When MLI began over four years ago, those of us leading MLI had very few preconceived notions. We wanted to keep as open a mind as possible about how MLI could help developing countries follow through on their priorities for the health care of their people. Our initial thought going into the job was that we could help build leadership in health ministries. But we quickly realized that it wasn’t about building leadership-- dynamic leadership was very much present but sometimes swamped beneath the enormous pressures of huge jobs with little resources. MLI looked for ways to support ministry leaders’ efforts and to better position and promote their voices and their priorities to national and global audiences. And we gained an appreciation for the value of senior ministry leaders supporting, learning, and sharing with each other.
In February 2012, EnCompass released its final evaluation of the MLI program. This evaluation aimed to document and inform the development of the MLI approach and to assess the outcomes of that approach. The final report summarizes the evolution of MLI; explores the roles and efficacy of each enabling strategy; and summarizes the extensive findings of the project in each country and globally, as well as lessons and feedback from MLI participants.
MLI releases proceedings from 'Advancing Country Ownership for Greater Results: A Roundtable Dialogue'
The “Advancing Country Ownership for Greater Results: A Roundtable Dialogue” took place on January 12, 2012, and was hosted by the Ministerial Leadership Initiative for Global Health (MLI). Country ownership is viewed as an important step towards improving aid effectiveness for global health. Yet, country ownership is a debated issue, particularly what it means in practical terms to donors, development partners, civil society, and country governments. The proceedings document the rich dialogue that occurred during the roundtable.
MLI brought together a prestigious group of ministry leaders from MLI partner countries and development leaders representing donors and implementing partners. This frank and informed conversation will revolved around the growing movement toward country ownership of programs and its implications for the future of development practice and aid effectiveness.
As co-chair of the International Conference on Family Planning, Dr. Bocar Daff, director of Senegal’s Reproductive Health Division (DSR), was placed in the international spotlight. At one of the many sessions Dr. Daff participated in he gave a presentation on Advocacy Inside Ministries: How Ministerial Leaders Can Advance Reproductive Health and Family Planning Policy.
MLI co-sponsored a high-level meeting between Ministers of Health, Finance, Planning, and Social Development to address how the demographic dividend can improve their country’s economic growth and development at the 2011 International Family Planning Conference.
MLI co-sponsored a technical workshop organized by the Community of Practice on Financial Access to Health Services on the benefits package for maternal health fee exemption policies. Delegations from three MLI countries participated, Mali, Sierra Leone, and Senegal. Mali and Sierra Leone presented their country’s experience with fee exemption policies in plenary.
The Ministry of Health and Sanitation in Sierra Leone, with support from MLI, hosted a two-day participatory and interactive meeting on Adolescent Sexual and Reproductive Health (ASRH). On September 15th and 16th, multiple stakeholders met in order to discuss the needs of adolescents and to prepare an implementation plan to ensure that adolescent sexual and reproduction health services including preventing mother-to-child transmission of HIV (PMTCT) are easily accessible and friendly for young people.
The Ministry of Health and Population (MoHP) in Nepal has launched a Digital Library containing a searchable catalogue of over 2983 copies of documents including key policy documents and government health acts. They are available in both Nepali and in English. The digital library compliments the already existing Ministry of Health and Population’s conventional library, adding to it more relevant policy documents, guidelines and other health sector related documents as reference material and putting in place a barcode system to track documents online and send automated messages to users.
In August, Nepal held a Negotiations Workshop for 20 participants in the Ministry of Health and Population as it continued its series of training workshops that began in September 2009. The trainings strive to build participants’ awareness, skills and confidence in negotiation strategies, methods and techniques
The WHO report on Women and Health that was issued in 2009 analyzes how interventions in childhood, through adolescence, during reproductive years and beyond, affect health later in life and across generations. The report also draws attention to the consequences and costs of failing to address health issues at the appropriate points of women’s lives. MLI in collaboration with the WHO is working with Nepal’s Ministry of Health and Population (MoHP) to bring attention to the recommendations made in the WHO report, specifically around Adolescent Sexual and Reproductive Health (ASRH). MLI supported a two-day national policy dialogue on adolescent friendly health services specifically in the context of sexual and reproductive health and HIV in Kathmandu, Nepal from July 27th to the 28th. The workshop was attended by not only policymakers, but also by the adolescents that ASRH decisions affect, including those identified as vulnerable and at-risk.
