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Maureen Gallagher SAM International conference London, Oct 17, 2013

From vertical to horizontal: Experiences & recommendations in integrating SAM treatment to health systems. Maureen Gallagher SAM International conference London, Oct 17, 2013. Presentation Outline. Setting the context Background HSS & SAM treatment Experiences – How does it look?

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Maureen Gallagher SAM International conference London, Oct 17, 2013

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  1. From vertical to horizontal: Experiences & recommendations in integrating SAM treatment to health systems Maureen Gallagher SAM International conference London, Oct 17, 2013

  2. Presentation Outline • Setting the context • Background • HSS & SAM treatment • Experiences – How does it look? • Strategic & practical implications • Conclusion

  3. Setting the context • Universal health care • Focus on design and implementation • Health systems strengthening (HSS) - -WHO 2007 • Integration – ‘institutionalization’ of SAM treatment

  4. Background • Changing landscape of treatment of acute malnutrition with huge advances the last 25 years • Coverage still low at between 8-13% globally • Need to strengthen treatment of SAM as a disease – linkage Nutrition & Health • Learning from experiences of Global Health Initiatives (GHI) shift from disease specific to health systems strengthening

  5. Shifting dynamics of HSS Vertical (from Wilson, U of Colorado) Horizontal

  6. Shifting dynamics of SAM treatment Vertical Horizontal

  7. NIGERIA Government support Partner support

  8. DR CONGO Government support Partner support

  9. Where should we aim to go Government support Partner support

  10. Strategic Implication • Bringing nutrition into health & working through the HSS building blocks to achieve sustainable availability & access to SAM treatment • Including SAM treatment as part of a minimum health package • Shift role of partners from ‘implementer’ to ‘facilitator’ • Simplifying CMAM protocols, implementation and follow-up • Transitioning from donor financing to MoH financing basic minimum health package of which SAM treatment is part

  11. Practical Implications General: • Identifying new ways of working from being model oriented to process oriented • Coordination of actors in working with one health system Design: • Comprehensive assessment of health system • Joint planning and implementation • Simplification of protocols and systems Implementation: • Human resources • Supply chain

  12. Next steps • Health System Strengthening Task Force ToR developed with support of WHO & UNICEF • ACF finalizing the CMAM Integration Guidelines • Health System Assessment tool being tested by UNICEF & partners • Experiences need to be further tested and documented in relation to quality of care and coverage

  13. Conclusion There lies a significant opportunity ahead in the increasing MoH leadership and commitment in SAM treatment with the evolving role of partners in support of it to ensure that SAM treatment is available as part of regular health services, moving towards quality global coverage.

  14. Thank you

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