer Supervisor

Social Mobilisation Action Consortium

Let’s ALL Make Lemonade and Then Actually DRINK It!!

Let’s Capitalise on Strengths and Momentum!

Infrastructure

Human Capacity

Social Capital & Determinants

Services and Systems

And Let’s Make It Sweeter!

Let’s Advocate for the Community to DRIVE the Process!

Human Centred Design to decide what to do with ETUs/ETCs/CCCs

Integration of Skilled Workers in System

Capitalise on New and Existing Community Networks

Rebuild Trust in Services and System

Let’s ask (and answer) the question:

What COULD the system look like in 10 years if the community were driving Decision Making?

Discuss HOW the Lemonade Is Made:

What clear steps can be taken internally within your own organization?

What can CORE do as a community in terms of an advocacy platform to push these ideas forward?

Thank you!