National Health Observatories Network as an Instrument for Strengthening Health Systems in SIDS

1. National Health Observatories Network as an Instrument for Strengthening Health Systems in SIDS WHO\AHO

2. Presentation Outline • Background and Context • Seychelles and Cape Verde Declarations • Health Observatories • Why in WHO? Why Now? • AHO Objectives and Components • National Health Observatories • NHO Objectives and Major Components • SIDS NHO’s Virtual Community Network • Cape Verde NHO Experience • ICT Challenges in SIDS • Next Steps and Expected Outcomes

3. The Seychelles Declaration Mahé, 24th of October 2006 • SIDS Ministers of Health: (6) need for collaboration between the SIDS with special reference to best public health practices including health information systems. • Commit to (15) Redesign health systems to make them more relevant to the specific context of Small Island States. • Request from WHO: (22) Disseminate reliable evidence of health situation and health risks facing SIDS and sensitize the international community to contribute to sustain health services and improve progress towards health MDGs.

4. Cape Verde Declaration Praia, 19th of March 2009 • SIDS Ministers of Health: (2) Considering the Ouagadougou Declaration on Primary Health Care and Health Systems in Africa and (3) Considering the Algiers Declaration on Research for Health and the Bamako call to Action. • Commit to (10) set up mechanisms for documenting and sharing best practices by using modern communication technologies including the creation of a website and drawing upon the specific expertise existing in each country. • (11) Selected areas of cooperation by country: Mauritius - Establishment of databases on communicable diseases and noncommunicable diseases.

5. From Astronomical to Health Observatories • Observing the heavens (Astrology, Astronomy...) • 1st Health Observatory in France - 1974 • Numerous now, but mostly in Europe & USA • One-stop shop for high quality information and evidence • Some also strive to improve the use of information, evidence, knowledge

6. Why in WHO? • Ouagadougou & Algiers Declarations (2008) • GPW 2006-2015 • Gaps in Social Justice • Gaps in Knowledge • WHO-Core functions on IEK • AFRO’s Strategic Orientations

7. Why Now? • Reforms are required to strengthen health systems • An observatory can assist: • NHIS Fragmented • Under-resourced • Extra burden on collectors • Limited clients • Narrow scope of inquiry • Old architecture

8. AHO is an Instrument for Strengthening National Health Systems • Bridging the Knowledge Gap • Relevant, timely, valid & reliable IEK • Shared & used for policy & decision • Multitude of Clients • Public & private; multi-disciplinary; Multi-sectoral; • Broader Scope • Systems in addition to outcomes; • social goals plus health goals; • quantitative plus qualitative sources • Better Information Architecture • Transparent; Collaborative; Communities of practice

9. AHO Seven Major Components 1. Collaborative Web Portal 2. The Regional Director’s Blog 7. Networks / Communities of Practice

10. AHO Seven Major Components 1. Collaborative Web Portal 2. The Regional Director’s Blog 7. Networks / Communities of Practice

11. 2. The Regional Director’s Blog (Blog is an abbreviation of Web-log)

12. 3. Data and Statistics

13. 4. Country and Regional Profiles • Employ Wiki for better collaborative effort • Analysis based on the latest evidence • Focus on systems as well as outcomes • Involve stakeholders, including policy makers • Built in equity gauge: gender, location, income, etc • Combination of narrative text, tables, & figures • Contents accepted as own by country

14. Structure of Profiles • Brief introduction to the Region / country & people • Health status & trends • Health systems • Specific programs & services • Key determinants • Progress on health MDGs & other goals (Ouagadougou, Algiers, Libreville etc)

15. 5. Observatory Publications • Relevant, high-quality publications on thematic, Regional, sub-regional & country-specific issues • Statistical factsheets & atlas • Country & Regional profiles • Case reports • Best practices • Progress reports • Policy papers • Evaluation reports • Research papers • Systematic reviews, etc… • Produced by Working Groups or commissioned to consultants

16. 6. National Observatories The Target: Support all countries to establish national observatories - Regional model adapted to country settingsCurrently: On going work with 3 countries to establish national observatories (1 English, 1 French, 1 Portuguese speaking) National Observatory Portal Networks / Communities of Practice

17. 7. Networks/working groups • Working Groups established at the Regional Office • Health systems • HIV/AIDS, TB, malaria • Family & reproductive health • Communicable diseases, chronic diseases, mental disorders & injuries • Key determinants (Risk factors, food & nutrition, physical environment, social determinants) • More as needed

