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Country Summary

Guinea-Bissau

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

Resumo analítico - Políticas públicas de saúde

Panorâmica das principais reformas em matéria de políticas

Políticas de saúde pública

Políticas de sistema de saúde

Políticas em outros sectores e políticas intersectoriais

Prioridades e rumo a seguir - Políticas públicas de saúde

Outros - Políticas públicas de saúde

Notas finais: fontes, métodos, abreviaturas, etc.

References

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Central_African_Republic

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

Résumé analytique

Vue d'ensemble des réformes politiques

Politique de santé publique

Politique du système de soins de santé

Politiques intersectorielles et dans d'autres secteurs d'activités

Priorités et pistes pour l'avenir

Autres

Notes de fin: sources, méthodes, abréviations, etc.

References

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Cape_Verde

The English content will be available soon.

Rostos8.jpg

Cabo Verde passou por três modelos distintos de sistema de saúde no processo de organização e reorganização sectorial na tentativa de melhor responder às demandas da população[1]. O país passou por um sistema de saúde desorganizado e mal definido durante a era colonial até 1975. Num estágio seguinte do seu desenvolvimento experimentou um sistema completamente estatal com limitação da liberdade de escolha, tanto dos usuários quanto dos recursos humanos e provedores até 1991.

Burundi

The English content will be available soon.

Le Burundi a adopté une Politique Nationale de Santé [2] (PNS 2005-2015), qui est basée sur les Soins de Santé Primaires. Elle est mise en œuvre à travers un Plan National pour le Développement du Secteur de Santé et des Plans Stratégiques sous sectoriels.

Le Ministère de la Santé et de la lutte contre le Sida vient d’élaborer son 2ème Plan de développement sanitaire (PNDS II) 2011-2015 [3] à l’issu d’une évaluation externe de son PNDS I 2006-2010. Il a également élaboré un Cadre de Suivi Evaluation du PNDS II, ce qui constitue un avantage par rapport au PNDS I. Etant donné que le MSPLS s’oriente vers l’approche de planification programmatique en laissant tomber l’approche projet, ses équipes viennent de terminer une proposition pour le « compact » à discuter avec les partenaires dans le cadre du démarrage de l’approche sectorielle (SWAP).

Cameroon

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[4] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.


References

  1. Uma Análise compreensiva da reforma do sistema de Saúde de Cabo Verde: Identificando as perspectivas de futuro na opinião dos principais actores. Orlando Ferreira Dias, Recife, 2010
  2. Politique Nationale de Santé 2005-2015. doc 188 Ko
  3. PNDS 2011-2015. 895Ko
  4. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Burkina_Faso

The English content will be available soon.

Le Burkina Faso a procédé en 2010 à la révision de sa politique sanitaire nationale et à l’élaboration d’un Plan national de développement sanitaire [1] couvant la période de 2011 à 2020.

Le but de la nouvelle politique nationale de santé est de contribuer au bien-être des populations. Le document de politique national de santé est organisé autour de huit orientations stratégiques que sont :

Botswana

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[2] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

Analytical summary

The master policy for the health system is the National Health Policy that was first formulated in 1995 to guide the development of the health sector toward attainment of the highest level of health. In response to changes in the health status of the population, health care technologies and the organization of the health system, the National Health Policy was revised in 2011.

The revised policy puts emphasis on:

  • quality of care
  • optimum health services utilization
  • fair distribution of services across the population spectrum
  • protection of disadvantaged and vulnerable populations
  • social determinants of health
  • partnerships of the public sector, private sector, civil society and communities.

Plans are underway to establish a National Health Council to coordinate and oversee all health sector activities.


Overview of major policy reforms

Public health policies

Health system policies

Policies in other sectors and intersectoral policies

Priorities and ways forward

Others

Endnotes: sources, methods, abbreviations, etc.

References

  1. plan national de développement sanitaire. 3,2Mo
  2. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Benin

The English content will be available soon.

Le droit à la santé, clairement stipulé par la Constitution du 11 décembre 1990 en ses articles 8 et 26, est un enjeu majeur pour le développement de notre société. Les Etudes Nationales de Perspectives à Long Terme Bénin ALAFIA 2025 en ont fait une priorité de même que les Orientations Stratégiques de Développement du Benin 2006-2011 [1]. Aussi, le Bénin a-t-il souscrit à la réalisation des Objectifs du Millénaire pour le Développement en matière de santé.

Angola

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[2] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

Analytical summary

Overview of major policy reforms

Public health policies

Health system policies

Policies in other sectors and intersectoral policies

Priorities and ways forward

Others

Endnotes: sources, methods, abbreviations, etc.

References

  1. OSD Bénin 2006-2011 OSD Bénin. 8,6Mo
  2. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Algeria

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.


References

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Zimbabwe

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.


