Health Systems and Services Cluster WHO Regional Office for Africa Cité du Djoué, Brazzaville Republic of the Congo Tel. + 47 241 39260 email afrgohssinfo@who.int www.afro.who.int/en/hss G ALS SUSTAINABLE DEVELOPMENT 03 /2 01 8 WHO support for Universal Health Coverage in Africa 3) Increased domestic resources component of THE in focus countries (especially in MICs & HICs) 4) Increased proportion of populations (vulnerable & adolescents) within reach of essential health services 5) Improved services resilience and IHR indicators in all “focus countries” 6) Improved quality of care and client satisfaction indicators 7) Improvements in core HSS building blocks/input indicators (HR Density, Medicines Access, Infrastructure, etc.) 8) Improved access and health status for adolescents in Africa (Adolescents flagship)The Process in countries 9) in Africa (Adolescents flagship) More information on WHO’s global approach and the Regional Office’s UHC Framework and Flagship programme can be accessed as follows: Printed in the WHO Regional Office for Africa, Brazzaville, Congo The flagship programme aims to: ▶ Translate the WHO framework of actions into concrete country actions to design and implement integrated and synergized health systems interventions that result in critical UHC outputs and outcomes ▶ Strengthen health sector leadership, governance, management and accountability within and between countries ▶ Develop and promote use of UHC aligned tools, guides and other enablers and facilitators of health systems strengthening actions important for the African context ▶ Establish in countries of the Region systems platforms for integrated and sustainable delivery of priority health programmes (promotive, preventive, curative and rehabilitative) particularly at districts and community levels ▶ Develop context related and appropriate plans and monitoring frameworks for implementation of UHC and SDG 3 actions, including building resilient systems that have an impact on other SDGs ▶ Promote data collection and analyses, with learning and knowledge generation on lessons for sustained health systems development in Africa The core deliverables expected of the flagship programme will include: ▶ Holistic UHC plans and implementation starting with 10 “focus countries” each biennium ▶ Planned integrated technical support to the “focus countries” to initiate interventions, demonstrate results and learn lessons ▶ Establish and implement a learning program on UHC & SDGs (Regional Learning Program – RLP) ▶ Develop national and regional institutions with capacity to support HSS and UHC in Member States and the Region; and ▶ Hold an annual Regional Meeting of MoH Directors of Planning on strengthening health systems for UHC and the SDGs Expected Results by 2030: 1) Improved UHC framework outputs and outcomes indicators 2) An average reduction of 10% in OOP as % of THE over the 15 year (SDG) period Flagship Programme (1) World Health Organization. Twelfth General Programme of Work 2014–2019: not merely the absence of disease. http:// www.who.int/iris/handle/10665/112792 (2) Draft thirteenth general programme of work 2019−2023. http://www. who.int/about/what-we-do/gpw- thirteen-consultation/en/ (3) The transformation agenda of the World Health Organization Secretariat in the African Region 2015-2020. http:// www.who.int/iris/handle/10665/178621 (4) World Health Organization. Regional Office for Africa (2017). Leave no one behind: strengthening health systems for UHC and the SDGs in Africa. http:// www.who.int/iris/handle/10665/259686 Je un es fi lle s– Sy lv es tre M an go ua nd za © WHO Regional Office for Africa (CC BY NC-SA 3.0 IGO) WHO support for Universal Health Coverage in Africa – Flagship Programme To provide critical leadership to Member States and stakeholders on health and Universal Health Coverage, as a leadership priority of the 12th WHO Global Programme of Work (GPW) (1) (Fig. 1) and as one of three result pillars of the draft 13th GPW (2) (Fig. 2), the WHO Regional Office for Africa has changed its organizational structure in line with the Region’s Transformation Agenda (3). Fig. 3 summarizes the new Health system development work streams. It aims to improve health sector leadership and governance, reduce priority morbidity and mortality, mitigate health risks and foster the poverty reduction and economic gain needed to achieve the SDGs