[afro-nets] Global Initiatives may be undermining Health Systems

["Tarry Asoka" <carenet2020@yahoo.co.uk>]

Global Initiatives may be undermining Health Systems
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It has long been learnt that early achievements of extending delivery of specific health interventions such as childhood Immunisation cannot be sustained unless they become an integral part of national health systems. This entails adequate budgetary allocations, human resources, systems for logistics, supervision, monitoring and evaluation mechanisms. 
 
Global Initiatives have been set up usually as projects and therefore ignore these systemic issues that are necessary to drive the delivery of disease interventions. These projects have a tendency to develop a life and momentum of their own. Secondly, Global Initiatives also overlook how the health system is situated within the political economy of a particular country. For example, in a federal country such as Nigeria, where the States have considerable autonomy and resources well above the annual budgets of many countries in the sub-region Global Initiatives have often failed to take this into account in its programming. 
 
Bilateral donors working in-country (who also contribute to Global Initiatives) do not spend enough time in persuading countries to develop harmonized plans led by the countries. The focus has always been on developing policies rather than effective institutions that would ensure the delivery of services on a sustainable basis. This requires working the politics as well as providing expert know-how. 
The role of a Health Systems Action Network could be seen as a resource that strengthens the competences of “change champions from within countries“ who are at the forefront, championing institutional reforms that will enable whole countries to make progress towards the MDGs.

 
Dr Tarry Asoka 
Executive Director - Care-Net Ltd
www.carenet.info
+234-8023048497
mailto:carenet2020@yahoo.co.uk