Week 2: Health Systems Strengthening

07-30-2008 6:20 PM

Switzerland
Global Fund Secretariat
Posts 187

Re: Week 2: Health Systems Strengthening

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Dear members of the English Forum,

Thank you for all your contributions this week on the theme of health systems strengthening.

I’m seizing the opportunity of this week’s discussion to actually make a few announcements that might be of interest to you.

We would like to inform you that we have opened a new forum called Future Scenarios – Call for Ideas. This forum is NOT part of the e-Forum 2008 but anyone can participate so we invite you to do so. The purpose of this new forum is to share your ideas on the future of the Global Fund. The authors of the two most interesting and viable ideas will be chosen to attend the Global Fund Partnership Forum in Dakar, 8-10 December 2008. Read more and participate.

Also, the Global Fund will be participating of the 2008 International AIDS Conference next week in Mexico (August 3 to 8) hosting different satellite sessions and providing information about its work at a booth in the Exhibition Hall. If you are attending the conference please come visit us (second level, area D, booth 320). We will also host a satellite session about the Partnership Forum and the e-Forum 2008 on Thursday 7 August at 17.30 in the Community Dialogue Space of the Global Village. Please contact me if you are attending the meeting in Mexico or just visit us at the booth or at the sessions.

I look forward to seeing you.

Best regards,
Marcela.
e-Forum facilitator

07-30-2008 9:35 AM

ASHISH SRIVASTAVA

India
Not currently affiliated with the Global Fund
Posts 85

Re: Week 2: Health Systems Strengthening

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Regarding better use the support of GF for strengthening health system at national level ,national/state/peripheral interest& partnership, awareness of GF program up to grassroot level, mechanism support in Governance's inability,providing GF principles with country's constitution,universal coverage provision with political commitment ,integration of health assistance resources, ready access of health infrastructure could ensure help & broad support for strengthening health system at national level in countries. GF& partners have already provided ROLLING CONTINUATION CHANNEL, financial instrument ,innovative financing,disbursement according to GF principles,though these mechanism & process have given finance framework to less GDP countries& developing countries but presentation, priority & intervention might differ in social,eco- nomical,environmental expanse in many countries.In Asian,African countries ,disbursement of pending grants,CCM support,innovative financing including official development assistance(ODA)& IFT could use GF broad support by making INTRA-INNOVATIVE FINANCING TEAM for state& peripheral internal financing relation for fund raised & spent. Intra-innovative financing team could give better predictability of funding decision,correct disbursement approaches & its integration with LFA&CCM could ensure balanced manner of financial resources in PR& Sub-recipient countries& regions. CSS,GF Secretariat& governance have formal authority of policies, procedures&procurement of goods & services,countries with less technically,economically,& resources could use above formal authority in strengthening national health infrastructure,distribution of funding,CCM support in expenditure,voluntary replenishment mechanism, &prediction of GF resources mobilization. Pledges& contribution could make financial instrument for availability of essential life saving drugs ,greater use in finance limitation,productivity,prevention of artificial restraint, increase expenditure in long term health infrastructure & services, expansion& diversification of health system ,research,development &innovation ,development of free market mechanism for strengthening health system in countries. Countries could use CCM structure for health system strengthening, CCM could ensure diseases specific prevention,determining health system funding channel,correct funding decision,availability of financial procedure,making state& peripheral enterprize resources approaches for business oriented interventions& business models priority in developing & less GNP countries.

Thankyou

ASHISH SRIVASTAVA
ex-International Marketing
CCM(SEAR-INDIA)81237

07-29-2008 10:47 AM

Robson Olwe

Uganda
Not currently affiliated with the Global Fund
Posts 22

Re: Week 2: Health Systems Strengthening

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Dear eForum,

GF and partners should support specific policies that have been enacted by different countries in the relevant sectors of health, nutrition, gender, community development, agriculture, justice and governance. These policies provide the guidelines and overall framework under which GF and partners project is implemented. It should also be one of the projects that government should put in place to contribute toward the national drive for the eradication of poverty among communities.

