Jessica Martini

Results from implementation of aid effectiveness principles in the health sector in Mali

The international community holds high expectations for aid producing demonstrable results in the health sector, at the global and developing country levels. Yet, measuring the effectiveness of aid presents methodological challenges. Existing evaluation frameworks are not sufficiently geared toward learning whether and how practices have changed. We present a framework for measuring the results of implementing aid effectiveness principles at three levels: implementation process, health system strengthening, and outcomes/impact. We developed this framework in the context of monitoring results on the effectiveness of the aid agenda in the health sector in Mali. Despite some changes in behavior that resulted in increased aid effectiveness and improved results at system and outcome levels, overall, the aid effectiveness principles have not been fully implemented. Thus expectations in terms of health outcomes should be realistic.

Aid effectiveness from Rome to Busan: some progress but lacking bottom-up approaches or behaviour changes.

The Busan partnership adopted at the 4th High Level Forum on Aid Effectiveness at the end of last year is a significant step forward towards the improvement of aid quality and the promotion of development. In particular, the inclusiveness achieved in Busan and the shift in discourse from ‘aid effectiveness’ to ‘development effectiveness’ are emblematic. However, key challenges still remain. Firstly, decision‐making should be more bottom‐up, finding ways to take into account the populations’ needs and experiences and to enhance self‐learning dynamics during the policy process. Today, it is particularly necessary to define what ‘development’ means at country level, according to the aspirations of particular categories of people and meeting operational and local expectations. Secondly, changes in language should be followed by a real change in mindset. Development stakeholders should further adapt their procedures to the reality of complex systems in which development interventions are being dealt with.

The evaluation of the Paris declaration on aid effectiveness: what does it tell us? What results for the health sector?

Introduction: The climate of reform and change is evident in the current Australian health care system where significant challenges are faced due to a growing burden of chronic disease, an aging population, workforce issues, and unacceptable inequities in access to services and health outcomes. Improved management of chronic conditions and a focus on health promotion and prevention are key priority action areas. It is vital that the health workforce has the appropriate knowledge and skills to work in a holistic approach that allows them to contribute to the downstream, midstream, upstream actions that will be required to address the future challenges. This presentation describes workforce health promotion capacity building initiatives developed in Northern Australia. Methods and Materials: A range of courses have been developed to build workforce capacity including a 5-day Core Health Promotion Short Course and tertiary level courses including a postgraduate certificate, postgraduate diploma and Master of Public Health (Health Promotion). Results: Between 2007 and 2011, fourteen 5 day short courses in health promotion were conducted for 254 participants. Follow up impact evaluation shows that the courses succeed in providing knowledge, skills, confidence and enthusiasm to undertake health promotion work but that a lack of understanding of health promotion from co-workers and managers, lack of organisational support and commitment, lack of resources, competing clinical priorities, and lack of time were barriers for undertaking health postgraduate courses commenced in 2010. Conclusions: There is strong support for workforce development in health promotion in north Queensland. Short courses and tertiary level training are one way to achieve this. However shifting health service delivery to a more upstream approach to address chronic disease requires broader capacity building within health services and systems including leadership, partnerships, resource allocation and organisational development.

Patient involvement in care strategies for chronic diseases: the case of diabetes and HIV/AIDS care in Mali. What lessons can be learned?

Introduction: The climate of reform and change is evident in the current Australian health care system where significant challenges are faced due to a growing burden of chronic disease, an aging population, workforce issues, and unacceptable inequities in access to services and health outcomes. Improved management of chronic conditions and a focus on health promotion and prevention are key priority action areas. It is vital that the health workforce has the appropriate knowledge and skills to work in a holistic approach that allows them to contribute to the downstream, midstream, upstream actions that will be required to address the future challenges. This presentation describes workforce health promotion capacity building initiatives developed in Northern Australia. Methods and Materials: A range of courses have been developed to build workforce capacity including a 5-day Core Health Promotion Short Course and tertiary level courses including a postgraduate certificate, postgraduate diploma and Master of Public Health (Health Promotion). Results: Between 2007 and 2011, fourteen 5 day short courses in health promotion were conducted for 254 participants. Follow up impact evaluation shows that the courses succeed in providing knowledge, skills, confidence and enthusiasm to undertake health promotion work but that a lack of understanding of health promotion from co-workers and managers, lack of organisational support and commitment, lack of resources, competing clinical priorities, and lack of time were barriers for undertaking health postgraduate courses commenced in 2010. Conclusions: There is strong support for workforce development in health promotion in north Queensland. Short courses and tertiary level training are one way to achieve this. However shifting health service delivery to a more upstream approach to address chronic disease requires broader capacity building within health services and systems including leadership, partnerships, resource allocation and organisational development.