Cotonou Regional Forum on Community Health: exchanges between Southern countries are more than ever needed

The end of 2019 was marked by significant events for community health in the Southern countries. These included the Regional Forum on Community Health in the context of Primary Health Care. It was held from November 12 to 15, 2019 in Cotonou, Benin.

By Adalbert Tchétchia & Mohamed Ali Ag Ahmed

The purpose of the forum was to promote and increase investment in strengthening community-based primary health care (PHC) in West and Central Africa countries. It brought together the Ministers of Health of Benin and Liberia, country delegations, civil society organizations and development partners. As facilitators of the Community Health Community of Practices (CH-CoP) and of the AFRAFRA network, we were able to take part in the exchanges and of the  recommendations that emerged from the deliberations.

On the far right, Dr YAMEOGO Pierre and in the middle the ministers of health of Benin and Liberia.
On the far right, Dr YAMEOGO Pierre and, in the middle, the ministers of health of Benin and Liberia.

On the sidelines of the forum, we got an opportunity to interview with Dr Pierre Yaméogo, [Technical Secretary in charge of the implementation of Universal Health Coverage (UHC) in Burkina Faso & coordinator of the implementation of the One Health platform]. The opportunity provided us to assess some of the major action points of the forum. From the outset, Dr Yaméogo highlighted the need for exchanges between the Southern countries and the value for platforms like the forum in Cotonou and the Communities of Practice.

Moving from word to action

The Cotonou forum raised hopes for the future of community health in the subregion. The recommendations formulated to meet the challenges to community health focused on different aspects such as funding community-based PHC, human resources, strengthening accountability and community empowerment in PHC, coordination and partnership, strengthening governance, implementing PHC, strengthening community systems and community empowerment. Dr Yameogo, mentioned.

“It is good to take initiatives, lots of statements. But when you look at our implementation environment, we need to leave the purely technical field and go to its implementation.”

Moving from intentions to action by giving priority to vulnerable populations is the first lever of action for the southern countries. It is also important to anticipate a set of conditions for the implementation of community health interventions.

Rational use of resoources

One of these conditions relates to resource management. In this respect, their rational use is the core  and as mentioned:

“During these four days, we talked a lot about funding. It is true that funding is not enough. But what are the mechanisms that we put in place to be able to make rational use of the few resources available? You  know that 20% to 40% of resources are often misused; either it doesn’t reach its destination, or in reality we use it for something else. And that’s really a challenge that the countries of the South should be able to solve quickly.”

The challenge of multi-sectorality

Second, multi-sectoriality implies a certain capacity to ensure that there is coordination about their role in  community health and it is not only about Ministry of Health .

“I am making the parallel with the Minister of Finance. You know that in the organization of ministries of finance, they have representatives in all ministerial departments. Why at the level of the Ministry of Health, we would not have representatives in all the other ministerial departments? It will set the stage for multi-sectorality … The vision that I have is that health actors are not compartmentalized in a department … we will see the difference.”

Whatever the mechanism by which we proceed, multi-sectorality requires a paradigm shift.

And proposals for communities of practice

At the end of our interview with Dr Yaméogo, who is also a member of the CoP, made some suggestions regarding the functioning of the Communities of Practice as the can help materialize the motto of universal health coverage (UHC), which is to leave no one behind.

Regarding the activities, our experts suggested of having a fair balance between the virtual exchange activities and those of face to face.

“It is good to exchange virtually through a platform, but it would be even better, in my humble opinion, to have sessions, only every two years or every year to be able to exchange on specific themes. It can be  climate change or  insecurity which weakens the health systems. “

Another activity he highlighted is that of co-production

“And finally, I think we have to match our words with action. It is true that the CoP is there to advocate for all that is good and to draw attention also to what does not work. But I think one need to produce technical notes for certain things that work and that don’t work.”

The Cotonou forum provided another opportunity to renew the commitment of countries in the subregion to community health system and policies. The CH-CoP and AFRAFRA intend to contribute towards this commitment.

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