Making Lemonade out of Lemons

1. Making Lemonade Out of
Lemons
CORE GHPC 2015 Closing Plenary
April 17, 2015
Janine Schooley, PCI
Gillian McKay, GOAL Global
How to Optimize Health System
Strengthening instead of Running from One
Crisis to Another

2. For Your Consideration For the Next 90
Minutes
 Let’s Think “Recommissioning” not “Decommissioning”
 Plan
 Context
 Case Study
 Recap of Key Issues
 Group Discussion
 Presentation of Highlights from Discussion

3. Lemons by Themselves: Pretty Sour
 In thinking about the Ebola Response, we are at risk of:
 Withering away the momentum
 Neglecting to integrate new healthcare workers into the Health Care System
 Allowing new infrastructure (like ETCs) to rot away
 Continuing to allow the Health System to omit Communities
 Perpetuating parallel health care systems
 Might as well just sit and wait for the next crisis!

4. Ebola in Sierra Leone: A
Case Study

5. A World Before Ebola
Health SystemCommunity

6. EBOLA

7. Stage 1: Health Systems Medicalized
Approach

8. Step 2: Social Mobilization & Community
Engagement

9. Are We Making Lemonade in Sierra
Leone?
 Government is Leading on Early Recovery
Prioritization with Partner Support:
 Restoration of Health Services and Build a
Resilient Health System
 Reopen Educational Facilities
 Enhance Food Security Initiatives
 Expand WASH
 Increase Private Sector Participation
 Expand Social Protection Services
 Close the Deficit
 GREAT PRIORITIES, no question! But is this
enough? How do we mitigate the backlash?

10. Some LemonAID…
 Keen Donor and NGO engagement for
long term recovery efforts
 But much remains Top-Down
 Medicalized Approaches
 Infection Prevention & Control
 WASH
 Triage
 “Core” ETCs
 Emergency Obstetric Care
 Surveillance/Social Mobilisation Efforts
 Communicable-disease preparedness
 Immunisation programming
 Data Collection and Analysis

11. A Voice from the Field
“I think it would be of great benefit if the current
structures are maintained. In the first place, it encourages
involvement of local people in decision making as well as
the use of local resources in addressing problems. I strongly
believe that one of the key reasons why we initially
struggled to contain the Ebola outbreak was because local
people felt left out in the response. Once that was rectified
we have increasingly seen the power held by tribal, local,
religious leaders, youths and women at the ward level to
solve problems. I would love to see biweekly meetings at
ward level even after Ebola to address any other problems
or spikes that may arise.”
Sulaiman Bah
Peer Supervisor
Social Mobilisation Action Consortium

12. Let’s ALL Make Lemonade and Then
Actually DRINK It!!
 Let’s Capitalise on Strengths and Momentum!
 Infrastructure
 Human Capacity
 Social Capital & Determinants
 Services and Systems

13. And Let’s Make It Sweeter!
 Let’s Advocate for the Community to DRIVE the Process!
 Human Centred Design to decide what to do with ETUs/ETCs/CCCs
 Integration of Skilled Workers in System
 Capitalise on New and Existing Community Networks
 Rebuild Trust in Services and System
 Let’s ask (and answer) the question:
 What COULD the system look like in 10 years if the community were driving
Decision Making?

14. Discuss HOW the Lemonade Is Made:
 What clear steps can be taken internally within your own organization?
 What can CORE do as a community in terms of an advocacy platform to push
these ideas forward?

15. Thank you!