1. Eidgenössisches Departement für auswärtige Angelegenheiten EDA Direktion für Entwicklung und Zusammenarbeit DEZA Health Projects in Eastern Europe & Central Asia Synergies, collaboration and knowledge sharing: progress and way forward SDC EECA Regional Learning Event Bishkek, 5th of November 2015

2. Eidgenössisches Departement für auswärtige Angelegenheiten EDA Direktion für Entwicklung und Zusammenarbeit DEZA Presentation AR CIS 2012 « Health projects develop in parallel instead of collaboratively, knowledge and good practices are insufficiently exchanged» « Synergies can be exploited at different levels: operational, policy, capitalization, etc.»

3. Epidemiologic transition Double burden of diseases NCDs as leading cause of death and morbidity Prevalence of main behavioural risk factors (tobacco, alcohol, physical inactivity, unhealthy diet) Mental health disorders on the rise Decreasing MCH, still high MM, MDG4 ~reached Eidgenössisches Departement für auswärtige Angelegenheiten EDA Direktion für Entwicklung und Zusammenarbeit DEZA EECA Health Trends

4. Health systems reform: institutionnalization and decentralization of accessible and cost-effective PHC based on FM model Poor leadership/stewardship and governance Service delivery: limited access/coverage, still curative and hospital centered, poor quality, inefficient, limited responsiveness, weak PH services, poor management and technical efficiency Financing: underfunded, no/limited financial protection (high OOPs), unsustainable insurance schemes, weak management Health workforce: understaffing/overstaffing, brain drain, lack of GP, FN, CHW, lack of competencies, no task-shifting, unequal distribution Limited/poor quality medical products, weak HIS Eidgenössisches Departement für auswärtige Angelegenheiten EDA Direktion für Entwicklung und Zusammenarbeit DEZA EECA Health Systems

5. Health Systems Strenghtening, implementation of Health reforms Strenghtening PHC based on family medicine model, decentralization, autonomy of service providers NCDs control&prevention, mental health, cross-sectoral approach Strong focus on medical education and training (FD, FN) Focus on prevention and promotion at the community level Focus on health financing: financial risk protection, UHC, PBF, health facility management, cost-effectiveness, etc. Focus on equity, reducing exclusion and social disparities in health, social accountability Continuous policy dialogue, governance, anti-corruption, increasing stakeholder participation and coordination Eidgenössisches Departement für auswärtige Angelegenheiten EDA Direktion für Entwicklung und Zusammenarbeit DEZA SDC/OZA Health Portfolio

6. Priority areas to develop synergies&collaboration identified:  HSS, capacity building  PHC, FM  Medical education, training  Community health  Prevention, promotion  NCDs (MH included)  SRH  Health policy, advocacy, govenance  Capitalization 6 Eidgenössisches Departement für auswärtige Angelegenheiten EDA Direktion für Entwicklung und Zusammenarbeit DEZA Collaboration&Knowledge Sharing: Progress 2013-2014

7. Tool to «materialize» the collaboration elaborated and used for planning and monitoring 7 Eidgenössisches Departement für auswärtige Angelegenheiten EDA Direktion für Entwicklung und Zusammenarbeit DEZA Collaboration&Knowledge Sharing: Progress 2014-2015 CountryDemandExpertiseCollaboration/ exchange with Milestone&Type of collaboration/sharing Achievements as of January 2015 Planned/Timeframe BiH Development of Community- Based Mental Health Care services Moldova  Sharing CP on mental health reform in Moldova with BiH for comments/feedback  Exchange among project teams on topics of specific interest regarding mental health (coordinated care / continuous education in community mental health; exchange of documents, guidelines, training curricula) May 2014: Moldova shared the CP on community-based mental health with BiH for feedback and advice August 21-22th: Conférence Suisse de Santé Publique 2014, Olten (Switzerland) : presentation of the Mental Health Program in BiH by the NPO September 4 th : MGAP, WHO Geneva, presentation of SDC supported mental health programs in BiH and Moldova, in the frame of the parallel sessions 2015: common event on mental health (eventually in the frame of the regional OZA F2F) Autumn 2015: eventually, BBL on mental health Autumn 2015: eventual article on mental health in “Un seul monde” 2015: in collaboration with the SDC health focal point, selection of organizations active in mental health for an eventual institutional support (via the global program) Moldova Integration of NCDs in PHC Ukraine, Kyrgyzstan  Workshop PHC-focus on NCDs in Moldova: invitation of NPOs involved in PHC and NCD’s programs in Kyrgyzstan and Ukraine  Close collaboration with Ukraine in the preparation and implementation period (eventual joint reviews) July 2014: learning event on NCDs in Moldova, participation of health NPOs from Ukraine and Kyrgyzstan organized. 2015: Participation of the Ukraine Health NPO to the validation WS of the NCDs project in Moldova