Evidence from Africa shows that poverty is often not associated with HIV infection in the wat assumed. There are risk factors associated with wealth as well as with poverty (greater mobility, more disposable income for alcohol and recreation and urban residence) which can lead to higher HIV prevalence rates among the wealthy than among poorer population segments. I strongly affirm that poverty reduction is critical to human health and well -being, poverty alleviation is not a panacea to the scourge of AIDS. Therefore general economic aid and poverty alleviation programmes, while critical, should not substitute for effective behaviour change programmes.

The main purpose should be to improve the nutrition, health, cognitive and psychosocial development, development of innovative strategies based upon existing knowledge of best practices, to protect women and girls from male behaviours that put them at risk of HIV infection or abuse, innovative programme for youth that encourage them to abstain and delay sexual debut, research of abstinence and faithfulness behaviours, interventions, levers for change, and best practices in order to improve and guide interventions on the ground and development of innovative strategies that increase consistent and correct condom use among those engaging in risky sexual bevaviour, in ways that do not inadvertently foster a false sense of security.

This should not be dominant intervention for the general population. In line with scientific evidence to date. Specifically the project should create awareness in families and communities of children's rights and needs, built on the knowledge and skills of families and communities so as to provide proper health care, appropriate child nutrition, early childhood development and protection, and increase the skills and capacity of families and communities to mobilise resources and manage their own income generating activities, thereby enhancing their ability to care for the core and vulnerable people.

GF and partners should help communities organise service for children, men, women and vulnerable people through growth monitoring and promotion and establishment of community health care and education facilities, strengthening the capacity of families and communities through sensatisation, education and skills training on basic health care, training on early childhood development, nutrition and training for saving and income generation, providing support to communities through grants and incentives which will respond to local initiative for the needy, supporting on going counties national programs that are related to growth and development of children (early childhood education, prevention of micro-nutrient deficiencies, child rights and advocacy campaign and national data base.

In supporting the above activities communication strategy aimed at promoting community health, teaching skills in forming friendships, understanding peer pressures, fostering self-respect and respect for others, what it means to be healthy, what it means to take responsibility for one's own behaviour, and how certain actions and decisions can have life-long consequences are strategies whose components are complementary.

Emphasis be placed on individual elements needs to vary according to target population. Besides specific messages on nutrition and eearly childhood development, communual health awareness and advocacy campaigns will also include messages on the control of micro-nutrient deficiencies in communities. A number of nutrition, health and early childhood development services are currently provided by many countries and line departments and NGOs budget. Essential linkages also be established by GF and partners with other relevant services to complement the services provided by them and improving the efficiency and cost effectiveness of health project outputs.

Through a process of resource mapping, communities be able to identify existing and planned services that can be accessed during project implementation. This would help communities not to spread out the resources to activities that are already planned or taking place and opt for services that already easily accessible. Some of the important linkages to be established are; existing health infra-structure in private and public sectors (for growth monitoring, nutrition and education and counselling, malaria control, TB, immunisation, vitamin A supplementation, de-worming etc). These can be done at policy level with various Ministries of Health at the centre and regional levels to establish appropriate referral facilities. This may call for upgrading some of the health facilities and re-training of health workers. New policies on HIV/AIDS, malaria and TB management may also be necessary.

At the project level GF and partners could assist lower government and communities to include in their plans activities related to HIV/AIDs, malaria and TB and co-ordination among NGOs/CBOs be strenghthened in the areas of operation.

Robson Olwe

07-29-2008 9:40 AM

c.Ravichandran

India
Not currently affiliated with the Global Fund
Posts 22

Re: Week 2: Health Systems Strengthening - Mother Theresa Trust

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Dear Friend,

Regarding My global fund e-forum discussion on partnerships & Health Systems Strengthening, it's the health system spread at grass root level which needs support and service through the partners at community level. The following mechanisms can strengthen health systems at the national and community level.