After participating in two MLI peer-learning experiences, Senegal’s leadership training and Nepal’s negotiations health development leadership training last summer, leaders from Mali’s Ministry of Health organized their own training to combine both curricula into a seven-day workshop. This workshop equipped 18 officials from the ministries of health, social development, and promotion of women, children and family affairs with skills that will help the ministries manage cross-cutting and multi-sectoral initiatives.
MLI was invited to host a special session at the 2011 Global Health Council Conference in June. "If Countries Lead will Donors Follow?" featured officials from the five MLI countries and addressed how MLI countries are taking action to increase country ownership and leadership. The session was moderated by MLI Senior Advisor John Donnelly
At the 2011 Global Health Council Conference, MLI offically launched the Call to Action for Country-Led Development. MLI brought together a large group of MLI leaders, Washington-based development partners, and non-governmental organizations to highlight this important document that was developed after last fall's Learning Collaborative Forum.
The Balanced Scorecard (BSC) epitomizes strengthening health systems through strengthening governance. Rahel Gizaw, MLI Country Lead for Ethiopia, told the audience at the Global Health Council’s annual conference that the BSC strengthens Ethiopia’s Federal Ministry of Health through capturing performance measures, targets and initiatives. With more clarity, more can be accomplished As a featured panelist on the Abt Associates’ session, ‘Integrating Governance into Health Systems Strengthening,’ Gizaw explained how the BSC, who’s roll out was supported by MLI, has created change over the last year for the majority of the health sector. This was only accomplished, she stated, through the commitment of leaders within the ministry. The government’s dedication was contagious.
The Global Health Council has invited MLI to participate at its annual conference. The 2011 conference, taking place in June in Washington, D.C., will focus around the theme, “Securing a Healthier Future in a Changing World.” Among the conference co-chairs is Dr. Francis Omaswa, MLI Senior Advisor and Executive Director of the African Centre for Global Health and Social Development (ACHEST). Two of the panels MLI will be featured in two sessions:
At the Sixty-fourth World Health Assembly in Geneva, MLI staff and senior representatives of all five MLI countries met to talk about ways of advancing country ownership.The health ministries from Ethiopia, Mali, Nepal, Senegal, and Sierra Leone are working on a document that they hope to release at the Global Health Council conference next month.
One recommendation participants from July 2010's leadership training proposed to Senegal's Health Minister Fada was to provide another session of leadership training to additional high-level staff within the Ministry of Health and Prevention (MOHP). This recommendation was put into action in the first week of May with a new training. Using the same curriculum as the previous training, this session included Minister Fada's advisors, managers and program leaders at the central level as well as leaders at the regional and district level. MOHP staff identified increasing leadership capacity as an essential skill necessary to improve performance throughout the health system and operationalize the implementation of the National Health Development Plan 2009-2018 (PNDS-II).
Staff from the Ministry of Health and Population (MOHP) and Nepal's Administrative Staff College (NASC) who received training on how to teach negotiations skills in November 2010 practiced their skills by training 20 participants in negotiating for health development. A representative from CMPartners, a conflict management and negotiation firm, who trained the Nepali trainers was present to provide feedback and support to the team. The training session was a success and the team of trainers are now ready to lead future sessions on their own.
In recent years the Ministry of Health (MoH) in Mali extended its free care policies to include coverage of anti-retrovirals in 2004, cesarean sections in 2005 and new treatments against malaria (ACT) in 2007. In addition, several pilot projects supported by different NGOs have also been exploring strategies to provide free care for children under the age of five. Given the multitude of initiatives being implemented at the moment in Mali, the Ministry of Health requested researchers to gather useful evidence for decision-making particularly around the effects, implementation challenges, and costs associated with these various free care initiatives.
Aspen Global Health Roundtable: Straight Talk: A Conversation about Tough Questions in Global Health
The roundtable featured Hon. Tedros Adhanom Ghebreyesus, Minister of Ethiopia’s Federal Ministry of Health, Amie Batson, Deputy Assistant Administrator for Global Health at USAID, and Amb. Mark Dybul, Co-director of the O’Neill Institute for National and Global Health Law at Georgetown University and Former U.S. Global AIDS Coordinator.
MLI presented multiple abstracts at The African Health Economics and Policy Association (AfHEA) conference in Senegal in March. AfHEA provides a forum for peer learning and information sharing for professionals in health economies in Africa.
