Investing in Partnerships for Health Impact

Investing in Partnerships for Health Impact

In fragile states, constraints on governments often prevent them from simultaneously building their stewardship role and immediately expanding service delivery. National and local governments must ultimately lead the process and work together with NGOs and the private sector to successfully strengthen their own health systems.

In Haiti, a two-pronged approach was successfully developed and implemented prior to the earthquake by a four-way partnership between the Government of Haiti, the United States Government, a network of Haitian and international NGOs  (Santé pour le Développement et la Stabilité d’Haíïti) (SDSH), and Management Sciences for Health.

The two-pronged approach included:

  • First, the partners restored leadership capacity of the Ministry of Health to strengthen policymaking, convening, standard-setting, and coordination roles that uniquely belong to the government.
  • At the same time, partners preserved, respected, and built on existing local human resources, physical infrastructure, and health system elements already in place. Partners worked with all existing service providers – public, NGO, and private sector – to support and build their capacity to provide responsive, quality, community-based, and facility based preventative and curative care.

My colleague, Dr. Florence Guillaume, Deputy Chief of Party/ Technical Director (SDSH), visited Washington, DC in March and shared her thoughts with Congress on this two-pronged approach, “It is about starting from the base, planning from needs to resources to priorities, harnessing under-utilized resources, and increasing public-private partnerships,” she said. “The vision behind this is to achieve effective decentralization through integrated departmental planning and strengthened management systems to provide quality health services.”

The SDSH network made an important impact on maternal health, family planning, and HIV & AIDS. From 2008-2009, they trained and supported over 4,000 traditional birth attendants. As a result, 45% of pregnant mothers had three prenatal visits, and 40% received a home visit within three days of giving birth.  They also tested 49,196 pregnant women for HIV, and saw over half of those who tested HIV positive through the entire course of treatment to reduce the risk of HIV transmission to their babies. By training and equipping 1,035 community health agents to promote family planning, the network contributed to a 24% increase in the use of modern contraceptives methods.

A two-pronged approach is essential to strengthening health systems in fragile states such as Haiti, Afghanistan, Southern Sudan, or Liberia.

Our partnership with the Haitian Ministry of Health has proven that it is possible to build on complementary strengths of governments, civil society, and the private sector to achieve significant health impact.

I look forward to continuing the conversation and dialogue with the Haitian Minister of Health Alex Larsen at our reception, “Strengthening Health Systems: What Do We Know?” at the Global Health Council Conference on Tuesday, June 15, 6:30-8:30pm.

Dr. Jonathan D. Quick is president and chief executive officer of MSH. Dr. Quick has worked in international health since 1978, he is a family physician and public health management specialist.

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