Editorial: Health system strengthening and conflict transformation

Dear reader,

The Mauritszaal in KIT Amsterdam was filled to capacity on the 11th of October. Members of the MMI Network and representatives of a range of NGOs came together to explore if it is possible to strengthen health systems and address fragility at the same time. In other words, as Egbert Sondorp (Senior Advisor KIT) summarized the objectives of the day: “Can we kill two birds with one stone? How and what are the various pathways? And can we measure and get funding for it?”

Rene Grotenhuis (Director Cordaid) argued that building state institutions is not enough to bring a state out of fragility. Cordaid believes that the answer to conflict and fragility is in communities and not state entities. Health service delivery should be looked at as not merely technical delivery of services but also as a means to build flourishing communities. It’s a social intervention that has the potential to make social changes. Quality health care can become a bridge to overcome differences and conflicts. Rachel Slater (ODI, Research Director SLRC) warned for the danger that other duties and responsibilities are heaped on the health system, thus loosing focus on the main priority of a health system – curing sick people and preventing disease. While keeping service delivery as our focus, it is important however to look at the context one is working in and keep on asking ourselves the question whether we “do not do harm” with our intervention.

The case studies seemed to point in the direction that you probably could kill two birds with one stone, as long as you strategize and position yourself properly. However, no clear answer emerged from the discussions around the 11 case studies from fragile situations, rather more questions emerged. Being cognizant of the context, understanding that neutrality is a difficult concept and dealing with the “do no harm” – concept while working at community level: how do you put this into practice? It is naïve to think that HSS automatically leads to conflict transformation?  Should we consider conflict transformation to be a goal of the health system or should we only be cognizant of the fact that an intervention could lead to changes in the power relation in a given area?

In the unnerving Pecha Kucha presentations, presenters agreed that there is a relation between health systems and conflict transformation but that we need to be more precise about what this linkage is and how we want to address this in our interventions. Here as well, more and more questions kept emerging: What exactly are fragile states? Should we take a community/educational/strengthening approach? Can we narrow down key terms and make labels more meaningful? What is exactly incorporated in the concept of health system – even though it is a common term, people look at it from different perspectives?

At the end of a full day, the conclusion to be drawn was that there seems to be plenty of anecdotal or “intuitive” evidence that health system strengthening contributes to conflict transformation, but we need to build the evidence to get a deeper understanding of health as an instrument of change. This will allow us to develop a common framework which can help to make interventions conflict-sensitive without compromising the main goal of health system strengthening – the improved provision of health services. Thus, can we kill two birds with one stone? Probably. This expert meeting was only a first step in getting a more conclusive answer to this question. In Cordaid, we hope that we can venture on this journey with MMI members and – using the existing Health and Fragile States Network* – share and learn together so that when we meet next year, we have more answers

Jennie van de Weerd
Policy Officer Health and Well-being, Cordaid
Co-organiser of the expert meeting
Jennie.van.de.Weerd@cordaid.nl

*To become member of the Health and Fragile States Network, simple send an email to healthfragilestates@gmail.com

 

Health systems strengthening and conflict transformation in fragile states
Expert meeting in Amsterdam, 11 October 2012
Meeting documentation: www.bit.ly/mmi-amsterdam2012

 

MMI Network: Events, news, debates and resources

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Network Event: Medicus Mundi Switzerland
Mother and child health, Basel, 6 November 2012

This year’s Swiss Health Cooperation Symposium organized by the Network Medicus Mundi Switzerland will focus on mother and child health. Announcements are available in German and French only.

www.medicusmundi.ch/mms/view?set_language=de

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MMI Network event: DWA Cuamm
Mothers and children first: initial steps
Rome, 15 December 2012

“We will discuss about innovation and research on Maternal, Neonatal and Child Care and present the results of CUAMM’s five year project Mothers and children first started a year ago. Will be showing the activities implemented and the improvement of four hospitals (in Ethiopia, Uganda, Angola and Tanzania), underlining the outcomes and the use of innovative methodologies and tools.”

www.medicusmundi.org/en/contributions/events/2012/mothers-and-children-first-initial-steps

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MMI Network resources
UN thematic consultation: Health in the post-2015 UN development agenda

In the current Millennium Development Framework (MDGs) three out of the eight goals directly refer to health conditions (maternal health; child health; AIDS, TB and Malaria). What will be the role of health in the development agenda beyond 2015? The UN is putting in place a series of thematic consultations on the post-2015 development agenda. Health is one of the 9 topics covered. The consultation on health lead by WHO and UNICEF has started now. It will takes place between October 2012 and February 2013. Beyond 2015, a global civil society campaign pushing for a strong and legitimate successor framework to the Millennium Development Goals, appointed the Medicus Mundi International Network to coordinate campaign input in the health consultation.

