Lower fertility rates, coupled with reduced mortality and investing in human capital development, will enable African countries to achieve the demographic dividend.
This was emphasized by Dr. David Okello, the Director of Non Communicable Diseases and Health Ageing at the African Center for Global Health and Social Transformation(ACHEST), as he participated on the panel that discussed the newly launched report: Foresight Africa: Top Priorities for the continent 2020-2030.
Published by the Brookings Institution's Africa Growth Initiative, the report, among other topics, discusses how the Sustainable Development Goals (SDGs) will shape policy priorities for African governments and their partners in the next decade. The report shows that one of the top challenges facing the continent continues to be the mismatch between demographic trends and job creation.
However, Dr. Okello told participants that there is an answer to this dilemma: an empowered population would be productive to the economy.
He gave candid observations on how the high fertility rate in Africa was a burden not just to the economy, but also to a woman’s health.
“We need to reduce our fertility urgently. The population pyramid shows that we are producing too many people. Yet, many are dying before they reach the productive age,” said Dr. Okello.
“In my village, some women are subjected to give birth to up to 10 children! No woman should be drained that far! 10 is a disservice to the woman! A lot of these children don’t grow to become economically active. Having 50 percent of the population below 15 years is an economic burden. You cannot achieve the demographic dividend,” he added.
Lower fertility rates, coupled with reduced mortality and investing in human capital development, will enable African countries to achieve the demographic dividend.
Ensuring quality and sustainability of the health workforce is an essential element of the Sustainable Development Goals.
This is the strong message that came out of the 2019 Global Symposium on Health Workforce Accreditation and Regulation, held from December 10-12 2019, in Istanbul, Turkey.
Co-organized by the World Health Organization (WHO), Educational Commission for Foreign Medical Graduates (ECFMG), and the Global Health Workforce Network (GHWN), the symposium reviewed health workforce-related accreditation and regulation, enhanced data sharing across Member States, relevant stakeholders and institutional readiness in this area.
It also looked at consistency of the different approaches by member states regarding the adoption of the Global Strategy on Human Resources for Health: Workforce 2030 and its 2020 milestone.
It addressed policies and implementation strategies for the accreditation of health worker education institutions and health worker regulation to advance quality and sustainability. Furthermore, it reviewed and addressed health worker accreditation and regulatory issues with a focus towards achieving Universal Health Coverage, as emphasized in the WHO’s 13th Global Programme of Work and the 2018 G20 Health Ministers Statement.
By Prof. Francis Omaswa
We as humans are by nature empathetic, social and capable of collaborating in mutuallysupportive ways for the individual and common good. Naturally, we are saddened when we see human suffering. Likewise, we are cheered when we witness success. Yes, we also have in us negative non-cohesive tendencies such as selfishness and greed, jealousy and aggression. Ultimately, however, the common good tendencies predominate. This is the reason why we have collectively overcome vices such as ending slavery and apartheid. Indeed, negotiating and adopting the Sustainable Development Goals (SDGs) is an example of the success of our cohesive tendencies. How is this interplay currently impacting the achievement of Universal Health Coverage (UHC)?
Previously, health was classified as a cost without economic returns. However there is sufficient evidence that proves that investing in health has high economic and social returns.
Let’s face it: Non Communicable Diseases (NCDs) are preventable. Yet, they claim millions of lives annually.
According to the World Health Organisation, NCDs kill 41 million people each year, equivalent to 71% of all deaths globally. Cardiovascular diseases account for most NCD deaths, followed by cancers, respiratory diseases and diabetes. Tobacco use, physical inactivity, the harmful use of alcohol and unhealthy diets all increase the risk of dying from a NCD, according to WHO.
How can countries stop these depressing figures? Did you know that digital technologies could offer solutions by empowering people with basic health information?
Against this background, the African Center for Global Health and Social Transformation (ACHEST) was recently privileged to participate in the dialogue on curbing NCDs, at Wilton Park in London.
The meeting was convened to explore ways on how digital health can be used to tackle the growing burden of NCDs in low and middle income countries.
Seeking a practicing license is now just a click away on the computer. The African Center for Global Health and Social Transformation (ACHEST) has successfully developed Uganda’s first ever online platform for the annual practicing licenses for health professionals and facilities.
With support from the World Bank Group, the online platform is a game changer in the health sector. It automatically means that professionals will no longer have to travel hundreds of miles to the capital Kampala to register or renew their annual practicing licenses.
One only needs to create an account and register in the portal to acquire the registration certificate. For previously registered professionals, login credentials will be forwarded to them on their cell phones.