“Family Planning in the context of Population and Development: the Urgency to Act,” a conference held in Burkina Faso in February for francophone West African countries, focused on family planning. The event, which featured an address from Burkina Faso’s President Compaoré at the opening ceremony, was attended by a large delegation from two MLI countries, Mali and Senegal. The objective of the conference was to help identify innovative ideas and concrete solutions to reduce by 2015 the maternal mortality rate and level of unmet need for family planning by at least 25% for the whole region of francophone West Africa.
Senegal’s Department of Health and Prevention (MSP) and key health sector stakeholders finalized a results-based financing (RBF) pilot plan last week. RBF is a performance management tool that compensates health service providers for rendering high quality services and attaining certain outcomes. The MSP is experimenting with RBF as its Health Development Plan 2009-2018 strives to establish a culture of performance and fairness in the system to motivate health workers and develop a sense of responsibility.
MLI sponsored a Capacity Enhancement Seminar on January 21, 2011 with top technical experts from the Ministry of Health and Population in Kathmandu, Nepal. The seminar drew from the theory of capacity building and focused on its applicability for key health sector activities. The seminar allowed Ministry leaders to create new insights and ideas to develop a capacity building strategy for the National Health Sector Programme-Implementation Plan 2, which will guide the country’s health sector until 2015.
MLI launched Phase 1 of a long term organizational development and team building training for the reproductive health division (DSR) in the Ministry of Health and Prevention in Senegal. This training was at the request of Dr. Bocar Daff, Director of Reproductive Health, thought it a priority to invest in his team’s development to meet the objectives of Senegal’s ambitious Reproductive Health Strategic Plan.
MLI hosted a Learning Collaborative Forum in Addis Ababa, Ethiopia, from November 29- December 3, 2010, for the five MLI countries. This Forum provided a highly interactive series of sessions to strengthen the leadership capacity of participating Ministers of Health to advance health policy reforms through south to south peer learning.
Access to quality health services does not come without a price. In several developing countries, decreasing the financial burden on individuals and families seeking health services continues to be a major challenge. However, in recent years, many African countries have launched ambitious national policies aiming to reduce or eliminate financial barriers to health care. In response to these country-led initiatives and in efforts to foster greater south-to-south peer learning, the Harmonization for Health in Africa (HHA) group joined MLI in sponsoring a regional workshop on “Improving Financial Access to Health Care for the Poor” in Dakar, Senegal from the 2-4 November, 2010. HHA, comprised of the African Development Bank, UNAIDS, UNFPA, UNICEF, USAID, WHO, and the World Bank, is committed to providing support to governments of poor countries wishing to adopt health financing policies to improve access to health services.
Following on a successful Negotiating Health Development Leadership Training (NHD LT) in August 2010, Nepal’s Ministry of Health and Population (MoHP) was eager to further enhance training for additional staff members. MLI collaborated with the World Health Organization (WHO) and Nepal Administrative Staff College (NASC )to provide additional training to 27 representatives from the MOHP and NASC.
Political will, country ownership, and technical capacity were identified as essential elements needed to address gender inequalities in health this policy dialogue, co-sponsored by WHO, PAHO, MLI, and USAID.
High-level support and smart program design are crucial to launching health financing strategies, but success hinges on developing effective implementation and monitoring, according to a MLI issue brief on reducing financial barriers to reproductive health released this month. “While design of any financing strategy is important, it is often problems in implementation that derail effectiveness,” writes author Allison Gamble Kelley, a health economist and MLI Country Lead for Mali. Kelley outlines the need for continuous monitoring and adaptation of new programs to ensure that they meet their potential.
Communicating with the public is an essential skill that is often not emphasized in public health curricula. Seven senior staff of the Ministry of Health and Population, as well as an international and a national officer from the World Health Organization in Nepal attended a half-day session on "Effective Communication and Media Relations" organized by Ministry of Health and Population, with assistance from MLI.
Senior staff from Nepal's Ministry of Health and Population attended a Negotiating Health Development Leadership Training Program facilitated by MLI in August 2010. Building on a pilot training in September 2009, the course helped advance and refine the staff’s capacity to manage vital relationships, mitigate potential conflict and conduct negotiations related to health.
Senegal’s Reproductive Health Division is revising its reproductive health policies to meet current World Health Organizations guidelines. Final approval of the change is expected at the end of September. The revisions were developed during a 5-day August workshop supported by MLI and led by Dr. Bocar Daff, head of the Reproductive Health Division within the Ministry of Health and Prevention (MoPH).
