Title: FBOs and Alma Ata II Renewing Primary Health Care
1FBOs and Alma Ata II Renewing Primary Health
Care
- Franklin Baer
- Carl Taylor
- Sarla Chand
- Frank Dimmock
- Samuel Mwenda
2Renewing PHC in the Americas
3Various Approaches to PHC(and the need for
complementarity)
4The renewed definition of PHCFocusing on the
health system as a whole
- Include public, private, and non-profit sectors
- Recognize PHC as more than provision of health
services - Differentiate values, principles and elements
- Highlight equity and solidarity
- Incorporate sustainability and a quality
orientation. - Specify measurable organizational functional
elements - Recognize dependency on other health system
social processes - Recognize need for each country to design their
own strategy
5Role of FBOs in renewing PHC?
- No mention of FBOs, Faith, or church
- 1 mention of missionaries Christian (Annex C)
- The Christian Medical Commission was created by me
dical missionaries working in developing countries
. They emphasized training of village health
workers - 1 mention of private and non-profit sectors
- Renewing PHC should include public, private, and
nonprofit sectors
6Faith-Based Health Care
Public
Private
7Renewing PHC Back to the Basics
8A is for Alma Ata
- The Alma Ata Conference (1978) defined PHC
- 10 Declarations of Alma-Ata
- The people have the right and duty to participate
individually and collectively in the planning and
implementation of their health care. - 8 Essential Components of PHC
- 4 As of PHC (Accessible, Available, Acceptable,
Affordable) - 3 Aspects of PHC (Curative, Preventive
Promotion)
9Community-Based Congregational-Based
- Role of the Church in Community-based Health Care
- Community Health Global Network Working Group
- Evidence-Based study of Community-Based PHC
- Community Health Evangelism (CHE)
- Care Groups
- Training for Transformation, Building our Lives
10Building Integrated Health Systems
- A 3-D conceptual model of a comprehensive
health system based on PHC (1988, Smith
Bryant) - First Dimension PHC Program elements
- Second Dimension Functional Infrastructure
- Third Dimension Level of Service delivery
11Conceptual Model of a Comprehensive Integrated
Health System
12(No Transcript)
13FBOs PHC Health Systems
- 1st PHC Program Elements
- Risk of becoming labeled as being single issue
- WIMEN CHD
- 2nd Support Systems
- ? ? ?
Water Sanitation Immunizations Mother Child
Care (FP) Essential Drugs Nutrition
Food Curative Care Health Education Disease
Control
- Essential Drug Systems
- Human Resource development
- 3rd Health System Levels
- Family Home
- Community-Based ( Congregation-Based)
- Health Facility-Based
- Health Districts
- National Level (FBO Health Networks)
14FBOs Renewing PHC
- 1) Review the legacy FBOs and Alma Ata
- 2) Articulate a strategy for FBO contributions to
renewing PHC - 3) Lay out steps to achieve this vision
15FBOs and Alma Ata IIRenewing Primary Health Care
- Franklin Baer
- Carl Taylor
- Sarla Chand
- Frank Dimmock
- Samuel Mwenda
16Medical Missions transition to Health Missions
- Christian Medical Commission of the World Council
of Churches in Geneva - 1960s Tubingen Conferences (Martin Scheel)
- Key Leaders
- Jack Bryant, Jim McGilvary, David Jenkins,
- Anthony Bloom, Hakan Hellberg, David Morley,
- Fred Sai, Nita Barrow, Caroll Behrhorst
- Surveys of ripple effect of health impact from
hospitals - Need to do more prevention and behavior change
- Christian Medical Commission Journal Contact
pioneered the early explorations of what we now
call Community Based Primary Health Care
17Rockefeller to WHO Christian Connections
- Ding Xian John B Grant, Jimmy Yen, CC Chen
- Second Generation Projects
- Hydrick in Jogjakarta, Indonesia
- Eloesser in Chile and China
- Kark in Pholela, South Africa
- Third Generation Projects
- Narangwal
- Jamkhed
- Christian Medical Commission projects (Litsios,
AJPH) - Health by the People (Newell, WHO)
- Alma Ata Conference in 1978 (Halfdan Mahler, WHO)
- Comprehensive vs Selective (top-down vs bottom-up)
18FBOs and Alma Ata IIRenewing Primary Health Care
- Franklin Baer
- Carl Taylor
- Sarla Chand
- Frank Dimmock
- Samuel Mwenda
19Faith- Based Maternal Newborn Health Care
Programs
- 1. Community-based
- - India ,Jamkhed, CRHP
- - Mozambique, World Relief, Care Groups
- 2. Congregational Health Model
- - Malawi, CCAP Malaria Prevention Program
- 3. National faith-based health networks
- Uganda , UPMB, UMMB
- Kenya, CHAK
- Tanzania, CSSC
- 4. District Health
- Co-Management
- - DR Congo, ECC-DOM,
- the SANRU Program
201. Comprehensive Rural Health Project Jamkhed,
India
Since 1970 Jamkhed has empowered communities to
take health into their own hands through
principles of Integration, Equity and
Empowerment with leadership of village health
workers (VHWs). Christian principles of justice
and service provide an alternative model of
society to the inequitable Indian caste
system. The government of India started the
National Rural Health Mission (NRHM) chaired by
the Prime Minister. NRHM has adopted the
village health worker model of Jamkhed for this
country wide program.
