By: Elizabeth Lopez, Knowledge Maanagement Associate, PHC Initiative, PAI
In September, Gavi CSO Constituency and Catholic Relief Services held the Gavi CSO ConneXions 2018 conference in Nairobi, Kenya. This meeting highlighted the importance of ensuring routine access to immunization, strengthening health systems and the advocacy needed to achieve those goals in light of the changing landscape around health program financing. Significant portions of funding for health programs in low- and middle-income countries have depended on external financing and are often channeled into disease-specific health programs. Current discussions on achieving universal health coverage and the third Sustainable Development Goal (SDG) — to “ensure healthy lives and promote well-being for all at all ages” — has turned towards health systems strengthening as well as the need to mobilize public funding and improve accountability.
During the past 20 years, much has been done in low- and middle-income countries to improve access to health services, such as vaccination and antenatal care, in addition to related services, such as clean water and sanitation. The World Health Organization (WHO) and United Nations Population Division report that vaccination and immunization rates have gone up from 48–52 to 84–86 percent between 1985 and 2015. Likewise, WHO and the United Nations International Children’s Emergency Fund (UNICEF) report that in developing countries, access to antenatal care has gone up by 21 percent. This increase has greatly contributed to improving health outcomes and preventing deaths related to infectious diseases. However, a closer examination of these achievements reveals disparities in access to health services, leaving rural populations most vulnerable. Additionally, noncommunicable diseases in low- and middle-income countries are taxing to health systems that are fragmented, inefficient, and ill-equipped to face these growing challenges. The Lancet Global Health Commission recently reported that changing health needs, growing public expectation and ambitious new health goals are raising the bar for health systems to produce better health outcomes. The format of siloed external financing for disease-specific health programs is the format of the past — it is time for comprehensive, integrated and people-centered health systems.
Civil society organizations (CSOs), especially in developing countries, have proven to be key allies in supporting health systems strengthening and accountability. The role of CSOs has become even more significant in this SDG era by encouraging citizens to participate in calling for solutions that affect their daily lives. CSOs are uniquely positioned to make a greater impact by finding common ground and consolidating their voices:
Finding Common Ground: Regardless of the health issue, CSOs seek to reach those who are most vulnerable and remove barriers to health and wellbeing. This shared value can be built on to develop cross-cutting approaches that break through barriers between different health issues and disease-specific advocacy objectives.
Consolidating CSO Voices: CSOs can have greater, longer-term impact when they come together and align resources. This includes standing together to create a strong voice for health systems strengthening with the ultimate goal of achieving universal health coverage. CSOs from different health areas can forge strong partnerships, share experiences and combine resources for effective, targeted advocacy. The role that CSOs play in capacity building, service delivery, policy and accountability can be particularly useful when targeting policy change.
The Gavi CSO ConneXions conference effectively modeled how CSOs of different health backgrounds and expertise can come together to work towards the broader goal of achieving health for all. Achieving health for all is not a race, with winners and losers. Rather, it is a path that we must all walk on — with those in the front clearing away the roadblocks and helping those behind avoid pitfalls.