World Health Organization

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Presentation transcript:

World Health Organization 30 August, 2018 Generating Evidence of Governance Contributions to Health Outcomes USAID – HFG workshop Washington, 23 July 2014

WHO as part of a broader picture [1/2] WHO has done a lot of efforts to put governance as a key element of the health system strengthening approach WHR 2000, Building blocks,WHR 2008, WHR 2010, System Thinking (AHSR&P),… Corporate or RO (EMRO, EURO, PAHO/AMRO…) Many areas (medicine, HR, Transplantations, …) The issue of governance is part of one of the 4 categories (HS) for the new WHO's General Programme of Work

WHO as part of a broader picture [2/2] The current work is influenced by overall priorities as determined by the Member States: Universal Health Coverage, People centered approach for service delivery, determinants of health and non communicable diseases, etc. Governance at country level is still largely shaped by external interventions (The Global Fund, GAVI, bilaterals, UN, others. [to be considered in the gap analysis]

What are we doing? (HGF perspective) [1/3] Support to the development of a health sector strategic vision (UHC) and/or design system at country level (policy and plans, strategies, NHA, etc) Participation and consensus orientation (national forums, implication of political decision makers,etc) M&E – accountability / transparency (Joint annual or mid term reviews) Coordination mechanisms (IHP+ among others))

What are we doing? (HGF perspective) [2/3] Development of tools: JANS, OneHealth (costing) NHA, etc Direct support to countries with ROs (at least 40: UE- Lux-WHO Partnership for UHC, CoIA,…) Measurement relates very often to undertaken activities, sometimes to programmes of interventions and rarely to policy

What are we doing? (HGF perspective) [3/3] All these efforts are generating information: how do we use it to demonstrate effects on health outcomes? Contribution vs attribution? How process analyses can help? Indicators, routine vs surveys? Quantitative vs qualitative? Examples: Tunisia, Tchad, Sierra Leone,…

What does it mean for us? In Sierra Leone [1/2]  Increase of Improved governance  HRH Policy launch [2013] HRH Strategic Plan launch HRH automated information system leadership training information Increase of Midwives' & auxillary's skills Increase of staff density 1/ 1500 to 1/ 620 inhab. Improved management … Free healthcare Launch [2010] Gaps in HR identified Resource mobilization Increase of salary Increase of number of staff  [EU-Lux-WHO UHC Partnership workshop, Ouagadougou, May 2014]

What does it mean for us? In Sierra Leone [2/2] Financial Mangement Assessment (FMA) FMA assessment required by some donors Number of Partners disbursing through the financial model in 2016 (any >1) Adhesion of other donors FMA report [2012] Financial Management System improvement joint Plan & arrangement [2014] Leadership & credibility of the MoH Building capacity @ MoH level Partners’ interest for a joint sector programme Health sector financial model to be replicated in all other government sectors [EU-Lux-WHO UHC Partnership workshop, Ouagadougou, May 2014]