What To Do To Strengthen a Health System Before, During and After a Public Health Crisis (Part 3)
“It is all about more effective health system strengthening….”
This is the third message I will send you about health system strengthening related to epidemic prevention and control in Africa. However, the advice I will give you applies to every country. Last week, I shared with you the RGH system for taking action during an epidemic. This week, I will share with you the part of the system I suggest you use for strengthening health systems after an epidemic is controlled. There may still be cases going forward, but there should be an epidemic prevention and control program in place to stop, or at least reduce transmission. That is when its time to start the “after” activities.
Health system strengthening (HSS), also known as health reform in some countries, is a continuous process of improving the organization and management of the health system to meet the changing needs of the population. However, if your country or organization does not have a HSS program, it is time to start one! If you do have one, perhaps it is time to upgrade it. I will show you how in this message. Every country in the world, and particularly in Africa, has to continuously strengthen its health system. The HSS program in every country must be designed and implemented to continuously improve the quality, coverage and efficiency of its health system. It must avoid inefficient practices and processes, duplication of efforts, provision of services that does not meet quality standards, and lack of access to highest attainable quality standard of healthcare. If you want to help during an epidemic, plan your work to strengthen the system and plan to stay after the epidemic in order to finish the HSS work. This is important to ensure an effective handover of epidemic control activities so the affected country can continue these activities, and service delivery will continue after the help and the epidemic are over.
Country ownership must be respected at all times, in Africa and elsewhere, before, during and after an epidemic. HSS is the job of everyone in the health system and must be coordinated by the government, or at least, by an agency on its behalf. In Africa, HSS is mostly the job of every government with the assistance of donors and other partners such as civil society and private sector providers. It is tempting to want to go to a country and help during an epidemic without thinking of the how, and where, this help will fit and contribute while being sustainable. However, that kind of help is not helpful in the long run because it is not sustained and does not strengthen the health system. Many people think that there is no time to strengthen a health system during an epidemic but they are wrong. You cannot afford not to. It is inefficient to do things that will not mitigate the impact the epidemic has on the health system and not to strengthen the system to better control the epidemic.
Now that HSS is clear, here are simple and powerful steps of what to do after an epidemic that will prevent it from spreading again and that will strengthen the health system to deliver quality healthcare:
- Strengthen the country’s health surveillance system, that is, improve the notifying, storing, reporting, and use of data on all of the country’s notifiable diseases.
- Bring up to standard at least 10% per year of the country’s government-run health facilities, starting where there is most need, AND ENSURE THAT THEIR STAFF HAVE REVISED JOB DESCRIPTIONS AND JOB ROUTINES AND PROCEDURES.
- Ensure all the facilities run by civil society organizations, faith-based organizations and private providers deliver care according to quality standard and all are reporting the notifiable diseases.
- Improve the capacity of the National Public Health Laboratory to confirm epidemic diagnoses and ensure the quality of facility laboratories throughout the nation.
- Evaluate the performance of the Central Epidemic Control Command (CECC), where all decisions were made and all assistance is coordinated. Based on the findings of the evaluation, update CECC Operations Manual to be ready for future epidemics, either Ebola or the flu.
- Evaluate and improve the country’s health education and prevention program to include the epidemic prevention behaviors, vaccination and general hygiene practices.
- Work with the country’s medical and nursing schools to ensure their curricula include the new preventive and control information.
If you are interested in learning more about Epidemic Prevention and Control (EPC), you might want to sign up for the next EPC online training program that starts in September 7, 2015. In this program, I will teach you all these simple steps and more, including how to apply the International Health Regulation, and how to design or improve your EPC program. I will also coach you as you apply all you learn to an organization, a facility, a program or even a whole country. Reserve your place by writing to info@realizingglobalhealth.com and tell us your name and organization.
If you want to learn more about improving aid effectiveness to develop resilient health systems, I invite you to join me at the next free RGH webinar entitled “Aid Effectiveness: Getting Back to Basics in Global Health” on June 26, 2015 at 12:00noon, EST.
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