through UHC. Fig. 1 WHO leadership priorities of the Twelfth General Programme of Work 2014–2019 The International Health environmental determina nts He al th -r el at ed M ill en niu m Unive rsal health coverage Regulations (2005)De ve lo pm en t G oa ls to m ed ica l p ro du ct s including disabilities, m ental health, violence and injuries Social, economic and In cre as in g ac ce ss N oncom m unicable diseases WHO leadership priorities The WHO Regional Office developed a framework of actions (4) (Fig. 4) to guide health system strengthening for UHC in Africa. It provides a systematic approach to ensure that member states reach the following targets: a) By 2030, at least 80% of Member States have health systems that are performing optimally for effective delivery of essential package of health and related services. b) By 2030, all Member States have at least 80% of their populations utilizing the identified essential package of health and related services. c) By 2030, all Member States have in place and are implementing the investment plans needed to align their health systems with the SDGs. In 2017, a flagship programme (Fig. 5) as been initiated to assist Member States in the African Regionm to translate the Framework into context relevant interventions that can lead to demonstrable health outputs and outcomes in the short to medium-term. Fig. 2 Three pillars of the draft Thirteenth General Programme of Work 2019–2023 AREA 2. Technical and evidence based guidance, norms and capacity building on HS “Building Blocks” including for improving governance of health systems AREA 3. Integrated essential service delivery with focus on decentralized & community systems that coordinates HS building blocks to provide efficient priority programs implementation AREA 4. Achieving & Monitoring coverage & trends of people, populations & locations with comprehensive services of equity, resilience, quality and e ciency • Improved health sector leadership, governance with informed actions • Priority Morbidity & Mortality Reduction (SDGs, UHC) • Mitigation of Health Risks, Poverty Reduction, Economic Gain EXPECTED OUTCOMES AREA 1. Comprehensive & coherent policies and strategic planning to facilitate stakeholder & partner dialogue, prioritization and alignment of financing Fig. 3 Work streams for health systems strengthening activities Fig. 4 Framework of actions for Health Systems Strengthening towards UHC and the SDGs in Africa Fig. 5 WHO flagship programme to translate the Framework of actions HEALTHY LIVES AND WELLBEING FOR ALL AT ALL AGES H EA LT H S EC U RI TY SE RV IC E SA TI SF AC TI O N H EA LT H F IN A N CI N G H EA LT H IN FO RM AT IO N ACCESS TO ESSENTIAL SERVICES QUALITY OF ESSENTIAL SERVICES NATIONAL AND SUB NATIONAL SERVICE DELIVERY SYSTEMS HEALTH WORKFORCE HEALTH GOVERNANCE HEALTH INFRASTRUCTURE MEDICINES, PRODUCTS & SUPPLIES DEMAND FOR ESSENTIAL SERVICES RESILIENCE IN ESSENTIAL SERVICES PROVISION 1. Poverty 2. Nutrition 4. Education 5. Equality 6. Clean water 8. Econ growth 10. Inequalities 13. Climate 16. Inclusiveness 17. Partnerships OTHER SDGS HEALTH INTERVENTIONS IMPACT SDG 3 goal OUTPUTS Health system performance INPUTS / PROCESSES Health system building block investments OUTCOMES Essential services utilization U N IV ER SA L H EA LT H C O VE RA G E - Essential services availability - Essential services coverage - Financial risk protection
• KNOWLEDGE GENERATION & SHARING • Process documentation • Results analysis and attribution • Mapping evolving best practices • National UHC observatories & “Think-Tanks” • Knowledge translation • INITIAL ENGAGEMENT AND MOH CONSENSUS BUILDING • Scoping mission • Developing common country agreement on health expectation in SDGs • Introduction of the HSS for UHC framework • Develop a roadmap/ LogFrame of cooperation • COUNTRY ASSESSMENT • Rapid assessment of health system and health services • Generation of data and needs • Identi cation of actions needed across framework • AGREEMENT ON EXPECTED GOALS & ACTIONS WITH STAKEHOLDERS • Stakeholders consultations • Intersector mapping • Key policy interventions identi cation • Building political will • Design an HSS investment plan • AGREED WHO SUPPORT E.G. • Technical support • Learning & capacity programs (e.g. CLP) • Re-engineering, etc. of various interventions as needed; system design • Document best practices • Political mapping and engagement