This section on General country health policies is structured as follows:

Analytical summary

Overview of major policy reforms

Public health policies

Health system policies

Policies in other sectors and intersectoral policies

Priorities and ways forward

Others

Endnotes: References, sources, methods, abbreviations, etc.

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Comoros

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

Résumé analytique

The English content will be available soon.

Journées médiacles d'Ophtalmologie au Moroni.jpg

L’Union des Comores dispose d’une Politique Nationale Sanitaire 2005-2014, réactualisé en octobre 2012 dont les objectifs globaux sont :

  • La réduction des mortalités maternelle, néonatale, infantile, en ligne avec les objectifs du millénaire
  • Réduire le taux de paludisme à moins de1% (par le traitement de masse avec les ACT)
  • Maintenir le taux de prévalence du VIH SIDA inférieur à 0,025%

Vue d'ensemble des réformes politiques

Politique de santé publique

Politique du système de soins de santé

Politiques intersectorielles et dans d'autres secteurs d'activités

Priorités et pistes pour l'avenir

Autres

Notes de fin: sources, méthodes, abréviations, etc.

References

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Equatorial_Guinea

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

Résumé analytique

La première initiative d'élaborer la politique nationale de santé (PNDS), a eu lieu en Juin 1994 pour manque d'expérience, le document n'était pas conforme, en raison de manque d'assistance technique dans ce domaine.

La première édition a été préparée par un groupe d'experts nationaux avec l'assistance technique de l'OMS en Octobre 2002. cette édition, avais produise quatre documents:

Document de Politique Nationale de Santé

Ce document décrit le cadre politique général, sous réserve de toute action de développement sanitaire en Guinée équatoriale, avec le contenu suivant: l’introduction, sommaire exécutif, les orientations stratégiques, la vision, les principes, objectifs, buts et objectifs spécifiques ainsi que le stratégie.


Vue d'ensemble des réformes politiques

Politique de santé publique

Politique du système de soins de santé

Politiques intersectorielles et dans d'autres secteurs d'activités

Priorités et pistes pour l'avenir

Autres

Notes de fin: sources, méthodes, abréviations, etc.

References

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Kenya

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

Analytical summary

Overview of major policy reforms

Public health policies

Health system policies

Policies in other sectors and intersectoral policies

Priorities and ways forward

Others

Endnotes: sources, methods, abbreviations, etc.

References

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Guinea

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

Résumé analytique

Vue d'ensemble des réformes politiques

Politique de santé publique

Politique du système de soins de santé

Politiques intersectorielles et dans d'autres secteurs d'activités

Priorités et pistes pour l'avenir

Autres

Notes de fin: sources, méthodes, abréviations, etc.

References

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Ghana

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

Analytical summary

Overview of major policy reforms

Public health policies

Health system policies

Policies in other sectors and intersectoral policies

Priorities and ways forward

Others

Endnotes: sources, methods, abbreviations, etc.

References

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Gabon

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

Résumé analytique

The English content will be available soon.

Les nouvelles autorités ont entrepris un vaste programme de réformes qui visent à créer l’environnement idoine pour faire du Gabon un pays émergent à l’horizon 2025.

Sont concernés par ce programme le renforcement de la bonne gouvernance, notamment dans son volet « lutte contre la corruption et contre la pauvreté », l’accès au logement et à la propriété foncière, la mise en place du régime obligatoire d’assurance maladie universelle, le fonctionnement de l’appareil statistique national pour produire des informations de qualité sur le suivi des OMD et des secteurs économiques et sociaux, le dispositif législatif et règlementaire pour le conformer aux Déclarations, Conventions et Accords internationaux signés par le Gabon, la promotion des initiatives et organisations à base communautaire facilitant l’appropriation par les populations des mesures préventives favorables à l’amélioration de leur bien-être, l’entrepreneuriat local pour qu’il contribue à la diversification de l’économie nationale, la mise en œuvre des politiques et stratégies sectorielles visant le développement équitable, égalitaire et inclusif du capital humain, l’accès aux services de qualité en matière d’éducation et de santé, notamment pour les populations les plus démunies.

Vue d'ensemble des réformes politiques

Politique de santé publique

Politique du système de soins de santé

Politiques intersectorielles et dans d'autres secteurs d'activités

Priorités et pistes pour l'avenir

Autres

Notes de fin: sources, méthodes, abréviations, etc.

References

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Gambia

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

Analytical summary

Decentralization is the major cornerstone of the Government of the Gambia's Poverty Reduction Strategy 2007–2011[2] to improve service delivery to the poor. Decentralization involves the creation of regional health teams, which currently are headed by directors. Regular meeting between the regional teams is an entry point to revitalize primary health care in the regions.

