WHA70 Side Event Summary- Against All Odds: Strengthening Health Systems to Better Serve Vulnerable


At the recent 70th World Health Assembly, MSH with the support of Frontline Health Workers Coalition, Global Health Council, IntraHealth International, US Pharmacopeial Convention and Women in Global Health brought together a series of leading experts to discuss the challenges health systems face in complex and post-conflict settings and how these challenges impact the health of the most vulnerable – women and children.

During the side event, Dr. Ed Kelley, Director, Department of Service Delivery and Safety, WHO, emphasized that vulnerability and equality issues are always greater within country rather than between countries. For example, during the during Ebola outbreak the rural and urban poor saw a breakdown in services. As such it is important to focus health system building and strengthening on these gaps and inequalities. Additionally, Dr. Kelley, utilized the current crisis in Syria to illustrate that whilst front loading services such as vaccine provisions are important during conflict it is also important to look at building up primary and secondary health services such as mental service so that the post-conflict health system is prepared.

Samalie Kitooleko, a nurse working on Rheumatic Heart Disease in Uganda, emphasized that many of her patients are women and children, and that the focus needs to be on community to reach those most vulnerable. For example, the RHD registry she works with initially on focused on patients who presented to hospital, but they quickly realized that this limited them to providing services only to patients who were quite late in their disease progression. As such they decided to go directly to the source of patients, instituting a school screening programme that allowed them to initiate care early and to set up a surveillance system for those children at risk.

Dr. Jude Nwokike, Director, Promoting the Quality of Medicines Program, US Pharmacopeial Convention emphasized that regardless of whether a country is classified as recovering or post-conflict women and children will always be the most vulnerable in the health system. Dr. Nwokike emphasized that women reproduction does not stop during conflict and in post-conflict settings and that women will continue to have babies in these situations, and as such it is necessary to ensure access to safe and quality assured medicines in both conflict and post-conflict settings. In particular, he highlighted the example of increasing the availability of chlorhexidine in Nigeria and its impact on reducing neonatal sepsis. This was achieved by ensuring the registration of chlorhexidine in Nigeria and as such increasing its availability and use. Finally, he emphasized that if you can take the production of these essential medicines closest to the area of the burden of disease that is where you will see the most impact.

Dr. Nosa Orobaton, Deputy Director, MNCH, Gates Foundation, emphasized the need for targeted funding to systematically increase the odds of a country’s health system being resilient, especially for women and children. Dr. Orobaton emphasized the Global Financing Facility (GFF) as being germane to this particularly since there was unfinished business for MDGs 4 and 5. He noted that the GFF was unique in that it tapped into country’s own resources and connected external donors’ resources and funding around each country’s priorities as well as increased the efficiency of the funding that is available. He highlighted that in the 16 countries currently being financed, half of them were vulnerable health systems. Additionally, the underserved were emerging as priorities, particularly in the areas of sexual and reproductive health and rights, nutrition and adolescent health and care.

Dr. Roopa Dhatt, Director, Women in Global Health provided closing remarks where she emphasized the commonality of the need to engage with the community across the stories shared with speakers. She highlighted the need to truly engage with the people working on the front lines of health systems, particularly women, and ensuring that they are giving the opportunity to lead and change the health systems in which they are working. She concluded the session with a final challenge to panelists and attendees to commit to achieving gender equality in health leadership and to apply a gender lens to their leadership work to ensure more equitable, efficient, effective and resilient health systems.

Speakers (from left to right) Dr. Nosa Orobaton, Dr. Roopa Dhatt, Dr. Jude Nwokike, Samalie Kitooleko, Dr. Ed Kelley, Catharine Taylor (Vice President of the Health Programs Group of MSH)

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