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<p style="MARGIN-BOTTOM: 12pt; MARGIN-LEFT: 0.5in; MARGIN-RIGHT: 0in" class="MsoNormal"><b><font color="maroon" size="3" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: maroon; FONT-SIZE: 12pt; FONT-WEIGHT: bold">Strong Ministries for Strong Health Systems</span></font></b></p>
<p style="MARGIN-LEFT: 0.5in" class="MsoNormal"><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">Francis Omaswa, Executive Director The African Center for Global Health and Social Transformation (ACHEST)</span></font></p>
<p style="MARGIN-LEFT: 0.5in" class="MsoNormal"><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">Jo Ivey Boufford, President The New York Academy of Medicine <br><b><span style="FONT-WEIGHT: bold">Support from The Rockefeller Foundation - January 2010</span></b></span></font></p>
<p style="MARGIN-LEFT: 0.5in"><font size="1" face="Helvetica Neue LT"><span style="FONT-SIZE: 9pt"><br></span></font><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">Available online PDF [32p.] at: <a href="http://bit.ly/bRzkGN" target="_blank"><font color="navy"><span style="COLOR: navy">http://bit.ly/bRzkGN</span></font></a> </span></font></p>
<p style="MARGIN-BOTTOM: 12pt; MARGIN-LEFT: 0.5in; MARGIN-RIGHT: 0in"><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt"><br>“……Strengthening health systems is a major priority of the Rockefeller Foundation. They support better health and financial protection for poor and vulnerable people through improved health systems performance and progressive adoption of universal health coverage.</span></font></p>
<p style="MARGIN-BOTTOM: 12pt; MARGIN-LEFT: 0.5in; MARGIN-RIGHT: 0in"><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">While health systems have received worldwide attention, little has been done to strengthen ministries of health, the central institutions responsible for stewardship of health systems at the country level. This report addresses the gaps in our understanding of the roles ministries play, their needs and the challenges they face, so that we can take effective action to fortify them….”</span></font></p>
<p style="MARGIN-BOTTOM: 12pt; MARGIN-LEFT: 0.5in; MARGIN-RIGHT: 0in"><b><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt; FONT-WEIGHT: bold">Report Highlights</span></font></b></p>
<p style="MARGIN-BOTTOM: 12pt; MARGIN-LEFT: 0.5in; MARGIN-RIGHT: 0in"><span><b><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt; FONT-WEIGHT: normal">• “………….</span></font></b></span><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">Strengthening health systems has emerged as a priority in global and national health policy and practice.</span></font></p>
<p style="MARGIN-BOTTOM: 12pt; MARGIN-LEFT: 0.5in; MARGIN-RIGHT: 0in"><span><b><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">• </span></font></b></span><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">A <b><span style="FONT-WEIGHT: bold">health system </span></b>is defined for the purposes of this report as consisting of four core elements: personal health care services, public or population health services, health research systems, and health in all policies. Effective health systems strengthening requires attention to all four of these elements.</span></font></p>
<p style="MARGIN-BOTTOM: 12pt; MARGIN-LEFT: 0.5in; MARGIN-RIGHT: 0in"><span><b><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">• </span></font></b></span><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">Governments are <b><span style="FONT-WEIGHT: bold">stewards, </span></b>or protectors, of the public interest and have the ultimate responsibility for assuring conditions that allow people to be as healthy as they can be. Ministries of health and the ministers who lead them must be able to perform a set of core stewardship functions within the ministry and across government. Stewardship is one of the central building blocks of an effective health system.</span></font></p>
<p style="MARGIN-BOTTOM: 12pt; MARGIN-LEFT: 0.5in; MARGIN-RIGHT: 0in"><span><b><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">• </span></font></b></span><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">Health ministries must also work effectively with an increasing number of non-governmental partners who bring important knowledge, expertise, and advocacy to help them meet their responsibilities (e.g. universities, professional associations, academies of medicine and science, business, civil society). <b><span style="FONT-WEIGHT: bold">Governance </span></b>is the alignment of multiple actors and interests, such as these, to promote collective action towards an agreed upon goal, in this case, to assure the best use of resources for health.</span></font></p>
<p style="MARGIN-BOTTOM: 12pt; MARGIN-LEFT: 0.5in; MARGIN-RIGHT: 0in"><span><b><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">• </span></font></b></span><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">Despite the central role ministers and ministries of health play in these processes, they are currently overlooked when investments are being made and initiatives are being designed to strengthen health systems. </span></font></p>
<p style="MARGIN-BOTTOM: 12pt; MARGIN-LEFT: 0.5in; MARGIN-RIGHT: 0in"><span><b><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">• </span></font></b></span><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">Among the ministers and stakeholders interviewed, there was significant support for the specific proposals for an executive leadership development program for new ministers, leadership support for sitting ministers, and the establishment of a virtual information resource center on health systems stewardship and governance. </span></font></p>
<p style="MARGIN-BOTTOM: 12pt; MARGIN-LEFT: 0.5in; MARGIN-RIGHT: 0in"><span><b><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">• </span></font></b></span><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">There is a need to build awareness among politicians, policy makers, and the public, of the importance of stewardship and governance in strengthening health systems, and the critical role of ministers and ministries of health. </span></font></p>
<p style="MARGIN-LEFT: 0.5in"><span><b><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">• </span></font></b></span><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">Based on data from minister and stakeholder interviews and supporting research and consultation activities, this report offers seven action items geared toward building <b><span style="FONT-WEIGHT: bold">a systematic and sustained program of support for health ministries. </span></b>Recommendations and proposals provided address: </span></font></p>
<p style="MARGIN-LEFT: 1in"><font color="navy" size="1" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 9pt">− Capacity assessment tools </span></font></p>
<p style="MARGIN-LEFT: 1in"><font color="navy" size="1" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 9pt">− Leveraging existing management development resources </span></font></p>
<p style="MARGIN-LEFT: 1in"><font color="navy" size="1" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 9pt">− Mapping country networks of expertise </span></font></p>
<p style="MARGIN-LEFT: 1in"><font color="navy" size="1" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 9pt">− Regional networks to support health systems stewardship and governance </span></font></p>
<p style="MARGIN-LEFT: 1in"><font color="navy" size="1" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 9pt">− A knowledge network for ministers of health </span></font></p>
<p style="MARGIN-LEFT: 1in"><font color="navy" size="1" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 9pt">− Executive leadership development </span></font></p>
<p style="MARGIN-BOTTOM: 12pt; MARGIN-LEFT: 1in; MARGIN-RIGHT: 0in"><font color="navy" size="1" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 9pt">− Advocacy for strengthening health ministries</span></font></p>
<p style="MARGIN-BOTTOM: 12pt; MARGIN-LEFT: 0.5in; MARGIN-RIGHT: 0in" class="MsoNormal"><span><b><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">• </span></font></b></span><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">Collective action on these proposals is needed to strengthen health ministries, enhance the leadership capabilities of ministers, and assure their full ability to serve as effective stewards of health resources in the drive to achieve national, regional, and global health objectives….”</span></font></p>
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