This past Thursday, Orotta Referral Hospital, located at the center of Asmara, is, as usual, providing consistent health care services. Patients are flowing inside getting checked from their preferred doctors and physicians, while the directing officials are discussing on a more advanced and efficient health services patterns to be provided over the health centers across the country. The conference room is on the second floor of the main building where crucial matters are discussed or even debated to the limit of their prominence. The program has initially gathered the concerned parties of the day to discuss over the review of the new Health Sector Strategic Development Plan (HSSDPII) to represent years of 2017 to 2021.
Every sector in a country’s basic necessity foundation has to promote and continually update its status and works according to the need and demand of the population it holds. In the last two days, the 24th and 25th of November, the Ministry of Health (MoH) has conducted a consensus and validation meeting upon a new draft focusing on a five year strategic development plan of the health sector. The discussion, led by higher officials from the Ministry as well as representatives of the World Health Organization (WHO), has taken a span of two days to validate the proposed draft of strategic development. After Minister Amina Nurhussien and Dr. Josephine Namboze, the WHO country representative, gave the official opening remarks, Mr. Tewelde Yohannes, Director of the Policy and Planning division, presented the process development objectives of the meeting and expected outcomes.
The Ministry confirmed a cluster of motives for the development of this new strategy on the basis of global and country level consideration. Henceforth, the need for a renewed focus and efforts to meet the 2030 Sustainable Development Goals (SDGs) agenda and achieve universal health coverage (UHC) by looking at its prerequisites in terms of refocusing on services to ensure integrated and people centred care, building resilient health systems and ensuring health security. On the domestic consideration side, the country’s commitment to the global agenda, the health sector contribution to the national agenda were shortlisted in the meeting.
Mr. Berhane Gebretensae, Director General of the medical services at the MoH, stated that this new strategy (the HSSDPII) is designed to meet up, first, the strategic planning processes at the national level including: Program based planning (e.g. HIV, NCD, malaria, etc.), with the HSSDP II providing targets and key interventions, the System investment strategies (e.g. HRH, infrastructure, financing, etc.), with the HSSDPII providing targets and key interventions. And, secondly, to inform the budgeting process through identification of priorities for funding during the budget cycles of the period covered within the plan.
To this date, the health sector has managed to show progress on life expectancy, maternal mortality reduction, on infant mortality reduction, on under five age mortality, on expansion of health services as well as in controlling communicable diseases. Making the base of the data of 2015 from the Ministry, life expectancy presently is registered having the average of 64.7 compared to 49 in 1995, while the average rate for the African continent stagnates at 60 years of age. The Maternal Mortality figure has significantly decreased from 1,590 in early nineties to 501 in 2015. Considering the under-five years of age mortality rates per 1,000 live births displayed a downward slope in the graph assessed (151 in 1990 and just 47 in 2015). Likewise the infant mortality rate is on the same pattern. While progresses in controlling the spread of communicable diseases were also documented properly as they recognize the vigorous efforts of health personnel distributed throughout the nation. About 60% decline in TB incidence, prevalence and mortality over a 25 year period, 54% decline in HIV prevalence over a ten year period (2005 – 2015), 45% increase in skilled birth attendance over a five year period (2010 – 2015), 91% reduction in malaria incidence (the country at present is at the malaria pre-elimination stage) were among the achievements the sector prospered well.
The other approach of the conference was the Costing of the HSSDP II were Mr. Tewelde Yohannes stressed that “without coherent cost allocation any project or plan would be worthless”. Other not less than nine key shifts in the health sector in terms of general to specific detail development were pinpointed in the first day meeting.
The new HSSDP II principles and values rely upon equity, owner and participation, partnership, community empowerment, efficiency, and stewardship. Four strategic priority areas were made clear to audience starting from (1) maternal, neonatal and child health and nutrition, (2) to the priority of prevention, control and management of communicable diseases, to prevention and control of non-communicable diseases, cross-cutting health interventions, (3) to essential medical services and, (4) health promotion and social determinants of health. Respective and detailed strategic focus outlined within the priority areas.
Moreover, strategic priorities on essential health systems and governance have given the audience the insight on priority areas of human resources, procurement, supply and logistics management, National Medicines and food administration, infrastructure and support services, legal and regulatory frameworks, governance and principles and also on partnership arrangements. The health care financing, funding and budgeting strategic priority focused on mobilizing resources to fund the health care services, innovative financing mechanism and addressing equity and efficiency in mobilizing, allocating and utilizing resources.
The overview of the HSSDP II set aspirations for the years 2017- 2021 and the sector’s current status and foundation will be relying on those aspiration looking forward to register a promising figures on communicable and non-communicable diseases, life expectancy at birth, violence and injuries, age specific mortalities, incidence rates of targeted conditions (such as TB, Cancer, Malaria and Hepatitis B and C) Prevalence rates on HIV, TB, Tobacco and alcohol use among Adolescents, raised Blood Pressure at age 18 and above including overweight and obesity in adolescents having the current estimates and the targets for next five years.
All of these moves simply demonstrate that the health sector is genuinely devoted to deliver the goal of utmost quality health and related services efficiently and equitably available to all Eritreans, in line with their specific individual and communal health needs.