UN thematic consultation website (online since 5 October 2012)
WHO: Health in the post-2015 UN development agenda
Beyond2015/MMI Network: call for input and inbox
MMI thematic guide: Health in the post-2015 UN agenda

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MMI meeting documentation: Geneva, 18 October 2012
Future policy of WHO engagement with NGOs

The Sixty-fifth World Health Assembly requested the WHO Secretariat to present a draft policy paper on WHO’s engagement with nongovernmental organizations to the Executive Board at its 132nd session in January 2013. As a step in developing this draft policy WHO was consulting NGOs on issues concerning consultation, collaboration and accreditation. Remco van de Pas (Wemos) and Thomas Schwarz (secretariat) participated in a consultation meeting chaired in a first session by WHO DG Margaret Chan as representatives of the Medicus Mundi International Network and part of the Democratizing Global Health coalition on the WHO reform (DGH).

www.bitly/2012-whoconsultation

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MMI meeting documentation: Amsterdam, 10 October 2012
Getting evidence into NGO practice and policy

At this workshop hosted by HealthNet TPO, members of the MMI Network and other NGOs working in the field of international health cooperation learnt from HealthNet TPO (The Netherlands) and Memisa (Belgium) how they deal with the challenge of getting evidence into their practice. In a second part, NGOs and representatives of research and teaching institutions discussed the feasibility of a project initiated by the MMI Network to create a “marketplace” for NGOs and young researchers. The workshop documentation with all inputs is available now.

www.bit.ly/mmi2012-research

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MMI meeting documentation: Amsterdam, 10 October 2012
Welcome to medico international, CWGH and Health Poverty Action!

Amsterdam, 10 October 2012. At the Extraordinary Assembly of the Medicus Mundi International Network, three organizations working in the field of international health cooperation and advocacy were admitted as new members of the Network. Welcome!

Assembly and Board meeting documentation
www.medicusmundi.org/en/intern/ga

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MMI Network campaign: Health Poverty Action
Mothers on the Margins

Every year between 230,000 and 398,000 women die before, during or just after childbirth. 99% of these women are in developing countries. These figures are unacceptable in themselves, but some women are more at risk that others. Indigenous women, or those from other cultural minorities, are more likely to die or face complications related to pregnancy. Why not pledge your support for the maternal health of indigenous women by signing up to the Mothers on the Margins campaign?

www.healthpovertyaction.org/campaigns/mothers-on-the-margins/

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MMI Network paper: medico international
Institutionalising Solidarity for International Health

“The concept of International Health refers to more than just controlling pandemics. It refers to an internationally shared responsibility for health perceived as the well-being of all.” medico international: Health – our position.

www.medico.de/en/themes/health

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MMI Network paper: EPN
HIV programming in Church institutions – challenges & responses

Pharmalink is an annual publication of the Ecumenical Pharmaceutical Network (EPN)  focusing on advocacy issues that EPN is involved in at a particular time. Every edition tackles a different subject. The 2012 edition on HIV programming in Church institutions is now out. The electronic version can be downloaded, prints are being distributed to various health institutions and professionals through EPN members, partners and friends of the network.

www.epnetwork.org/pharmalink-newsletter

 

International Health Policy: MMI Updates

Bits and pieces of news on international health policy: each “MMI update” is 140 characters or less – these are the rules of the game on twitter. Just enough for a headline, eventually an author, a date, the source – and a link to the website where you find the full information. Have a look at some of our “tweets” published during the last month. As usual, it’s a bit much, so take it or leave it.

 

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Health systems strengthening
Health services, health financing
Universal health coverage

 

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Human resources for health

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Access to medicines and vaccination

 

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

 

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Equity and human right to health
Social, economic and political determinants of health
Poverty and social protection

 

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Global health governance and policy
WHO reform
Beyond 2015, MDGs and SDGs

 

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World Mental Health Day
10 October 2012

 

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Noncommunicable diseases

 

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Tuberculosis

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Other topics

 

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