Collective action for better health outcomes

Strengthening the Humanitarian,

Development & Peace Nexus:

Fostering collaboration between the

emergency response programming and

health systems development

Collective action for better health outcomes

Humanitarian-Development Nexus in the news

Collective action for better health outcomes

Photo: WHO/C. Haskew

The Humanitarian-Development Divide

Humanitarian Principles/ IHL

Humanitarian Development

Substitution/parallel

Outlook

Coordination/Leadership

Planning Frameworks/Tools

Legal Frameworks

Types of Settings

Culture/Approach

5-10 years 6-12 months*

System-led: clusters

HRP/HNO

Sovereign Law, Aid effectiveness principles

Stable/Willing Fragile/ Unwilling

UNDAF/ CCA, NHP&SP, NAPHS

Government-led; IHP+/UHC2030

Complementarity

Humanitarian Principles/ IHL

Collective action for better health outcomes

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New Way of Thinking: 2016 Global Processes

Agenda for Humanity

“Reduce risks and vulnerabilities”

“leave no-one behind”

Agenda 2030

Collective action for better health outcomes

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Bridging the Hum-Dev Divide in Health

Joint Analysis

Define Collective Outcomes

Joint Planning

Life Saving

Assistance and

protection

Integration in

National Health

System

UHC & resilience:

Health System

Strengthening and

preparedness

Humanitarian Development

‘Joined Up’ Programming

Collective action for better health outcomes

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A new way of working

•Humanitarian interventions should apply early recovery approaches in the response, and seek integration with existing health services and transition of governance to local authorities

•Development oriented workstreams should target fragile and conflict affected areas in a more operational manner, addressing key bottlenecks in health system performance that also constrain the humanitarian response, with more flexibility in contracts and adapted management of risks.

•Fostering the interface between them through connections in analysis, planning and coordination

Collective action for better health outcomes

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HDPN for health

1. Collective outcome:

•SDG3: As overarching goal Universal Health Coverage: ensuring that people can use essential services when they need them without suffering financial hardship

•Preparedness of the health system and communities for shocks.

Collective action for better health outcomes

Collective outcome: UHC

Collective action for better health outcomes

Photo: WHO/C. Haskew

HDPN for health

2. Joint analysis: bringing together

•humanitarian assessments (MIRA/HNO/HeRAMS, etc),

•health sector performance/bottleneck/capacity assessment

•all hazard risk analysis (STAR, VRAM, PHRA, etc)

•context analysis

Collective action for better health outcomes

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HDPN for health 3. Joint operational planning at national & subnational level:

•Integrating where possible both humanitarian and development support in the operational plans.

•Multi Year HRP, using the health system analysis framework to identify priorities and opportunities for early recovery to connect with longer term health system recovery and resilience

•National Health Strategic Plan that prioritises areas and populations in most need, and preparedness for all hazards.

Collective action for better health outcomes

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HDPN for health Give example how humanitarian partners can support

health system strengthening for the HDN

1.Service delivery

2.Health workforce

3.Information

4.Medical products

5.Financing

6.Leadership/governance

See chapter on early recovery of the health cluster handbook

Collective action for better health outcomes

Humanitarian/emergency coordination, EOC Health development partner coordination (IHP+, etc)

Registration and mapping of all health partners Coordination for the recovery assessment and planning

Sub national emergency coordination Core functions and capacities for district health management

Accountability to Affected Populations People-centred and integrated health services

Focused capacity building of DHMT to supprt life saving functions Guidance for district, community and village health committees

Decentralisation policies

Humanitarian Response Plans National Health Strategy/policy planning (JANS)

Emrgency preparedeness and contingency planning Disaster Risk Management, IHR 2005

(selected) Morbidity surveillance IDSR

EWARNS EWARNS

HeRAMS SARA

Selected HIS indicators HMIS

Restore life saving services Restore basic services, and improve for access and performance

Essential Packages of (life saving) Health services Package of health services

Patient safety, and IPC

Progressive expansion of coverage and quality Universal Health Coverage

List of core life saving pharmaceuticals Essential medicine lists, by level of health facility

Drug and equipment donation guidelines Essential medical equipment lists, by level of health facility

Quality control of drugs procured by international partners Prequalification of suppliers

Standardised remuneration/incentives HRH policies and plans

Task shifting Staffing standards by level of health facility

Scaling up community outreach programs/CHWs Standard post descriptions

Training curricula for types of health workers

CHW policy

Services free at point of delivery Health financing policies, public funding, reduce OOP, PBF

(temporary) waiving of user fees Financial protection from catastrophic health expenditures

Recovery and Health System resilience

Coordination

Governance

HIS

Service delivery

Pharmaceuticals

and equipment

Financing

HRH

Response and Early Recovery

Collective action for better health outcomes

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Implementing HDPN for health

1. Focus on service delivery:

•Progressively expand access, coverage and quality of an Essential Package of Health Services (EPHS)

•Health financing with social & financial protection

•Address health system constraints for its implementation, and

•Address barriers to access services from HH/community perspective

Collective action for better health outcomes

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Implementing HDPN for health

2. Preparedness for acute emergencies

•Preparedness and risk management for all hazards, including health security and IHR core capacities

• Strengthen national EWARS, investigation, control and response capacities (including for example scaling up epidemic related treatment centres)

•Health system strengthening for preparedness: ensure integration in NHSP, and respective policies for health system components

•Essential Public Health Functions in fragile contexts

Collective action for better health outcomes

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3. Governance & partnership:

• Coordination architecture that provides links between humanitarian and development partners, as well as intersectoral connections

• Maintaining health governance, in particular at subnational level: District Health Management & community engagement

• Platform for policy dialogue, based on joint analysis, planning and monitoring

• Conflict sensitive programming, Health as a Bridge for Peace

• Commitment to humanitarian principles & principles for Aid Effectiveness

Implementing HDPN for health

Collective action for better health outcomes

HEALTH

programme EMERGENCIES

A new way of working

Funding and financing:

•Increased public funding and local resources

•Predictable and flexible humanitarian and development funding to support HDPN

•Avoid the humanitarian development funding gap

•Create dedicated emergency pooled funds for health (e.g. to reimburse loss of revenue due to user fee waiver policies, subsidise access to medicines, scale up service delivery for epidemics, etc)

•Pilot different provider payment mechanisms in protracted emergencies, complemented by demand side financing