Responding to the health systems challenge
MANILA, 23 October 2013 - The World Health Organization (WHO) has responded to regional health challenges in the Western Pacific with a review of its strategies for helping Member States develop their health system. The goal is to ensure these WHO strategies are appropriate to meet the post-Millennium Development Goals agenda, especially with regard to achieving universal health coverage and greater equity in health outcomes.
“The post-2015 development agenda is looking towards universal health coverage as the overarching framework for this Region,” said Dr Shin Young-soo, WHO Regional Director for the Western Pacific. “This review will allow us to better support Member States with this goal—both by assessing their progress and by refining our own strategies and practices to help them.”
Dr Shin was speaking at the sixty-fourth session of the Regional Committee for the Western Pacific, being held on 21–25 October in Manila, the Philippines. The consultation was attended by representatives of the Region's countries and areas. The review itself focused on 10 countries in the Western Pacific Region and gauged the extent to which WHO’s strategies and frameworks helped with their health systems development.
The challenges facing Member States include addressing the gaps in access to health care between rich and poor. Despite the Region's economic progress, health gaps in terms of coverage and affordability are a major problem for the poor. Other challenges are the implications of population ageing and the increased incidence of noncommunicable diseases such as heart disease and diabetes. WHO is keen to continue to help countries address these challenges by adapting their health systems, which involves the strategies under review.
Over the past 10 years, WHO has been using six health systems strategies to assist Member States with health systems strengthening, namely:
- Regional Strategy for Improving Access to Essential Medicines in the Western Pacific Region 2005–2010, followed by the Regional Framework for Action on Access to Essential Medicines in the Western Pacific (2011–2016)
- Regional Strategy on Human Resources for Health 2006–2015, followed by the Human Resources for Health Action Framework for the Western Pacific Region (2011–2015)
- Strategy on Health Care Financing for Countries of the Western Pacific and South-East Asia Regions (2006–2010), followed by the Health Financing Strategy for the Asia Pacific Region (2010–2015)
- Asia Pacific Strategy for Strengthening Health Laboratory Services (2010–2015)
- Western Pacific Regional Strategy for Health Systems Based on the Values of Primary Health Care (published 2010)
- Regional Strategy for Traditional Medicine in the Western Pacific (2011–2020).
“These strategies cover the key components of public health policy,” continued Dr Shin. “They use the core values of WHO and primary health care to support health system development.”
However, Dr Shin noted that the review also showed continued efforts are needed in areas such as the production and distribution of health workers, the rational use of antibiotics, financial protection for the poor and the development of sufficient disaggregated data to monitor equity.
WHO is worried that there are too few health workers in the countryside of many Member States. WHO is also concerned about the use of antimicrobial medicines: their frequent availability without prescription in several countries raises concerns about patient safety and the potential for antimicrobial resistance to develop.
For WHO, universal health coverage in Member States means ensuring full coverage of the population and affordability for all segments of society, especially the most vulnerable groups. Financial sustainability is the other pillar needed to ensure that the health system can serve the population over the years.
Regarding data systems, the strategies list 122 indicators to track health systems progress. There are gaps in the availability of data. One of the key recommendations is to strengthen civil registration and vital statistics in Member States so as to improve monitoring of health trends and health services delivery. Another is the importance of disaggregated data to adequately monitor equity in health outcomes.
The review also underlined the value of specific expertise in WHO country offices, where experts are on hand to assist ministry of health officials with programmes and plans. WHO would also like more engagement with relevant non-health sectors and non-state sectors in health—along with careful planning and control to mitigate any negative effects on equity.
WHO hopes the review will guide the Organization and Member States to improve their strategies in health systems development, allowing acceleration towards universal health coverage. The review can also be viewed as part of the wider WHO reform process, aimed at improving the Organization's ability to respond to the public health leadership challenges of the 21st century.
“We aim to continue fostering new ways of thinking and working across our Region with a stronger culture of evaluation and learning,” said Dr Shin. “That way, we can continue to meet the challenges of health systems development and accelerate the drive for universal health coverage.”
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Mr Ruel E. Serrano
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