The Ministry of Health and Prevention (MOHP) in Senegal identified leadership strengthening as a critical component in the success of the National Health Development Plan (PNDS-II) for 2009-2018, which includes reduction of maternal and child mortality, increased access to services, the strengthening of the health system and funding mechanisms as key priorities. Upon receiving the findings from various evaluations of the previous PNDS that showed performance lacking at all levels of the health pyramid, the MOHP leadership determined to undertake significant reforms to improve its capacity for implementation during the PNDS-II. With the goal of better coordination and implementation, the MOHP asked MLI to support the achievement of their policy and leadership development objectives through a leadership training workshop.
Aminata Kanu has joined MLI as the new Country Lead for Sierra Leone.
Stephanie Weber joins the MLI-Washington team as a Program Officer at the Aspen Institute.
At a time when aid effectiveness is under scrutiny, Ethiopia is embracing a new approach to make health aid work – not least with an innovative programme to train and deploy thousands of ‘health extension workers’ in communities across the country. Follow the link to read the Q&A with Ethiopia's Federal Minister of Health, Dr Tedros Adhanom Ghebreyesus .
A delegation from the Federal Ministry of Health in Ethiopia participated in a World Bank sponsored study tour to Botswana. The Ethiopian delegation learned about Botswana's experiences implementing the Balanced Scorecard.
MAYANGE, Rwanda — The maternity ward in the Mayange district health center is nothing fancy. It has no running water, and the delivery room is little more than a pair of padded benches with stirrups. But the blue paint on the walls is fairly fresh, and the labor room beds have mosquito nets. Inside, three generations of the Yankulije family are relaxing on one bed: Rachel, 53, her daughter Chantal Mujawimana, 22, and Chantal’s baby boy, too recently arrived in this world to have a name yet.
MLI/Mali co-sponsored and actively participated in the workshop “Extending Health Insurance – How to make it work” held in Kigali, Rwanda May 30-June 4, 2010. Country teams from five countries – Mali, Senegal, Cameroon, Benin, and Burkina Faso – were present at this “hands-on” workshop designed to help them chart an informed and responsible path to expanding the form of health insurance that fits their needs and resources.
A panel discussion, chaired by Hon. Mary Robinson, on the role of political leadership in realizing the right to health for all.
During the World Health Assembly (WHA) in Geneva in May 2010, MLI hosted a successful program of events and cross-country exchanges. MLI significantly expanded its program from last year, providing country teams the opportunity to participate in sessions on a number of topics related to their work with MLI over the past year.
MLI ran a busy event schedule during the 2010 World Health Assembly in May including communications and technical sessions along with a roundtable on Political Leadership. Throughout the week, MLI was able to conduct short interviews with global health leaders from each of the MLI countries as well as with MLI senior advisor and director of ACHEST, Dr. Francis Omaswa.
MLI hosted a policy dialogue in Washington, D.C. on the WHO report, Women and Health: Today's Evidence Tomorrow's Agenda. Developed with support from MLI, it is the first ever report which focuses on the global status of women’s health from birth to older age and which identifies key areas of reform both within and outside of the health sector.
L’Atelier d’élaboration du programme quinquennal de mise en œuvre de la stratégie nationale développement des mutuelles de sante au Mali
Depuis Septembre 2009, le Mali s’est engagé dans un processus qui aboutira à l’adoption d’une stratégie nationale de développement des mutuelles de santé et d’un programme de sa mise en œuvre. La première version de la stratégie ainsi rédigée a été présentée, discutée et amendée lors d’un atelier de concertation organisée en Janvier 2010. Parallèlement le comité technique a élaboré un premier draft du document de mise en œuvre de la stratégie. Le comité technique s’est réuni et a intégré les observations formulées lors de l’atelier de concertation. La version actuelle de la stratégie nationale sera soumise à l’appréciation du comité de pilotage. Enfin il est prévu d’observer une retraite pour le comité technique afin d’élaborer le programme de mise en œuvre de la stratégie.
As the next step in its mission to extend health insurance coverage to all Malians, the Ministry of Social Development, in partnership with the Ministry of Health, recently held a 3-day workshop to vet and validate the national strategic plan to scale-up of community-based health insurance nation-wide (CBHI, or mutuelles de santé).
