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INFORMATION DOCUMENT ON THE FIRST INTERCOUNTRY MEETING ON

THE IMPLEMENTATION OF THE HEALTH COMPONENTOF

THE UN SPECIAL INITIATIVE ON AFRICA, COTONOU, REPUBLIC OF BENIN

29-31 JULY, 1998 WORLD HEALTH ORGANIZATION

REGIONAL OFFICE FOR AFRICA HARARE, JUNE 1998

The UN System-wide Special Initiative on Africa (UNSIA) was launched on March 15, 1996. The launching was the culmination of consultations within the UN that sought to address concerns of waning development support for Africa. The goal of UNSIA is to help Africa help itself since the Initiative stresses strengthening country-driven strategies as the primary basis for donor assistance. A second goal is to ensure the honouring of the commitment of the UN system to support African development efforts in African-identified priority areas, through appropriate country and regional programmes. Put differently, it is aimed at harnessing the efforts of the United Nations system to work in a synergistic manner to support the development of Africa. Health and education constitute important components of the Initiative.

Some efforts had gone into translating the health component of the Initiative into a practical action programme since its launching. WHO/AFRO, the World Bank, UNDP, UNESCO, UNFPA, UNICEF, ADB and some other Agencies and institutions met several times in Brazzaville to develop the implementation strategy for the health sector.

Six months after the launch, progress report was presented to the forty-six session of the Regional Committee (Africa). The Ministers of Health reviewed the thrust of the Initiative and confirmed its congruence with each country’s agenda for health sector reform. The Ministers stressed the need for capacity building, the broadening of consensus and additional resource for effective implementation of the Initiative. For capacity as well as consensus building, the need for intercountry activities to enable ‘less advanced’ countries learn from ‘advanced’ ones was stressed. The OAU annual Conference of Foreign Ministers and the subsequent June 1997 Summit of African Heads of State and Government held in Harare, Zimbabwe, deliberated on UNSIA and the Heads of State and Government reaffirmed their ownership of the Initiative by ‘urging Member States to implement the Initiative and by assuming, in a concerted manner, their share of the responsibility’.

Following the expressed need for intercountry activities primarily for sharing experiences between countries by the African Ministers of Health in their annual meeting in Brazzaville, September 1996, the Secretariat of UNSIA in New York, the World Bank and WHO/AFRO had been holding discussions on the organization and financing of intercountry meetings on issues related to the implementation of the health component of UNSIA. This meeting organized by WHO/AFRO in collaboration with the World Bank is the first to be held within this context. It is planned that two more meetings will be held to bring policy makers in order Sub-Regions together before the end of 1999.

The title of the meting is First intercountry meeting on the implementation of the health component of the UN Special Initiative on Africa. The venue is Cotonou, Republic of Benin and the dates are 29 - 31 July, 1998.

The objectives of the meeting are to:

(i) clarify to the participants, the objectives and content of the health component of the UN Special Initiative on Africa as well as the roles of the various stakeholders (governments, civil society, WHO/AFRO, the World Bank and other donors) in its implementation;

(ii) Discuss basic concepts and approaches related to health sector reform with a view to having a common understanding of such concepts and approaches (e.g. sector-wide approaches for health development);

(iii) Share experiences on countries' understanding of health sector reform as well as on how various countries have developed and implemented their health sector reform programmes;

(iv) Share experiences on how countries have been dealing with the issue of public budget allocation and reallocation (for health) within the context of health sector reform and/or sector-wide approaches for health development;

(v) Determine what follow-up actions each country team will like to undertake at country level and what support will be required from WHO/AFRO and the World Bank.

(i) Participants' better understanding of the content of the Special Initiative, particularly the health component, and the roles expected from governments, civil society, the UN system, particularly the World Health Organization at the Regional level, the World Bank and other donors in its implementation;

(ii) Participants' awareness and knowledge of approaches to health sector reform that have been adopted in the participating countries as well as of how the difficult problem of public budget allocation and reallocation (for health) has been tackled by various countries;

(iii) Identification of country follow-up actions for starting or accelerating the implementation of the health component of UNISIA as well as the specification of support that will be required from WHO/AFRO and the World Bank.

