WHO proposes plan to improve district health systems in Africa  

The World Health Organization (WHO) has proposed a new framework that aims to provide essential health services to at least 80 per cent people in African countries by 2030.

This is in line with the universal health coverage, as listed under the Sustainable Development Goals, mandated by the United Nations.

The framework aims to improve access to quality health services and ensure that no one is left behind, upholding the people’s right to health as enshrined in the countries’ constitutions. To achieve this, the WHO has focussed on strengthening the district or the local health systems (DHS).

The DHS is a network of organisations and health facilities that provides equal, full and integrated health services to a defined population.  

It has been recognised as an important vehicle for achieving universal health coverage, according to the recent Declaration of Astana (2018) and by the Declaration of Alma Ata (1978). 

The framework is also in line with the ‘triple billion target’ set by the WHO’s 13^th General Programme of Work (GPW 13).

The target aims to provide one billion people each with universal health coverage; better protection from health emergencies and better health and well-being.

While African countries have made progress in DHS, but, on an average, the Region provides only 48 per cent of the health services that could be potentially provided, the WHO said.

The Region currently avails only 36 per cent of the essential services needed by the population to attain universal health coverage, according to the WHO AFRO State of Health report (2018). There are huge gaps in the availability of health services between member countries, it stated.

For the success of the DHS, the WHO aims to:

• Rope in communities as equal partners in health by providing them with adequate information, knowledge and skills.
• Review the current district-level leadership and address gaps
• Develop appropriate policies and mechanisms to decentralise health system functions
• Set up robust systems for generating good quality data
• Enhance the use of information and communication technology

The framework was released at the ongoing 69th session of the WHO Regional Committee for Africa in Brazzaville, Republic of the Congo.

The committee has been requested to examine and adopt interventions and actions proposed in the framework.

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