TRAORE seydou’s Post

How can basic healthcare be operationalised in Nigeria? The World Health Organization Council on the Economics of Health for All has found that at least 140 countries recognize health as a human right in their constitution. Yet countries are not passing and putting into practice laws to ensure their populations are entitled to access health services. Nigeria can potentially join the rest of the world to meet the Sustainable Development Goals (SDG) by 2030 if there is a sustained, deliberate, decisive and collaborative approach to identifying the constraints, course-correcting and activating broad-based action towards achieving the SDGs. #WorldHealthDay

#UHCDay: Pooling health resources is about more than efficiency—it’s about fairness. By merging pools and aligning benefits, countries like #Kyrgyzstan and #Colombia are achieving progress toward #UHC. With support from USAID's LHSS Project, these efforts are paving the way for a future where no one is left behind. Read on: https://bit.ly/3S7QZGF #UHC #LearnWithLHSS #HealthForAll

Glad to have been a local delegate at the just ended 11th Zambia Health Research Conference - ZHRC 2024 whose theme was: “Sustainable and resilient Health Systems: Accelerating Progress towards Universal Health Coverage in the Face of Service Delivery Challenges, Emerging Diseases, and Pandemic” As a part-time researcher working with both the non-governmental and the private sectors, I was particularly interested in a side symposium discussing the Government Stewardship of the Private Sector in Healthcare Delivery hosted by Coalition Health Zambia (CHZ) formerly John Snow Health Zambia (JSH). The following were the key takeaways: There is need to find balance between regulation and the private sector to foster efficiency and effectiveness. Private sector-led economy in health should be the case and the private sector should be looked at as equal partners to achieve Universal Health Coverage -UHC. The private sector is accommodated through the PPD in every meeting but there isn't representation from health available to influence and direct policy. New national health policy - Private sector to be involved and encouraged to work closely with the health advisor to the President. There's need for more interactions and an action matrix should be developed to ensure growth monitoring.

#ToRead - great article on sustainable health financing, vertical programs and the need to make partners investments more efficient. “#TANZANIA CONTRIBUTES A SIGNIFICANT PROPORTION OF HEALTH FINANCING BUT THERE IS A HIGH DEPENDENCE, PARTICULARLY IN PRIORITY PROGRAMS. WE NEED MORE AND NEED MORE EFFICIENT INVESTMENT.” #UHC #HealthFinancing

From the journal article: exploration shows that this tepid growth is expected because the percent of overall government spending that is dedicated to health 7·2% (6·3–8·3) compared to average of 12·4% (11·7–13·2) in other regions) is expected to stay low. Even if the amount, of resources provided from donors climbs some, it is not expected to keep pace with growing economies in sub-Saharan Africa and may transition towards other global public health goods. Critically, development assistance for health provided to sub-Saharan Africa is expected to decrease in some countries, and the expected growth in government health spending might not be enough to cover this expected decline. Increases in spending with a concordant prioritization of health and the appropriate health system governance and structural reforms are critical to ensure that people who live in sub-Saharan Africa are not left behind.

