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55thth AFRICAN CONFERENCE ON SOCIAL ASPECTS OF HIV/AIDS RESEARCH AFRICAN CONFERENCE ON SOCIAL ASPECTS OF HIV/AIDS RESEARCH 2009.2009.
WHO Regional Office for AfricaWHO Regional Office for Africa
Heath system responses and need Heath system responses and need Heath system responses and need Heath system responses and need Heath system responses and need Heath system responses and need Heath system responses and need Heath system responses and need
for changed multisectoral for changed multisectoral for changed multisectoral for changed multisectoral for changed multisectoral for changed multisectoral for changed multisectoral for changed multisectoral
approaches to improve the health of approaches to improve the health of approaches to improve the health of approaches to improve the health of approaches to improve the health of approaches to improve the health of approaches to improve the health of approaches to improve the health of
migrantsmigrantsmigrantsmigrantsmigrantsmigrantsmigrantsmigrants
55THTH AFRICAN CONFERENCE ON SOCIAL ASPECTS OF HIV/AIDS RESEARCHAFRICAN CONFERENCE ON SOCIAL ASPECTS OF HIV/AIDS RESEARCH
Gallagher Estate, Midrand, South AfricaGallagher Estate, Midrand, South Africa
30 November30 November-- 3 December 20093 December 2009
Dr. H. SomanjeMO/HPS/DSD/AFRO
55thth AFRICAN CONFERENCE ON SOCIAL ASPECTS OF HIV/AIDS RESEARCH AFRICAN CONFERENCE ON SOCIAL ASPECTS OF HIV/AIDS RESEARCH 2009.2009.
WHO Regional Office for AfricaWHO Regional Office for Africa
OutlineOutline
Background
Health Systems challenges related to migration
Health system responses and expected outcomes
Needed multisectoral changes
The primary health care framework for change
Conclusion
55thth AFRICAN CONFERENCE ON SOCIAL ASPECTS OF HIV/AIDS RESEARCH AFRICAN CONFERENCE ON SOCIAL ASPECTS OF HIV/AIDS RESEARCH 2009.2009.
WHO Regional Office for AfricaWHO Regional Office for Africa
Background
� The number of migrants in all forms is increasing in Africa
� about 2% of Africa’s population – increasing health service needs
� In 2008, there emerged a number paradigm shifting documents
� The final report of the WHO commission on Social determinants of health
� The Ouagadougou Declaration on Primary Health Care and Health Systems
� The 2008 World Health Report on Primary Health Care – Now More Than Ever
� World Health Assembly Resolution 61.17 on the Health of Migrants
� All the above documents emphasize on the enjoyment of health services as a
human right by all regardless of whether they are migrants or not
� Migrants still face a lot of challenges related to access and utilisation of health
services
55thth AFRICAN CONFERENCE ON SOCIAL ASPECTS OF HIV/AIDS RESEARCH AFRICAN CONFERENCE ON SOCIAL ASPECTS OF HIV/AIDS RESEARCH 2009.2009.
WHO Regional Office for AfricaWHO Regional Office for Africa
HEALTH SYSTEMS CHALLENGES RELATED TO MIGRATION
� Health outcomes can be influenced by the multiple dimensions of migration� Legal status
� Employment opportunities
� Social exclusion
� Some groups of migrants experience increased health risks� Legal status, Employment opportunities, Social exclusion
� Internally displaced
� Health needs of migrants are not fully considered in the framework of the broader agenda on migration and development
� Inadequate data on migrants’ health and their access to health care to substantiate evidence-based policies
� Inadequate focus on utilisation of health services as a human right when promoting social inclusion
55thth AFRICAN CONFERENCE ON SOCIAL ASPECTS OF HIV/AIDS RESEARCH AFRICAN CONFERENCE ON SOCIAL ASPECTS OF HIV/AIDS RESEARCH 2009.2009.
WHO Regional Office for AfricaWHO Regional Office for Africa
Health system responsesHealth system responses
All organisations, people and actions All organisations, people and actions whose primary intention is to promote, whose primary intention is to promote,
restore and maintain healthrestore and maintain health
HEALTH SYSTEMS BUILDING BLOCKS HEALTH SYSTEMS BUILDING BLOCKS AND THEIR OUTCOMESAND THEIR OUTCOMES
IMPROVED HEALTHIMPROVED HEALTH(level and equity)(level and equity)
RESPONSIVENESSRESPONSIVENESS
SOCIAL AND FINANCIAL SOCIAL AND FINANCIAL RISK PROTECTIONRISK PROTECTION
IMPROVED EFFICIENCYIMPROVED EFFICIENCY
ACCESSACCESS
COVER AGECOVER AGE
QUALITYQUALITY
SAFETYSAFETY
SYSTEM BUILDING BLOCKSSYSTEM BUILDING BLOCKS OVERALL GOALS / OUTCOMESOVERALL GOALS / OUTCOMES
The six building blocks and their The six building blocks and their priority areas priority areas
BUILDING BLOCK PRIORITY AREAS
SERVICE DELIVERY Packages, Delivery models, Infrastructure, Management, Safety & quality and Demand for care
HEALTH WORKFORCE
National workforce policies and Investment plans; Advocacy; Norms, standards and Data
INFORMATION Facility and population based information & surveillance systems; Global standards, tools
MEDICAL PRODUCTS, VACCINES & TECHNOLOGIES
Norms, standards, policies; Reliable procurement; Equitable access; Quality
FINANCING National health financing policies; Tools and data on health expenditures; Costing
LEADERSHIP/ GOVERNANCE
Health sector policies; Harmonization and alignment; Oversight and regulation
55thth AFRICAN CONFERENCE ON SOCIAL ASPECTS OF HIV/AIDS RESEARCH AFRICAN CONFERENCE ON SOCIAL ASPECTS OF HIV/AIDS RESEARCH 2009.2009.