The platform was developed over a period of three years and can be accessed through: www.ehealthlicence.go.ug
"My daughter told me she knew what condoms were. Yet, I had never spoken to her about them," disclosed Dr. Gaston Zulu, one of the panelists at the ICPD side event that was hosted by the African Center for Social Transformation (ACHEST) on November 13, 2019 in Nairobi.
Another panelist, Dr. Elizabeth Gitau from Kenya Medical Association also disclosed:
"My child keeps asking me, 'mummy what is HIV?' Yet she's only six years old. If I don't tell her, the next time she could be playing with a 14-year-old and he gives her wrong information."
These two personal stories shared by both Dr. Zulu and Dr. Gitau speak volumes on just how much children have an idea about sexuality health. Yet, many adults continue to burry heads in the sand, rather than face the reality and talk about sex education.
While delivering the key note address on gender equity gaps and health services for the youth, Dr. Anne Beatrice Kihara, the President at African Federation of Obstetrics and Gynaecology decried the high rate of teenage pregnancies that are putting adolescents at the risk of contracting HIV.
Dr. Kihara said 21 million girls aged 15 -19 in developing countries become pregnant every year. About half of these pregnancies (49%) are unintended. “Pregnancy is just a sign of another bigger problem: HIV. We also still have a problem of abortions, as girls resort to terminate unwanted pregnancies. Young women aged 15- 24 are twice more likely to be living with HIV than men," said Dr. Kihara.
Dr. Richard Mugahi, from Uganda's Ministry of Health said there is need to define safe spaces for adolescents to open up and seek help about issues affecting them. This, he emphasized, will curb on teenage pregnancies. “If gender-based violence is inflicted by our relatives in homes, where are the safe spaces in a patriarch society? A young girl from school walking through the boda-boda stage is not safe. If you say let them stay in school, we know that some teachers are defiling our girls!"
Dr. Mugahi added: "All women who are productive are as a result of a safe place. A safe place has to take into context the background and individual needs of the girl. It can't be universal. Adolescents, parents and guardians are key in defining this space."
Dr. David Okello, the Director of Non-Communicable Diseases and Healthy Ageing at ACHEST urged young people to speak up. “When HIV started, civil society were not talking until the people affected themselves started talking. How much are these girls involved? The children should get involved!"
Dr. Kihara agreed but was quick to note that it was not always easy for a girl who has conceived to speak out. "I would like to agree. However, how will they talk? You get pregnant and leave school to take care of the baby." Some participants argued that huge finances of were needed to achieve reproductive health and family planning needs.
The years of hard work, self-acrifice and selflessness paid off for Prof. Francis Omaswa, the Executive Director of the African Centre for Global Health and Social Transformation (ACHEST) was awarded the honorary Hideyo Noguchi Africa Prize in Japan yesterday, 30th August 2019 by the Japan Government.
The award that was presented by Shinzo Abe the Prime Minister of Japan honors individuals with outstanding achievements in the field of medical research and medical services to combat infectious and other diseases in Africa and comes with a prize of 1m cash price.
In his acceptance speech presented in Japan Prof. Omaswa said it is a great honor and pleasure for him to receive the 3rdHideyo Noguchi Africa Prize for Services rendered in Health. “When I received a phone call forming me of the decision on laureates of the Prize from the Government of Japan, I was shocked. I immediately asked my driver to take me to the nearest church to thank the Lord God for the news of the award. By God’s design, I found my wife also in the same church.”
“Sitting and conversing with you this evening at the banquet table is a singular privilege for me and my daughter Gloria as well as my other family members who are here in this room. I want thank Your Excellency Mr. Shinzo Abe, the Prime Minster of Japan and the entire government for this award. My heartfelt gratitude also goes to Dr. Kiyoshi KUROKAWA, Chairperson of the Hideyo Noguchi Africa Prize Committee.” Prof. Omaswa said.
He also expressed his gratitude to the President of the Republic of Uganda, His Excellency President Yoweri Kaguta Museveni who was represented at the ceremony by the Minister of Health Hon. Dr Jane Ruth Aceng whose decision to appoint him and support during his work in the position of Director General of Health Services in the government of Uganda provided the platform for him to undertake the national and international work that has been recognized by this award.
Dr. Hideyo Noguchi demonstrated in his life a spirit of global solidarity and humanity in risking his life by leaving the comforts of Japan and America to go to Africa to seek solutions to the menace of viral hemorrhagic fevers such as yellow fever that took his life. This is the spirit which today’s world needs more than ever.
