Moderator
Dr. Ian Pett, Chief of Health Systems and Strategic Planning for Unicef

Panel discussion

• Introduction and overview of policies and systems—the 2010 Countdown findings
  Elizabeth Mason, Director, Department of Child and Adolescent Health and Development, WHO
• Zambia shares lessons on policy change for scaling up
  Victor Munyongwe Mukonka, Director Public Health and Research, Ministry of Health, Zambia
    Download Powerpoint [PDF – 446.6 KB]
  
• Civil society contributes to change
  Technology for Equity: the DHI Initiative
  Denis Gilhooly, Executive Director, Digital Health Initiative (DHI)
  Download Powerpoint [PDF – 1.62 MB]

Session Report

“I think the current momentum we’re in, we see that things are going to be different for Zambia,” Dr Mukonka said.  “We know where we are going, and we are very clear on where we want to be.”

During the final Countdown session on Wednesday, an interactive panel discussion explored the architecture of a successful health system including issues of leadership, policy making and demand creation.  Speakers included individuals who have helped create systems that work in moving closer to health for all. UN experts and a Zambian Ministry of Health representative promoted a diverse set of strategies including task shifting, abolishment of user fees, and smartphone technology as ways to sustain and accelerate countries’ progress towards MDGs 4 and 5. 

Dr Elizabeth Mason, Director of the Department of Child and Adolescent Health and Development at WHO:   Dr Mason pointed out that shifting the task of infection treatment from facility-based clinicians to community health workers is an increasingly popular approach for countries trying to manage human resources crises and bring care closer to families, especially in rural areas. “We have very good news that now, as of this Countdown report, 29 of the [68 priority] countries have adopted community case management for pneumonia,” Dr. Mason said.  “This is a massive increase, up from 18 in the last Countdown report.”

On the issue of health financing, Dr. Mason advocated prepayment, risk-pooling and abolishment of user fees to curb out-of-pocket health expenditures. “We know that if a country’s percentage is above 50% for out-of-pocket, the likelihood is that families are struck with ‘catastrophic expenditure’,” Dr. Mason said.  “Maybe a husband has to sell a cow for the woman to get a Caesarian section, and then there’s no milk for the family.” 

Dr Victor Mukonka, Director of Public Health & Research at Zambia’s Ministry of Health:   Dr Mukonka discussed Zambia’s intensifying efforts to reach MDGs 4 and 5.  In the last decade, Zambia has reduced under-five and maternal deaths and increased coverage of antenatal care and institutional deliveries.  Its human resource crisis, however, is pronounced:  it would take another 40 years to attain the number of doctors currently needed in Zambia, Dr  Mukonka said.  As a result, Zambia has endorsed the role of community health workers in community case management of pneumonia and diarrhea.  The country has also abolished user fees to improve access to care.

“I think the current momentum we’re in, we see that things are going to be different for Zambia,” Dr Mukonka said.  “We know where we are going, and we are very clear on where we want to be.”

The final speaker, Dr. Denis Gilhooly, Executive Director of the UN Digital He@lth Initiative (DHI), discussed the potential of information technology and communication to accelerate progress towards the MDGs.  He named data collection and emergency transportation as two areas that would dramatically improve through mobile phone and smart phone technology.

“Imagine every community health worker in Africa with a smartphone in 12 months,” Dr. Gilooly said.  “This is possible.”

The panel was moderated by Dr. Ian Pett, Chief of Health Systems and Strategic Planning for Unicef.