With HEP+ support, inter-institutional agreements that pave the way for the transfer of health functions to local health areas were signed on July 18 between Guatemala’s central government ministries and six municipalities. These agreements allow for improved coordination between central and local authorities and support capacity strengthening at the municipal level, empowering local health area directorates and municipal health districts to plan, operate, and monitor newly delegated responsibilities. With this increased monitoring at the local level, authorities can better monitor health outcomes according to the epidemiological profile of each municipality and thus, support the reduction of morbidity and mortality indicators. The newly delegated comprehensive healthcare approach is also anticipated to improve water and sanitation services for communities. HEP+ supported the Presidential Secretariat for Executive Coordination with designing a framework and methodology to collect input from stakeholders at all levels on the competencies to be delegated and provided input on the inter-institutional agreements.
On November 9, 2021, Liberia’s Ministry of Health launched a new private sector engagement strategy, which HP+ helped develop, moving the country’s health system a step closer toward achieving universal health coverage. At the launch, representatives from the Ministry of Health, county health team, USAID/Liberia, and the private sector praised the government’s commitment to engaging the private health sector to tackle some of the country’s most pressing challenges, referring to the day as a historic moment. The strategy provides a framework for transparent, informed, and effective engagement between the public and private health sectors. It highlights four goals to be implemented collaboratively between public and private stakeholders that focus on expanding access, quality of care, and financial protection for clients. To implement the strategy, the Ministry of Health will establish a multisectoral private sector engagement technical working group, roll out the strategy at the county level, and train key focal persons on private sector engagement. With this strategy, the Ministry of Health is committing to ongoing, deliberate engagement with the private health sector to tackle some of the country’s most pressing needs in the coming years.
Success stories are emerging from efforts to train Malawi youth in business management and entrepreneurship through HP+ and Palladium’s Feed the Future Agricultural Diversification project. The project is focused in Mangochi District, where several youth clubs have dramatically increased their profits. The Wake UP youth club doubled its revenue after the training, from MWK 400,000 ($ 497), at which level it had stagnated for the past four years, to MWK 800,000 ($994) in 2020. Mlambe Youth Club increased its investment in land for its green maize production from 2019 to 2020 and grew its revenue. The club now makes an average annual gross profit of more than MWK 1 million ($1,242). Through the youth clubs’ Village Savings and Loan programs, individuals have been borrowing start-up funds and launching their own successful businesses, such as selling tomatoes or fish. In addition to investing in expanding their businesses, the clubs also are putting their profits toward constructing youth corners, physical structures where youth can access family planning services and commodities. Other clubs are supporting needy students with school fees and bicycles and motorbikes to help youth from remote areas access youth friendly health services.
Family planning is a key part of Liberia’s first private sector engagement strategy, advanced during a recent workshop in Monrovia supported by USAID and HP+. “The Ministry of Health has recognized the need to engage effectively with the private sector if we are to succeed in our mission,” Assistant Minister George Jacobs told the assembled Ministry of Health staff and representatives from professional associations, federation and regulatory bodies, nonprofit organizations, and the private health sector. The strategy for 2021–23 calls for private facilities offering family planning services to have regularly trained providers, consistent with the ministry’s family planning costed implementation plan. Government approval of the strategy is expected by fall 2021. Following that, the Ministry of Health will begin implementation with a multisectoral technical working group led by the ministry’s newly designated focal point for private for private sector engagement. The group will bring together public and private sector actors, begin rollout of the strategy at county level, and undertake a master training for key ministry focal persons.
Achieving improved health outcomes through multisectoral actions was the focus of an online policy forum convened by Health Policy Plus on June 22, 2021. The session—A Multisectoral Endeavor Called Health: Working Across Sectors for Quality and Sustainability—delved into the importance of designing cross-sectoral interventions and building strong collaborations, such as networks that focus on common goals and bring success to all their members. Clive Mutunga of USAID opened the discussion and provided insights on how multisectoral approaches strengthen health policy and sustainability. Building on his remarks, lead authors from the HP+ blog series “A Multisectoral Endeavor Called Health” shared some lessons learned around youth, nutrition, public and private sector collaboration, and governance. In a panel discussion led by Jay Gribble, deputy director for HP+, panelists addressed challenges faced when coordinating across silos, the importance of understanding context, the need to have good communications, and the role of stakeholder engagement. Speakers addressed audience questions around adapting strategies for sustainability in response to the COVID-19 pandemic and how to work with global organizations to support countries in undertaking multisectoral action.
