Sharing knowhow and joining forces towards Health for All

MMI Network News, August 2013

MMI Network News, August 2013

Editorial: The 2013 World Health Report: Several missed opportunities, one imminent danger

Dear reader,

Let me start with three truisms: “Universal health coverage cannot be achieved without evidence from research”, “research into health services and systems gets relatively little support and tends to be narrowly focused”, and “there is a particular need to close the gap between existing knowledge and action”. No health policy or health systems researcher would disagree with any of these quotes from the World Health Report 2013: Research for Universal Health Coverage (1). But what kind of evidence is most needed, how can a systems perspective be brought to the fore, and how will the research advocated for really improve health for all? In my opinion, the present World Health Report falls short in answering these questions, in the first place because it is narrowly focused itself.

The core of the report (pages 31-89 of 146) consists of the feel-good message that “research for health is on the rise worldwide”, followed by 12 examples “of studies that show how research can address some of the major questions about achieving universal health coverage”. The promise is made that these examples “rang(e) from the prevention and control of specific diseases to the functioning of health systems”. At first sight, the promise is held: six case studies are directly related to disease control and six are more related to health systems. But the report articulates none of these from within a systemic perspective that is beyond ‘programmatic advantages’ and takes into account the interactions of actors and interventions, which is a little surprising to say the least.

Wasn’t it WHO that four years ago published Systems thinking for health systems strengthening (2), rightly recognizing health systems as complex adaptive systems and promoting systems thinking as “an essential approach for strengthening health systems”? Or just about a year ago, Health policy and systems research – a methodological reader (3), 474 pages of advice to improve the evidence base for health policy making and health systems strengthening? And is systems thinking not “key for policy and decision makers dealing with universal health coverage”, as – among others – Medicus Mundi International (4) argues?

A second missed opportunity is the very fragmentary coverage of social determinants as part and parcel of research for universal health coverage. Social determinants are mentioned sporadically, yet not explicitly in the examples, and equity is treated only superficially. Yes, “indicators should be disaggregated”, but when will we start unpacking processes that reproduce inequity? Will categorical data be enough to “measure and understand the problem (of health inequities) and assess the impact of action”, as argued by WHO (5) and for Developing an evidence base for political action (6)? Will this be sufficient for an equity-focused research agenda (7) in support of truly universal health coverage?

Equally under-addressed is research on Health-in-All policies (8), in spite of being a promising way forward to tackle health inequities and to arrive at fair or at least proportionate universalism. The World Health Report 2013 recognizes the need “to develop research that can enhance understanding of how intersectoral policies can improve health”, but only as “an additional and complementary challenge” and by adding that “because many more questions can be asked than answered, it is vital to set priorities”.

These three missed opportunities are interrelated. What unites them is a lack of people centeredness. At best, uptake of the report might lead to more of the same. There is however a risk that worse will happen. Research for Universal Health Coverage makes a strong call for “finding local answers to local questions”. Admittedly, coverage gaps and health inequities have local manifestations, worthy of research. But doesn’t the combination of a more-disease-than-people-centred approach and local priority setting encompass a peril: chances are that universal health coverage then gets stuck in selective health coverage, just like comprehensive primary healthcare watered down to selective primary healthcare three decades ago? We all know what that meant. The world deserves better, and we should feel obliged to research deeper and broader.

Guest editorial by Werner Soors, ITM Antwerp,
First published in: IHP Newsletter 234, 23 August 2013

....................
References:

  1. World Health Report 2013: Research for Universal Health Coverage
    www.who.int
  2. Systems thinking for health systems strengthenin
    whqlibdoc.who.int
  3. Health policy and systems research – a methodological reader
    www.who.int
  4. MMI discussion paper on UHC published in August 2013: see below
    www.medicusmundi.org/
  5. Closing the gap in a generation Health equity through action on the social determinants of health
    whqlibdoc.who.int
  6. The social determinants of health: Developing an evidence base for political action
    www.who.int
  7. Ostlin et al., Priorities for Research on Equity and Health: Towards an Equity-Focused Health Research Agenda
    www.plosmedicine.org
  8. Health in All Policies. Seizing opportunities, implementing policies
    www.euro.who.int

 

MMI Network: Events, news, and resources

.............
Network event: Memisa / Medicus Mundi International
Health-y answers to comple#ity: Are we able to move beyond the control panel?

Brussels, 27-28 November 2013, Medicus Mundi International Network meeting hosted by Memisa and linked to the annual seminar of Be-cause Health. The seminar will take place on 28 November at the Egmont Palace in Brussels. Registration opens on 6 Septembe. If the event’s title is confusing, this might even be intentional: the conference is all about providing health care in a complex environment and how to deal with this complexity. The Assembly, a Board meeting and workshops of the Medicus Mundi International Network are scheduled for 27 November.

