1. The comparative strengths and advantages – faith-based networks in health programmes Presentation by: Dr Renier Koegelenberg NRASD Health and Community Care Programme, SA Ahimsa Round Table on Global Health and Faith based Communities 16-18 June 2013, Lyon, France

2. Presentation Outline 1.Introduction 2.Poverty in a rich country: South Africa 3.Challenges of healthcare in South Africa 4.Challenges of religious healthcare programmes 5.NRASD health and community care programme 6.Conclusion 7.Challenges and gaps

3. Introduction 1.Historic role 2.Current role 3.Potential - primary healthcare (WHO) 4.Weaknesses & strengths

4. Poverty in a rich country -SA legacy of colonialism and apartheid 50% of the population lives in chronic poverty; 40% of the potential labour force is unemployed; The richest 20% receives 74.3% of all income; 3.4% of income goes to the lower 30% of population not limited to rural, remote areas

5. Challenges of healthcare in SA 1.175 th out of 190 countries – South Africa has 5.5 doctors per 100,000 people 2.Burden of disease: – HIV/AIDS and TB – maternal and child morbidity and mortality; – non-communicable diseases – violence, injuries and trauma

6. Priorities to address challenges Developing strong leadership to turn around healthcare outcomes; Implementing a National Health Insurance (NHI); Overhauling healthcare systems and management; Improving human resources and physical infrastructure; Accelerated implementation of an HIV/AIDS plan and reduction of TB deaths; etc.

7. Challenges of religious healthcare 1.Competition for scarce resources; 2.Unintended negative consequences of donor principles – E.g. PEPFAR ART programme – Global Fund programme – Financial concepts versus caring communities

8. NRASD Programme Developing strong leadership to turn around healthcare outcomes; The ambiguity of religious communities Responding to shortage of doctors, nurses Establishing smart partnerships

9. Conclusion Tension: a biomedical versus a holistic and human behaviour approach Tension: investment language versus caring communities Challenge: cooperation between sectors

10. Challenges/gaps Balance between emergency, vertical responses - more horizontal, sustainable solutions Flexibility & smart partnerships Challenge to keep qualified staff Foster inter-sectoral partnerships (leverage) Community system strengthening – based on local needs