HEP+ Guatemala and one of its long-standing civil society partners are among the co-authors on a recent article on the importance of encouraging partnerships during challenging times such as the COVID-19 pandemic. The paper draws on a 12-country study series on multisectoral collaboration for health and sustainable development in the context of the health and rights of women, children, and adolescents to incorporate sectoral analysis into multisectoral research methods, develop a core set of research questions, and identify shared indicators of success and failure across sectors. The article, “Specific Considerations for “Research on the Effectiveness of Multisectoral Collaboration: Methods and Lessons from 12 Country Case Studies,” appeared in BMC Globalization and Health. Among its co-authors are Susana Palma from HEP+ and Silvia Xinico from HEP+ the partner National Alliance of Indigenous Women’s Organizations for Reproductive Health.
In the lead up to Universal Health Coverage (UHC) Day on December 12, HP+ published two new blogs in our series that highlight multisectoral actions critical to strengthening the health systems through which UHC is achieved. HP+ Nigeria Country Director Frances Ilika shows how multisectoral actions in Nigeria are prioritizing the health sector and removing obstacles to financing to increase enrollment in social health insurance at the state level. A second entry, co-authored by Sachi Jani, Daniel Cotlear, and Sayaka Koseki, discusses the need for the public sector to collaborate with the private sector as a key player in the health market to reach UHC. “The public sector can also improve access to services by leveraging existing private sector networks to expand or improve the efficiency of public health services,” they write. “For example, to improve commodity distribution in Kenya, Palladium used a total market approach to integrate the Kenyan government’s family planning program and contraception distribution with the private sector provider network.”
A new blog published on the Wilson Center’s New Security Beat by HP+’s Dara Carr -- Reducing the Risk of Pandemic Disease Threats Through Multisectoral Action -- looks past our current “war time” footing on COVID-19 to the importance of sustaining and strengthening multisectoral collaboration to address future shocks. She discusses barriers to multisectoral collaboration and makes the case that existing policy assessment and advocacy approaches, including evidence-generating policy models, can be readily adapted to help address these barriers. The blog is part of a series edited by HP+’s deputy director for family planning, Jay Gribble, titled A Multisectoral Endeavor Called Health. The series examines the benefits of multisectoral actions in responding to the complex environment in which we live and explores the interrelationships between health and other sectors. Other topics in the series discuss the need for multisectoral collaboration to achieve health outcomes; the link between the health and nutrition sectors; the need for a creative and flexible policy and financing environment for effective planning across sectors.
A new blog by HP+ family planning/reproductive health deputy director Jay Gribble and monitoring and evaluation lead Nicole Judice—"Multisectoral Actions: Creative Thinking, Effective Planning, Power Sharing”—seeks to answer the question “Why do so many policies fail to improve the problem they are designed to address?” and offers approaches to collaborate across sectors to improve health outcomes. The blog is the third in the series “A Multisectoral Endeavor Called Health,” which examines the benefits of multisectoral actions in responding to the complex environment in which we live and explores the interrelationships between health and other sectors.
HP+ explores links between food insecurity, poverty, and poor health outcomes and the need to address underlying causes such as malnutrition with a multisectoral approach. In a new blog in its series, A Multisectoral Endeavor Called Health, co-authors Jay Gribble and Joni Waldron of USAID’s Feed the Future Ag Diversification Activity showcase efforts in Malawi where project design and implementation are linking agriculture to food security, economic growth, and health for long-term, sustainable change. Read the blog, “Reducing Malnutrition: A Multisectoral Approach to Addressing Underlying Causes.
HP+ launches a new blog series today, A Multisectoral Endeavor Called Health: Working Across Sectors for Quality and Sustainability. The series will tackle a range of health development challenges and examine how multisectoral actions can help address complex, interrelated issues. Focusing on high-level objectives, such as achieving universal health coverage and reducing malnutrition, the blog series considers how multisectoral actions contribute to better health status of populations and play a role in achieving economic growth and other development goals. Read the first blog by Jay Gribble, Nicole Judice, and Suneeta Sharma, Unity is Strength: Improving Health is a Multisectoral Endeavor.