8. Mental Health: Moldova program developed in close collaboration with BiH PHC/NCDs: internal learning/planning event on NCDs in Moldova, participation of health NPOs from Ukraine and Kyrgyzstan, output: new EP on PHC/NCDs MCH: capitalization meeting at HQ, dissemination of Perinatology capitalization work Moldova and Ukraine Medical education: Peer review in Tadjikistan with participation of MER project in Kyrgyzstan backstopper, participation of AKF representative (project on FM) 8 Eidgenössisches Departement für auswärtige Angelegenheiten EDA Direktion für Entwicklung und Zusammenarbeit DEZA Collaboration&Knowledge Sharing: progress 2014-2015

9. Health care waste management: dissemination of Kyrgyzstan experience/best practices Community health: capitalization event on CAH Kyrgyzstan organized with SRC; development of project factsheets Continuous exchange of information and documents: Tadjikistan tender document shared with Kosovo, HFA EP Kyrgyzstan shared with Kosovo Ukraine Summer School: participation of NPOs from Moldova and Romania OZA Regional learning and sharing event on health 2015, Bishkek, 2-5 November 2015 9 Eidgenössisches Departement für auswärtige Angelegenheiten EDA Direktion für Entwicklung und Zusammenarbeit DEZA Collaboration&Knowledge Sharing: Progress 2014-2015

10. Peer Review on Mental Health (BiH-MD) Learning trajectory on inclusion in the health sector Ukraine Summer school 2016 SDC basic indicators for health programs Side event/ministerial lunch WHO EURO 66 on home-based care/ageing care (Poland, Bulgaria, Moldova) with SRC SDC internal sounding board on Basket Funding/SWaP 10 Eidgenössisches Departement für auswärtige Angelegenheiten EDA Direktion für Entwicklung und Zusammenarbeit DEZA Collaboration&Knowledge Sharing: Planning 2016

11. Intensify thematic exchanges with WBA (new health portfolio) Intensify exchanges and collaboration with Global Health Program and Global program Water Enhance visibility: articles, conferences, ws, presentations, etc. Learning event on Policy Dialogue Encourage partners to identify opportunities for synergies and make concrete proposals to SCO/ OZA health advisor for financial or other support 11 Eidgenössisches Departement für auswärtige Angelegenheiten EDA Direktion für Entwicklung und Zusammenarbeit DEZA Synergies&Knowledge Sharing: next steps&challenges

12. 12 Eidgenössisches Departement für auswärtige Angelegenheiten EDA Direktion für Entwicklung und Zusammenarbeit DEZA What kind of synergies and/or collaboration are you interested in further developing? How can you better contribute to and promote the regional capitalization and exchange of experience?

13. If you want to build a ship, don't drum up people to collect wood and don't assign them tasks and work, but rather teach them to long for the endless immensity of the sea. Antoine de Saint Exupéry “If you want to build a ship, don’t drum up the men to gather wood, divide the work, and give orders. Instead, teach them to yearn for the vast and endless sea.” 13