Health Care Professionals meet in Malawi
11 November 2007 Blantyre - Health care professionals from Africa have responded to a "call to action" at a workshop in Blantyre, Malawi bringing together participants from several countries in Africa as well as counterparts worldwide.
The workshop, The Health Care Professional Associations (HCAP) Role in Achieving MDGs 4 and 5 has brought together 56 participants, including members of professional health care associations and the public health sector from Ethiopia, Malawi, Nigeria, Tanzania and Uganda as well as representatives from international and regional associations and agencies based in Canada, the Netherlands, South Africa, Switzerland and Zimbabwe.
Dr Songane, Director of the PMNCH, set the tone for the workshop at its opening session on Sunday evening, outlining current MNCH issues and their relation to HCPA's and calling the participants for action. This call for action was reinforced in the welcome address, given by Honorable, Minister of Health of Malawi, Dr Marjorie Ngaunje, who noted personal experience and personal commitment to convey the urgency of the need for action on the part of the HCPAs. "In the Africa region," said Dr Ngaunje, "maternal and child health is an area of great concern firstly because it is a human rights issue and secondly because it is central to development."
Engagement and interaction were the order of the day as participants gave presentations and spoke on panels about the role of HCPAs as advocates and the role of HCPAs in the development of One MNCH plan. "I can assure you that this is the first time that the Health Care Professionals for all of the sectors are coming together and ensure you that we will deliver," said one participant, Mrs Okoli, Chief Nursing Officer in charge Anaesthetic Unit, General Hospital Awka, Anambra State, Nigeria - Nigeria Nurses and Midwives.
The remainder of the workshop will focus on discussions on the role of HCPAs in: quality improvement, the human resources crisis and organizational strengthening. Group work leading to the development of concrete action plans by groups of country participants are planned for later in the week.
Dr Francisco Songane, Director, The Partnership [pdf 2.22Mb]
Dr Chisale Mangho, FRCOG [pdf 740kb]
Key note address by Hon. Marjorie Ngaunje MP, Minister of Health [pdf 14kb]
In September 2006, the Health Care Professional (HCP) associations affiliated with the Partnership for Maternal, Newborn and Child Health (PMNCH) issued a Joint Statement to guide HCPs in their efforts to work with key stakeholders on issues of advocacy, capacity development, and implementation of health policies at country level.
A meeting of HCP Associations was facilitated by the PMNCH around that time to identify means of increasing the effectiveness of Associations in contributing to country efforts to reach the Millennium Development Goals 4 and 5. Among the challenges discussed was the need to clarify and strengthen the role of HCP Associations at country level. This need was echoed during the 2007 PMNCH Partners' Forum.
In addition, the World Health Report, 2006, “Working together for health”, highlighted the potential of HCP Associations as important actors in helping to address the health sector human resources crisis. Several other meetings and documents, including the Multi-country Forum on Engaging the Private Sector in Child Health (in Africa), held in Munyonyo, Uganda in November 2005, and some less formal discussions have also reinforced the importance of HCP Associations taking action.
In this context, the PMNCH Secretariat, with guidance from an HCP Workshops Advisory Group*, is preparing a series of multi-country workshops. The workshops will bring together representatives from national professional associations involved in service delivery, and public sector representatives, to establish a common vision and identify practical means by which HCP Associations can maximize their contribution to national maternal, newborn and child health (MNCH) policies and programmes.
The first of these workshops took place in Blantyre, Malawi, and assembled teams of 6 - 8 HCP Associations' representatives and senior government officials from Ethiopia, Malawi, Nigeria, Tanzania, and Uganda. In addition, 15 resource persons from regional and international associations and agencies have been invited to enrich the exchange and learn from the national associations about the types of support that they need in order to be more efficient.
Workshop discussions focused on the following five areas of work: the role of HCP Associations in advocacy and policy dialogue, planning for MNCH, quality improvement, working together to address the MNCH human resources crisis, and organizational strengthening of the associations themselves. Panel discussions on these topics helped identify actions that need to be undertaken by HCP Associations in order to increase the impact of their contributions. These discussions also opened communications across professional lines as well as between HCP Associations and the public sector.
* Members are representatives on the PMNCH Board of the International Pediatric Association, the International Federation of Obstetrics and Gynecologists, and the International Confederation of Midwives.
Objectives and results
The overall objective of this workshop is to increase the contribution of HCP Associations to national MNCH plans through a strengthened participation in policy and programme development and an increased alignment of activities to the national targets regarding the achievement of MDGs 4 and 5 (reducing child mortality by 2/3 and maternal mortality by ¾ by 2015).
