29th May, 2008
Communities must become the driving force for health development if any progress is to be made in fighting disease and if the Millennium Development Goals are to be met, participants at the 35th Global Health Council conference agreed today.
During discussions led by the African Medical and Research Foundation at the one-week conference, whose theme is ‘Community Health – Delivering, Serving, Engaging, Leading’, stakeholders in the health sector recognised the importance of engaging communities as partners in health development to ensure that health programmes are tailored and responsive to their needs.
“Health is a human right, but this fundamental truth is merely a slogan in many parts of the world, particularly in Africa and Asia where people carry a disproportionately heavy burden of disease,” said Dr Peter Ngatia, AMREF’s Director for Capacity Building, who moderated the discussion. “Thirty years after the Alma Ata Declaration on primary health care, and despite some significant increase in investment in health during the past two decades, people continue to die from easily preventable diseases. That gap between communities and the formal health care systems must be addressed if health is truly to become a human right for all. We can only do this by ensuring that communities are at the very core of those systems.”
In his keynote presentation, AMREF’S Director for Community Partnering, Dr Daraus Bukenya, identified community partnering as the missing link in the process of creating sustainable health development in sub-Saharan Africa.
“The deriorating state of health of African communities suggests that both public and private sector-driven health services are failing. Africa continues to experience unacceptably high levels of morbidity and mortality often exacerbated by new and reemerging diseases such as HIV and AIDS, TB and malaria, which are all preventable. In the past 20 years, life expectancy in many countries has gradually declined, and none of the African countries is on track to meet the MDGs.
“Africa’s high disease burden cannot be reversed by medical technologies alone,” he added. “There has got to be change of behaviour that begins within communities and households if we are to see any real change. This cannot happen unless communities become an integral part of the health system and joint owners, rather than mere recipients, of health interventions. Through community partnering, health services will become more responsive to the needs of the community, so that we can begin to reverse the negative health trends in poor countries.”
Dr Bukenya noted that although Africa has 24% of the global disease burden, it invests a meager 1 per cent of global funding for health and has only 3 per cent of the world’s health workforce, and yet the continent has vast untapped resources in the communities.
“Communities are disenfranchised by a host of factors, including culture, poverty and rules and laws that do not allow them to be involved in determining their health needs and priorities, thus denying them their human right to health. But they are very resourceful, and are in themselves a very powerful resource. They only need to be empowered to harness those resources and organised into functional groups to make them effective and to give them a voice. We must become the catalyst for strengthening communities and to participate in development of the health system,” Dr Bukenya concluded.
Mr Walter Mukhwana with the Aga Khan Health Services in Kenya, presented a case study to demonstrate the effectiveness of building a community’s capacity to drive a community-based health information system. Based in Kenya’s coastal Kwale District, the community-driven process has seen a rise in ante-natal clinic attendance by women in the district.
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