Public health policies have been formulated by the Ministry of Health and Social Welfare to engage all disciplines for effective management of the population`s health and well-being. The National Health Policy serves as the basis for all other policies in the health sector. The Health is Wealth 2011–2020 Policy covers areas of health system strengthening as well as new inputs resulting from gaps identified in the previous policy.


Overview of major policy reforms

Public health policies

Health system policies

Policies in other sectors and intersectoral policies

Priorities and ways forward

Others

Endnotes: sources, methods, abbreviations, etc.

References

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009
  2. Final report of the mid-term review of the Poverty Reduction Strategy Paper (PRSPII) 2007–20011 (pdf 580.60kb). IMF Country Report No. 11/27. Washington DC: International Monetary Fund, International Development Support Services; 2011

Ethiopia

Historically, the health system in Ethiopia was centralized and services were delivered in a fragmented manner with a reliance on vertical programmes. There was little collaboration between the public and private sectors. Administrative arrangements were also centralized until 1991. In 1992, a new health policy was developed following a critical examination of the nature, magnitude and root causes of the prevailing health problems of the country and awareness of newly emerging health problems.

The new policy was founded on commitment to democracy, the rights of the people, and decentralization as the most appropriate system of government for the full exercise of these rights and powers in a pluralistic society. At the core of the health policy is:

  • democratization and decentralization of the health care system
  • developing preventive, promotive and curative components of health care
  • accessibility of health care for all parts of the population
  • encouraging private and nongovernmental organization participation in the health sector.[1]

Côte_d'Ivoire

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[2] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

Résumé analytique

The English content will be available soon.

La Politique Nationale de Santé traduit la volonté du Gouvernement et de ses partenaires d’apporter des réponses urgentes et efficaces aux problèmes sanitaires du pays caractérisés surtout par des niveaux encore élevés des taux de morbidité et de mortalité touchant plus particulièrement la femme et l’enfant. La vision du pays en matière de santé est celle d’un système de santé performant à même de garantir à tous les citoyens particulièrement les populations les plus vulnérables, un état de santé optimal pour soutenir durablement la croissance et le développement du pays. Cette vision est soutenue par les valeurs d'équité, de justice sociale, d'éthique, de solidarité nationale, de rigueur et de transparence.

Vue d'ensemble des réformes politiques

Politique de santé publique

Politique du système de soins de santé

Politiques intersectorielles et dans d'autres secteurs d'activités

Priorités et pistes pour l'avenir

Autres

Notes de fin: sources, méthodes, abréviations, etc.

References

  1. Health Sector Development Programme IV. Annual performance report. Addis Ababa, Government of Ethiopia, Ministry of Health, 2010
  2. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Chad

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

Résumé analytique

Vue d'ensemble des réformes politiques

Politique de santé publique

Politique du système de soins de santé

Politiques intersectorielles et dans d'autres secteurs d'activités

Priorités et pistes pour l'avenir

Autres

Notes de fin: sources, méthodes, abréviations, etc.

References

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Democratic_Republic_of_the_Congo

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

Résumé analytique

Vue d'ensemble des réformes politiques

Politique de santé publique

Politique du système de soins de santé

Politiques intersectorielles et dans d'autres secteurs d'activités

Priorités et pistes pour l'avenir

Autres

Notes de fin: sources, méthodes, abréviations, etc.

References

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Eritrea

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

Analytical summary

Overview of major policy reforms

Public health policies

Health system policies

Policies in other sectors and intersectoral policies

Priorities and ways forward

Others

Endnotes: sources, methods, abbreviations, etc.

References

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Uganda

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.


This section on General country health policies is structured as follows:

Analytical summary

Uganda has an overall policy and planning framework enshrined in its National Development Plan.[2] The sector planning framework is guided by the National Health Policy[3] and the Health Sector Strategy and Investment Plan.[4]

The key collaborative sectors also have specific sectoral plans.


Overview of major policy reforms

Public health policies

Health system policies

Policies in other sectors and intersectoral policies

Priorities and ways forward

Others

Endnotes: References, sources, methods, abbreviations, etc.

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009
  2. National Development Plan (2010/11–2014/15) (pdf 10.01Mb). Kampala, Government of Uganda, Ministry of health, 2010
  3. The Second National Health Policy. Promoting people’s health to enhance socio-economic development (pdf 849Kb). Kampala, Ministry of Health, 2010
  4. Health Sector Strategy and Investment Plan (2010/11 - 2014/15) (pdf 2.91Mb). Promoting People’s Health to Enhance Socio-economic Development, Ministry of Health, Kampala, Uganda

Togo

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

3.10.1 Analytical summary
3.10.2 Overview of major policy reforms
3.10.3 Public health policies
3.10.4 Health system policies
3.10.5 Policies in other sectors and intersectoral policies
3.10.6 Priorities and ways forward