On May 6, representatives from Kenya’s health leadership at the county level adopted a prototype of a new County Health Planning Unit (CHPU) for each county, created to address gaps in planning and advocating for budget allocations for strategic programs such as HIV, family planning, and malaria. HP+ supported the establishment of the CHPU through multisectoral collaboration with individual counties, the Ministry of Health, the Council of Governors, and the National Treasury. Moving forward, HP+ will support CHPU capacity strengthening and mentorship to institutionalize planning and budgeting at the county level, underscoring long-term sustainability on Kenya’s journey to self-reliance.
In December 2019, Burkina Faso’s Ministry of Health launched a monitoring and evaluation (M&E) plan to measure its progress on increasing contraceptive access. The finalization and implementation of the Costed Implementation Plan M&E plan is an important milestone showcasing the country’s commitment to increasing modern contraceptive prevalence, which at 30.7 percent, is the highest in the West Africa region. The M&E plan was developed following the formation of a multisectoral steering committee and thematic groups comprised of public, private sector and civil society representatives who advocated for a tool to track progress, a model for the region. Read our news story for more details.
In recent months, HP+ has supported Cambodia’s National AIDS Authority to identify and budget for HIV-related activities for the coming year in coordination with non-health line ministries. Using the National Strategic Plan for a Multi-Sectoral, Comprehensive HIV/AIDS Response (2019-2023) as guidance—a strategic plan for coordinating the country’s HIV response, produced with HP+ support—the ministries committed approximately US$500,000 to fund HIV-related activities in Cambodia. This commitment supports progress toward achieving the vision of government funding of 50% of the HIV response by 2023 (up from 24% in 2017).
HP+ recently launched Growing Together: Multisectoral Investments in Malawi’s Youth, an ENGAGE multimedia presentation that describes how investments in young people’s health, education, employment opportunities, and participation in governance can create a window of opportunity for accelerated economic development. The presentation was developed with the guidance of a multidisciplinary taskforce chaired by Malawi’s Ministry of Health and included youth leaders and representatives from government and civil society. The presentation was utilized by UNFPA to launch their event “Road to Nairobi for the ICPD” on World Population Day 2019, and stakeholders across sectors will continue to use the resource in their call for increased cross-sectoral investments in Malawi’s young people.
On December 19, the Pharmaceutical and Other Health Technologies Policy was approved by ministerial decree in the presence of authorities from the Ministry of Public Health (MSPAS), the Guatemalan Institute of Social Security (IGSS), over 70 health sector public officials, and representatives of international cooperation agencies. The event where the policy was approved was led by the Minister of Health. The policy represents a strategic mechanism that guides, directs, and implements comprehensive actions with national reach. It strengthens health sector governance by establishing criteria and strategies to define roles and responsibilities in the management of medicines and other health technologies. It also unifies guidelines for health and public sector institutions to guarantee access to medicines to all Guatemalans. During the event, IGSS committed to adhere to the policy and collaborate with MSPAS to achieve its full implementation. The MSPAS Logistics Management Unit Director acknowledged the technical assistance received by the Pan American Health Organization, World Health Organization, and USAID/HEP+ during the design, development, validation, and approval process of the policy.
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In recent weeks, Guatemala’s Ministry of Education (MINEDUC) officially established the National Workforce Training System (SINAFOL) for school and extracurricular education systems. SINAFOL—a system that has been supported by HEP+ for over a year—is the structure that manages and coordinates the government, private sector, and social agents to define and implement policies and strategies that guide education and technical occupational training in the country. It incorporates standardization processes, training, evaluation and certification of labor skills, entrepreneurship, and citizenship in a permanent learning context. In addition to establishing the system in early November by ministerial degree, on January 3, MINEDUC published two additional decrees to (1) support the creation of six new careers in order to expand opportunities for young people in the education system, and (2) create a system of skill certification. HEP+ will continue to support the operation of SINAFOL and the skill certification system in coming months. Read the press coverage.
HP+ Kenya/East Africa provided technical assistance to an East Africa Community (EAC) workshop, held in Kampala, Uganda, to review and validate the proposed EAC Health Policy. For the past two years, the EAC secretariat has worked with its five member states and various stakeholders to develop a regional health policy to enhance collaboration in all areas of health, including disease surveillance and epidemic prevention and control. With USAID support provided through HP+, the secretariat convened representatives from member states’ ministries of health to review and validate the draft policy, so that it can be tabled for endorsement and adoption by the East African Community Council of Ministers later in the year.