It is expected that the meeting will be attended by the following groups of participants:

(i) From countries: a team from each of the eleven participating countries (Benin, Cote d'Ivoire, The Gambia, Ghana, Guinea Conakry, Liberia, Mali, Mauritania, Nigeria, Togo and Senegal) comprising two top-level policy makers from the Ministry of Health, one from Ministry of Finance and Development, one from the President's Office/Ministry of Planning/Budget Department, one representative of the private health providers, and the WHO Representative. Where possible, the WHO representatives had been advised to sponsor the member of the country support team that is in charge of issues related to health sector reform to attend the meeting;

(ii) From the World Bank: task managers particularly;

(iii) From the World Health Organization: the WHO representatives in the eleven countries and some regional advisers;

(iv) From UNSIA Secretariat, New York: at least one representative.

1. Dr. Eyitayo Lambo, Regional Adviser for Health in Socio-economic Development, WHO/AFRO (Temporary Office), Harare, Zimbabwe.

2. Dr. Katja Janovsky, Coordinator, Health Policy and Strategic Planning, Health Systems Development Programme, WHO, Geneva.

3. Mr. Anwar Bach-Baoab, Senior Public Health Specialist, the World Bank, Washington DC, USA.

4. Dr. Charlotte Leighton, Abt Associates Inc., Boston, USA.

5. Dr. Ngallande-Banda, Permanent Secretary, Ministry of Health, Malawi.

6. Dr. Nana Enyimahew, Ministry of Health, Accra, Ghana.

7. Mr. Daouda Toure, UNISA Secretariat, New York.

8. Mr. A. Edward Elmendorf, Lead Health Specialist, The World Bank, Washington D.C.

9. Mr. Vincent Musowe Director of Health Planning, Zambia.

1. Overview chapter as well as the health component chapter of UNSIA document (English and French).

2. A guide to sector-wide approaches for health development: concepts, issues and working arrangements by Andrew Cassels (English only).

3. The Broad Sector Approach to Investment Lending, Sector Investment Programmes by Peter Harrold and Associates (English and French).

(To be determined).

French and English (simultaneous interpretation will be provided).

The following table summarizes the method of work with regard to the major concepts, approaches and issues to be discussed at the meeting in order to achieve the intended objectives.

 

PROGRAMME OF WORK (See Annex I)

COUNTRY PREPARATION FOR THE MEETING

 

Each country team is expected to prepare a paper of not more than ten pages (double-spacing) addressing the following issues:

Health sector reform – when it started and why; key issues or agenda items; stage of implementation; inventory of factors facilitating/inhibiting implementation.

Public budget allocation and reallocation for health; country experiences since Alma-Ata; problems and prospects.

Note: Ghana, Zambia, Senegal and Mali will make presentations on experiences so far in adopting sector-wide approaches for health development.

It is expected that the WHO country office will facilitate the preparation of the country paper as well as the necessary overhead transparencies that would be used for making country presentations on each of the above topics at the meeting.

WHO/AFRO will fully finance the participation of the five national officials from each country (i.e. two from MoH, one from Ministry of Finance and Economic Development, one from the Department or Ministry of Planning/Budget/President’s Office, and a representative of private providers) through some funds made available by the World Bank. Such financing will cover travel cost and per diem during the period of the meeting.

Travel cost, per diem and fees (using WHO rate) of resource persons who are not from WHO, the World Bank and UNSIA Secretariat will be paid by WHO/AFRO.

All other participants are expected to meet the cost of their participation from their institutional sources.

It is planned that the report of the meeting will be published in due course. This will contain highlights of major presentations, discussions and major recommendations of the meeting. It is foreseeable that the country presentations could be edited and reformatted for the production of a complementary publication, depending on the quality of country reports.

For additional information or clarification about the meeting, please, feel free to contact us through the following:

Mailing address: Dr. Eyitayo Lambo, HEC/AFRO,

WHO/AFRO (Temporary Office), Medical School, Ward C,

Parirenyatwa Hospital, Mazoe Street,

P.O.Box BE 773,

Belvedere, Harare,

Zimbabwe

(263) 4 791 214; (263) 4790 146

1 – 407 – 733 - 9020

E-mail: Lamboe @ whoafr.org.