Development of core groups by imparting training and knowledge on HIV/ AIDS, STDs, TB, Malaria them as peer educators.
Conducting awareness programs for the workers and drivers at their work place. Use of local folk media groups for communicating HIV/AIDS/ STD problems to the community.
Medical and paramedical workers shall be given training on safe injecting practices.
The local community leaders shall be approached for advocacy and social mobilization in support of HIV/ AIDS/ TB/ Malaria affected people.
Setting up of counselling cell for motivating individuals to attend STD clinics for check up and HIV testing if required.
Condom distribution through government institutions.
Setting up of monitoring committees in hospitals and dispensaries for using safe injecting methods.
Awareness and education classes for union leaders/ managers of industries/ labour contractors.
Sensitization of staff of government hospitals towards use of safe injecting instruments and management of STD cases.

Keeping in mind the above mentioned approach (Methodology) the following key strategies may be adopt to strengthen health system

A. Primary Prevention through Education

a. Identification and enrolment of local truck drivers in and areas and peripheral villages

b. Identification and contacts of risk groups

c. Training and education to both these groups by personal contacts and in groups

d. Organising awareness camp

e. identification and enlisting of Health centre and dispensaries

f. Contacts with medical/ paramedical workers. Identification of quacks organising training programs for medical/ paramedical workers

B. Condom promotion and improving availability for distribution

Exploring availability of condoms from dispensaries/ health centres and hospitals Procuring condoms for social marketing Contacting distribution centres for condoms at easily accessible places of truck drivers, industrial workers and casual labourers

C. Social mobilization work and counselling

Contacting union leaders, local body representatives and contractors. Training through discussions on HIV/AIDS/ STD for sensitisation and social mobilization. Establishment of counselling centres and pre/ post test counselling for HIV and for people living with HIV/AIDS and their families. Activities can be undertaken for the program Environment building by wall writings Training to core groups, medical/paramedical workers Awareness campaigns through folk dancers and rural fairs

a. Among Core groups

b. General Community Condom Promotion Counselling Social Mobilization through press, panchayat institution, labour unions, contractors Development of IEC materials Meetings with community leaders, women groups, labour unions, hospitals, PHC management Contacts and personal visit to target groups Sensitization of local institution and transfer of the intervention These above mechanism level and community level.

Tag(s): HSS, education, condom distribution, counselling, social mobilization, primary intervention, condom promotion, community level

07-29-2008 9:21 AM

Kidegcollins

Uganda
Not currently affiliated with the Global Fund
Posts 22

Re: Week 2: Health Systems Strengthening

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Dear members,

Global Fund should put in place the committees that would be charge with the responsilities to identify the immediate intervention depending on each country demand in otherwords am saying let the local people speak for themselves we should not impose on them the priority might vary from one place to another. When we talk of national budget let us not forget that at the time the country budget might be good but the question is are they able to raised that money to meet their budget like for Uganda this fincial year budget on Health is 90 billion uganda shilling out of this 60bilion shilling will be use to purchase anti retroviral treatment and care now our country is saying these financial they are able to support it budget through tax local revenue collection will contribute to the 70 percent meanwhile donor will contribute to our national budget of 30 percent

What i would like to tell the member is that basing on the national budget of the country will not help us what if they failed to raised the money they have budgeted for the effect will be on our local people at the grassroot to me i suggest that Global Fund should work closely with the country national budget so that they are able to fill the gap immediately if the country failed to meet the required budget.

Members these is my submission at the moment hope to come back again.

Collins Kidega

Radio King

GULU UGANDA

Tag(s): HSS, national budget, local voice, committees

07-29-2008 9:15 AM

ASHISH SRIVASTAVA

India
Not currently affiliated with the Global Fund
Posts 85

Re: Week 2: Health Systems Strengthening

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I would like to give reference of Gender theme for GF& partners broad support to community system strengthening(CSS)including affected population, gender factors& grass root solutions at community level.
Developing countries could develop their own & use above CSS system for better use of broad support of GF& partners.Distribution of funding(portfolio by income level)could use CSS for determining innovative finance approaches,funding decision & contribution, for strengthening country's CSS.

