World Health Organization : Year 1997 ; World Health Organization, Analysis, Research, And Assessment, Current Concerns, No. 97.2: Current Concerns a W Paper Number 12 Health Sector Reform in Sub-Saharan Africa - A View of Experiences, Information Gaps and Research Needs

By P. E. N. Sikosana, Dr.

Book Id: WPLBN0000142543
Format Type: PDF eBook
File Size: 3.5 MB
Reproduction Date: 2005

Title:	World Health Organization : Year 1997 ; World Health Organization, Analysis, Research, And Assessment, Current Concerns, No. 97.2: Current Concerns a W Paper Number 12 Health Sector Reform in Sub-Saharan Africa - A View of Experiences, Information Gaps and Research Needs
Author:	P. E. N. Sikosana, Dr.
Volume:
Language:	English
Subject:	Health., Public health, Wellness programs
Collections:	Medical Library Collection, World Health Collection
Historic Publication Date:
Publisher:	World Health Organization


Citation APA MLA Chicago N. Sikosana, Dr, P. E. (n.d.). World Health Organization : Year 1997 ; World Health Organization, Analysis, Research, And Assessment, Current Concerns, No. 97.2. Retrieved from http://www.gutenberg.cc/

Description
Medical Reference Publication

Excerpt
SYNOPSIS AND ACKNOWLEDGEMENTS Countries across Africa are engaged in redefining their health policies and restructuring institutions in response to the challenges posed by an economic decline, dramatic increase in poverty, and serious erosion of the human development achievements over the past two decades. While Health For All (HFA) through Primary Health Care (PHC) remains the main goal of health development in Africa, health sector reform is urgently needed in order to re-shape the future of health systems in the African region. African health systems need to be reformed in order to strengthen their capacity to provide an adequate access to quality care for all populations, especially vulnerable b~oupsa, nd thus to reduce on a sustainable basis the most common causes of morbidity and mortality. African countries are in no way homogeneous, and present many different stages of health system development as well as different nature and direction of health sector reform. In spite of this divergence, there are many commonalities, and the aimed objectives, the issues addresscd and the tools mobilized are often similar or comparable across the borders. While every refomm experience is country specific, there are always important lessons to learn from comparing options and evaluating effects of various reform initiatives.

Table of Contents
TABLE OF CONTENTS 1 . SYNOPSIS AND ACKNOWLEDGEMENTS . . . . . . . . . . . . . . . . . . . . . . . . . 2 7 . BACKGROUND TO HEALTH SEC'TOR REFORMS . . . . . . . . . . . . . . . . . . . . . . . . 3 3 . CONI'EXT OF REFORMS IN SUB-SAHARAN AFRICA . . . . . . . . . . . . . . . . . . . . 6 4 . INSTITUTIONAL PIND ORGANIZATIONAL CHANGES . . . . . . . . . . . . . . . . . . 10 Civil Serv.i ce .R eform and Changing Roles of Government . . . . . . . . . . . . . 11 Decentrallzatlon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 Role of the Private and NGO Sectors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Human Resources Development and Capacity Building . . . . . . . . . . . . . . . . 24 5 . CI~IANGESIN HEALTH FINANCING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.9 Public (Government) Financing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 User ChargesIFecs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3.1 Health Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3.9. External Financing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4.6 Changing Rolcs of Key Actors in Health Financing . . . . . . . . . . . . . . . . . . . 47 Some Conclusions on Health Financing . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 8 6 . SERVICE DELIVERY CHANGE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .50 Priority Setting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5.0 Essential Packages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. 1 Integrated Service Provision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5.3 Quality Improvement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5.4 7 . THE ROLE OF DONORS TN HEALTH SECTOR REFORM . . . . . . . . . . . . . . . . . 57 8 . 'THE ROLE OF HEALTH SYSTEMS AND POLICY RESEARCH . . . . . . . . . . . . . 60 9 . GENERAL CONCLUSIONS .L OOKING AHEAD . . . . . . . . . . . . . . . . . . . . . . . .6 5 10. REFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6.8. Annex 1 List of Participants at the Intercountry Meeting on Achieving . . . . . . . . . . . . 71 Evidence-Based Health Sector Reforms in Sub-Saharan Africa. Arusha. Tanzania. 20-23 November 1995