Two weeks ago, the World Bank organised the Africa Health Forum in Washington DC. Arjanne Rietsema attended the event as member of the Civil Society Consultative Group, a group set up by the World Bank to engage with the civil society on it health, nutrition and population action. Arjanne is country director of Cordaid in Zimbabwe, where Cordaid assists the Ministry of Health in implementing a PBF program. She reports on the meeting.
Objectives of the Africa Health Forum 2013
The forum (for those of you who are on Twitter: #africahealth) built on the Tunis declaration and it was a rapid response to the call from African leaders. The Forum, with the theme of “finance and capacity for results,” and a cross cutting focus on country level institution building, had the following objectives:
A. To learn from Ministers of Finance and Ministers of Health and to explore policy options to ensure that investments in health produce sustainable systems and results, with more reliance on domestic funds. Themes for dialogue were:
a1. Policies to achieve results and lasting impact, taking into account the following: trends in health outputs and outcomes, improvement in quality of services, and diversity of results across countries.
a2. Innovative domestic and external financing approaches: current experiences and policy actions including risk pooling, revenues from taxes, and revenues from investments in natural resources.
B. To formulate and adopt practical mechanisms for the World Bank, in collaboration with the African Development Bank and partners in Harmonisation for Health in Africa (HHA) to support the improvement and expansion of the capacity of country institutions to use development assistance more efficiently. Themes for dialogue:
b1. Emerging operational and policy modalities for support: Public Private Partnership, Results Based Financing and Program for Results.
b2. Growing knowledge and evidence base on what works, how it works and how well it works (including the use of measurement tools such as Service Delivery Indicators; systematic interventions to improve quality of services; and impact evaluation).
Dynamic of the forum
I promised colleagues @Cordaid to report the event via Twitter and that might be the reason that what I recall is slightly fragmented but you can still follow the entire panel presentations via the internet if you are in a part of the world with good connectivity.
The high profile presenters mentioned the importance of value for money, raised the question of what comes first, Health or Wealth, stressed the need for alignment and harmonisation between donors and the need for transparency and accountability. The President of the World Bank, Dr Jim Yong Kim, said that not one disease is more important than another, for which he received applause… When and where did I hear about the importance of Health System Strengthening before? He also said that time has come not only to end poverty but also to share prosperity. When he ended I felt like the most important part of his speech was yet to come and that was the “how” part.
The tight planning of the panels (or were it the elaborated discourses from politicians who tend to prefer talking over listening..;) did not allow for discussion, so we remain with some food for thought on the many good examples of progress made in Africa and how to scale those up. E.g. use natural resources to support the budget for health, use tax money, establish a levy or health fund, share the financial burden, minimise out of pocket expenditure, Results Based Financing, all means to help achieving #UHC.
You may wonder what has been the use of this certainly expensive and time consuming gathering. There were no measurable outcomes, but very often during these events business is being done in the lobby. We may just hope that dialogue around the themes happened there.
The background documents are brief but serve the purpose of focusing attention on some topics including Results Based Financing. I believe that the PBF CoP, which already plays a role in continuous advocacy for RBF, could be a resource to tap next time (if there is any new edition of this forum).
There was a lot of talk on Universal Health Coverage, but few people mentioned it directly. Why did the Forum not use Universal Health Coverage as a theme? Let us hope we will not treat UHC as another vertical programme (or need a second Forum…). As argued by Jurrien Toonen a year ago on this blog, RBF experts need to step up the effort on linking RBF to UHC. It will be a great opportunity to scale up RBF.
Ending poverty, including providing access to good quality health services, is a process. Part of the process seem to be forums where people talk too long or too short in 140 characters using hashtags#. Well and good, hashtags# come and go with Forums or other events. The hashtag #africahealth has almost died.
Time to #putinpractice, a hashtag that should not die!