ABSTRACT
Understanding Health systems have now become the priority focus of researchers and policy makers, who have progressively moved away from a project-centred perspectives. The new tendency is to facilitate a convergence between health system developers and disease-specific programme managers in terms of both thinking and action, and to reconcile both approaches: one focusing on integrated health systems and improving the health status of the population and the other aiming at improving access to health care. Eye care interventions particularly in developing countries have generally been vertically implemented (e.g. trachoma, cataract surgeries) often with parallel organizational structures or specialised disease specific services. With the emergence of health system strengthening in health strategies and in the service delivery of interventions there is a need to clarify and examine inputs in terms governance, financing and management. This present paper aims to clarify key concepts in health system strengthening and describe the various components of the framework as applied in eye care interventions.
ABSTRACT
This report describes some of the interventions; debates; discussions and conclusions from the conference `Mobilising the African Diaspora Healthcare Professionals for Capacity Building in Africa'; which was held in London from 21-22 March 2006. Voices in the report come from many diverse stakeholders; including health ministers from Africa; civil society; donors and the diaspora. The conference was organised to create a stimulating and interactive forum to discuss the crisis in human resources for health; in an effort to influence national; regional and international policies for the promotion of sustainable skills capacity in Africa and to engage the African diaspora in innovative; practical steps to move the agenda forward. The report describes the nature of the problem; while examining the causes and possible ways forward; concluding with recommendations on how to plug the gap of one million healthcare professionals needed by Africa today; to reach its millennium Development Goals (MDGs) for health.3 2006 has been dedicated; by the World Health Organization (WHO); to human resources for health. The 2006 World Health Report focuses on the human resource crisis and is entitled Working Together for Health. It was launched in Zambia on 7 April; World Health Day. This report will be used as an advocacy tool in various international health fora (like the Commonwealth Health Ministers meeting and the World Health Assembly (WHA)) to ensure that the voices from this meeting are heard and are able to influence strategies and policy discussions. It must be noted; however; that while adequate representation cannot be secured in a short meeting and voices from such a diverse group will not be homogeneous; opportunities must be sought to harness the valuable skills of the diaspora. There are many innovative mechanisms described in this report; but it is only by involving the diaspora in context-specific planning; research; training; advocacy and policy formation that their support can be used to help strengthen Africa's health systems. The meeting heard calls for donors to fund the recommendations from the Commission for Africa to give more financial support to healthcare ($1-6bn for human resources and $9bn for strengthening health systems) while calling for African nations to meet their promised Abuja target of spending 15 per cent of their national budgets on health. The diaspora was asked to support national ministry plans while countries were advised to carry out detailed human resource gap analyses; and to use their consulates to develop databases for migrant health workers willing to return home to work. Positive retention policies - includingimproved salaries; working conditions; rural post incentives; enhanced career opportunities and improved mechanisms to return home - were put forward as ways to improve staff motivation andretention. The issues of HIV and conflict were highlighted along with poverty and economic policies as causal factors in a growing global health worker market. Save the Children UK called on the UK government to pledge 10 per cent ($100 million annually) of the $1bn needed; by 2007; to support the training and retention of 100;000 health workers in Africa as part restitution for the unjust subsidy the UK NHS and Department of Health receive from African health systems through health worker migration