Strong Ministries for Strong Health Systems
Francis Omaswa, Executive Director The African Center for Global Health and Social Transformation (ACHEST)
Jo Ivey Boufford, President The
Support from The Rockefeller Foundation - January 2010
Available online PDF [32p.] at: http://bit.ly/bRzkGN
"……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.
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…."
• "………….Strengthening health systems has emerged as a priority in global and national health policy and practice.
• A health system 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.
• Governments are stewards, 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.
• 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). Governance 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.
• 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.
• 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.
• 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.
• Based on data from minister and stakeholder interviews and supporting research and consultation activities, this report offers seven action items geared toward building a systematic and sustained program of support for health ministries. Recommendations and proposals provided address:
− Capacity assessment tools
− Leveraging existing management development resources
− Mapping country networks of expertise
− Regional networks to support health systems stewardship and governance
− A knowledge network for ministers of health
− Executive leadership development
− Advocacy for strengthening health ministries
• 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…."
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