References

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Tanzania

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

3.10.1 Analytical summary
3.10.2 Overview of major policy reforms
3.10.3 Public health policies
3.10.4 Health system policies
3.10.5 Policies in other sectors and intersectoral policies
3.10.6 Priorities and ways forward



References

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Mauritius

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

3.10.1 Analytical summary
3.10.2 Overview of major policy reforms
3.10.3 Public health policies
3.10.4 Health system policies
3.10.5 Policies in other sectors and intersectoral policies
3.10.6 Priorities and ways forward



References

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Malawi

In Malawi, the Ministry of Health is implementing public health policies that are guided by a number of documents, including the Constitution of the Republic of Malawi, the Public Health Act and To the year 2020: a vision for the health sector in Malawi.[1]

A number of health sector reforms have been initiated by the Ministry of Health with a view to improving efficiency and providing quality health services. The major policy reforms include:

Mauritania

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[2] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

3.10.1 Analytical summary
3.10.2 Overview of major policy reforms
3.10.3 Public health policies
3.10.4 Health system policies
3.10.5 Policies in other sectors and intersectoral policies
3.10.6 Priorities and ways forward



References

  1. To the year 2020: a vision for the health sector in Malawi. Lilongwe, Government of Malawi, Ministry of Health and Population, 1999
  2. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Madagascar

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

3.10.1 Analytical summary
3.10.2 Overview of major policy reforms
3.10.3 Public health policies
3.10.4 Health system policies
3.10.5 Policies in other sectors and intersectoral policies
3.10.6 Priorities and ways forward




References

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Mali

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

3.10.1 Analytical summary
3.10.2 Overview of major policy reforms
3.10.3 Public health policies
3.10.4 Health system policies
3.10.5 Policies in other sectors and intersectoral policies
3.10.6 Priorities and ways forward



References

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Lesotho

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

3.10.1 Analytical summary
3.10.2 Overview of major policy reforms
3.10.3 Public health policies
3.10.4 Health system policies
3.10.5 Policies in other sectors and intersectoral policies
3.10.6 Priorities and ways forward



References

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Liberia

The Government of Liberia's 2011 National Health Policy builds on:

The 2011 National Health Policy draws upon the knowledge gained by implementing these policies as well as from numerous sources of new data on the health status of the Liberian population. Thus, the Ministry of Health and Social Welfare is confident that the 2011 National Health Policy’s orientation is evidence based and reflects the best information and guidance available at the time it was developed.

The mission of the Ministry is to reform and manage the sector to effectively and efficiently deliver comprehensive, quality health and social welfare services that are equitable, accessible and sustainable for all people in Liberia.

Congo

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

Résumé analytique

Vue d'ensemble des réformes politiques

Politique de santé publique

La politique Nationale de Santé (PNS) stipule que la santé représente un secteur d’investissement et doit, de ce fait, obéir aux règles d’utilisation rationnelle des ressources afin que le meilleur état de santé de la population soit le garant de la prospérité et du développement économique et social du pays1. De ce fait elle repose sur quatre fondements majeurs : le droit à la santé, l'équité, la solidarité et la démocratie. Elle vise à améliorer l’état de santé des populations afin de promouvoir leur participation au développement socio économique du pays. La concrétisation de ce but passe par la réalisation de trois objectifs généraux :

  • promouvoir et protéger la santé des individus et des collectivités sur l’ensemble du territoire ;
  • garantir l’accessibilité des populations aux services et aux soins de santé de qualité ;
  • renforcer les capacités nationales à la gestion du système de santé.

Politique du système de soins de santé

La PNS édicte cinq principes directeurs qui doivent guider sa mise en œuvre :

  • Le ministère en charge de la santé assure la tutelle technique et administrative de la mise en œuvre de la politique nationale de santé sous le triple contrôle des pouvoirs exécutif, législatif et des représentants de la société civile ;
  • L’Etat doit restructurer l’organisation et le fonctionnement de l’administration pour la mobilisation et l’utilisation optimale des ressources en vue d’une meilleure gestion du système de santé ;
  • L’Etat doit assurer, grâce à ses fonctions de régulation et d’arbitrage et en tant que garant de la santé des citoyens, les conditions d’une saine concurrence et d’un développement harmonieux du système national de santé ;
  • L’Etat recherche un meilleur rapport coût – efficacité dans la gestion du système national de santé en fonction des ressources disponibles et des priorités identifiées.

Politiques intersectorielles et dans d'autres secteurs d'activités

Priorités et pistes pour l'avenir

Autres

Notes de fin: sources, méthodes, abréviations, etc.

References

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

AFRO

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

Analytical summary

Overview of major policy reforms

Public health policies

Health system policies

Policies in other sectors and intersectoral policies

Priorities and ways forward

Others

Endnotes: sources, methods, abbreviations, etc.

