PHA-Exchange> Global Initiatives may be undermining Health Systems

[Claudio]

From: "Tarry Asoka" <carenet2020 at yahoo.co.uk>
 <afro-nets at healthnet.org>


> Global Initiatives may be undermining Health Systems
> ----------------------------------------------------
>
> It has long been learnt that early achievements of extending delivery of 
> specific health interventions such as childhood Immunisation cannot be 
> sustained unless they become an integral part of national health systems. 
> This entails adequate budgetary allocations, human resources, systems for 
> logistics, supervision, monitoring and evaluation mechanisms.
>
> Global Initiatives have been set up usually as projects and therefore 
> ignore these systemic issues that are necessary to drive the delivery of 
> disease interventions. These projects have a tendency to develop a life 
> and momentum of their own. Secondly, Global Initiatives also overlook how 
> the health system is situated within the political economy of a particular 
> country. For example, in a federal country such as Nigeria, where the 
> States have considerable autonomy and resources well above the annual 
> budgets of many countries in the sub-region Global Initiatives have often 
> failed to take this into account in its programming.
>
> Bilateral donors working in-country (who also contribute to Global 
> Initiatives) do not spend enough time in persuading countries to develop 
> harmonized plans led by the countries. The focus has always been on 
> developing policies rather than effective institutions that would ensure 
> the delivery of services on a sustainable basis. This requires working the 
> politics as well as providing expert know-how.
> The role of a Health Systems Action Network could be seen as a resource 
> that strengthens the competences of change champions from within countries 
> who are at the forefront, championing institutional reforms that will 
> enable whole countries to make progress towards the MDGs.
> Dr Tarry Asoka
> Executive Director - Care-Net Ltd
> www.carenet.info