Aid Effectiveness in Global Health: Ownership
Ownership: The Successful Future of Local Health Professionals
Health professionals, both direct care providers and program or facility managers, must own the service delivery system and the programs they are responsible for implementing in their countries. And by that I mean the whole system, all that goes on into their health system. These local health professionals are ultimately responsible for implementing, scaling up, and institutionalizing improvements in the health system through projects introduced by donors, international agencies, and development organizations. The projects are usually small scale interventions that take place at public and private health facilities and local civil society organizations to improve the health status of a certain group or community. If these projects are not owned, they will not be sustained and have the expected impact.
Global health initiatives and projects must support, strengthen, respect and protect the authority and responsibility of local health professionals. How? Well unfortunately, the inputs and outputs of ODA projects, and faith-based and civil organizations are not usually part of the overall country plan. Therefore we can ensure local ownership by facilitating local participation in the process of developing national health plans that get translated into provincial or state and district action plans. And second, all parties must commit to, and be accountable for, defined outputs and outcomes within a defined geographic area. Furthermore, this needs to be done every quarter of every year the project is funded, or at least while the organization is working in country. Read below to find out what it will look like when local health professionals own and are responsible for the development of their health system. Here is my vision for local health professionals by 2030:
- Every country will have implemented a 15 year national health plan with annual targets that progressively showed how the health programs expanded their coverage to everyone in the population, accounting for projected population growth by the year 2030. Every local health professional will have played their part, and local training institutions will have developed new updated training curricula to train future health professionals. New health professionals will been taught to provide the highest attainable standard of healthcare and own and achieve their country’s health targets.
- Every country will have improved the performance of their health programs to address the country’s current and projected health priorities. Every country will have had a formal triennial review of their health programs to ensure they included the latest evidence-based interventions to deliver quality healthcare. Every local health program and facility manager and every healthcare provider will have digital copies of the revised and updated health program documents, including updated policies and operational manuals, provided on their tablets. The program’s operational manuals will include updated service delivery standards, work routines, and job descriptions as well as supervision checklists for supervisors to implement through local implementation plans. These plans will have been designed and agreed to by all public and private implementers through local quarterly district management and coordination meetings.
- Every country will have improved all their health facilities, that is all health centers, clinics and hospitals so that all local health professionals work in facilities that meet quality standards. This will have become a reality because every country will have developed and funded a facility improvement program that ensured at least 5 to 10% of the public facilities be modernized, updated and even replaced when sub-standard. All facilities will have electricity and running water and kept an inventory of assets and supplies for which the facility managers were responsible and accounted for. All private facilities will have met quality standards to be accredited and licensed.
I believe humankind has the knowledge and the technology to fulfill this vision of the future local health professionals and save millions of lives. 2015 is not the time to make up excuses; global health projects and initiatives must empower local health professionals to meet the 2030 global health goals.
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