Click here to access the statistical fact sheets on health systems.

References

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Mozambique

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

3.10.1 Analytical summary
3.10.2 Overview of major policy reforms
3.10.3 Public health policies
3.10.4 Health system policies
3.10.5 Policies in other sectors and intersectoral policies
3.10.6 Priorities and ways forward



References

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Namibia

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.


This section on General country health policies is structured as follows:

Analytical summary

Overview of major policy reforms The Namibia health and social services sector since independence was guided by the Policy Statement of 1990 and the 1998 Policy Framework. The National Health Policy Framework 2010-2020 was developed to keep pace with changes in the health sector and is aligned to the National Development Plan 3, the Ministry of Health and Social Services Strategic Plan 2009–2013, and the Millennium Development Goals. (MoHSS, July 2010)

The main reform initiatives that have taken place since independence include the restructuring and re-orientation of the health sector in line with the Primary Health Care (PHC) approach; the shift in orientation of social services from curative and remedial social work to a developmental approach with emphasis on prevention of social ills and empowerment of individuals, groups, and communities; the performance improvement of the civil service through the establishment of the Wages and Salaries Commission (WASCOM) and the introduction of the Public Service Charter; the broadening of health financing options through the introduction of user-fees policy at all facilities; and the introduction of the principle of managed competition in the area of buying-in support services. (MoHSS, 2008)


Overview of major policy reforms

Public health policies

Health system policies

Policies in other sectors and intersectoral policies

Priorities and ways forward

Others

Endnotes: References, sources, methods, abbreviations, etc.

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Swaziland

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.


This section on General country health policies is structured as follows:

Analytical summary

The Ministry of Health promulgated a National Health Policy, 2007 in pursuit of the health sector vision. The vision of the sector is that by 2015, the sector shall have developed an efficient and effective system that will contribute to a healthy population that lives longer and has socially fulfilling lives.

The policy addresses seven thematic areas namely, organization and management, coordination, human resources, quality assurance, health financing, infrastructure development and equipment maintenance and service provision (public health and clinical services). The policy is being implemented through the National Health Strategic Plan 2008 -2013.

The national health sector strategic plan is linked to the PRSAP. This linkage turns the PRSAP into concrete MDG-based long-term results-oriented health plan. The essence of the national health sector strategic plan is to reposition the health sector to capitalise on its strategic competencies and redefine its approach to improving quality of health care.


Overview of major policy reforms

Public health policies

Health system policies

Policies in other sectors and intersectoral policies

Priorities and ways forward

Others

Endnotes: References, sources, methods, abbreviations, etc.

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

South_Sudan

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

3.10.1 Analytical summary
3.10.2 Overview of major policy reforms
3.10.3 Public health policies
3.10.4 Health system policies
3.10.5 Policies in other sectors and intersectoral policies
3.10.6 Priorities and ways forward



References

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

South_Africa

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

3.10.1 Analytical summary
3.10.2 Overview of major policy reforms
3.10.3 Public health policies
3.10.4 Health system policies
3.10.5 Policies in other sectors and intersectoral policies
3.10.6 Priorities and ways forward



References

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Sierra_Leone

Various health sector policies have been developed over the years:[1]

SchoolChildren.png

Seychelles

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[2] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

3.10.1 Analytical summary
3.10.2 Overview of major policy reforms
3.10.3 Public health policies
3.10.4 Health system policies
3.10.5 Policies in other sectors and intersectoral policies
3.10.6 Priorities and ways forward



References

  1. Monitoring and evaluation of the National Health Sector Strategic Plan: a framework for results and accountability 2010–2015. Government of Sierra Leone, Ministry of Health and Sanitation, 2011
  2. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Senegal

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

3.10.1 Analytical summary
3.10.2 Overview of major policy reforms
3.10.3 Public health policies
3.10.4 Health system policies
3.10.5 Policies in other sectors and intersectoral policies
3.10.6 Priorities and ways forward



References

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Sao_Tome_and_Principe

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

3.10.1 Analytical summary
3.10.2 Overview of major policy reforms
3.10.3 Public health policies
3.10.4 Health system policies
3.10.5 Policies in other sectors and intersectoral policies
3.10.6 Priorities and ways forward



References

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Rwanda

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

3.10.1 Analytical summary
3.10.2 Overview of major policy reforms
3.10.3 Public health policies
3.10.4 Health system policies
3.10.5 Policies in other sectors and intersectoral policies
3.10.6 Priorities and ways forward



References

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Nigeria

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

3.10.1 Analytical summary
3.10.2 Overview of major policy reforms
3.10.3 Public health policies
3.10.4 Health system policies
3.10.5 Policies in other sectors and intersectoral policies
3.10.6 Priorities and ways forward



References

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Niger

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.