> www.bit.ly/mmi2013-brussels


.............
Network event: Medicus Mundi Switzerland
Universal health coverage and global health beyond 2015

Basel, 6 November 2013. How can global health policy be structured to ensure that even the poorest people in developing countries have access to health services? That's one of the topics of the ongoing international debate on the new development goals for the period beyond 2015. The World Health Organization (WHO) is advocating universal health coverage (UHC) as a way of making health services affordable and accessible to all. At its this year's symposium, Medicus Mundi Switzerland will be discussing how UHC is defined and what form it should take in the light of the new development policy agenda..

> http://www.medicusmundi.ch


.............
Network event: Medicus Mundi Switzerland
Global Health: Interconnected Challenges, Integrated Solutions

Geneva, 15-17 April 2014. "During recent decades significant progress has been made to focus policy attention and channel new financial resources towards global health issues. Despite this, the challenges facing our global community are becoming increasingly complex and inter-connected." The Geneva Health Forum is organized by the Division of International and Humanitarian Medicine at the Hospitals of the University of Geneva, a member of Medicus Mundi Switzerland. Submissions of abstracts close on 30th September 2013.

> http://ghf.globalhealthforum.net


.............
Network paper: Medicus Mundi International
Questions and answers on Universal Health Coverage
…and some more comments and open questions. MMI discussion paper

Like many other actors in global health, the Medicus Mundi International Network (MMI) is overwhelmed by the attention given to the concept of Universal Health Coverage (UHC) in the last two years, mainly by the World Health Organization and related to the debate on health in the post-2015 development agenda. We have followed this debate with great interest (see: MMI thematic guide), as the “UHC hype” brought health systems strengthening, a core concern of MMI, back to the top of the global health agenda. The discussion paper compares key elements of the concept of UHC as promoted by the World Health Organization with our own ambition of Health for All

> Discussion paper: http://www.medicusmundi.org
> Thematic guide on UHC: http://www.medicusmundi.org


.............
Network paper: Medicus Mundi Spain
Healthcare in the Development Agenda post 2015

A declaration by Medicus Mundi Spain approved at their Jubilee Assembly in June 2013 The proposal of Medicus Mundi Spain: Universal, Global and Public Health Coverage.

> Spanish version: FAMME website
> English version: download


.............
Network resource: Medicus Mundi Switzerland
Formation de haut niveau "Diplomatie et santé"

The Graduate Institute of International and Development Studies, a member of Medicus Mundi Switzerland, will organise its first executive course on GHD in French language this November in Geneva. Registration is open until mid-September.

> http://graduateinstitute.ch


.............
Network paper: EPN / Medicus Mundi International
The role of faith-inspired health care providers in Sub-Saharan Africa and public-private partnerships

The World Bank Publication "The role of faith-inspired health care providers in Sub-Saharan Africa and public-private partnerships (Vol. 1 of 3): Strengthening the evidence for faith-inspired health engagement in Africa" published in November 2012 is now available online. The reader edited by Jill Olivier and Quentin Wodon includes, among others, an article on the MMI contracting research (2009) and an EPN paper on access to medicines.

> WB publication: http://bit.ly/156FNP1
> MMI research: http://www.medicusmundi.org


International Health Policy: MMI Updates

.............
Health systems strengthening
Health services, health financing
Health systems research

MMI thematic guide:
www.bit.ly/mmi-hss

 

.............
Universal health coverage

MMI thematic guide:
www.bit.ly/mmi-uhc

MMI events and resources: see above

 

.............
Human resources for health
Migration of health professionals

MMI thematic guides:
www.bit.ly/mmi_hrh

www.bit.ly/mmimigrationguide

 

.............
Access to medicines and vaccination
Medical research and development
Neglected diseases

 

.............
Women’s and children’s health
Sexual and reproductive rights and health

MMI thematic guide:
www.bit.ly/mmi-mch

 

.............
Noncommunicable diseases
Mental health

 

.............
Equity and human right to health
Social determinants of health
Poverty and social protection

MMI thematic guide:
www.bit.ly/mmi_sdh

 

.............
Global health governance and policy
WHO reform
NGO debate

 

MMI thematic guides:

www.bit.ly/ghgovernance

www.bit.ly/mmi-beyond2015guide

www.bit.ly/whoreformguide

www.bit.ly/mmi-ngoguide

 

.............
Health beyond 2015
MDGs and SDGs

MMI thematic guide:
www.bit.ly/mmi-beyond2015guide

MMI events and resources: see above

 

...............
MMI Network News are edited and distributed by e-mail by the secretariat of Medicus Mundi International. Network members (only) are kindly invited to send us your contributions.

You can get the monthly MMI Network News by sending a simple "subscribe" message to the secretariat. Please conctact us also if you have received the newsletter by e-mail, but do not want to be included any more in our mailing list.

Follow the MMI Updates on Twitter:
https://twitter.com/mmi_updates

 

Document Actions