South-South and South-North partnership workshop to strengthen Local Health Systems between Morocco, DRC, Mauritania and Belgium

As part of the Institutional Strengthening Program for Evidence-based Policies, RIPSEC stands for an experience exchange workshop on Local Health Systems (SyLos) between Morocco, Belgium, Mauritania and the Democratic Republic of Congo is held from 25 to 27 March 2019 at ENSP Rabat. These foundations are part of the vision of sharing learned lessons, good practices and evidence generated by the experiences of transforming local health systems in the three countries RIPSEC members’ consortium to achieve the Sustainable Development Goals and universal coverage

The first day was launched by an inaugural speech made by Professor Bart CRIEL of the Antwerp Institute of Tropical Medicine on primary health care 40 years after Alma Ata, on the conceptual reminder of the organization and presentation of health systems in the dynamics of Universal Health Coverage; experience exchange on the process and results of research conducted to address the problems of the functionality of local health systems.

The experiences focused on Belgium, Morocco, Mauritania and the DRC. The last day of the work was focused on the guided visite of the Casablanca local health system, including the practice of family medicine and the health centers management of the interaction with their population of responsibility. The allocation of resources for the operation of health care facilities and the subsidization of poor households in the context of the fight against precariousness are strong actions that concretize the will to implement UHC.

The exchanges revealed that all health systems face different challenges. Piloting, the service providers’ accountability and the service providers supervision are important in the health systems management :

Overview of the fora moments and statements on primary health care highlighted the role of the district in meeting the needs of the communities, the provision of coordination of local actors and the need for adaptation of policies and strategies. to the local context. The Astana Declaration reinforces the obligation on realistic political choices for health, sustainable financing of health and the involvement of all stakeholders for UHC;
Experiences with Learning and Research Health Zones (MOUGHATAA) have shown that action research is a more practical way of stimulating the appropriation of norms and their contextualization in relation to evidence and evidence. The need has emerged for more autonomy for the local health systems steering teams and for structuring their interactions with the normative level ;
Shared experiences have explored different research methods in solving health service problems. Emphasis was put on the supervision of the actors involved in these innovative actions and a structured documentation to facilitate the capitalization and dissemination of good practices. Communicating with local decision-makers is crucial for their ownership of results and appropriate decision-making.

To conclude, the different experiences proved to be very interesting in terms of questioning and in improving the practices and performance of local health systems, particularly on strengthening the leadership of the district steering teams, coordination and motivation of the local health systems actors, the transformation of first line services. The exchanges provided a better understanding of the demonstration approach of testing tools before scaling them up.