On February 18, the Ministry of Health in Senegal hosted an MLI workshop to: review and validate the two technical reports on resource allocation and donor harmonization developed for the Ministry by local consultants; review MLI activities and accomplishments in 2009; and to discuss the MLI work plan for 2010.
The second national workshop on the extention of community-based health insurance, or mutuelles, will be held from January 22-24, 2010.
Balanced Scorecard Certificate Training for the National BSC Team of the Ministry of Capacity Building
During the month of January, consultants from the Balanced Scorecard Institute provided a BSC certificate training for the National BSC Team of the Ministry of Capacity Building.
In July 2009 the Senegalese government sent a letter to the International Health Partnership expressing the country’s interest in adhering to the IHP+ principles. In her letter the Minister of Health, Mrs. Theresa Coumbe Diop, explained that Senegal intends to use the tools and practices of the IHP+ to make more progress toward the Millennium Development Goals.
At the GAVI Alliance Partners’ Forum in Hanoi on November 19, 2009, Nepal was one of two countries to receive awards for the highest average annual rate of reduction of child mortality among all of the 72 GAVI countries since 1990.
With the launch of the new report: Women and Health: Today's Evidence Tomorrow's Agenda, WHO calls for action beyond the health sector to improve the health of girls and women.
To launch the recently announced process of the Ministry of Social Development, Solidarity, and the Elderly (MDSSPA) to develop and implement a strategy to expand mutuelles de santé nationwide to provide financial access to health care for 80% of its population currently not covered by any form of health insurance, MLI co-sponsored a kick-off workshop, “National diagnostic and discussion toward scaling up mutuelles de santé in Mali,” held the 24-26 of September 2009 in Bamako.
In September 2009, MLI Nepal conducted a successful leadership training workshop with CMPartners for senior members of the Ministry of Health and Population.
PricewaterhouseCoopers-Ghana to Conduct Assessment in Sierra Leone and Balanced Scorecard Institute Selected to Improve Strategic Performance of Ethiopian Health Sector
As the “face of MLI,” Country Leads play a critical role in the success of MLI. Country Leads play a critical role in success of MLI. They serve as the “face of MLI” in that they are the point of contact between the Ministry of Health team, key donors and technical partners, and external consultants. In addition to facilitating in-country communication, Country Leads coordinate the implementation of the technical assistance package for each country.
Dr. Omaswa will work as a Senior Advisor to MLI to provide support, advice and assistance in developing and implementing health policy reform in the five MLI countries.
MLI hosted a reception featuring all MLI Ministers during the 2009 World Health Assembly in Geneva, Switzerland.
On May 20, 2009 MLI hosted the second annual MLI reception during the World Health Assembly in Geneva, Switzerland. Held in a room with a scenic view of Geneva, the evening brought MLI colleagues from the five MLI Ministries of Health together with other prominent figures in the global health community.
The May 20, 2009 MLI Technical Session in Geneva during the World Health Assembly provided a forum for Ethiopia, Mali, and Nepal to discuss the International Health Partnership (IHP+) compact process.
In April, a senior level delegation from the Ministry of Health in Sierra Leone participated in a MLI study tour to Ghana to learn about Ghana’s national health insurance scheme and its donor harmonization efforts- two priority areas for MLI in Sierra Leone. The study tour was timed to coincide with Ghana’s annual Health Summit, a two day workshop presenting the performance review of the health sector.
Central to improving health outcomes at the country level is addressing the health of women. In response to this need, the David and Lucile Packard Foundation has provided support for a reproductive health (RH) component of MLI, applying MLI's leadership development approach to reproductive health and linking reproductive health reforms to MLI's health financing and aid effectiveness policy reform.
MLI held meetings prior to the November 17-19 2008 Global Ministerial Forum on Research for Health in Bamako, Mali, featuring MLI ministers and members of their senior team.
MLI held its first reception during the World Health Assembly to announce that Ethiopia, Mali, Nepal, Senegal and Sierra Leone had been competitively selected as MLI focus countries. The reception was hosted by Ambassador Eckart Guth, Permanent Delegation of the European Commission and took place at his residence in Geneva.
Aspen Institute Receives $8.7 Million Grant from Bill & Melinda Gates Foundation for Ministerial Leadership Initiative for Global Health
A significant new grant from the Bill & Melinda Gates Foundation will strengthen the leadership capacity of health ministers and their senior staff in select countries, and support renewed efforts to have a positive impact on women's health around the world.