An analysis of the three approaches to development in africa

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An analysis of the three approaches to development in africa

This situation exists despite the existence of cost-effective interventions for addressing the targeted health problems.

An analysis of the three approaches to development in africa

It is increasingly assumed that the missing link has been ineffective use of the interventions and the weakness of health systems that are unable to scale up implementation of the interventions.

Consequently, a health systems review was conducted in five countries of sub- Saharan Africa, namely Kenya, Malawi, Namibia, Uganda and Zambia. The countries were purposefully selected on the basis of the availability of country reports.

A literature review was carried out, focusing primarily on country health sector reports and United Nations data on MDG indicators complemented by on-line literature. Whereas Malawi, Namibia and Zambia are likely to achieve the measles immunization targets, only Malawi and Zambia are likely to meet the under-five mortality targets.

However, in considering the maternal mortality rate MMRwhere approximately 5. Health information systems are fragmented and not fully utilized and health service coverage is not adequate.

Overall, there is inadequate progress towards achieving the selected MDG impact indicators in the five reviewed countries, against a background of non-conducive health sector policy environment and inadequate resources and service coverage.

Achieving the MDGs will require timely national refocusing of health sector policies and commitment to health systems strengthening.

The countries were selected purposefully based on the availability of national health sector reports. The review primarily focused on country health sector reports that are in the public domain and data from the United Nations on MDG indicators.

The basics

The status of country health systems was assessed using the WHO's six health system building blocks' selected desirable attributes as outlined in the Framework for Action for Strengthening Health Systems to Improve Health Outcomes. Malawi and Uganda show a declining trend in under five mortality while the other three countries seem to have a generally stable trend.

Kenya and Namibia's public health services have a policy of applying user fees at the hospital level with the former exempting under five children.

The vacancy rates were worsened by recruitment freezes in Kenya and Uganda in and respectively. The immunization trends show stagnation or little increase in coverage. However, Malawi, Namibia and Zambia are reported potentially likely and Uganda unlikely to achieve the measles immunization target by Namibia reported good progress towards attaining the MDG goal of providing skilled attendance at births while the rest of the reviewed countries reported inadequate progress.

The reduction of MMR which requires a 5. This inadequate progress is against a background of weak health systems unable to effectively deliver health services required to reach the MDGs.

MDGs are meant to influence re-alignment of national priorities towards human development; effective national leadership in this regard will ensure that strategic policies and plans are formulated or existing ones aligned to the MDGs and followed by effective oversight and coalition building.

The finding that some health policies and guidelines were in draft form or needed updating and in some countries had been that way for a number of yearsraises questions over the sector's stewardship in meeting the MDGs.

This raises questions on the fungibility of public funds in the face of favourable donor support — increases in external support do not seem to lead to increases in the allocations to health, but are absorbed elsewhere.

Inadequate health financing has adverse implications for the other health systems such as health worker remuneration, the availability of medicines and supplies and health service coverage scale up.Approaches to policy development October 30 This document forms part of a larger piece of work to design a policy process for the Department of .

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