Regarding gender sensitive approach & responsiveness all three mechanisms are important for strong & more effective partnership for sustained impact. In gender sensitive program planning new gender aspect can include improved overall nutrition& bio-availability for lactating mothers & undernourished,under weight female children's. Understanding of genetic factors , differential Resistance to diseases,prevention of gender sensitive cultural& traditional practices.

Business models, TRP,can also help in elimination of mal-practices of gender sensitive approach.Business models should be related to improving socio-economic condition of marginalised ,gender condition
vulnerable to climatic condition,socio-legal rights of infrastructure natural& productive resources,civil society participation with rural community focussing on gender sensitive approach.

Business models should ensure better access to markets,improved working& service condition, legal aid in the unorganised business sector& basic services, literacy level, adult education,universal
primary education. TRP& Board are technical concepts which are very useful in prevention strategies& treatment ,awareness, behavioural change ,capacity building & health care provision in gender sensitive approaches & responsiveness.

Other mechanism can include humanitarian approaches with administration support, organisation that are gender sensitive may catalyse& encourage gender responsiveness, country corporate leadership,basic services education,health, financial infrastructure & universal benefit.

Thank you,

ASHISH SRIVASTAVA

ex-International Marketing

CCM(SEAR-INDIA)81237

07-28-2008 4:48 PM

Robert E. Lovelace

United States
Not currently affiliated with the Global Fund
Posts 3

Re: Week 2: Health Systems Strengthening

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The question that is being posed is a good one, not just for health system strengthening but for generating ideas about advocacy on all aspects of responding to the three infectious diseases. However, there are really three subjects raised in this conversation starter --

1) What are the Fund and its partners strengths that can be translated into advocacy tools?

2) How can these tools be applied to strengthen health systems? and

3) Aid harmonization at country level.

Before discussing how "to apply the broad support" available it might be very useful to collect thoughts and share ideas about what advocacy tools the Fund and its partners have at their disposal. Then move on to how these tools might be used to address a wide array of areas where the advocacy of the Fund and its partners might be put into play.

Points 1 and 3 suggested as items to include in possible responses are clearly related to the broader issue of "aid harmonization"-- a timely discussion given the promixity to the upcoming HLF3 in Accra. These subject of aid harmonization and the specific points are topics in themselves.

Aid harmonization is not a topic that is free of controversy. Serious questions have been raised about the degree of civil society input to guide national and donors decision-making. Many contend that those most able to influence decision-making related to harmonizing aid at country level either have little interest and even less expertise on health issues.

This would seem to raise a related question--having conducted an inventory of the Fund's advocacy tools, what can be done to increase civil society's voice on health related decision-making as it relates to aid harmonization at country level.

Tag(s): health systems strengthening, support, advocacy, programs

07-28-2008 11:30 AM

Info

Switzerland
Global Fund Secretariat
Posts 685

Week 2: Health Systems Strengthening

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Read the introduction to this topic

How can the Global Fund and partners help countries better use the broad support available from the Global Fund to strengthen health systems at the national and community level?

(This question is also available in: Español - Français - Русский)

Your answer could include (but does not have to be limited to):

·   Mechanisms (processes, systems, frameworks) to align and harmonize efforts to provide financial support to health systems, whether through disease specific or health sector funding channels;

·   Priority interventions that should be the focus of Global Fund support;

·   Measures (certain limitations, procedures) to ensure that Global Fund support is in addition to, not in place of, national budgets for the improvement of health infrastructure.

Reference material:

Partnerships overview
How the Global Fund Works
A New Partnership

Health Systems Strengthening
WHO portal
WHO HSS webpage
WHO HSS webpage on Global Fund R8 support
HSS Factsheet [200 kb pdf]
Global Fund HHS leaflet [228 kb pdf]

Tag(s): partners, partnerships, HSS, health systems strengthening, national, community, health systems