{"id":2655,"date":"2016-05-13T11:08:02","date_gmt":"2016-05-13T09:08:02","guid":{"rendered":"http:\/\/www.sina-health.com\/?p=2655"},"modified":"2016-07-09T08:39:33","modified_gmt":"2016-07-09T06:39:33","slug":"recommendations-mali-ic-and-drc","status":"publish","type":"post","link":"https:\/\/www.sina-health.com\/?p=2655","title":{"rendered":"Recommendations for Mali, IC and DRC"},"content":{"rendered":"<p><div id=\"attachment_2654\" style=\"width: 410px\" class=\"wp-caption alignright\"><a href=\"http:\/\/www.sina-health.com\/wp-content\/uploads\/Les-participants-de-Cotonou-e1463130175865.jpg\"><img aria-describedby=\"caption-attachment-2654\" decoding=\"async\" loading=\"lazy\" class=\"wp-image-2654 size-full\" src=\"http:\/\/www.sina-health.com\/wp-content\/uploads\/Les-participants-de-Cotonou-e1463130175865.jpg\" alt=\"Les participants de Cotonou\" width=\"400\" height=\"268\" \/><\/a><p id=\"caption-attachment-2654\" class=\"wp-caption-text\">The participants of Cotonou<\/p><\/div><\/p>\n<p>A PBF course was held in Cotonou from the 25th of April to the 6th May 2016 with seventeen participants from Mali, and one from respectively the DRC and Ivory Coast. The course was organised by SINA Health and BEST-SD B\u00e9nin and we thank the Benin MOH for their warm\u00a0cooperation.<\/p>\n<p>The atmosphere of the course was excellent and the participants left Cotonou with a strong desire to improve the health system in their respective countries. They concluded that\u00a0Mali and the DRC still needs improvements in their\u00a0PBF design. Three participants (all from Mali) obtained distinctions.<\/p>\n<p><strong>MALI<\/strong><\/p>\n<div id=\"attachment_2650\" style=\"width: 360px\" class=\"wp-caption alignright\"><a href=\"http:\/\/www.sina-health.com\/wp-content\/uploads\/Autorit\u00e9s-de-village-e1463129944737.jpg\"><img aria-describedby=\"caption-attachment-2650\" decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-2650\" src=\"http:\/\/www.sina-health.com\/wp-content\/uploads\/Autorit\u00e9s-de-village-e1463129944737.jpg\" alt=\"Autorit\u00e9s de village\" width=\"350\" height=\"269\" \/><\/a><p id=\"caption-attachment-2650\" class=\"wp-caption-text\">Autorit\u00e9s de village<\/p><\/div>\n<p>The design\u00a0of the new PBF project and the process to start PBF in Mali could benefit from the following:<\/p>\n<ul>\n<li>Prepare a report and organise feed back meetings with the aim to have the same views\u00a0for the central level authorities, technical and financial partners as well as for the authorities at regional and district levels;<\/li>\n<li>Advocate for the implementation of\u00a0PBF during an enlarged meeting with the Cabinet of the MOH;<\/li>\n<li>Harmonise the PBF documents and improve in particular the\u00a0institutional set up;<\/li>\n<li>Arrange 1 or 2 training sessions for decision-makers from the central in Mali on PBF with the support of external consultants;<\/li>\n<li>Organise\u00a0a study tours for\u00a0health high\u00a0decision\u00a0\u00a0makers to countries that have advanced with\u00a0PBF;<\/li>\n<li>Involve participants of this course and the October 2014 course to advance with PBF in Mali;<\/li>\n<li>Organise training sessions in those\u00a0districts that will start PBF;<\/li>\n<li>Conduct\u00a0a baseline study;<\/li>\n<li>Review the PBF project budget to ensure that financial resources are sufficient to start the project. It takes around 4 dollars per year per inhabitant to provide the full health packages at primary and hospital levels;<\/li>\n<li>Transfer GAVI funds now available for a project that seeks to accredit health facilites towards PBF;<\/li>\n<li>The current project has 16 indicators while an average of 25 to 35 would be desired. We propose to include\u00a0more\u00a0indicators to\u00a0assure that\u00a0holistic health packages can be provided at health facility level instead of only\u00a0limiting them to reproductive health and immunisation indicators.<\/li>\n<li>Liberalise the market for the distribution of essential medicines. Promote the development of\u00a0multiple distributors operating in competition while the government\u00a0strengthens\u00a0its regulatory capacity to assure the quality among those distributors. This requires an accreditation system for all public and private distribution centres;<\/li>\n<li>Develop a document that explains the role and autonomy of the in-charges of health facilities.<\/li>\n<\/ul>\n<p><strong>Ivory Coast<\/strong><\/p>\n<div id=\"attachment_2651\" style=\"width: 360px\" class=\"wp-caption alignright\"><a href=\"http:\/\/www.sina-health.com\/wp-content\/uploads\/Meilleur-participant-dune-journ\u00e9e-e1463130055892.jpg\"><img aria-describedby=\"caption-attachment-2651\" decoding=\"async\" loading=\"lazy\" class=\"wp-image-2651 size-full\" src=\"http:\/\/www.sina-health.com\/wp-content\/uploads\/Meilleur-participant-dune-journ\u00e9e-e1463130055892.jpg\" alt=\"Meilleur participant de la journ\u00e9e\" width=\"350\" height=\"250\" \/><\/a><p id=\"caption-attachment-2651\" class=\"wp-caption-text\">Best participant of the day in cotonou<\/p><\/div>\n<p>The population contributes 56% of total health expenditure in Ivory Coast while the government only contributes 18% of in total USD 60 per person per year. Maternal mortality with 614 deaths per 100,000 live births is high.