| Titre : | Interventions in targeted health sectors and the support of Health System in Sub-Saharan African countries : the importance of commitment of the government, accountability governance, good leadership and management to improving Health System performance. |
| Auteurs : | Blaise Bikandou |
| Type de document : | Mémoire |
| Année de publication : | 2013 |
| Description : | 45p. / ann. |
| Langues: | Anglais |
| Classement : | EHMBA13/ (Master EHESP Executive Health MBA (master of business administration)) |
| Mots-clés : | Système santé ; Santé publique [généralité] ; Transfusion sanguine ; Vaccin ; Immunité ; Gouvernement ; Gestion ; Planification sanitaire ; Management ; VIH ; Séropositivité ; Congo Brazzaville ; Togo ; Pays ; Afrique subsaharienne |
| Résumé : | Most of the countries in developing world, mainly those in Sub-Saharan Africa, are still facing huge issues in delivering basic essential health services to their populations. Although during the past decade, the unprecedented amounts of money have been invested in the health sector of these countries, it did not yield the expected return in terms of improved health outcomes. Intermediate evaluations reveal that some progress has been made but that many African countries are not on track to achieve the health MDGs by 2015. Among health systems’ weaknesses, the insufficiency of political interest and commitment, lack of accountability governance and leadership in management are noteworthy. Although most of actors agree that strengthening the whole health system is the best way to deliver health services to people, in the reality, donors and funding agencies still prioritize and focus their assistance (financial and technical) on targeted health sectors through vertical instead of horizontal and broader interventions. To contribute on the international debate on the effectiveness of support provided to health sector, and highlight the key role of interest and proactive commitment of local government, good health governance, leadership and management, to generate positive outcomes and strengthen the health system. The study, focused on the performance of targeted and vertical health interventions, scans six core competencies of three health sectors. We carried out a comparative review of the organizational governance; leadership and management; technical expertise, resource mobilization and coordination capacities in 2005 versus 2011 in the blood transfusion system, vaccines and immunization and national AIDS councils in two Sub-Saharan African countries: Congo-Brazzaville (Central Africa) and Togo (West Africa). Although these selected countries are French-speaking areas, beyond their geographical distance, they also had some diversity in term of their socio-economical profiles, as well as the pattern of their public health system; both countries are facing the burden of communicable and non-communicable diseases. We employed two complementary approaches for data collection: a review of the literature and databases and interviews with senior institutional/organisational officials during a short sites visit. In Togo, in spite of limited national financial resource (GDP $531 for a population of 6 millions), stressed by the dramatic decrease of the international assistance due to the withdrawal of all of funding agencies consecutive to the political unrest and slaughters arisen during the year 2000’s political uprising, most of key indicators show that the health status has been improved. Health spending reaches 6% of total public expenditure and 3% of GDP. In contrast, Congo, with substantial financial resources (GDP almost $3000 for a population of 4 millions) and significant financial support from International donors (World Bank, Global Fund, GAVI, bilateral cooperation) shows a per capita total expenditure on health of $72 ($90 in 2000) whereas the average in the African region is around $140. Worse, the health spending represent only 3.4% (1% of GDP) of total public expenditure whereas the average in Sub Saharan African countries is around 7% (In 2001, in Abuja the recommendation was to reach 15%). This comparative analysis in these two countries highlights the difference in political vision, interest and proactive commitment, good and accountability health governance, leadership and management. Beyond the funding aspect which remains important point, these capacities are essential for improving the outcomes of health system and therefore generating the positives impacts on various communities throughout countries. This study demonstrates that the positives outcomes of targeted health interventions through vertical projects are closely linked to political vision, interest and commitment, good governance and accountability, leadership and management. This may require more investment in building capacity, strategically focus on the human resource strengthening to forge the health system which should be flexible and resilient Congo-Brazzaville, Togo and other sub-Saharan African countries. The implementation of short-term recommendations may allow these countries to respond to their population’s needs, face the challenges of communicable diseases and a rapid increasing of non-communicable. |
| Diplôme : | Master MBA Executive Health |
| Plan de classement simplifié : | Master EHESP Executive Health (MBA) |
| En ligne : | http://documentation.ehesp.fr/memoires/2013/ehmba/bikandou.pdf |
Exemplaires (1)
| Code-barres | Cote | Support | Localisation | Section | Disponibilité |
|---|---|---|---|---|---|
| 080332 | EHMBA13/0001 | Mémoire | Rennes | Magasin | Empruntable Disponible |
Documents numériques (1)
 ehmba/Bikandou URL |