This section of the health system profile is structured as follows:

3.10.1 Analytical summary
3.10.2 Overview of major policy reforms
3.10.3 Public health policies
3.10.4 Health system policies
3.10.5 Policies in other sectors and intersectoral policies
3.10.6 Priorities and ways forward



References

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009

Zambia

Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities.[1] They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).

Primary health care reforms necessary to refocus health systems towards health for all

The following policies must be in place:

  • Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
  • Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
  • Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.


This section on General country health policies is structured as follows:

Analytical summary

Over the past years, the Government of Zambia has taken a number of actions and strategies in various sectors, aimed at reducing inequities and improving health and living conditions. The concept of "equity of access to assure quality, cost-effective and affordable health services, as close to the family as possible" is at the heart of the 1992 National Health Policies and Strategies which is guiding policy reforms since it enactment.


Overview of major policy reforms

Over the years, the health sector has under-gone major policy reforms, which are still on-going. These reforms have been guided by the National Health Policies and Strategies of 1992, which has provided the strategic direction to the reforms, based on the following vision, goal and principles:

  • Vision: Equity of access to assured quality, cost-effective and affordable health services, as close to the family as possible.
  • Goal: To further improve health service delivery in order to significantly contribute to the attainment of the health Millennium Development Goals and national health priorities.
  • Principles: Equity, cost-effectiveness, affordability, accountability, partnerships, decentralisation and leadership.

In practice, these policy reforms materialized into a major restructuring of the health sector which conducted to the enactment of the National Health Services Act (attach doc) of 1995. This led the same year to the first model of decentralization of responsibilities of priority setting, planning and health service delivery to the districts and local communities. Yet, the model opted for was hardly sustainable in practice and the second version developed in 2005 somewhat resulted in re-centralization of decision-taking at central level, as discussed in Decentralization of the system

Also in 2005, the Government of Zambia has launched a new long-term vision, called “Vision 2030” (attach doc), which aims at transforming the country into a “middle-income prosperous nation by 2030”. During the same year, the Fifth National Development Plan (FNDP) (attach doc), the National Health Strategic Plan 2006-2010 and the Human Resources for Health Strategic Plan 2006-2010, all covering a period of 5 years from 2006 to 2010, were launched, and are still being implemented. The FNDP is broad-based and focused at achieving accelerated, meaningful and sustainable development across the sectors. In this respect, it is largely influenced by local and international priorities, particularly the Millennium Development Goals (MDGs). Through this plan and the respective sector strategies, all the 8 MDGs have been appropriately domesticated and incorporated.


A summary of the evolution of the major health sector policy reforms implemented since 1992 is provided Table 7.1 below.

Zambia Table 7.1.jpg


Public health policies

By design, the existing health policies are modelled along the national health vision of “equity of access to assured, cost-effective and affordable health services, as close to the family as possible”.

In this respect, key policies and accompanying strategies implicitly comprise an objective of ensuring equitable access to primary health care services for all the population, regardless of the social, economic and geographical status, and comply with most recommendations of the WHO Commission on Social Determinants for Health.

The Zambian policy formulation process, is articulated around broad consultations at all the levels of the health system, which provide additional guarantee on their compliance with international standards and concepts (as the WHO PHC renewal). The process is also significantly influenced by global health initiatives, through the SWAp arrangement and also through various global initiatives and disease-centered approaches[2].

However, in practice, the health system faces a number of challenges which contribute to inequities in various areas, such as: inadequate funding and imperfect coordination arrangements regarding Global Initiatives; critical shortages of health workers and sub-optimal distribution of available health workers, to the disadvantage of rural communities; weaknesses in the supply of drugs and other medical items; inappropriateness of some infrastructures and equipment, and maintenance issues.

The above factors largely affect health service delivery, particularly for rural communities and disadvantaged vulnerable population groups, such as women, children, and physically challenged groups. These matters are discussed in addressed in a number of reports and assessments[3]. It creates various forms of iniquities:

  • Iniquities between the urban and rural areas in several areas, including the distribution of facilities, human resources and drugs and other medical supplies.
  • Iniquities between provinces with a significant differential in the distribution of resources between A and D provinces (see among others the section on HR stock and distribution). These iniquities actually extends to differences in socio-economic development and access to other essential public services (education, transports, etc.).
  • others

Efforts made towards primary health care policies are also somewhat undercut by the importance taken by priority health programmes in the Zambian health system. These mainly include: HIV&AIDS programmes, including the National HIV/AIDS/STI/TB Council (NAC); the National Malaria Control programme; National TB and Leprosy Control Programme; the Child Health and Nutrition Programme; and the Maternal Health Programme.

These programmes undoubtedly play an important role in the implementation of various health policies, which they spearhead at all the levels. Nevertheless the vertical nature of their activities may undermine PHC services, mainly through creation of imbalances in the financing and support to critical activities throughout the health system and through inadequate coordination and integration within the SWAp institutional arrangements.


