Advocating for Health Systems Strengthening

It is imperative for health policy to engage in advocacy. This can influence key policy decisions and directions at national, regional and global levels to realise societal objectives for population health.

The COVID-19 pandemic, while a devastating crisis, has exposed and aggravated structural weaknesses of health systems worldwide and consequently validated the argument for investment in health systems strengthening to prevent, prepare, and respond to future pandemics.

We witnessed several hospitals with strong surgical systems in place being able to increase the hospital capacity in terms of space, staff and supplies needed for safely admitting a large number of critically ill patients with COVID-1917 We can affirm therefore that surgical and anaesthesia professionals and systems are essential to any pandemic response. If the pandemic has precipitated a key policy window for the health systems strengthening agenda, it should include surgical and anaesthesia care.

In a post-pandemic world, we can build back better equitable and responsive health systems and thereby decrease disability and mortality from all diseases. In fact, we have another chance to motivate global and national investment in the health systems using the six WHO building blocks and make significant progress towards SDGs.

Health systems strengthening is central to KidsOR’s strategic, research and policy agendas. We have aligned our strategic objectives and operations with the WHO six building blocks framework. In addition to the structural interventions that can address accessibility and surgical quality, we have sought to engage health leadership at global and national levels with evidence to inform robust health planning and policy-making processes.

During 2022, KidsOR held multiple advocacy events, including the roundtable ‘Systems not symptoms: Tackling the root causes of the global health crisis’ held in the Houses of Parliament in London. Key global health figures, such as Dr Neema Kaseje, Founding Director of the Surgical Systems Research Group in Kenya and visiting surgeon for KidsOR and for Doctors Without Borders, discussed the role local surgical capacity and expertise plays in strengthening the wider health system. We have also had the opportunity to interview Global Surgery champions such as Professor Emmanuel Makasa, to raise awareness to audiences beyond the surgical world.

Moving forward we will continue to advance surgical care systems strengthening and advocate for health systems strengthening. We will engage in policy as well as advocacy, as well as coalition building and collaboration with different partners in global surgery. We aim to create resilient and well-financed healthcare systems, that are agile in responding to health challenge and able to sustainably invest in their own health workforce training programs.

KidsOR, WHO Bulding Blocks, and Health Systems Strengthening

Operating Rooms

Service Delivery

Access to Medical Products, Vaccines and Technologies

Scholarships, Training & E-Learning Platform

Health Workforce

Advocacy & Policy Initiatives

Financing

Leadership/ Governance

Data Collection & Research

Financing

Health Information Systems

References

1. NCD Countdown 2030: worldwide trends in non-communicable disease mortality and progress towards Sustainable Development Goal target 3.4 https://pubmed.ncbi.nlm.nih.gov/30264707/

2. Kucchal T, Pigeolet M, et al. International organisations in global surgery: challenges and opportunities. Journal of Public Health and Emergency.2020

3. World Health Organization. Global action plan for the prevention and control of noncommunicable diseases 2013-2020. World Health Organization; 2013. https://apps.who.int/iris/handle/10665/94384

4. World Health Organization. Everybody’s business–strengthening health systems to improve health outcomes: WHO’s framework for action. Geneva, Switzerland: World Health Organization; 2007.

5. World Health Organization. The World health report: 2000 : health systems : improving performance. World Health Organization, 2000. https://apps.who.int/iris/handle/10665/42281

6. Belli PC, Bustreo F, Preker A. Investing in children’s health: what are the economic benefits? Bull World Health Organ. 2005 Oct;83(10):777-84. Epub 2005 Nov 10. PMID: 16283055; PMCID: PMC2626422.

7. Meara JG et al. Global surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet. 2015

8. World Health Organization. (2022). Third round of the global pulse survey on continuity of essential health services during the COVID-19 pandemic: November–December 2021: interim report, 7 February 2022. World Health Organization. https://apps.who.int/iris/handle/10665/351527

9. Potentially Avertable Child Mortality Associated with Surgical Workforce Scale-up in Low- and MiddleIncome Countries: A Global Study (2021) https://pubmed.ncbi.nlm.nih.gov/34110458/

10. Leisinger KM, Garabedian LF, Wagner AK. Improving access to medicines in low- and middle-income countries: corporate responsibilities in context. South Med Rev. 2012 Dec;5(2):3-8. Epub 2012 Dec 27

11. Access to medicines and vaccines: Report by the Director-General [A72/17]. World Health Organization; 2019. http://apps.who.int/gb/ebwha/pdf_files/WHA72/A72_17-en.pdf?ua=1.

12. From the first mile to the last: Challenges of the global surgical supply chain https://www.ncbi.nlm.nih.gov/ pmc/articles/PMC7983454/

13. WHO global report on trends in prevalence of tobacco use 2000-2025, fourth edition. Geneva: World Health Organization; 2021.

14. Yap A, Muzira A, Cheung M, Healy J, Kakembo N, Kisa P, Cunningham D, Youngson G, Sekabira J, Yaesoubi R, Ozgediz D. A Cost-Effectiveness Analysis of a Pediatric Operating Room in Uganda. Surgery. 2018 Nov;164(5):953-959. doi: 10.1016/j.surg.2018.03.023. Epub 2018 May 23. PMID: 29801729; PMCID: PMC6399742.

15. WHO. WHA 68.15: Strengthening emergency and essential surgical care and anaesthesia as a component of universal health coverage (2015).

16. Spicer N, Agyepong I, Ottersen T, Jahn A, Ooms G. ‘It’s far too complicated’: why fragmentation persists in global health. Global Health. 2020 Jul 9;16(1):60.

17. Carenzo, L., Costantini, E., Greco, M., Barra, F.L., Rendiniello, V., Mainetti, M., Bui, R., Zanella, A., Grasselli, G., Lagioia, M., Protti, A. and Cecconi, M. (2020), Hospital surge capacity in a tertiary emergency referral centre during the COVID-19 outbreak in Italy. Anaesthesia, 75: 928-934.

The KidsOR Global Advocate Network is for individuals interested in volunteering with KidsOR and would like to be part of a network that gives them the opportunity to ask any questions they may have, find out ways in which they can volunteer and interact with their fellow volunteers.

A global advocate can volunteer in a variety of different ways, utilising their social media to spread awareness of current global health issues advocating for KidsOR’s work getting involved in fundraising activities within their community.

Does this sound like something you would be interested in?

Then scan the QR code and fill in the global advocate network application form.