Reflections from the HP+ End-of-Project Learning Exchange
Our work is about people, youth, traditional leaders, faith leaders, babies, mothers, healthcare workers, policymakers, and the collective wisdom and dignity of all lives lived.
Frances Ilika, Country Director, HP+ Nigeria
Written by Anna Lisi, HP+, Palladium
Photos by Katie West Slevin, HP+, Palladium
What makes development sustainable? Accountability? Relationships? Tools? These were among the topics discussed at the HP+ End-of-Project Learning Exchange, held on March 30, 2022, at the Ronald Reagan Building in Washington, DC and at a virtual innovation café the following day. The event featured a diverse set of panelists from across 13 countries, who convened to reflect on not just the results that were achieved but, more importantly, how achievements and advancements can be made that are equitable, inclusive, and sustainable.
The event began with a welcome from HP+ Nigeria Country Director Frances Ilika of Palladium, who served as the event’s master of ceremonies. The themes she touched on—equity, dignity, inclusion—were reflected throughout the event, in particular the notion that “all progress is local.”
Following the theme of local progress, USAID Assistant Administrator for Global Health, Atul Gawande's video address discussed the project's work with youth in Malawi, advocates in Madagascar, civil society in Guatemala, and healthcare workers in El Salvador. He remarked, "With HP+'s focus on stewardship and accountability, it has been at the forefront of locally led development."
Detailing efforts around health insurance policies, USAID Health Development Officer and HP+ Agreement Officer's Representative, Veena Menon talked about successes that extend coverage to people living with HIV in Cambodia and provide insurance coverage for the first time to people in Osun State, Nigeria. These achievements of the project, she noted, represent the "millions of men, women, children, and families, who've positively benefitted from policy change and implementation work that HP+ has undertaken."
The keynote address was delivered by Melissa Jones, USAID Deputy Assistant Administrator, Bureau for Global Health. She spoke about USAID's commitment to making foreign assistance more accessible, equitable, and responsive. These core principles are reflected in HP+, which Jones remarked has "helped to make policy development more inclusive, context specific, realistic, and focused on achieving equity."
Looking at the numbers, over seven years HP+ has worked in nearly 50 countries, mobilized nearly half a billion dollars of domestic funding for health, and developed, adopted, implemented, or monitored 187 context-specific policies. Project Director for HP+ and Vice President of Health at Palladium, Suneeta Sharma announced that within the past week, HP+ efforts working with the government and advocates in Mali cumulated in a decree that formalized the status of community health workers—a transformative policy that will ensure their rights and funding by the government. Similarly, after years of civil society advocacy supported by HP+, a law was approved in Guatemala that will allocate annual payments to traditional midwives.
Results such as those highlighted in the opening remarks were explored in depth throughout the day via panel discussions on approaches, challenges, and next steps. Three panels, moderated by Janet Fleischman, Palladium consultant, and Palladium's Jay Gribble, HP+ Deputy Director, Family Planning and Reproductive Health, explored locally led health policy, advocacy, financing, and governance and improving equitable access through advocacy voices.
A common theme was the need to listen to diverse perspectives and to enhance cross-sectoral trust. As stated by HEP+ Guatemala Country Director, Herminia Reyes, "Civil society is the most sustainable resource that a country has." Collecting and sharing data-driven evidence with local populations can empower them to advocate for their needs and hold government accountable, which can lead to sustainable changes.
Another theme was the need to align with government priorities, leveraging government institutions and laws that sustain policies. Panelists noted that policy work is a marathon not a sprint and that we must work on long-term, rather than short-term, solutions.
The next session, which focused on COVID-19, began with a standing ovation for the panelists—doctors Alicia Cerrato, Reynaldo Flores, Sara Rivera, and Eduardo Tercero. They have worked tirelessly for the past two years to support efforts to contain the virus in El Salvador, Guatemala, and Honduras. Their efforts, ranging from training thousands of healthcare workers to supporting prevention, care, and vaccination guidelines and policies to reach the most vulnerable, have strengthened the healthcare system beyond the immediate pandemic.
The afternoon sessions included guest video appearances by Dr. Chan Narith of Cambodia’s National Social Protection Council and Dr. Moses Muwonge of Uganda's Samasha Medical Foundation. The topics covered included implementing national-level policies at the local level; stewardship, accountability, and transparency; and health financing. In many cases, policy success came when the government was put in the driver's seat and when the project worked within existing systems. Data-driven evidence, such as the results of costing exercises or modeling, can inform decisionmakers and bring together different stakeholders to align on an issue.
Fostering local champions is another important effort, particularly in places where government players may change frequently. David Jacobstein with USAID's Center for Democracy, Human Rights, and Governance talked about the importance of relationships and adaptive approaches in measuring success.
The next morning provided an opportunity to join an online innovation café where attendees chose to join 3 out of 15 virtual rooms. Each room covered a topic that related to how HP+ conducts policy work. I learned about (1) the FamPlan online tool to help countries determine what is needed to achieve family planning goals, (2) a male engagement policy framework that was implemented in Nepal, and (3) a partnership with faith leaders in Mali to confront gender-based violence. Despite limited time, there was thoughtful discussion around the application of these approaches in countries with similar contexts.
Reflecting on a question raised at the event—"What makes development sustainable?"—I go back to the inspiring words spoken by Ilika in her welcome: "Our work is about people, youth, traditional leaders, faith leaders, babies, mothers, healthcare workers, policymakers, and the collective wisdom and dignity of all lives lived." HP+ has shown how tapping into this collective wisdom to build approaches, processes, accountability, and relationships at the local level can advance equitable, sustainable development.