PHM-Exch> Universal health coverage (5)

[Claudio Schuftan]

From: Remco van de Pas <remco.van.de.pas at wemos.nl>


Was glad to read Massimo's reply on the 'privatisation' of health care in
South-Darfur, Sudan. It reminds me of the period that i worked in Nyala for
an international NGO in 2005/2006.  I reflected at that time that
humanitarian assistance had become big business while responding to a
disastrous conflict situation. This analysis can be found here:
http://www.phmovement.org/en/node/250

We should indeed be careful how we position ourselves as non-state actors in
both humanitarian crises and while working in more stable health systems.
The NGO code of conduct for health systems strengthening that we discussed
last month is a clear effort to that. It is now up to us to walk our talk.
This would imply

   - (a) To be humble in the way we relate ourselves towards the people we
   work with, not only in ownership and priority setting for health
   improvements, but also *how *we present ourselves. Even beyond salaries;
   the big cars, fenced compounds and sometimes 'exclusive' behavior will add
   to the divide between 'us' and 'them'. It is indeed not so strange that it
   pulls high skilled health workers to be part of it, or to try via both
   public and  private sector to reach a similar status.
    - (b) To be conservative with consultancy fees for international short
   term assignments, M & E and capacity building programs. Domestic
   assignments, with a moderate budget and with less initial capacity might be
   implemented for a longer period and in the long term prove more sustainable.

    - (c) To refrain ourselves from blaming  governments to be corrupt and
   non-trustworthy in health development. This agenda is often 'hidden' in
   international health cooperation. We must first be introspective and
   transparent on how we allocate our budgets and what our own agenda is. The
   global health market is a competitive one, and each of us has to 'sell his
   brand approach or particular organization'. This leads to fragmentation and
   further undermining domestic health systems. We should have the courage to
   cooperate beyond our program frameworks on strategies for basic health
   systems strengthening. There is no magic bullet to it, but it is no magic
   either. Supporting integrated primary health care with clear community
   involvement; in coordination with stakeholders working on the six building
   blocks for health systems, intra- and inter sectoral coordination, providing
   stewardship and capacity on health systems reforms, listen and responding to
   local priorities in global contexts...In theory it is so clear, but health
   as a public good does provide friction with those having vested financial
   interests both at the local and global levels. Health cooperation (or its
   derivative medical aid) is too often a trade-off that accompanies economic
   and business deals . We as health community should understand and position
   ourself in the politico-economic context we work in. We are too often used
   as trade-offs while we actually want to improve health and rights of the
   people.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://phm.phmovement.org/pipermail/phm-exchange-phmovement.org/attachments/20101125/df1e6db4/attachment.html>