Prof. Omaswa likened Dr. Hideyo Noguchi to his daughter Dr. Freda M Omaswa who passed away three years ago who spent time, from her base at the National Institutes of Health in the USA, testing vaccines for malaria in Bamako, Mali, West Africa for several years. In pursuit of this Hideyo Noguchi common good spirit and to advance his mission, a portion of the Prize award funds will be committed to a public cause in memory of Dr. Freda M Omaswa.
The African Centre for Global Health and Social Transformation (ACHEST) supported the Parliamentary Health Committee to review the 2017/18 Annual Performance Report of the Health Services Commission in a half day dialogue held on the 1st of August 2019 at Imperial Royale Hotel Kampala.
The review of the report was led by Prof. Francis Omaswa, the Executive Director of ACHEST where issues on; matching the health workforce to the population needs, forming a structured coordination committee by parliament, filling the Director Generals position at Ministry of Health, reviewing the staffing norms, increasing the health budget and the per capita expenditure and expediting the National Health Insurance, among others were discussed.
Prof. Omaswa explained to the Members of parliament the hurdles by some districts in trying to attract potential candidates for District Health Officer (DHO) positions while others have to bribe local authorities to get to such jobs. He advised that in order to streamline the services delivered in the districts, the Health Services Commission should take charge of the recruitment of the DHOs.
The meeting participants suggested that the recruitment of the DHOs and their deputies be re-centralized to the central recruitment system to guard against such issues.
During the discussions, the Director of Policy at ACHEST, Dr. Patrick Kadama cautioned that as we push for the re-centralization of the recruitment of DHOs, care should be exercised in keeping in mind the functions to be performed by the officers stressing that the population has grown as the staffing norms have not changed.
“We need 40,000 doctors for the population of Uganda, but we only have 6,000, even though we cannot employ all of them. This shows that we are very far from what we require.” Dr. Kadama said.
Some of the recommendations made included: Update the staffing norms to match with the population growth; Government of Uganda should reduce leakages, tax evasion, unfair tax exemptions and capital flight; expand the tax base and use Development Assistance for Health more effectively and return to Swaps and Paris Declaration on aid effectiveness.
The chairperson of DHOs Dr. Ivan Kamya echoed that DHOs have recently recommended that their positions be re-centralized with better resource allocation.
The Vice Chairperson of the committee, Spellanza Baguma says MPs are yet studying the idea of re-centralization of the DHO recruitments. ACHEST was tasked to provide technical input to the report before it is tabled at parliament.
The meeting was attended by representatives of the Parliamentary Committee on health, civil society organizations working on Health and health journalists.
“We should strive to have a health system where the population does not face financial catastrophe. This is not possible without supported health workforce and strong health governance, a driver to UHC which is a political choice.” Dr Tedros Adhanom Ghebreyesus the WHO Director-General said in a video recorded speech played at the Opening Ceremony of the Special Consultation Meeting on Governance for Health in Africa.
The three day (16th-17th July 2019) Consultation Meeting was organized by the African Platform on Human Resources for Health (APHRH) hosted at the African Centre for Global Health and Social Transformation (ACHEST) at the Commonwealth Conference Center, Munyonyo, Kampala.
The meeting brought together 70 delegates from Sixteen countries within and outside Africa that included health leaders, academia, policy makers, representatives of governments, United Nation Agencies, researchers, CSOs, journalists among others to discuss challenges of poverty, disease and ignorance faced by Africa and chat a way forward on getting rid of these challenges so that no one is left behind.
The African Centre for Global Health and Social Transformation (ACHESTs) Dr. Elsie Kiguli-Malwadde, Director Health Workforce Education and Development and Dr. David Okello, Director NCDs and Healthy Aging attended the East Central and South African - Heath Community (ECSA-HC) 12th Best Practices Forum held at Mount Meru Hotel, Arusha, Tanzania from 19 - 21 June 2019.
The Forum with the theme “Innovation and Accountability in Health towards achieving Universal Health Coverage” brought together Senior Officials from Ministries of Health, Health Experts, Health Researchers, Heads of Health Training Institutions from Member States of the ECSA Health Community (Uganda, Kenya, Tanzania, Eswatini, Zambia, Lesotho, Zimbabwe, Malawi and Mauritius) with the aim of identifying policy issues and making recommendations to accelerate and scale up best practices in the ECSA Region.