Health system policies

Zambia’s health system offers an interesting set of policies, which have clearly been influenced by principles as decentralization, community participation, patient centeredness and equity.

Yet, reforming a health system takes time. For various reasons, there are still gaps between the principles (“bringing health services as close to the family as possible”) and actual implementation.

In this section, we briefly discuss, building block per building block, to what extent health system reforms comply with the primary health care (PHC) objectives and the key options conveyed by the Commission on Social Determinants for Health.

Leadership and governance (see Chapter 1)
  • The 1995 decentralization policy was a clear attempt to strengthen community participation, distribution of power, and the responsiveness of the health system to the patients’ demand. However, the actual outcomes are now being questioned with the latest 2005 restructuring, which appears to have re-concentrated decision-making power back to the MOH.
  • The long-lasting SWAp governance system is a strong Zambian asset to stimulate the participation of main stakeholders of the sector, including other sectors, cooperating partners. Yet, these are mainly the big players. An important (identified) challenge is now to see how it can be extended to the civil society and under-represented groups, as NGOs and civil society organizations.
Service Delivery (see Chapter 2)
  • A policy on Basic Heath Care Packages (BHCP) is under discussion since 2004, and should guarantee citizens with access to a full range of essential and affordable health services at the different levels of the health system. However it is not yet implemented and the current organization of services does not full comply with PHC requirements.
  • The Government has consented important efforts for improving geographical coverage with the agreement made with the (faith-based) Churches Health Association of Zambia health facilities, including provision of subsidized health staff. The opportunity to conduct similar arrangements with the private for-profit sector is a pending question.
  • Vertical programmes are contributing significantly to health services delivery at primary level, including in underserved areas. To a certain extent, they may also interfere with PHC performance. As an illustration, it is estimated that approximately US$200 millions, from the USG alone, are absorbed by HIV/AIDS activities country-wide
  • The MOH acknowledges failures in the provision of PHC services and attempts to provide alternative solution through e.g. innovative targeting initiatives as the Child Health Weeks (CHW) (provision of a comprehensive set of preventive and curative services to children during specified weeks).
Health Workforce (see Chapter 3)
  • The MOH is struggling for years to provide solutions to the critical shortages and imbalanced in the distribution of health workers throughout the country. The policies currently under discussion include:
  • The retention programme is aimed at motivating quality health workers to settle in underserved areas. It was successfully introduced in 2008 and is now getting expanded to include other medical cadre, in addition to medical doctors
  • Since the 1990s, bonding of students agreements aim at improving the distribution of health workers, particularly for rural areas, by requiring students to work for specified institutions and for a specified minimum period upon completing the course.
  • A contracting strategy is being considered since the mid 2000s to fight the brain drain. It would encourage the recruitment on short-term renewable contracts of health professionals that are either returning from abroad or have been retired. The results are mild so far, with some partial success regarding retired professionals but no real results as relates to attracting Zambians from abroad.
  • Staff development: in-service training programme targeted at continuous capacity-strengthening. In 2008, a comprehensive in-service development plan was developed and is under implementation. This initiative is intended to provide for continuous upgrading of skills for the health workers, inorder for them to favourably cope with the changing health needs and environments;
  • Vertical programmes attract significant portion of skilled workforce due to the attractive conditions they offer. It impacts on the availability of health workers to the public sector, and particularly at primary level. Poor coordination of activities with the public sector may also negatively impact on PHC activities.
Medical products and infrastructures (see Chapter 4)
  • At present time, the distribution of health infrastructures and equipment is inequitable and favours urban areas, and the Lusaka and Copperbelt provinces. Efforts are being undertaken to correct geographic inequalities. The first comprehensive Health Facilities Census (HFC) has been conducted in 2006, together with a health facility database, which are now both used by the government and SWAp partners to orientate decisions and funds allocation.
  • Drug supply still suffers from shortages and erratic distribution, particularly in poor underserved areas. Since 2007, the issue of drugs procurement has been separated from other procurement arrangment, specific accompanying measures and budget lines were introduced. Also reforms of the drug information system were recently introduced together with other reforms of the Health Information System (e.g. reform of the HMIS). It led to significant improvements discussed during the latest Joint Annual Review.
Health financing (see Chapter 5)
  • There is surprisingly no formal Health Financing Policy at present time (2009). Discussions are ongoing since the mid-2000s and should soon lead to the production of a formal strategy and policy.
  • Results Based Financing (RBF) approaches have been piloted in 2008 with a aim to improve staff allocation throughout the country (with increased satisfaction and motivation), as well as the quality of services and their responsiveness to the population's expectations. The policy is to be extended in the coming months.
  • Financing options contributing to universal coverage are are still at an early stage in Zambia. Two main options are being considered for the time being: (1) a user fee removal policy which was implemented in health centres and district hospitals in rural areas in early 2006, and later extended to cover facilities in peri-urban areas in mid-2007[4] and (2) a forthcoming social health insurance for the formal sector (targeting a better-off population), which will probably be piloted in late 2009 / early 2010 (see the 2008 SHI Actuarial Report). It seems that the insurance / risk pooling option would be the preferred approach for future development towards universal coverage, yet this will still have to be confirmed in the forthcoming health financing policy.
  • The coordination of financial resources and alignement of strategies are quite satisfying in Zambia due to the long-lasting history of SWAp and basket funding arrangements. Still, only an estimated 25% of all donor funding transits through basket funding. There are also fears that specific global initiatives budget lines and some unaligned cooperating partners could jeopardize further coordination of partners and funds.
Health Management Information System (see Chapter 6)
  • Zambia benefits from a comprehensive set of data sources, which is constantly being improved, and can provide the information needed for conducting efficient primary health care reforms. SWAp arrangements and, to a lesser extent, decentralization policies, favour their concerted utilization in policy orientations and decision-making process.
  • The restructuring of the HMIS in 2008 is considered as a success. The new system has improved capabilities and features for data capturing, analysis and reporting, with additional capacity to provide refined information by gender, age, geographic area and other level of details.