www.jamkhed.org
212. Congregational Malaria Prevention Program
- 26 out of 150 CCAP congregations in hard to reach
areas of Northern Malawi trained women to - 1) Deliver malaria prevention and treatment
messages, and - 2) To provide/sell mosquito nets and
insecticide.
The Synods of Livingstonia Nkhoma, Presbyterian
Church of Central Africa, Malawi
223. National faith-based health networks
UPMB/UMMB/UCMB Interfaith, public PNFP
This project trained providers, CORPS and
mobilized Religious Leaders to promote
- Uptake of Intermittent Preventive Treatment for
Malaria - Use of ITNs among pregnant women
- Capacity among providers to deliver focused ANC
services - Pregnant women coming early (first trimester) for
ANC - pregnant women receiving IPT1 increased 43 to
94 - pregnant women receiving 1st IPT2 increased 63
to 76
234. District Health systems development and
Management
- SANRUs integrated and systems strengthening
- approach resulted in major achievements
- in maternal newborn care
Assisted births increased from 45 to 65
Prenatal Care increased to 80
SANRUs health system strengthening program
strengthens PHC interventions and encourages
co-management of health zones via FBO health
networks.
www.sanru.org
24Challenge for Faith Communities
- Save pregnant women and babies from preventable
deaths Through Integrated, comprehensive
community health programs - Enable capacity building of partners in Africa,
Asia and LA/C
25FBOs and Alma Ata IIRenewing Primary Health Care
- Franklin Baer
- Carl Taylor
- Sarla Chand
- Frank Dimmock
- Samuel Mwenda
26FAITH-BASED HEALTH NETWORKS IN AFRICA
Renewing the focus on Primary Health Care
27 Christian Health Associations
active CHAs networks
evolving networks
28History and Coverage of Faith-based Health
Services
Appreciating Religious Health Assets
www.arhap.uct. ac.za
Interfaith Health Program Emory School of
Public Health University of Cape Town Dept of
religious Studies University of Kwa Zulu Natal
Theology and Development Program University of
Witwatersrand Department of Sociology
Research supported by the World Health
Organization
29(No Transcript)
30LESOTHO GIS / PGIS 2006
31(No Transcript)
32AIDSLink publication of the Global Health
Council
Community Realities in Africa Show FBO
Partnership Key to Global Scale-Up
Amidst the ongoing, often fierce, debate about
the role of faith-based organizations (FBOs) in
combating HIV/AIDS, a pilot study by the World
Health Organization (WHO) and research partners
in sub-Saharan Africa put to rest any doubts
about the huge role played by faith communities
in HIV care and treatment. It also reconfirmed
the urgent need for partnerships with the public
health community to achieve better health
outcomes. With the rate of HIV treatment
scale-up still averaging 50,000 new people per
month, it is evident that government-sponsored or
supported health services alone will not come
close to reaching the target of universal access
by 2010, which is another 6 or 7 million persons
living with HIV. It is also evident from an
examination of multilateral and bilateral funding
programs and health policies that there is a
failure to understand the influence of religion
in African health worlds.
33(No Transcript)
34The study has recommended developing religious
and public health literacy through formal
courses, joint training, and shared materials to
improve understanding.
Time is of the essence for identifying religious
health assets that could help to scale-up
services, strengthen community support groups and
religious entities, and further link them to
nearby state-run hospitals, clinics and
dispensaries. Further examination of the nature
of intangible (spiritual encouragement, knowledge
and moral formation) health assets is needed to
more fully document the full extent of
possibilities for religious health assets.
There is an astonishing capacity possible in
religious communities to greatly enhance health
services, along with supporting people in their
care, stimulating the will to live, and building
communities. These are the added value of
enrolling FBOs as full participants in the health
system Building communities, saving lives, and
preventing the further spread of HIV.