Priority actions that support existing country MNCH plans identified and committed to by country teams* (implementation within 1-2 years). These actions should enhance the participation and role of HCP Associations in:
*Note: Each country team will choose 2 or 3 of the five areas to work on, that are clearly linked to country MNCH plans.
Areas of support from regional and/ or international bodies determined for the activities identified as priority by country teams.
A success story pertaining to a "growth area" have been presented and discussed. The stories illustrate the role played by the HCPAs in the success and highlight best practices or lessons learned.
A panel discussion followe each presentation. Panels were each be composed of 4 - 6 people from different professional associations, agencies and/or organizations. Each panel was chaired by a facilitator. A list of discussion points was available for each panel to ensure full review of topics. Time was allotted after the discussions for comments and questions.
The expected results of the meeting are centered on the identification of priority actions that country teams will to pursue in a 1-2 year time-frame. These actions will strengthen the role of HCPAs in supporting national MNCH efforts. The country team participants will also identify support needed from regional and international agencies and the government in order for these activities to be feasible.
The country working groups were the key forum for the identification of these activities and needs. Three sessions were planned. The first two focused on selecting 2 or 3 of the 5 growth areas for HCP Associations. Groups have been asked to:
In the third working group session, country teams identified as precisely as possible the support that they will need from regional and/or international bodies to facilitate the implementation of the identified activities.
For this exercise, participants from regional and international associations and agencies have been asked to join country groups.
The presentation during this session focused on the role of Association of Malawian Midwives (AMAMI) in advocating for mothers, neonates, families and midwives. The presentation outlined the channels used for different target audiences. It also outlined the major issues raised by AMAMI in their advocacy campaign: recognition of the midwife, salary, accommodation, uniform and protective wear, career development, brain drain and continuing & in-service education.
The four key issues outlined in the ensuing panel discussion were:
The recommendations outlined were:
Keith Lipato, The Association of Malawian Midwives (AMAMI) [pdf 138kb]
"One MNCH Plan" development
The presentation during this session regarded the Integrated Maternal, Newborn and Child Health Strategy in Nigeria. Providing MNCH related statistics in Nigeria, the presentation outlines the strategy's key approaches: advocacy, strengthening of the health system, empowering families and communities, organizing operational partnerships, mobilization of resources. The presentation also provides insight on the choice of priority areas for action and interventions, phasing of implementation, rolling out of the IMNCH. Finally the presentation lists opportunities and challenges linked to the IMNCH.
The panel discussion following this presentation agreed that HCPAs should focus on the following points:
Dr Nkeiru Onuekwusi, Nigeria [pdf 1.07Mb]
Addressing the human resources crisis
The panel discussion on human resources was preceded by a presentation on the ACCESS program collaboration with the health care professionals. This presentation, consisted in an overview of the ACCESS program and its partners, a discussion of the situation of maternal, newborn and child health in Ethiopia and a description of the ways in which work was conducted with the Ethiopian Nurses and Midwives Association and the Ethiopian Obstetrician and Gynecology Association to develop capacities of health extension workers, nurses, midwives and doctors.
The panel discussion that followed this presentation identified the following as necessary action points for HCPAs:
Joseph de Graft-Johnson, ACCESS [pdf 5.48Mb]
The session on quality improvement started with a presentation on the role of the Association of obstetricians and Gynecologists of Uganda (AOGU) in quality improvement. This presentation, in addition to outlining the definition of quality and providing information about the AOGU, detailed ways in which the AOGU contributes to improving quality; i.e.: training, continuing medical information, monitoring/support supervision, setting standards of care and awareness raising/health education.
The session on quality improvement also included a presentation on the role of HCPs in saving newborn lives. This presentation outlined global progress on MDG 4 and compared it to that of the African continent. It also related neonatal mortality burden with physician density in countries, highlighting the link between the two. It provided information about scaling up effective interventions, pointing to the difference the theoretical and real applications of integrated packages in the continuum of care. Finally the presentation listed some of the ways in which HCPs could help minimize neonatal mortality primarily through providing technical support for national planning and for public health policy, auditing deaths and quality of care, and advocating and promoting accountability among others.
A last presentation was made during this session which covered the partnering for the scale up of Kangaroo Mother Care (KMC) in Malawi. The presentation outlined the need for KMC in Malawi and detailed the role played by HCPs as champions in setting it up. It then went on to illustrate the need for government leadership and community support in the scaling up of this practice and drew the achievements of the KMC programs especially in terms of policy and training and implementation.