The subthemes that were discussed included, efforts to improve adolescent and young people’s health, opportunities for achieving water and sanitation health global target, equity and access to eye healthcare in the ECSA region, use of innovative approaches towards achieving food safety and improving quality of life, prioritizing substance use and mental health challenges in the ECSA region and tackling emerging and re-emerging health threats. Regional One Health approach to managing recurrent outbreaks in the region was discussed, coupled with bridging the gap between reality and aspiration in building health systems.
The African Centre for Global Health and Social Transformation (ACHEST) was represented at the conference on “SDGs Implementation in Africa – Reflection on a Three-Year Journey” by Dr. Patrick Kadama, the Director of Health Policy and Strategy at ACHEST who is also a Think Tank on SDGs in Kigali-Rwanda from 12-14 June 2019.
The conference had in attendance African leaders, policy makers, representatives of the UN system, civil society, the private sector, bilateral institutions, researchers and academicians, innovators and experts to debate the progress made towards achieving the Sustainable Development Goals (SDGs) in Africa. The conference also saw the launch of both the Africa 2030: Sustainable Development Goals Three-Year Reality Check report and the 2019 Africa Index and Dashboard report.
The SDGs, which were adopted by the 193 countries in the United Nations in 2015, are a global guiding agenda for sustainable development to be achieved by 2030. At their adoption, Africa’s starting point was lower than that of all other regions and emerging evidence over the last three years of tracking SDGs implementation indicates that complex challenges still prevail for the continent.
The pace of development progress in Africa over recent years is assessed as insufficient for the attainment of the 2030 Agenda for Sustainable Development. Accelerating SDGs implementation, successful matching of development goals to finance the role of different stakeholders, leadership, participation and ownership of the agenda by governments and the need for strong monitoring and evaluation mechanism are some of the challenges addressed during the conference. Achieving the SDGs and accelerating their implementation needs universal participation and collective action.
The Think Tanks at the meeting resolved to convene an inclusive policy dialogue with a broader set of stakeholders on a strategy to setup an Africa funding for financing the components of supplying water to households, health and education an idea birthed at the conference to fast track the SDG implementation in Africa.
Six heads of State attended the conference and pledged to present the recommendations at the African Union Summit.
Mr. Genichi TERSAWA, Director Office of Hideyo Noguchi Prize Counselor of Cabinet Office visited the African Center for Global Health and Social Transformation ACHEST after the Government of Japan awarded Prof. Francis Omaswa, the Executive Director and Founder of ACHEST the Third Hideyo Noguchi Africa Prize in the Medical Services category.
Mr. Genichi came to brief Prof. Francis Omaswa regarding the award and to learn more and appreciate the work of ACHEST.
He also briefed ACHEST about the current Japanese strategies for collaboration with Africa.
Afya Bora Consortium invited AFREhealth to speak at the Mid-Fellowship Meeting for the Afya Bora Consortium Fellowship in Global Health Leadership which is supported by the U.S. Health Resources and Services Administration (HRSA) and PEPFAR. The meeting was held in Nairobi, Kenya at the Fairview Hotel on May 31st and June 1st, 2019.
Dr. Elsie Kiguli-Malwadde, Director at the African Centre for Global Health and Social Transformation (ACHEST) who doubles as the Secretary AFREhealth represented AFREhealth at Mid-Fellowship Meeting and presented on AFREhealth activities and the vision for Africa.
The Afya Bora Consortium aims to contribute to health systems strengthening in African partner countries by implementing a leadership training program targeting African and US health professionals. The Afya Bora (“better health” in Swahili) fellowship model focuses on training leaders for HIV/AIDS prevention, care and research programs.
The consortium is in its seventh year and has graduated 164 fellows, 68 nurses, 87 doctors, and 9 public health professionals.
The meeting brought together 25 Fellows, Consortium Working Group members, key stakeholders, other representatives from participating African and US institutions to discuss current goals of the training and the desired outcomes of participation in the fellowship.
Enthusiastic young African health professionals; nurses, medical doctors, epidemiologists among others from 5 African countries that included: Uganda, Kenya, Tanzania, Botswana and Cameroon attended the meeting.
The fellows presented their work which was very inspiring to listen through whose aims resonated very well to those of AFREhealth and they were encouraged to register and become members of AFREhealth as well as attend the upcoming AFREhealth symposium which their leadership has attended severally and made presentations at.
The Afya Bora Consortium is grappling with the issue of sustainability beyond their funding mandate. They were happy to hear about how MEPI/NEP has transitioned into AFREhealth where Dr. Kiguli-Malwadde shared with them best practices of sustainability and encouraged them to see how they could team up with AFREhealth and sustain some of their activities through AFREhealth programs.