35Rev. Canon Ted Karpf
karpft_at_who.int
36SO. What are we doing to support Christian
partners in Africa, Asia, and elsewhere to be
engaged and seize the opportunity to reach out
within communities and through their
Congregations ???
37Christian Health Associations in Africa
Bi-annual (almost) Assemblies
- Siavonga, Zambia Conference 9/2001
- Nairobi, Kenya Conference 5/2003
- Mangochi, Malawi Conference 11/2004
- BAGAMOYO CONFERENCE Tanzania 2007
38FBOs and Alma Ata IIRenewing Primary Health Care
- Franklin Baer
- Carl Taylor
- Sarla Chand
- Frank Dimmock
- Samuel Mwenda
39BAGAMOYO AFRICA CHAs CONFERENCE 2007
- STATEMENT OF COMMITMENT RECOMMENDATIONS OF 18TH
JANUARY 2007 - Presented by Samuel Mwenda, CHAK
40Commitment agreed upon by the participating CHAs
partners
- The Bagamoyo conference reaffirmed the commitment
to continue the healing ministry of Jesus Christ,
serving the poorest of the poor and marginalised
but also recognising the need to care for the
carers in a biblical manner. In addition CHAs
will continue to work in partnership with
churches, governments and other development
partners. - The Bagamoyo conference recognised that much
progress has been made since the last conference
in Malawi (2004). The TWG on HRH which was
supported by IMA had facilitated this process.
41Strengthening a Support Platform for all CHAs
in Africa.
- A small rotating secretariat to improve
networking and communication between CHAs and
associated organizations in Africa and elsewhere.
CHAK agreed to host this secretariat for the
initial 2-3 year time period. (TOR were to be
developed) - This secretariat would include a fulltime program
officer who is fluent in both English and French - The platform would facilitate discussion on
specific issues concerning CHAs and would also
facilitate the preparation of the next meeting in
2009. - A virtual platform for better communication would
be hosted in such a network. IMA World Health and
MMI would give technical assistance with other
agencies contributing.
422..
- The newly established office would also
facilitate and promote the communication and
collaboration between partners of the CHAs such
as the capacity project (IMA), EPN, AIDS
initiatives, the Healing Study (DIFAEM), Medicus
Mundi International, CCIH and other collaborative
partners. - WCC, IMA, MMI, DIFAEM, CCIH and other partners
working with CHAs will facilitate the lobbying
and advocacy on behalf of CHAs, FBOs and
Christian Health Services among churches and the
international level. - CHAs committed to follow up on the HRH
recommendations and the TWG would continue to
support this process.
43Participants at the Bagamoyo Catholic Mission
Cross which marks the entry point of
Christianity into East Africa also marked the
renewing of the CHAs commitment
44Progress made
- TOR for the CHAs Platform secretariat and a work
plan were developed by CHAK - Seed funds to start provided by WCC Difaem
- A CHAs Platform Secretariat officer has been
recruited and hosted by CHAK in Nairobi, Kenya - Work plan implementation has started.
- The 1st Africa CHAs Bulletin is expected in June
2007 - One issue of WCCs Contact Magazine to focus on
CHAs
45Way forward
- A CHAs Platform website needs to be created with
a database of members and linkages to existing
CHAs resources websites - Africa CHAs Platform needs to establish an active
working relationship with CCIH and its members - Africa CHAs Platform members, stakeholders,
partners and collaborators are invited to
contribute articles, information news items for
inclusion in the Bulletin - New partners are invited to support the CHAs
Platform with ideas, programs and resources
towards making it a viable platform for engaging
Africa Christian Health networks - We should collectively begin putting our ideas
together for the next Africa CHAs Conference
which should be held in either Southern Africa or
Western Africa in 2009
46FBOs and Alma Ata IIRenewing Primary Health Care
- 1) Review the legacy FBOs and Alma Ata
- 2) Articulate a strategy for FBO contributions to
renewing PHC - 3) Lay out steps to achieve FBO visions.
I plan to promote integrated primary health care
as a strategy for strengthening health systems.
--Dr Margaret Chan, WHO Director-General
47(No Transcript)
48PAHOs Next Steps Building an International
coalition
- Frame PHC renewal as a priority
- Develop concept of PHC-based health systems as a
feasible and politically appealing policy option,
- Capitalize on the current windows of opportunity
- the recent the anniversary of Alma Ata,
- the Millennium Development Goals (MDGs)
- current focus on strengthening health systems.