By Freddie Ssengooba
Director SPEED Project, Makerere University School of Public Health
It was a great honor to attend the European Public Health Conference – courtesy of the European Union-sponsored initiative to Support Public Health Institutions Programs (SPHIP) housed in the European Commission’s Directorate for International Cooperation and Development (DG DEVCO). Before the main conference, the entire family of eight SPHIP initiatives held a 2-day pre-conference at Swedish International Development Agency (SIDA) headquarters in Stockholm, Sweden. Drs. Kevin McCarthy and his colleague Manual Couffignal from DG DEVCO and Dr. Jaap Koot representing the monitoring facility for SPHIP hosted the meeting.
As I pack my bag to get back to Kampala, I find the following reflections interesting to share with colleagues – especially those working with me on SPEED project, and in developing country contexts, to influence public health policies and systems that support good health and wellbeing of the population:
- The opportunity by EU to support public health institutes to improve their capacity for policy research and influence in their countries has started to bear fruits. Presentations from Haiti, Myanmar, Bangladesh Kenya, Uganda, Burundi and DR-Congo gave optimism that the European leadership in capacity building in this special niche is indeed getting local institutions to engage and embed their scholarship within the policy discourse of their host countries. Shared experiences at the pre-conference and SIDA meeting were indicative of the transformation many of these institutions are undergoing – transforming into think tanks to address policy problems in these countries. This transformation is well illustrated by the SPEED Project at Makerere University School of Public Health and its partnership with the National Planning Authority (NPA) and other agencies (see here). The presentation by Dr. Sarah Nahalamba from NPA provided insights about the links between Makerere University School of Public Health and NPA’s mandate of supporting Government in policy development and national planning across sectors.
- As a team leader for SPEED project, I was impressed by the different approaches being undertaken by SPHIP members in across countries. This is partly a demonstration of the principle of national ownership that EU has cultivated among SPHIP programs – each addressing priority national problems as conceived and prioritized by key stakeholders. Themes varied from NCDs in Myanmar, information systems in Bangladesh, Laboratory Systems in Haiti, Community information systems in Kenya, Universal Health Coverage in Uganda and soon to start program on district strengthening in DR Congo and Burundi. Despite the differences in thematic areas, all SPHIP were rooted within the policy and implementation demands of the host countries. These programs are receiving regular support, monitoring and nurturing by the EU commissioned agency led by Koot at the University of Groningen, Netherlands.
- Speaking at one of the conference sessions organized by SPHIP, Dr. Kevin McCarthy at DG DEVCO, observed that SPEED project ought to get in touch with WHO’s agenda on Universal Health Coverage and UHC2030 to provide synergy to this policy discourse at a broader scale. This is a vote of confidence to the potential that EU support has cultivated among its beneficiaries – in particular Makerere University School of Public Health in Uganda.
- Listening in to the many conference speakers and discussions at the European Public Health Conference, I got the sense that there are emerging public health issues in Europe that are yet to trickle down to countries like Uganda. Although countries like Uganda share similar experience with Europe on low spending for health promotion programs and deficits in health systems readiness to cope with UHC pressures, the growth in communication technology in Europe is starting to disrupt public health programs (pict) in developed countries. For instance the growth in social media is beginning to provide a short-cut to circumvent public policy and programs in Europe. Individualized health programs delivered through smart phones as Apps (software computer applications) are displace publicly oriented delivery of interventions. Many speakers referred to the concept of “embracing technology or transforming public health from public-orientation to individualized needs”. “We have Apps for exercise, health food choices and many more. … There is hardly a need for expensive public policy programs now. Just empower the individuals to get and act on the information they need” a panelist at the plenary session stated. Likewise, the discussions are starting to challenge the historical conventions like Primary Health Care (PHC). “We should be going away from the nostalgia of PHC and embrace the self-organizing nature of complex systems that we now live in” said the youthful president of the EUPHA. Overall, there are major leaps in the European conceptualization of the future of modern Public Health. There is need to keep an eye on these developments as the winds blow south of the Mediterranean Sea. For instance, social media may find resonance with the corporate world in countries like Uganda but the inequalities arising from “elite-based” innovations may invoke public policies in unpredictable ways to uphold social justice.
- Gender and equality are big themes at all levels of public health programming in Europe – more so in Sweden. Presentations at SIDA and at plenary sessions at the conference all were thick on concepts of gender and inequalities. Participation of women and minorities in public health leadership to operational programming were frequent themes. The SPHIP team benefited from an insightful exercise of reflecting on the inequality that initiatives like SPEED Project could directly or indirectly mitigating at country level. We were all encouraged to be more purposeful in addressing gender and other inequalities in our work.
- Regarding the methodology for policy engagements and especially methods for encouraging collective actions and collaboratives, I was particularly impressed by the brief presentation about “policy games” by Jan Jensen (from VTVIN2ACTION) that allows stakeholders from multiple sectors and perspectives to generate collaborative enterprises around policy implementation in a less formalized approaches. A brief overview of the “policy game” is presented [here]. According to Paul Williams, [click here] this is vital for mobilizing synergistic actions across wide networks of actors with less bureaucratic huddles and burdens. More methods are however needed to galvanize stakeholder collaborations for complex policy implementation. SPEED Project will soon be publishing (in Archives of Public Health journal) the protocol for a barometer for policy implementation across levels of implementation as well as policy areas that are vital for UHC. Stay tuned at @fssengooba and @SPEED4UHC