FROM VERTICAL TO HORIZONTAL: EXPERIENCES & RECOMMENDATIONS IN INTEGRATING SAM TREATMENT TO HEALTH SYSTEMS
October 2013
SAM international Conference
London, UK
M Gallagher & A D Israel
PRESENTATION OUTLINE
Setting the context
Background
HSS & SAM treatment
Experiences – How does it look?
Strategic & practical implications
Conclusion
Universal health coverage Focus on design and implementation Health systems strengthening (HSS) - -WHO
2007
Integration – ‘institutionalization’ of SAM treatment
SETTING THE CONTEXT
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
BACKGROUND
Vertical Horizontal
SHIFTING DYNAMICS OF HSS
NIGERIAPartner support
Government support
DR-CONGOPartner support
Government support
WHERE SHOULD WE AIM TO GO ?
Partner support
Government support
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 of
STRATEGIC 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 systemJoint planning and implementationSimplification of protocols and systemsIncluding strong component on community mobilization activities
Implementation:Working closely with authorities and communities to strengthen governanceIdentifying financing gaps and mechanisms/timeframe ‘Adaptive’ service delivery processHuman resources Supply chain Simplifying reporting and planning for integration of key indicators to the national information system
PRACTICAL IMPLICATIONS
Health System Strengthening Task Force ToR being developed with support of WHO & UNICEF
ACF finalizing the Health Systems’ Strengthening Guidelines for 2014
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
NEXT STEPS
There lies a significant opportunity ahead with the increasing MoH leadership and commitment to
SAM treatment, and 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 for children with SAM.
CONCLUSION
THANK YOU
QUESTIONS ?