MSH will host Universal Health Coverage Conference in Cape Town prior to Symposium

The post also appears on the SIAPS Program blog.

From September 28 to 30, 2014, global experts will convene in Cape Town, South Africa, in an invitation-only meeting organized by Management Sciences for Health (MSH) with funding from SIAPS to start a dialogue on medicines and universal health coverage (UHC). At last year’s meeting, it became clear that many national UHC plans do not give priority to medicines management. The meeting in Cape Town will focus on managing medicines in the context of UHC rollout. The meeting objectives are:

  • Sharing successful and unsuccessful experiences in how countries have incorporated medicines into their UHC strategies
  • Creating a shared understanding on how sound medicines benefits design and management can contribute to cost control
  • Building a case for use of evidence-based decision making in medicines benefits design and management
  • Sharing the pilot experiences of Namibia and South Africa as they implemented a new tool on medicines benefits management

For more information about this meeting and other UHC issues, please visit  www.uhc-medicines.org

 

Making Political Will Work for Health Systems

This post, written by Taylor Williamson and Derick Brinkerhoff, Health Policy Project, RTI International, originally appeared on the LMG For Health Project blog.

The Third Global Governance for Health Roundtable will be held in Cape Town, South Africa September 29-30th prior the the Third Global Symposium on Health Systems Research. The Leadership, Management & Governance (LMG) Project is collaborating on the Roundtable with the Health Policy Project and the Health Finance and Governance Project

Maternity care is free in Kenyan hospitals.Nearly 91% of Rwanda’s population is enrolled in a health insurance scheme. There are 2.4 million people on antiretroviral therapy in South Africa. What links these well-known examples of health system successes? Strong political will to improve health in these countries.

Commissioner of the Commission on Human Rights, Lauretta Vivian Lamptey, and Administrative Justice and the Director General of the Ghana AIDS Commission, Dr. Angela El-Adas, launch a partnership to protect the human rights of PLHIV and key populations. Photo Credit: Health Policy Project

Commissioner of the Commission on Human Rights, Lauretta Vivian Lamptey, and Administrative Justice and the Director General of the Ghana AIDS Commission, Dr. Angela El-Adas, launch a partnership to protect the human rights of PLHIV and key populations. Photo Credit: Health Policy Project

Political will is often only discussed in terms of its absence. How often have health systems experts heard that reform efforts were not achieved due to changes in the Ministry of Health, or that reform momentum ceased when donor funding ended?

Focusing on implementation failures reduces the concept of political will to the willingness and capacity of country officials to take responsibility for donor-funded programs.  For example, country officials are often willing to have donors fund programs, but balk at implementing complicated reforms or including donor priorities in national budgets.
The strength of a health system, however, depends on what country actors are willing and able to do, not just what donors will fund. To incorporate the perspectives of these country actors into the concept of political will, the USAID-funded Health Policy Project proposes a different approach to thinking about political will.

Reframing political will as the commitment of health system actors to act on policy objectives and sustain the costs of those actions over time can move country officials to the forefront of reform efforts. This approach places the responsibility of driving the reform process on country officials, who must formulate policy, implement programs that achieve their objectives, fund budgets to implement programs, and monitor program outcomes. Even when donor funding is available, political will requires the leadership of country officials to fulfill these roles.

Policymakers, implementers, and citizens are faced with the following questions that can inform the efforts of health systems experts to understand political will:

  • Where does the power to enact reforms rest? Are the willingness and capacity of individual decisionmakers, specific institutions, and/or a broader network of stakeholders taken into account?
  • What are the intentions of various health sector actors?  What motivates them to improve health systems? Can we infer that political will exists by observing budget allocations or public speeches?
  • Finally, what is the impact of civil society advocates? The media? Health providers? What about government structures and processes? Local variations in these influences can significantly affect the politics of health reform.

Based on these considerations, Derick Brinkerhoff, RTI International Distinguished Fellow in International Public Management, developed a model of political will that highlights seven components:

  1. Government initiative for policies and programs
  2. Choice of policies and programs based on scientific evidence and technically sound options
  3. Mobilization of stakeholders
  4. Public commitment and allocation of resources
  5. Design and application of credible incentives
  6. Continuity of effort
  7. Learning and adaptation

These components can be rated on a sliding scale to capture degrees of political will, from weak to strong.  They can also help health systems practitioners gain a greater appreciation for the political environment that supports health to improve their work identifying gaps and recommending reforms.

Reconsidering the “implementation failure” approach and applying a more rigorous analytical framework to political will can move health systems much closer to the goal of strengthening health systems for the long run, an aim shared by country officials, their citizens, and the international community.