<\/p>\n<p><strong>Recommendations Ivory Coast<\/strong><\/p>\n<ul>\n<li>Give PBF health facilities the legal authority (for example in a projet memorandum of understanding) to\u00a0formalize their autonomy and thereby to be able to apply the\u00a0PBF best practices. This document should also include the roles\u00a0for the Regional Health Directorates, District Health Teams and Regional CDV Agencies;<\/li>\n<li>Break the monopoly and exclusivity of\u00a0suppliers and provide an opportunity for health facilities to purchase\u00a0drugs at public and private distributors operating in competition but accredited by government;<\/li>\n<li>Ensure that private providers can\u00a0be\u00a0integrated in the PBF system;<\/li>\n<li>Provide a training program so that\u00a0public and private health facilities gain more knowledge, skills\u00a0to implement\u00a0PBF;<\/li>\n<li>Discuss with the Ministry, through the Directorate General and the DPPEIS in partnership with other partners such\u00a0as the Global Fund, USAID and the World Bank, the possibility of combining in health districts the MSH Development Program in Leadership and Governance with PBF.<\/li>\n<\/ul>\n<p><strong>DEMOCRATIC REPUBLIC OF CONGO<\/strong><\/p>\n<div id=\"attachment_2652\" style=\"width: 360px\" class=\"wp-caption alignright\"><a href=\"http:\/\/www.sina-health.com\/wp-content\/uploads\/Porte-de-non-retour-Ouidah-e1463130104806.jpg\"><img aria-describedby=\"caption-attachment-2652\" decoding=\"async\" loading=\"lazy\" class=\"wp-image-2652 size-full\" src=\"http:\/\/www.sina-health.com\/wp-content\/uploads\/Porte-de-non-retour-Ouidah-e1463130104806.jpg\" alt=\"Porte de non retour Ouidah\" width=\"350\" height=\"248\" \/><\/a><p id=\"caption-attachment-2652\" class=\"wp-caption-text\">Porte de non retour Ouidah<\/p><\/div>\n<p><em>There are concerns about the PBF pilot project funded by UNICEF. We propose the following recommendations:<\/em><\/p>\n<ul>\n<li>The government may\u00a0liberalise the drug sector and cancel the Regional Distribution Center monopoly system. Yet, this also requires that government and the partners ensure effective quality control of the\u00a0distributors through an accreditation system;<\/li>\n<li>UNICEF may\u00a0take into account and assure the financing of all indicators in the\u00a0primary and hospital health packages;<\/li>\n<li>UNICEF should assure that the Family\u00a0Kits approach is also assured with its\u00a0specific PBF targets;<\/li>\n<li>UNICEF may\u00a0transform,\u00a0if possible, the\u00a0budget for the inputs of the family kits into\u00a0PBF subsidies directly to providers, and create a supply system with\u00a0accredited distributors;<\/li>\n<li>UNICEF may transform the\u00a0subsidies allocated to the districts into\u00a0PBF;<\/li>\n<li>That the contract development and verification agency (CDV)\u00a0convinces the religious authorities to entrust the payment function\u00a0to an independent structure.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>","protected":false},"excerpt":{"rendered":"<p>A PBF course was held in Cotonou from the 25th of April to the 6th May 2016 with seventeen participants from Mali, and one from respectively the DRC and Ivory Coast. The course was organised by SINA Health and BEST-SD B\u00e9nin and we thank the Benin MOH for their warm\u00a0cooperation. The atmosphere of the course [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_mi_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[1],"tags":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.sina-health.com\/index.php?rest_route=\/wp\/v2\/posts\/2655"}],"collection":[{"href":"https:\/\/www.sina-health.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.sina-health.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.sina-health.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.sina-health.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2655"}],"version-history":[{"count":27,"href":"https:\/\/www.sina-health.com\/index.php?rest_route=\/wp\/v2\/posts\/2655\/revisions"}],"predecessor-version":[{"id":2738,"href":"https:\/\/www.sina-health.com\/index.php?rest_route=\/wp\/v2\/posts\/2655\/revisions\/2738"}],"wp:attachment":[{"href":"https:\/\/www.sina-health.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2655"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.sina-health.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2655"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.sina-health.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2655"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}