UHC Day 2019
By Dr. Githinji Gitahi, Gina Lagomarsino
To achieve universal health coverage, we need new kinds of partnerships that combine different perspectives and strengths — everything from technical expertise and knowledge of the global evidence base to strong local and regional networks and a deep understanding of local context and political economy.
This UHC Day we are hearing from many governments and civil society organizations working to make universal health coverage (UHC) a reality. It’s an ambitious goal for any country, but it’s particularly exciting that a number of low- and middle-income countries are leading the charge with new commitments. These countries are seeking advice and support as they strengthen their health systems and move closer to providing quality, affordable coverage across their populations.
The organizations we lead — Amref Health Africa and Results for Development (R4D) — are both committed to supporting countries throughout Africa to achieve universal health coverage. Our experience suggests that countries need technical resources and expertise to develop strong policies. But that’s not enough. They also need innovative ways to navigate the political challenges of competing interests, and better ways to engage citizens at the grassroots level. And these three dimensions need to be coordinated.
Recognizing we are better together, we have decided to work more intentionally with each other to leverage our complementary capabilities through a new kind of partnership focused specifically on achieving UHC in sub-Saharan Africa.
Better together: How we can achieve so much more
Amref is a large African NGO with a strong history of health service delivery and community engagement — and a vast existing network of deep connections in Africa. R4D is a younger, emerging international NGO, known for expertise in health systems strengthening that helps countries facilitate strong stakeholder engagement processes and build the institutions required to make appropriate technical approaches stick.
We have realized that we can be a formidable duo in supporting countries as they advance UHC and tackle some of their most pressing health challenges. R4D emphasizes technical knowledge relevant for UHC and lessons from around the world about how to get political processes to work. AMREF brings deep contextual knowledge of the health systems in many countries and a strong linkage to the social movements driving change in communities.
Given these collective strengths, the two institutions can, among other things, jointly:
- Co-convene international conferences, such as the Africa Health Agenda International Conference (AHAIC,) where stakeholders can discuss and share information on how to achieve a lasting change for health
- Collaboratively conduct multi-country research to inform policy around health
- Co-develop and implement technology-based solutions that address health needs in Africa
Working together isn’t new — since 2018, we’ve been collaborating on two projects focused on sustainable health financing, including the African Collaborative for Health Financing Solutions (ACS) and the Strategic Purchasing Africa Resource Center (SPARC).
The 2+2=5 metaphor best sums it up. Through this partnership, we are combining our strengths, expanding our reach and increasing the effectiveness of the support we provide. Amref’s deep relationships with policymakers and communities across the continent are complementing R4D’s health financing technical expertise to build a movement toward strategic purchasing of health services, supporting countries to use resources more effectively for UHC. This is a technical, political and social endeavor.
Under the SPARC initiative, Amref’s reach and presence on the continent and R4D’s technical expertise helped bring together a consortium of 11 institutions — a mix of Anglophone and Francophone academic institutions, research institutions, think tanks and policy analysis firms — in 10 countries. This network has now worked together to categorize country policies and actions on strategic purchasing and develop adaptable products, processes and knowledge to advance strategic health purchasing implementation across the continent. The group, led by Amref and R4D, is learning together how to combine technical, political and social tools to drive progress on UHC on the continent.
But our partnership is about more than working together on a transactional, project-by-project basis. We are exploring a deeper, longer-term relationship where we further integrate our respective assets to make more progress. We envision working together to support country-led reform agendas, to learn together from those engagements, and to spread that learning across the region.
In October, members of our executive teams met in Nairobi for a “shared values” workshop, where we explored our goals as organizations and how they are aligned. We also worked to understand the assets that each organization brings to the table, and how we could each benefit from a partnership. We recognized that building this kind of partnership won’t happen overnight or over a few months or even a year. We’ll need to set mutual agendas, develop shared tools, systems and communication mechanisms to ensure we are true partners working toward common objectives, and seek funding sources collectively. It won’t be easy, but we think combining forces will be more efficient and effective than having each of our organizations separately trying to build similar competing capacities. Eventually, we envision working together to co-develop and leverage additional platforms and programs that advance UHC on the continent.
Where do we go from here?
Increasingly, the global development community aims to support strong NGOs and institutions based in the countries and regions that they serve. This requires international organizations to re-think their roles and their operating models, focusing more on global knowledge creation and sharing and less on creating a global “footprint.”
As R4D and Amref mature as organizations operating in this changing development landscape, our leadership and program teams are excited to develop new more effective models that support country-level change agents achieve lasting impact. We also hope to learn a lot about building strong partnerships which can inform future models of peer organization collaboration across the globe.