Devolution: last situation paper

WORLD HEALTH ORGANIZATION O}ICHOCER.CIASIS COMIB.OL P]TGBAi,I,IB I}T TTM VOLBA RTTM BASIN AtrEA oRqANrsATroN MoNDIALE DE LA SANTE Nocg.4 fuiginal: tr*rench NATIO}TAI OI'trCHOCM.C lAS IS C O}M.4ITTEES Ninth meeting t 4-5 Jwre 1985 DEVOLUTI0}.tr: LAttrST SITIIATI0I{ PAPIR DEI/OLUTIOIS: IAIEST SIIUATIOII PAPHT -btr@tlgq 1. Up to now the concept of d.evolution has been intrinsically related., on the one hand.n to the id.ea that the Farticipatirr.q Countries would have naintena4ce activities to carry out a.fter the end. of OCPtsDmand.ate and., on the other ha4d., that since without the extensions aerial operati-ons should. be carreied. out becan:,se of a possible reinva*sion, there wor.rld be the need. for an irtor-corntuy facility to inte:srene if necessaiTr, 2. In the preparation v*rich was startod. ln 1!81 for d.evolution, attention rdas ther€fee focr.rsed. on ansr,uering the questions ln regard. to the d.eflnition of trasks, how to c-arry them out, resou.roes nceded., egs^nisation of the conti- nr:a.tion of coord.iiratlon ectivities at the national and. reg:iorral levels. 3. ft is aloqg those llnes that the vari.ous bod.ios of the Progra.une aird' the ilorking Groups of National E:cperts that assist the Progra"rnn,e and. the Participating Cor:ntries ln the fo:rlulation artd. j.r:rplementation of requisite recommend.atior:s have worked. so far (ref. doa. NtrB'4). of the adoption of the @ 4, The elaboration of the Long-Ter:'r Stratery lftich is to lead the Programare up to the time when its ob jectives will be atteined, rua.s the best r'ray to Irrerrent ar\lr reorud.escence of the cl-isease in the long nrn and. enable the ParticJ.pating Colnf,ries ta.ke over without risk certain ta,sks as and. l*ren possible, 5. After ad.opting the lorrg-Terrn Strategy the lth meeting of the Joint Programme ^\Connittee (,feCflreqoested. that a plan of operation be prepared. for it, to wleich should. be ad.d.ed a p1a3 of operation for d.evolution of Onchocerciasis Operational Zone 01 (OOZ.O1) apd a prelimina:ry plan fcr the other operatiorra-1 zones. 5. The ad.option cf the Long-Te::n Stratery has meant tha.t there shctuld. be a ocrnplete revision of ttre d.evolution prooess insofar as by the end of OCPt orrchocerciasis wou]fl be effectively und.er conbrol in the wlrole sub-re€iiont or better stil1 vroirld. have been e1i-minated. especially in the central zone of the extend.ed. OCP, Tais has 1ed. to d.evolution nol,r being envisa€Bd. much less as the oa.rqring out of f,ransferced. activities but muoh more as the integration into the health systens of the countries of a few residual tasks the volume of which will be ni1 in certain 00Zs by the end. of @P. Orohocercias is Control Progranuno 2) HelcL ln Nianey in Decembet 1984 of the on L:: -2- 7. The new approach should. therefore corr.sist i-n strergthenlng prirna.rry health sare prograrnmes, $iving training to and informing the persorueel in oharge of them, and. studying the mechanisms for integrating residual med.ioal and- entomological activities into these systerns, by using d.ia6nostic and. evaluation method.s such a,s new sar,rplings, irnmulological tests and tra.ps f or catchir,g blaakflies. B. fhe priority of the Participating Cor.mtries and. the Prqgra.mne w-iII therefore honceforth be to d.efine this integrated. approa.ch and. id.entify the best 11ay for each cor:ntry to plan the primary health care progfan:rles' This will be d.one by oarrying out operational rcsearch on the spot so as to lmow hoiu bEst to rrake d.evolution ccmoplementa:ry to prima,:ry health care for a better oost-effectiveness. This orientation rras supported. by the 5th Ji']C meeting in Niamey during vr?rich severa*1 d.onors prcmised. to help the cor:ltries, on bilateral basis, plan arrd- lnplernent prima.Iry health care programmes in the OC? zcne' S!ati:s. oLdevolution - Preparation of pIa,ll of -gler,+t.!.oq-fol {eY-olg!Lo! g. Soon after the .IPC meeting in ldiamey, Burkina Faso requested OCP to participate in the preparation of its plan of operation for a better integra- tion of it into the Five-Year Health Plan being prepared.. 10. Frcrn 9 to t2 April 1985 the Progra,rnme organised the 4th meeting of the 't,Iorking Group of national experts whose task rras to study the implications of the deoisions of the 5th JPC meeting and. e:camine the irnplementation of the recmrend.ations of the ]rd rneeting of tjre trIorking Group. 11. Une ltrorklng Group took note of the evolutio:r of the concept of d-evolution which frqt now on comes und.er the na,tior:aI pri-marT health care pros3alnmes' In this respect, a rnod.el- plan of operation for d.evolution which aims at the inpleinentation of prinary health care in the respective countries was ad.opted (Arurex I). LZ the 4th meeting: of the l,iorking Gro'up reviewed the i-uiplementation of the reoornmend.atiorrs of the Jrd. meeting of the Working Group j:r the light of the present concept of d.evolution and" ca.Iled. on the coqntries which had not yet d.esi6rrated, a national tean for d.evolution to d.o so, makir:g sr:re that the tasks are entrusted. to the most appropriate pri-mary health care levelst arrd' 1to prepare realistic prima.:q1 health car?e prograrmres for the OCP zone, ind.ioating clearly the pla.ce of d.evolution activities. This preparati.on r^rilL be facilitated. by the tripartite missions (ocp/tmO/national experts) whioh w111 visit the countries in ord.er to help tfoem draw up the plarrs of operation for d.evolution weII. 1-1. lalith this conception, OCPts role will stead.ily d.ecrease as the plar:s of operation are jmplenented., leaving l'lHO and. the other partners to play thei- rightful role in the general i-rnprovement of public health in the OCP a;roa. L4. ft is in this context that all the instif,otions involved in the Progra.rnms have to help in the search for ways and. meansr to make this strategy succeed,. --------o0o------- tAnrrex 1 ptAN OI, OFE,L{TION FOR DEVOIUtIO1I _ OUTLI]]E I - Introd-uction : General presentation of tr"re corrntry - Geography - Socio-economic and cultural situation - IIeaIth policy and place of Prjmary Health Care (fUC) If - Status of OCP a.ctivities in the oouatry ITI - Health sltuation and priorities in the Progra,mme area - State of implementation of the B IIIC conponents - Olerational research need.s for the settir€ up of PHC fV - Progra:rme for implementation of Devolution (r) otiectives (z) strategies - imPlernentation of PHC - PrioritY comPonents (1) Available resources (narrpower, material, fi:rancial) - available resources - add.itional resor::'ces (4) frovisional timetable V - Conclu,sion. --------o0o--------