18. Functions of Observatory Working Groups • Produce Regional and country profiles on their specific area • Generate high-quality publications • Promote & maintain the relevant datasets in the integrated database • Create & maintain networks at all levels of AFRO & countries • Assist in the forecast of events as part of an early warning system (e.g. as part of the SHOC) • Support national observatories

19. Unique Features of AHO • Comprehensive & analytical regional and country profiles • Network of 46 national observatories supporting national IEK systems • Sub-national (e.g. district) level data, statistics & profiles • Networks of health workers, researchers and policy makers working & learning together to improve health systems • Modern management systems & infrastructure • Constitutional mandate on IEK • Commitment to social justice

20. In SummaryThe African Health Observatory: • Is an instrument that assists efforts on strengthening health systems by its broader client base, scope or domain & improved architecture; and • Is a repository or ‘one-stop-shop’, a tool & a collaborating platform for acquiring, generating, sharing, and applying IEK for policy & decisions • Provides or support: • High quality data/statistics • Comprehensive & analytical Regional & country profiles • High-quality thematic publications • Dynamic & vibrant networks and Communities of Practice • 46 national observatories

21. National Health Observatories • NHOs similar in structure to AHO • Modified / adapted for country situation • National, regional, district observatories... National Observatory Portal Networks / Communities of Practice

22. NHO Major Objectives To provide easy access to high quality data, information, evidence and knowledge (IEK) To facilitate the generation of IEK To promote the application of IEK for policy & decision

23. NHO Functions • A descriptive function that provides for an easily accessible database; • An analytical function that draws lessons from successes and failures that can assist policy makers in the formulation of strategies; • A prediction function to forecast potential outcomes; • A prescriptive function that brings forward recommendations for action; • A monitoring and evaluation function that focuses on aspects that can be improved; • A capacity strengthening function that aims to develop partnerships and share knowledge both within the country.

24. SIDS NHO’s Stakeholders • Ministry of Health • WHO-AFRO • Government Institutions • Health Care Facilities • Universities & Research Institutions • Private sector & NGOs • African Regional Organizations • Other Organizations &Institutions

25. SIDS NHO’s Virtual Community Network • Advantages of using a network approach: • Weaving Community; • Enabling Diverse Perspectives; • Building and Sharing Knowledge (best practices); • Coordinating Resources and Action.

26. SIDS NHO’s Virtual Community Network Collaborative Work, Learning and Innovation • Groups, networks or communities of practice (COPs) • National level and District level • Come together on a regular or ad-hoc basis • To acquire, create and share information, evidence & knowledge; and • To collaborate on particular projects • Essential to any modern society • Bring together people to share insights & foster good practice • Build specific capacity in the society • Ensure that this capacity is retained in the agency as people move on

27. Cape Verde NHO Experience • OMS CV and CV MoH initiative in collaboration with, NOSI, INE and MCA to set 9 District Health Observatories. • Complete the Cape Verde Country Analytical Profile. • Country ownership and motivation. • Try to replicate the good practices/experience acquired in CV in other African countries.

28. Cape Verde NHO Experience Pilot

29. ICT Challenges in SIDS Percentage of population - telephone (fixed and mobile) subscribers, African Region, 2007 • Challenges: • Develop and implement Policies • Limited infrastructure and services • Limited human capacity • High costs of development and maintenance of a proper ICT infrastructure

30. ICT Challenges in SIDS Percentage of population using the Internet, African Region, 2007. • Challenges: • Weak ICT infrastructure and services within the health sector • Inadequate financial resources • The Digital Divide • Weak M&E systems

31. Expected Outcomes • for Leaders: • Have at hand the IEK of the district / community • Know where to go to find it • Leverage / use others’ IEK to improve performance • Have competent, satisfied & continuously learning staff • Retain / sustain IEK when staff leave • Official health information trusted and appreciated • for Health Workers: • Improve competence by continuous learning • More satisfaction • Consider IEK work as essential instead of extra task • Widely share & use IEK • Identify useful IEK

32. Expected Outcomes • for a District or Community: • Public health needs are anticipated & described timely • Improved transparency & accountability by leaders • Limited subjectivity / bias in decisions by leaders • Evidence used more effectively in policy & decisions • for Citizens: • Empowered • Increased awareness • Change in behavior • Better participation in community affairs

33. SIDS NHO’s Next Steps • AHO • Development of Analytical country profile (part of the AHO work) • Designation of a focal person • Identification of a working group • Establish SIDS Virtual Community Network • NHO • Designation of a focal person • Identification of a stakeholder group • Develop a framework

34. Thank you