What To Do To Strengthen a Health System Before, During and After a Public Health Crisis (Part 1)
“It is all about better management…”
Abdul Tejan-Cole is a Sierra Leonean lawyer, not a health professional yet he understands that to respond to Ebola and to all the health priorities in Africa, we must all coordinate and work together to improve how health programs and health services are managed in every African nation. I agree with Mr. Tejan-Cole. We, global health professionals, must help African leaders like him and others manage the three elements a Health System needs to have to work effectively:
- A National Health Plan;
- An Optimal Number of Effective Health Programs; and
- An Optimal Number of Effective Health Facilities.
I wrote you about these three elements last week. Today, I will talk about what needs to happen to achieve Mr. Tejan-Cole’s vision of a well-managed health system that people trust and use because it helps them get and stay healthy. In fact, his vision can be achieved in 10 years or less – the vision of a health system that effectively manages what it has to do before, during and after health crises such as the recent Ebola epidemic.
First of all, everyone in global health must simplify and coordinate how we work and keep things simple in order to deliver effective global health aid. There are hundreds of organizations and the old way of working independently is unsustainable and does not work.
Second, the global health aid that flows from donor organizations such as USAID, The Gates Foundation, DfID, and World Bank; and all implementing organizations such as CARE, World Vision, John Snow International, Chemonics International and Realizing Global Health need to work together in a coordinated manner to help African countries strengthen the three elements of their health systems before a crisis. In this way, the impact of the crisis will be minimized. Here is what is needed:
- National Health Plan (NHP): Effective global health aid will assist the Ministry of Health (MOH) of every country to have a NHP, that is, a ten-year health system development plan along with annual implementation plans and budgets that include the in-cash or in-kind contribution of each partner and donor. The NPH will include what all actors in the health sector will do as part of their share of implementing the NHP. The plan will include how all parties will implement the optimal number of health programs the country needs to meet its epidemiologically-informed needs through an optimal number of health facilities that are managed efficiently by government, private sector and non-profit and civil society organizations.
- An Optimal Number of Effective Public Health Programs: Effective coordinated global health aid will assist the MOH to implement the above plans and improve the organization, management and health information of each of its priority public health programs that target population needs such as maternal health programs, child health programs, newborn health, etc.. ; as well as public health programs that address disease prevention and control programs such as TB, HIV/AIDS, Ebola, NCDs, etc. The disease prevention and control programs need to include endemic and epidemic prevention and control activities according to international standards and existing evidence.
- An Optimal Number of Effective Healthcare Delivery Facilities: Effective and coordinated global health aid will assist the MOH to upgrade at least 10% of the country’s government-run health facilities per year, and set up a program to ensure 100% of the private ones meet international quality standards. All health facilities must demonstrate they can deliver quality health services in accordance with the guidelines of each and every public health program and implement efficient standard operating procedures.
Next week I will update you on what effective global health aid must do during a health crisis.
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