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Health Systems Strengthening in the DRC

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Presenter: Fred Rosensweig

Presenter: Fred Rosensweig

Published in: Health & Medicine, Business

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  • 1. better systems, better health Health Systems Strengthening in the DRC Better Health Systems: Strategies that Work Presentation Series at the Global Health Council Fred Rosensweig February 7, 2012Abt Associates Inc.In collaboration with:I Aga Khan Foundation I Bitrán y AsociadosI BRAC University I Broad Branch AssociatesI Deloitte Consulting, LLP I Forum One CommunicationsI RTI International I Training Resources GroupI Tulane University’s School of Public Health
  • 2. Overview of Health Systems 20/20’sActivities in DRC  Program facts: 4 years and $7.3m  Goals 1) Strengthen policymaking and inform strategies in health financing aimed at increasing access to services 2) Build sustainable institutional capacity of key national entities in management and coordination to enhance their effectiveness
  • 3. Health Systems 20/20 Program Health financing - National Health Accounts – including WASH subaccount - Development of performance-based financing policy (PBF) and initial support for roll-out - Evaluation of Mutual Health Organization experience - Sub-recipient assessment for Global Fund grant
  • 4. Health Systems 20/20 Program Capacity-building - Institutional Strengthening of Kinshasa School of Public Health (KSPH) - Strengthening of management and coordination capacity of HIV/AIDS Office (PNLS), Nutrition and Family Planning Offices in MOH
  • 5. Challenges Challenge ConsequencesWeak institutional capacity • No accountability • Limited follow through • Poorly paid staff • Poor working conditionsDependency on donor funding • Limited government resources • Strongly influenced by donor prioritiesLack of qualified local consultants • Best people leave to work for development partnersPersonal economic security • Everyone is in survival or rent- seeking mode • Lack of concern for the greater good
  • 6. Coping with these Challenges Weak institutional capacity - Identify and work in partnership with strong leadership - Build management capacity over time (no short- term fix) - Make tangible improvements in working conditions - Find ways to motivate staff
  • 7. Coping (cont.) Dependency on donor funding - Leverage other donors’ funding - Plan based on available resources - Develop capacity to attract and mobilize resources Finding qualified local consultants - Use a mix of local staff and resident expats
  • 8. Coping (cont.) Personal economic security - Create incentives so all benefit - Use existing incentives (e.g, per diems for residential meetings) - Reward performance (PBF)
  • 9. How these HSS InterventionsReduce Fragility KSPH is an enabling institution that trains public health leaders and carries out the analyses that inform HSS and health policy decisions PNLS has a stewardship role in development and oversight of HIV/AIDS programs By highlighting lack of resources, poor government commitments, and lack of support at provincial level, NHA provides information for improving state legitimacy
  • 10. Reducing Fragility Strengthening NHA unit in MOH has attracted other donors and enhanced its role Large-scale PBF system provides incentives to achieve results and improve service delivery
  • 11. better systems, better health Thank you www.HealthSystems2020.orgAbt Associates Inc.In collaboration with:I Aga Khan Foundation I Bitrán y AsociadosI BRAC University I Broad Branch AssociatesI Deloitte Consulting, LLP I Forum One CommunicationsI RTI International I Training Resources GroupI Tulane University’s School of Public Health