LMG to host Third Global Governance for Health Roundtable

Good governance is essential to strengthening health systems and has the ability to greatly impact health services utilization and health outcomes. The Leadership, Management & Governance (LMG) Project is hosting the Third Global Governance for Health Roundtable to bring together thought leaders from across the world to explore trends and practices for good governance within the health sectors of low- and middle-income countries.

Photo Credit: Todd Shapera, 2013

Photo Credit: Todd Shapera, 2013

The two day event, held in Cape Town, South Africa, is organized in collaboration with the Health Finance and Governance (HFG) Project, and the Health Policy Project (HPP), and will address the following six themes:

  • Generating Evidence for Action: Measuring the impact of governance
  • Advancing health equity and access to health services through good governance
  • Inclusive Governance: Meaningful engagement of women and traditionally marginalized populations
  • Politics, policy, and effective governance for health
  • Governing in Decentralized Health Systems: Case studies from the field
  • Donors: Investing in good governance for health

The insights from the invite-only roundtable will be reported out at the Third Global Symposium on Health Systems Research at the Cape Town International Conference Centre. Please join us on Wednesday, October 1st from 4:30 – 6:00pm (room 1.63-1.64) in the session titled, “Governance that enables evidence for stronger health systems and greater health outcomes,” Dr. James Rice, Project Director, Leadership, Management & Governance, will moderate the session discussing:

  • breaking through the challenge of measuring the impact of good governance
  • the power of effective women engagement in modern governance arrangements for health services delivery and finance in the journey to UHC and equity
  • lessons about governance practices that unleash more significant and more sustainable health services research for health systems performance

Attending the Third Global Symposium on Health Systems Research? Check out the full schedule of LMG events or follow live updates on Twitter and Facebook.

Proceedings from the previous two Global Governance for Health Roundtables are available here. For more information, please contact Sarah Lindsay:slindsay@msh.org

Leadership, Management & Governance Project to share research at the Third Global Symposium on Health Systems Research

Join the Leadership, Management & Governance (LMG) Project at the Third Global Symposium on Health Systems Research in Cape Town, South Africa from September 30th – October 3rd. LMG will be participating in multiple sessions throughout the week to share research and results on the impact of governance on health systems. If you can’t make it to the sessions in person, follow them Twitter and Facebook for live updates from Cape Town.