Policies in other sectors and intersectoral policies

In Zambia there are quite a number of policies and actions in various sectors which have a clear impact on health status and health inequities. Some of them include:

  • Nutrition : scaling up of activities, particularly in schools and vulnerable groups in rural areas, through a multi-sectoral approach (attach doc);
  • “Keep Zambia clean” campaign, a Presidential initiative aimed at improving general hygiene in public places, currently being implemented in all the districts (attach doc);
  • HIV/AIDS awareness campaign is placed under the leadership of the central governments and aims at ensuring that all sectors develop a HIV/AIDS component, in order to use every public opportunity to inform and educate the public (attach doc);
  • The Road safety initiatives under the leadership of the Road Safety Agency (RTA) is made of various actions related to inappropriate driving behaviour (drinking, cell phone, no helmet protection...). It strongly collaborates with the Police Service and led to increased road patrols, licensing rules and speed controls, with significant impacts on road safety (attach doc).

These health-related initiatives are merely the result of a strong leadership taken by the central Government on public health issues, rather than a direct influence of the MOH on other sectors' agenda.

It does not mean that the MOH's influence must be neglected. The National Health Strategic Plan 2006-2010 sets partnership as one of the leading principles underpinning the health sector reforms. It applies to the main stakeholders of the health sector, but also to stakeholders from other sectors, whose policies and actions may have an impact on the general health status of the population and on health inequities.

In this regard, stakeholders from a variety of sectors are invited as active voting members of the Sector Advisory Group (SAG), and represented at the lower levels of the SAG (Technical Working Groups, sub-committees etc.). It provides them with opportunities to influence and get a better ownership on public health issues discussed in the SAG. Reversely, the MOH to influence other ministries' policies by partcipating to their SAG.

Yet, results are mild so far. Except regarding HIV/AIDS, only a few sectors have a specific health programme on their agenda[5]. Similarly other ministries do not specifically attempt to measure the positive or negative externalities of their policies on the general health status of the population and on health inequities. Yet, the indicators produced by all ministries are consolidated and used to evaluate the implementation of the national development plan (NDP) (attach doc). Putting essential primary health care indicators higher on the NDP requirements to other ministries could possibly be an option to improve knowledge on progresses made regarding “Health in All” policies.


Priorities and ways forward

Others

Endnotes: References, sources, methods, abbreviations, etc.

  1. Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009
  2. It includes: the Global Alliance for Vaccines and Immunization (GAVI); the Global Fund to Fight AIDS, TB and Malaria (GFTATM); the USG Presidential Emergency Plan for AIDS Relief (PEPFAR) and the Presidential Malaria Programme; and several other initiatives under the UN Group
  3. These reports and assessment comprise among others the Joint Annual Reviews (JARs), Mid-Term Reviews (MTRs), Zambia Demographic and Health Survey (ZDHS), the Health Sector Public Expenditure Review (PER), the National Human Resources for Health Strategic Plan (NHRHSP) and other studies
  4. An evaluation has been performed with the support of the London School of Hygiene and Tropical Medicine. A first draft report has been communicated in August 2009 but is not yet ready for publication.
  5. The only ones who do have some kind of health-related policy (most often with a long-lasting collaboration with the MOH) include: Ministry of Local Government and Housing, Ministry of Education, Ministry of Labour and Social Services, Ministry of Agriculture, Food and Fisheries and Ministry of Defence and Home Affairs.