The panel discussion following these three presentations highlighted the following as necessary next steps for HCPAs:
Byaruhanga K. Emmanuel, Mbarara University Teaching Hospital, Uganda [pdf 386kb]
Dr Joy Lawn, Saving Newborn Lives/Save the Children [pdf 1.07Mb]
Evelyn Zimba, Programme Manager, Save the Children [pdf 438kb]
The presentation in the session focused on the strengthening strategy of the Society of Gynecology and Obstetrics of Nigeria (SOGON). The presentation described the activities undertaken to strengthen the organization which included: active membership drives, regular meetings and conferences, collaboration, focus on strengthening leadership through the creation of succession plans for members of the society, advocacy, structural adjustments: standing committees and the regular creation of ad hoc committees and partnership with the public sector, among others. It also outlined challenges faced by SOGON which included: funding, increase participation of women professionals, lack of administrative staff and voluntary membership among others.
The panel discussion following this presentation highlighted the following points:
The panel also made recommendations to the Partnership as follows. The Partnership should:
Dr Ezechi Oliver Chukwujekwu, Nigerian Institute of Medical Research [pdf 526kb]
Country groups work
Participants worked in country groups to:
This work was guided by the discussions, presentations and panel discussions.
Five country working groups were established:
During this session a presentation was made which outlined the support that The Partnership is able to provide to the HCPAs in order to facilitate the achievement of the goals outlined in the action plans. These areas of potential intervention consisted of technical support, especially in regards to the identification of sources for funding and in proposal writing and advocacy (lobbying on behalf of HCPAs) and facilitating communication among HCPAs and between HCPAs and members of other constituencies among others. The presentation also underlined the need for follow up and reporting on action plans.
This session also included a panel discussion on the types of support available to national HCPAs from international and regional professional associations. The session ended with the signing of a statement of commitment by participants.
The Partnership [pdf 49kb]
Blantyre Declaration of Commitment to Millennium Development Goals 4 and 5 [pdf 71kb]
List of presentations
2007.11.12 - MDGs 4 and 5: Where we are now, and how can HCP associations contribute to change the situation? [pdf 2.22Mb]
by Dr Francisco Songane, Director, The Partnership
2007.11.12 - Advocating for mothers, neonates, families and midwives. [pdf 138kb]
by Keith Lipato, Nurse-midwife, Association of Malawian Midwives (AMAMI)
2007.11.12 - One MNCH plan: the situation for Malawi [pdf 740kb]
Dr Chisale Mhango, FRCOG, Malawi
2007.11.12 - Experience in developing one country MNCH plan: Nigeria [pdf 1.07Mb]
Dr Nkeiru Onuekwusi, FMOH Nigeria
2007.11.13 - ACCESS Programme collaboration with health care professional associations in Ethiopia [pdf 5.48Mb]
Mr Joseph de Graft-Johnson, ACCESS
2007.11.13 - Partnering for Kangaroo Mother Care scale-up Malawi [pdf 438kb]
Mrs Evelyn Zimba, Programme manager, Save the Children
2007.11.13 - The role of HCPAs (AOGU) in quality improvement [pdf 386kb]
by Byaruhanga K. Emmanuel, Consultant Obstet/Gynaecologist, Mbarara University Teaching Hospital, Uganda
2007.11.13 - Saving newborn lives: roles for health care professionals [pdf 1.07Mb]
Dr Joy Lawn, Saving Newborn Lives/Save the Children
2007.11.13 - Organizational strengthening of health care professional associations [pdf 526kb]
Dr. Ezechi Oliver Chukwujekwu, Chief Research Fellow, Nigerian Institute of Medical Research
2007.11.15 - The role of health care professionals in reaching MDGs 4 and 5: closing remarks [pdf 186kb]
by Lennie Adeline Kamwendo, MSN
2007.11.15 - So what now? Next steps for workshop participants [pdf 49kb]
The Partnership for Maternal,Newborn and Child Health
Ethiopia - Priority actions for HCP associations and partners [pdf 72kb]
Malawi - Priority actions for HCP associations and partners [pdf 17kb]
Malawi - 2-year plan on the role of HCPs in reaching MDGs 4 & 5 [pdf 54kb]
Nigeria - Priority actions for HCP associations and partners: Advocacy [pdf 26kb]
Nigeria - Priority actions for HCP associations and partners: Organizational strengthening [pdf 23kb]
Tanzania - Priority actions for HCP associations and partners [pdf 47kb]
Uganda - Priority actions for HCP associations and partners: Development of a One MNCH Plan [pdf 84kb]
Uganda - Priority actions for HCP associations and partners: Quality improvement and organizational strengthening [pdf 89kb]