Photo Credit: Mark Tuschman, Kenya, 2014

Photo Credit: Mark Tuschman, Kenya, 2014

Monday, September 29th
Satellite Session: Translation Science: Lessons learned in health system strengthening from PEPFAR
10h30-14h00
Room 2.65, Cape Town International Convention Centre
PEPFAR will offer two separate panels to explore translation science: lessons learned in health systems strengthening.
Panel One: PEPFAR contributions to health systems research and lessons learned, will focus on findings from PEPFAR that may be applicable beyond the HIV epidemic, with a focus on service delivery, finance and human resources for health. Presentations will include research from four PEPFAR implementing agencies.
  • Alexandra Zuber, Centers for Disease Control and Prevention, USA (moderator)
  • Karen Cavanaugh, United States Agency for International Development, USA
  • Lyn Middleton, Health Resources and Services Administration, USA
Panel Two: Innovative metrics for capacity-building and country-led programming, will highlight innovative metrics to quantify and measure capacity in the HIV/AIDS response. Presentations will include important health systems metrics work conducted by PEPFAR and the Global Fund.
  • Mai Hijazi, United States Agency for International Development, USA (moderator)
  • Eric Sarriot, ICF International, USA
  • Dr. Reshma Trasi, Leadership, Management & Governance Project, Management Sciences for Health 
  • George Shakarishvili, Global Fund to Fight AIDS, TB and Malaria
Satellite Session: Fostering Change for  Scale-up of Effective Sexual and Reproductive Health Services
9h00-17h00
Room 1.41, Cape Town International Convention Centre
Everyone working to improve health, at all levels, is in the business of fostering or implementing change. The session is for health professionals who want to bring about widespread, lasting change in their countries—health professionals who want to move beyond the myriad of promising pilot projects to building stronger, more effective health systems.  The Guide to Fostering Change to Scale Up Effective Health Services provides a systematic ‘how-to’ process for introducing and scaling up innovations in health. The Guide serves as a ‘missing link’ to assist countries in systematically identifying effective practices, planning and implementing their scale-up, to make the kind of impact that we know you want to make in your respective health systems.
Join us to learn proven practices to help lead change efforts, identify and describe key components to scaling up, hear experiences in scaling up reproductive health practices and programs—including scaling up youth-friendly family planning services in Zimbabwe—and practice applying these methodologies to specific scaling-up processes. Participants will leave the workshop with new resources, tools and actionable steps they can take to support scale-up efforts in their particular contexts.
Panelists are:
  • Suzanne Reier, Public Health Advisor, WHO, Geneva (moderator)
  • Odongo Odiyo, East, Central, and Southern Africa (ECSA) Health Community
  • Cynthia Chasokela, Director, Nursing and Midwifery Services, Ministry of Health and Child Care, Zimbabwe
  • Kate Wilson, Technical Advisor, Leadership, Management & Governance Project, Management Sciences for Health, USA
  • Nandita Thatte, Technical Advisor, USAID, USA
Wednesday, October 1st
Concurrent Session: Governance that enables evidence for stronger health systems and greater health outcomes
16h30 – 18h00
Room 1.63-1.64, Cape Town International Convention Centre
This session will discuss the value of good governance to create conditions in which health services research is more likely to flourish and yield stronger health system performance. The session will report results from the Third Global Governance for Health Roundtable that took place prior to the Symposium and discuss:
  • Breaking through the challenge of measuring the impact of good governance
  • The power of effective women engagement in modern governance arrangements for health services delivery and finance in the journey to UHC and equity
  • Lessons about governance practices that unleash more significant and more sustainable health services research for health systems performance
Panelists are:
  • Dr. James Rice, Leadership, Management & Governance Project, Management Sciences for Health
  • Dr. Reshma Trasi, Leadership, Management & Governance Project Management Sciences for Health
  • Dr. Ayanda Ntsaluba, Former Director General Health South Africa and Board Member, Discovery Health (TBC)
  • Taylor Williamson, Health Policy Project and RTI International
Thursday, October 2nd
Oral Presentation: People-centered health systems and Corruption: A global survey of health managers’ perceptions of the causes of, and recommended ways to reduce, health sector corruption
16h30-18h00
Roof Terrace, Cape Town International Convention Centre
Presenter: Meghan Guida, Leadership, Management & Governance Project, Management Sciences for Health
Corruption adversely affects access to healthcare worldwide, especially in countries with poor governance, low transparency, and weak accountability.  The factors that encourage corrupt practices in health systems affect both the health workforce and patients. This session will discuss ways to mitigate these factors and the results of a July, 2013 online survey of health managers and leaders across 95 countries to assess perceptions of corruption in the health sector.
Learning Objectives:
  • Identify causes of corruption in the health sector, and ways to mitigate corruption.
  • Articulate how the health workforce and clients’ needs and rights overlap and are affected by corruption in the health sector.
  • Formulate ways in which stakeholders (governments, donors, practitioners, etc.) could empower communities to address corruption in the health sector.
Friday, October 3rd
Poster Presentation: Corruption in the health sector: An analysis of health leaders’ and managers’ perceptions on corruption by age
Authors:
  • Dr. Reshma Trasi, Leadership, Management & Governance Project, Management Sciences for Health
  • Mariah Boyd-Boffa, Management Sciences for Health
  • Angela Lee, Management Sciences for Health
Corruption erodes health services quality and access, particularly in low- and middle-income countries. This poster presentation will present the results from a survey hosted on statpac.com in July 2013 that queried health managers and leaders on factors contributing to health sector corruption, and the effectiveness of interventions on reducing corruption. Of particular interest is the finding of a difference between younger and older respondents’ views on the importance of societal acceptance of corruption as normal, and views in the lack of ethical or moral integrity among health workers.

How to Join the Symposium from Outside Cape Town

This post is cross-posted from the Third Global Symposium website.

Unable to make it to Cape Town? Follow the conference online!

The Symposium organizers encourage you to post comments or suggestions via Health Systems Global’s Twitter, Facebook or LinkedIn profiles.

Or contribute a blog or comment on one: http://www.healthsystemsglobal.org/GetInvolved/Blog.aspx

Or tweet a comment addressing one of the plenary themes for panels to consider:

And of course watch the plenaries live – or recorded, when you have time – via the Symposium website http://hsr2014.healthsystemsresearch.org/ .

Join MSH in Cape Town

Join Management Sciences for Health (MSH) at the Third Global Symposium on Health Systems Research in Cape Town, South Africa from September 30th – October 3rd. We will be featuring our work in health systems innovations, financing and costing, access to medicines, leadership, management, & governance, and universal health coverage. Can’t make it to Cape Town? Follow live updates on this blog and on Twitter and Facebook throughout the week!