Africa’s legislators should be involved in establishing strong community engagement structures to ensure that individuals actively participate in solving their own problems.
This would spontaneously lead to the achievement of Universal Health Coverage and Sustainable Development Goals.
The call to action was made by the Executive Director for the African Center for Global Health and Social Transformation(ACHEST), Prof. Francis Omaswa while giving a keynote address on universal access to reproductive health services amidst the COVID-19 pandemic. This was at the annual meeting of the Network of African Parliamentary Committees of Health (NEAPACOH) held virtually on October 28 – 29, 2020. The meeting was hosted by Partners in Population and Development and the African Institute for Development Policy.
Prof. Omaswa began his presentation with his famous quotation, “ Health is made at home. Be clean and eat well and do not share accommodation with animals,” which used to air on the radio in the early 2000s when he was Director-General of Services at the Ministry of Health.
“This to me is the elephant in the room. This is what we should be talking about if we want to achieve ICPD goals, SDGs, and UHC. The health of the people is made in their communities where they live and work,” he stressed.
In reference to COVID-19, Prof. Omaswa noted that it was important to engage communities on the standard operating procedures (SOPs) for the prevention of the pandemic, such as hand hygiene, wearing masks, and social distance.
“What is palpable now is about COVID-19 and SOPs. But we are not asking the people what their views on SOPs are! We are not asking them what their challenges are in looking for water; social distancing when you live in crowded houses; we are not talking to them about the challenges of stigma and quarantine; and issues like gender-based violence and teenage pregnancies. What do the people say about these?” asked Prof. Omaswa.
“If we addressed the needs the communities have, if we listened to them and respond, and make them own responsibility for it, we would be able to achieve progress. I would like to encourage Members of Parliament to think about this. How do we get communities to own and be responsible,” he said
He told the legislators that the newly launched Community Engagement Strategy by the Uganda Government is a move in the right direction. The strategy, endorsed by President Yoweri Museveni and launched by the Prime Minister, was developed by a multi-sectoral committee chaired by Prof. Omaswa
The overall goal of the strategy is that Ugandans are aware, empowered, and are participating actively in the prevention and control of COVID-19 as both a duty and a right, using existing structures, systems, and resources. This is underpinned by the principle that individuals have the primary responsibility for maintaining their own health and that of their families and communities. They are supported, if needed, by the skills, knowledge, and technology of the professionals.
This rhymes well with Alma-Ata declaration of 1978. The pandemic is also an opportunity for Uganda to implement and scale up the existing Integrated People Centered Primary Health Care strategy which was first launched in the year 2000.
The strategy uses a Whole of Society approach; which means that all sectors contribute to health..
“Prof. Omaswa elaborated further: “Health is not a separate entity; your health is impacted by what you do every day; and other sectors such as infrastructure, the roads, education, security all contribute to health.”
During his presentation, Prof. Omaswa showcased the evidence-based work undertaken by ACHEST in the area of intersectoral collaboration (ISC). In 2017 ACHEST undertook a scoping study on the status of implementation of SDGs in 7 African countries: Ethiopia, Kenya, Rwanda, Tanzania, Uganda, Zambia and Zimbabwe pointed out the need for countries to embrace ISC to accelerate the achievement of the SDGs.
In August 2020, ACHEST rolled out a six month project in Ngora district, Eastern Uganda, to test the feasibility of ISC for advancing primary health care at community level using existing structures. The Village Health Teams established alongside village local governing councils maintain health registers with records of the health status of each individual in each household and record the health practices, hygiene, and health conditions of household members. They also follow-up patients at home and ensure that immunization, maternal health, and other health conditions are addressed. This is the model that has been adopted and will be scaled up in the whole country with immediate effect.
“My message to you as Members of Parliament is that this is the quickest and cheapest way to achieve SDGs. Why don’t we do this? It is undisputed. Establish strong community engagement and communities are taking charge themselves of what happens to their health,” said Prof. Omaswa.
Compiled by Carol Natukunda, Communications Specialist, ACHEST