WHO Regional Office for AfricaWHO Regional Office for Africa
Ouagadougou Declaration Priority AreasOuagadougou Declaration Priority Areas
55thth AFRICAN CONFERENCE ON SOCIAL ASPECTS OF HIV/AIDS RESEARCH AFRICAN CONFERENCE ON SOCIAL ASPECTS OF HIV/AIDS RESEARCH 2009.2009.
WHO Regional Office for AfricaWHO Regional Office for Africa
Needed Multisectoral Changes 1/2Needed Multisectoral Changes 1/2
•• Is there need for change?Is there need for change?
Albert EinsteinAlbert EinsteinThe problems we face today cannot be solved at the The problems we face today cannot be solved at the
same level of thinking we were at when we created same level of thinking we were at when we created themthem
Mahatma GhandiMahatma GhandiThe difference between what we are doing and what The difference between what we are doing and what
we are capable of doing would solve most of the we are capable of doing would solve most of the worlds problemsworlds problems
Stephen CoveyStephen CoveyWe cannot continue what we are currently doing and We cannot continue what we are currently doing and
expect different resultsexpect different results
55thth AFRICAN CONFERENCE ON SOCIAL ASPECTS OF HIV/AIDS RESEARCH AFRICAN CONFERENCE ON SOCIAL ASPECTS OF HIV/AIDS RESEARCH 2009.2009.
WHO Regional Office for AfricaWHO Regional Office for Africa
Needed Multisectoral Changes 2/2Needed Multisectoral Changes 2/2
•• Critical sectors include those responsible for:Critical sectors include those responsible for:conditions of their legal status, employmentconditions of their legal status, employmenthousing, education, occupational health, housing, education, occupational health, nutrition and food security, environmental nutrition and food security, environmental conditions conditions and access to water and sanitationand access to water and sanitation
•• Adopt the primary health care framework in Adopt the primary health care framework in ensuring universal coverage, people ensuring universal coverage, people centeredness in all policies, planning, centeredness in all policies, planning, implementation and inclusive leadership implementation and inclusive leadership
•• However, partners need to be coordinated to However, partners need to be coordinated to support countries in a harmonised and aligned support countries in a harmonised and aligned mannermanner
55thth AFRICAN CONFERENCE ON SOCIAL ASPECTS OF HIV/AIDS RESEARCH AFRICAN CONFERENCE ON SOCIAL ASPECTS OF HIV/AIDS RESEARCH 2009.2009.
WHO Regional Office for AfricaWHO Regional Office for Africa
Framework for implementing the Changes
� Adopt the primary health care framework in ensuring
• universal coverage reforms,
• people centeredness reforms
• inclusive leadership reforms
• an all government public policy
55thth AFRICAN CONFERENCE ON SOCIAL ASPECTS OF HIV/AIDS RESEARCH AFRICAN CONFERENCE ON SOCIAL ASPECTS OF HIV/AIDS RESEARCH 2009.2009.
WHO Regional Office for AfricaWHO Regional Office for Africa
Linkages Linkages -- PHC Reforms & Ouagadougou PHC Reforms & Ouagadougou DeclarationDeclaration
Community Partic
ipation
Community Partic
ipation
Health Technologies
Health Technologies
Health Financing
Health Financing
Human Resources for H
ealth
Human Resources for H
ealth
Health Service delivery
Health Service delivery
Community ownership & participation
Community ownership & participation
Health information,
Health information,
Research for health
Research for health
Leadership and Governance
Leadership and Governance
Health information
Health information
Research for health
Research for health
Community ownership
Community ownership
Community Ownership and Participation
Community Ownership and Participation
Partnership for health development
Partnership for health development
Health Financing
Health Financing
55thth AFRICAN CONFERENCE ON SOCIAL ASPECTS OF HIV/AIDS RESEARCH AFRICAN CONFERENCE ON SOCIAL ASPECTS OF HIV/AIDS RESEARCH 2009.2009.
WHO Regional Office for AfricaWHO Regional Office for Africa
Primary care as a hub of coordination
55thth AFRICAN CONFERENCE ON SOCIAL ASPECTS OF HIV/AIDS RESEARCH AFRICAN CONFERENCE ON SOCIAL ASPECTS OF HIV/AIDS RESEARCH 2009.2009.
WHO Regional Office for AfricaWHO Regional Office for Africa
ConclusionConclusion
Legislation to minimise the discrimination of migrants in accessing their health and other social needs
Equitable allocation of resources during the budget sessions to all social sectors: health, agriculture, education, water, communication, energy, infrastructure development etc
Ensuring community involvement in implementation of the Primary Health Care reforms based on an all government approach
Dee Hock: ““ The problem is never to get new The problem is never to get new innovative thoughts into your mind, but how to get innovative thoughts into your mind, but how to get the old ones outthe old ones out ””