In early September, CoP facilitators gathered at the Institute of Tropical Medicine in Antwerp to reflect on the journey of HHA CoPs so far and to brainstorm on future development.** In this blog, the facilitators of the 3 ‘Financing CoPs’ revisit the role the communities of practice can play in promoting the UHC agenda. They also need your contributions, by the way…
Universal health coverage (UHC), whose aim is to ensure that all people obtain the health services they need without suffering financial hardship when paying for them, has recently risen to the top of the international health agenda. OK, so UHC may well be old wine in a new bottle, but if it helps to mobilize the troops, why not?
At this moment, the international community is still engaged in high-level negotiations on the exact make-up of post-MDG priorities. Judging by the actions, reports and rhetoric at the latest General Assembly of the United Nations, it seems quite likely that UHC will be chosen as one of these priorities in 2015. Whatever decisions are eventually taken at the global level, access to quality health care is now high on the agenda of many governments from the South. Onward, thus, for universal health coverage in Africa too.
More attention to Universal Coverage from the CoPs
UHC has been a priority topic for HHA communities of practice since their inception, but now seems an opportune moment to spell out their contributions to the UHC agenda for the future. HHA set up CoPs to meet a pressing need: to consolidate good practices and tacit knowledge related to health care financing in Africa, both for the benefit of countries, but also among national and international experts. This consolidation could be measured by the number of experts who understand and use these best practices, both in terms of volume (inclusion of new experts and more sharing among different profiles) and in terms of quality (boosting individuals’ knowledge). The CoPs’ theory of change is that this consolidation takes place via the exchange, co-production, systematization and dissemination of knowledge on a set of technical practices. The fact that CoPs are growing steadily (the PBF CoP for example now has more 1,000 members) confirms that experts feel to the need be part of a network in order to better understand and stay on top of health financing issues.
The CoP contribution: the strength of the collaborative model
Our personal experience as facilitators has definitively convinced us that through their open, collaborative and facilitated way of functioning, CoPs are making a real contribution to the universal coverage agenda.
This contribution is happening in several ways.
First, CoPs facilitate the dissemination of knowledge generated by the numerous actors contributing to the global agenda of UHC, both from within and outside the CoPs. This sharing of information happens through our online platforms but also and perhaps more importantly, at the face-to-face events that we organize. An excellent example is the conference that the Financial Access to Health Services CoP will hold at the end of November in Ouagadougou: in partnership with researchers from the North and from Africa, a high quality conference is currently being prepared. An increasing number of actors are also inviting us to their own events or workshops so that we can share our observations and knowledge, but also help them more widely disseminate the results of their own activities (for example, the Financial Access CoP is a consultative member of the regional technical support committee for extending universal health coverage in UEMOA member states).
A second, and perhaps more original contribution is the collaborative dynamic of CoPs that allows us to “tap into” the hundreds of brains ‘connected’ to our platforms. In ICT terminology today this is called Model 2.0 or more specifically ‘crowdsourcing’. Through exchange and debate, CoP members can contribute to the identification of good practices (in terms of design and implementation of financing schemes in particular). Ensuring dynamic interaction is critical here, whether online or at a workshop, and the facilitators’ role is essential to distinguish between opinions and facts, between hypotheses and evidence.
Our many experts, by their very involvement ‘on the ground’ (in ministries, health facilities, support units, …) play a key role in enlightening the international community on feasibility, or the results observed in their country. Their proximity to operational implementation provides a ‘reality check’ for major international and national declarations. The lively online discussion in late 2012 on UHC was an excellent example of this feedback. At the end of the day, we are looking for results and not just lofty rhetoric. In Africa, these implementation issues remain a major bottleneck.
A multi-country study is launched
Beyond online discussions and this blog, certain CoPs are undertaking more ambitious projects. Two CoPs, Financial Access and PBF, have joined forces to conduct a descriptive exploratory study in 12 French-speaking African countries. The project has been made possible through French funding (Muskoka Fund), with additional support from the NGO Cordaid. The research will map the health financing schemes in place in these countries to better understand their complementarity, and also their overlap, in order to shed light what has become an opaque tangle of health financing. This multi-country research project is using an innovative collaborative model, and will be presented in the coming weeks on Health Financing in Africa.
CoPs have proven that they have their place alongside traditional actors like Ministries of Health, international and bilateral agencies, NGOs and academic institutions. We are convinced that they can contribute in a very positive way to the universal coverage agenda, if they receive the support they deserve – from sponsors, but also from their members.
Last but not least, we want to make use of the opportunity to remind you that Health Financing in Africa is the blog of all members of ‘Financing CoPs’ of HHA. So if you want to submit a draft, don’t hesitate. In 2013 and 2014, we will be especially keen on receiving information on progress of UHC in your country, the challenges you face in your country, and the implementation process.
(*) CoP Financial Access to health services: Yamba Kafando, Allison Gamble Kelley, Isidore Sieleunou; CoP Performance-Based Financing: Nicolas de Borman, Serge Mayaka, Bruno Meessen, Emmanuel Ngabire; CoP Evidence Based Planning and Budgeting: Nadège Ade, Jérôme Pfaffman;
(**) More information on this meeting will be shared later.