#ToReadBut Thanks Madhukar Pai for sharing and thanks to the authors including Angela Esi Apeagyei (Micah) & Justice Nonvignon. While I value the use of modelling to inform on potential trends, I worry that when it comes to SSA & health financing, the assumptions we use have not changed or evolved at the risk of continuing to reinforce false ideas about government's attitudes towards health spending & actual ongoing reforms. Plus unsure which policy makers are targeted. Here are some of the (maybe) outdated assumptions & some of the limitations that are rarely included in such studies. The scholar in me knows the better way should be to respond to this paper but hopefully this can spark interesting reflections. 1. Lack of analysis of DAH content. The idea that if DAH invest $100m transition means that countries need to invest $100m is a complete fallacy that seems to imply that DAH investment are aligned with national models of service delivery, prioritisation on HR, admin models etc. Many if not most SSA government know that it is not true. There is a lack of analysis on these numbers. What is essential and will be transitioned and at what costs is a DAH policy and research gap. 2. You can spend less but spend better and general analysis hide important national reforms. One interesting document are Article 4 by the IMF because they speak of government reforms. Some countries in SSA have reduced their level of government spending by consolidating ministries and reducing non-essential spending including travels. It sometimes happened during austerity period but in fact they are trying to spend better. I have never seen an article reflect on potentiel efficiency gains in domestic financing for health.. 3. Decentralisation means PHC spending is not (fully) captured in international data on health especially in Francophone countries and different models for national health insurance means they are not always standalone or rattached to MoH (often Ministry of Labor) which creates complexities in estimation. Seen is in many countries! 4. General analysis comparing such long time period don't account for reforms that can distort the review. For example, HCW rattached to central level which are now rattached to decentralized entities and/or Ministries, large number of HCW being put on retirement, budget for infrastructures for health moved from MoH to other ministries, reallocation of tasks, etc. 5. Gov focus is often on health budget execution first before health budget increase (which is clashing with DAH research focus). Endogenous & exogenous factors impact budget execution but in short, no MoF would or should simply increase health budget if the MoH execute less than 70% annually excluding salaries and running costs because they are moving towards impact-based budget allocation & question the opacity of some DAH investments. Weak PFM skills at MoH directly influence access to resources. Again, just some reflections. Thank you for the paper!

Universal Health Coverage (UHC). My thoughts: Countries in Sub-Saharan Africa are failing to achieve the Universal Coverage due to financial constraints and competition between other development and security agendas. I humbly advocate for a country specific tailored health Coverage models adapted to our economic situations, but of course refering to the WHO driven agenda. Health financing is a challenge but with some political will, every country at its level can work on a specific model that works for its people. Zambia Health Research Conference (#zhrc).

The 2023 World Health Organization African Region Atlas highlights ongoing challenges in mobilising resources for health in Africa. Between 2012 and 2020, only five of the 47 countries in the region met the recommended health spending threshold of US$ 249 per capita, revealing significant disparities in health investments across countries. While there has been a gradual increase in domestic government spending on health, only South Africa consistently met the Abuja Declaration target of allocating 15% of government expenditure to health. Most countries still struggle to prioritise health spending, with figures ranging from 2.1% to 12% of total government expenditure. Out-of-pocket payments (OOP) continue to be a significant source of health financing, accounting for an average of 35.8% of current health expenditure. This high reliance on OOP poses a financial risk to vulnerable populations, making healthcare less affordable. External funding remains crucial, with over 20% of current health expenditures funded externally in half of the region's countries. However, this dependence raises concerns about the sustainability of health systems, especially in the face of pandemics and emerging health challenges. Explore the full report for more insights into the region’s health financing landscape. https://lnkd.in/etE5NuDG #HealthFinancing #UHC #WHO #HealthExpenditure #Africa #SocialHealthProtection

The importance of policy in shaping health development can not be overemphasized, especially in developing countries in Africa striving to create a plausible health sector. It was an insightful time with Dr Francis Ohayindo DG WAIPH learning about policy formulation, stakeholder inputs and other stages of legislative policy development. @Waaph_Adovocate @TheWaaph @ohanyidof #YPPH24 #HLLP24 #UHC #WAIPH #healthliteracy #healthadvocates #Policydevelopment #HealthPolicy

#Nigeria’s health system faces significant challenges that impact access to essential services for vulnerable groups like women and children like resource shortages, lack of financing, and insufficient data. To address these challenges, and to improve maternal and child health outcomes, the Chemonics-led USAID Frontier Health Markets (FHM) Engage is using the market development approach to analyze the health market and offer recommendations. By helping to create an enabling environment for collaboration between public and private health actors, FHM Engage and the SCIDaR - Solina Centre for International Development and Research are tackling market failures head-on to improve access to and quality of #FamilyPlanning and #MNCH health products and services. Read about the program’s work to help address healthcare challenges and foster #LocallyLed solutions in Ebonyi and the Federal Capital Territory Abuja to strengthen the Nigerian #HealthSystem: https://ow.ly/SVxE50SO7Z6