Strengthening the Humanitarian, Development & Peace Nexus: Fostering collaboration between the emergency response programming and health systems development
Humanitarian-Development Nexus in the news
The Humanitarian-Development Divide Culture/Approach Outlook Coordination/Leadership Planning Frameworks/Tools Legal Frameworks Types of Settings Humanitarian Substitution/parallel 6-12 months* System-led: clusters HRP/HNO Humanitarian Principles/ IHL IHL Fragile/ Unwilling Development Complementarity 5-10 years Government-led; IHP+/UHC2030 UNDAF/ CCA, NHP&SP, NAPHS Sovereign Law, Aid effectiveness principles Stable/Willing Photo: WHO/C. Haskew
New Way of Thinking: 2016 Global Processes Agenda 2030 Agenda for Humanity Photo: WHO/C. Haskew Reduce risks and vulnerabilities leave no-one behind
Bridging the Hum-Dev Divide in Health Joint Analysis Joint Planning Define Collective Outcomes Humanitarian Development Joined Up Programming Life Saving Assistance and protection Integration in National Health System UHC & resilience: Health System Strengthening and preparedness Photo: WHO/C. Haskew
Photo: WHO/C. Haskew A new way of working Humanitarian interventions should apply early recovery approaches in the response, and seek integration with existing health services and transition of governance to local authorities Development oriented workstreams should target fragile and conflict affected areas in a more operational manner, addressing key bottlenecks in health system performance that also constrain the humanitarian response, with more flexibility in contracts and adapted management of risks. Fostering the interface between them through connections in analysis, planning and coordination
1. Collective outcome: HDPN for health SDG3: As overarching goal Universal Health Coverage: ensuring that people can use essential services when they need them without suffering financial hardship Preparedness of the health system and communities for shocks. Photo: WHO/C. Haskew
Collective outcome: UHC
HDPN for health 2. Joint analysis: bringing together humanitarian assessments (MIRA/HNO/HeRAMS, etc), health sector performance/bottleneck/capacity assessment all hazard risk analysis (STAR, VRAM, PHRA, etc) context analysis Photo: WHO/C. Haskew
HDPN for health 3. Joint operational planning at national & subnational level: Integrating where possible both humanitarian and development support in the operational plans. Multi Year HRP, using the health system analysis framework to identify priorities and opportunities for early recovery to connect with longer term health system recovery and resilience National Health Strategic Plan that prioritises areas and populations in most need, and preparedness for all hazards. Photo: WHO/C. Haskew
HDPN for health Give example how humanitarian partners can support health system strengthening for the HDN 1.Service delivery 2.Health workforce 3.Information 4.Medical products 5.Financing 6.Leadership/governance See chapter on early recovery of the health cluster handbook Photo: WHO/C. Haskew
Coordination Governance HIS Service delivery Pharmaceuticals and equipment HRH Financing Response and Early Recovery Humanitarian/emergency coordination, EOC Registration and mapping of all health partners Sub national emergency coordination Recovery and Health System resilience Health development partner coordination (IHP+, etc) Coordination for the recovery assessment and planning Core functions and capacities for district health management Accountability to Affected Populations People-centred and integrated health services Focused capacity building of DHMT to supprt life saving functions Guidance for district, community and village health committees Decentralisation policies Humanitarian Response Plans National Health Strategy/policy planning (JANS) Emrgency preparedeness and contingency planning Disaster Risk Management, IHR 2005 (selected) Morbidity surveillance IDSR EWARNS EWARNS HeRAMS Selected HIS indicators Restore life saving services Essential Packages of (life saving) Health services Progressive expansion of coverage and quality List of core life saving pharmaceuticals Drug and equipment donation guidelines Quality control of drugs procured by international partners Standardised remuneration/incentives Task shifting Scaling up community outreach programs/chws Services free at point of delivery (temporary) waiving of user fees SARA HMIS Restore basic services, and improve for access and performance Package of health services Patient safety, and IPC Universal Health Coverage Essential medicine lists, by level of health facility Essential medical equipment lists, by level of health facility Prequalification of suppliers HRH policies and plans Staffing standards by level of health facility Standard post descriptions Training curricula for types of health workers CHW policy Health financing policies, public funding, reduce OOP, PBF Financial protection from catastrophic health expenditures
Photo: WHO/C. Haskew Implementing HDPN for health 1. Focus on service delivery: Progressively expand access, coverage and quality of an Essential Package of Health Services (EPHS) Health financing with social & financial protection Address health system constraints for its implementation, and Address barriers to access services from HH/community perspective
Photo: WHO/C. Haskew Implementing HDPN for health 2. Preparedness for acute emergencies Preparedness and risk management for all hazards, including health security and IHR core capacities Strengthen national EWARS, investigation, control and response capacities (including for example scaling up epidemic related treatment centres) Health system strengthening for preparedness: ensure integration in NHSP, and respective policies for health system components Essential Public Health Functions in fragile contexts
3. Governance & partnership: Coordination architecture that provides links between humanitarian and development partners, as well as intersectoral connections Maintaining health governance, in particular at subnational level: District Health Management & community engagement Platform for policy dialogue, based on joint analysis, planning and monitoring Conflict sensitive programming, Health as a Bridge for Peace Commitment to humanitarian principles & principles for Aid Effectiveness Photo: WHO/C. Haskew Implementing HDPN for health
Funding and financing: A new way of working Increased public funding and local resources Predictable and flexible humanitarian and development funding to support HDPN Avoid the humanitarian development funding gap Create dedicated emergency pooled funds for health (e.g. to reimburse loss of revenue due to user fee waiver policies, subsidise access to medicines, scale up service delivery for epidemics, etc) Pilot different provider payment mechanisms in protracted emergencies, complemented by demand side financing HEALTH EMERGENCIES programme