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 Programs - African Health Systems Initiative
African Health Systems Initiative
Background
Canada’s commitment
Main activities
Expected results
 Background
Mothers bring their children in for
a periodic check at the Reproductive
and Child Health (RHC) clinic in Tanzania.
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Contrary to popular belief, Africa is making considerable progress in several key areas. Poverty is on the decline. More women hold parliamentary seats. Child mortality rates are down. The number of children attending primary school has increased from 57 percent in 1999 to 70 percent in 2005.
However, Africa still faces high rates of disease, disability, and death. Average life expectancy is 47 years. Health systems in Africa are weak in part because of poverty, communicable and non-communicable diseases, and a shortage of health-care workers. Many simply do not have access to health care. Approximately 800 African children continue to die everyday because their parents cannot afford to pay for medical services. Without action to strengthen health systems, Africa will not meet the health-related Millennium Development Goals (MDGs).
Canada’s commitment
Millennium Development Goals
At the UN-sponsored Millennium Summit in 2000, the world’s nations unanimously made a commitment to reach eight targeted goals, now known as the Millennium Development Goals (MDGs), by the deadline of 2015. Through the Africa Health Systems Initiative, Canada is supporting efforts to reach the following MDGs:
MDG 4. Reduce child mortality.
MDG 5. Improve maternal health.
MDG 6. Combat HIV/AIDS, malaria, and other diseases.
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Canada is committed to providing basic health care by strengthening health systems in Sub-Saharan Africa. At the G8 Summit in 2006, Prime Minister Harper announced that Canada would give $450 million in new funding to the Africa Health Systems Initiative (AHSI). This 10-year program will support African-led efforts to strengthen health systems and make concrete progress toward the MDGs in Sub-Saharan Africa. The initiative will focus on providing support to train, equip, and deploy new and existing African health workers to make basic health care more accessible to the most vulnerable. Ultimately, by improving access to health care, the initiative will reduce Africa’s mortality rates and improve quality of life.
Main activities
AHSI will concentrate its efforts to making improvements in the following areas:
The initiative will support the large-scale expansion of front-line workers to care for the basic health needs of the population, especially women and children. Basic health promotion and disease-prevention services will be provided at the community level. These health-care services will be monitored to ensure the approaches achieve the desired result: saved lives.
- Strengthen national health systems
CIDA will support national strategies to address gaps in health systems, particularly related to issues regarding the health work force, and in some cases, to give support to increasing the number of community health workers in underserved areas. The initiative will focus particularly on the countries in which CIDA already has health-programming experience.
CIDA support provided under the Africa Health Systems Initiative will be aligned with health sector strategies developed by national ministries of health. A key focus of the initiative is to provide health sector managers and front-line workers in Africa with the necessary training and support to build more-effective and sustainable health systems. The initiative will also back health-system strengthening efforts of African regional and pan-African institutions such as the Conference of African Ministers of Health of the African Union (AU), New Partnership for Africa’s Development (NEPAD), and World Health Organization’s Regional Office for Africa (WHO/AFRO).
- Support African efforts to harmonize the work of donors
African countries will lead the health system strengthening process by developing effective health-sector strategies. CIDA will support the process by looking for strategic entry points in which our expertise and funding can be useful. CIDA will also continue to work with such global health partners as the Global Fund to Fight AIDS, Tuberculosis and Malaria and the Global Alliance for Vaccines and Immunization (GAVI) to support their efforts in harmonizing their programs with African countries to strengthen health systems.
- Engage Canadian and African partners
Canadian and African civil-society organizations and research communities with experience in working with African health systems will be identified and engaged. At the same time, our developing-country partners will be assisted in their efforts to strengthen the human resource capacity in Africa’s health sector.
Expected results
Working with African governments, the Initiative aims to achieve the following:
- significantly reduce death, disease, and disability;
- strengthen African leadership by improving leaders’ capacities to provide sustainable, accessible, and gender-responsive health care to the most poor;
- employ, train, equip and retain front-line African health workers to provide essential health and nutritional services to underserved populations;
- improve maternal and child health;
- combat infectious diseases such as measles, malaria, tuberculosis, and AIDS;
- reduce the prevalence of micronutrient malnutrition; and
- improve access to appropriate health-care services to improve the overall health of women and girls.
An approach to health systems that achieves results
Building on the successful results of past programming, CIDA will show that large-scale expansion of front-line workers into Sub-Saharan health systems can improve health outcomes, especially among women and children.
Canada Saves Lives in Tanzania by Improving Health Management
The Africa Health Systems Initiative will build upon the advances made through CIDA-funded programs such as the Tanzania Essential Health Interventions Project (TEHIP), a program implemented by the International Development Research Centre. TEHIP developed an “evidence-based approach to health planning.” This means that instead of relying on national assumptions about health priorities, the two targeted districts identified local health priorities based on research evidence and prioritized their budgets according to health needs. The project demonstrated how spending money more wisely, based on the health problems that pose the greatest threats, can have dramatic impact on improving health outcomes. In fact, strengthening health systems helped to reduce child mortality rates by nearly 40 percent in the two districts between 1998 and 2003.
New Approach to Improve Child Health Reduces Child Mortality Rates by Approximately 20 Percent
The Africa Health Systems Initiative will also work with multilateral organizations such as UNICEF to build on successes achieved through the Accelerated Child Survival Development Program. Launched in four West African countries and then expanded to 11 additional countries in the region due to its early success, the program reduced child deaths by approximately 20 percent in districts where it was fully implemented between 2002 and 2005.
Update on the rollout of the Africa Health System Initiative’s components
CIDA is working with partners to develop the necessary frameworks that will produce stronger, sustainable health systems in Africa. To date, the following components have been launched:
- In Tanzania, CIDA is providing $7 million (2006–2009) for the Tanzania Zonal Rollout of Essential Health Interventions project (ZoRo). ZoRo is building on the results of the Canada-funded Tanzania Essential Health Interventions Project (TEHIP) (1997–2004), undertaken by the International Development Research Centre (IDRC). Through ZoRo, Tanzania’s Zonal Training Centres will be strengthened and will play an integral role in the distribution of the health-intervention tools across the country. The tools were designed and tested in the two TEHIP districts where health-care delivery was strengthened and resulted in a measurable decrease in death rates.
- In Zambia, CIDA has given $2.4 million to support the Human Resources for Health Strategic Plan (HRHSP), an integral part of that country’s National Health Strategic Plan (2006–2010). The HRHSP is the Zambian government’s response to its health worker shortage crisis. The plan is supporting improvements in training, incentives for improved performance of health staff, retention schemes for critical staffing groups, and increased recruitment of staff.
- CIDA is providing $5 million (2006–2011) to WHO to support the activities of the Global Health Workforce Alliance and, more specifically, the Action Plan on Human Resources for Health. This funding has helped to establish the African Health Workforce Observatory (AHWO), which in turn, has supported setting up national observatories in Ethiopia, Ghana, Tanzania, and Zambia. The AHWO monitors and shares information, practices, and experiences with African nations. This supports informed decision making and advocates keeping health work-force priorities on national, subregional, regional, and global agendas.
- Through the Global Health Research Initiative (GHRI), a partnership between the IDRC, Canadian Institutes of Health Research (CIHR), CIDA, and Health Canada, CIDA is funding a $5-million initiative (2006–2011) to support an African-Canadian research program. This support will fund African research partnerships to find solutions to relevant operational issues and African health systems programming problems. It will ensure that the proposed solutions are: aligned with African government research strategies and priorities, and demonstrate a clear link between research, policy, and action to improve health programming in Africa.
Related CIDA sites
Government of Canada
Related sites
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