Leading the Way: The Health Workforce's Role in Country Ownership

Mesrak BelatchewCountry ownership—defined by the Paris declaration on aid effectiveness and the Accra agenda for action—is achieved when countries exercise effective leadership over their development policies, strategies, and actions. This is particularly visible when countries then translate these policies into prioritized operational programs.

For example, Ethiopia—as well as Rwanda, Malawi, and others—has shown marked improvement in expanding health services to the population and deploying health workers to rural communities. It’s also important that countries coordinate aid levels in conjunction with other development resources—in dialogue with donors—and encourage civil society and private sector participation.

Accelerating country ownership of health programs

In March I attended a roundtable session on country ownership, organized by the Aspen Institute. The panelists included representatives from PEPFAR and the Global Health Initiative, as well as the Ethiopian minister of health. Key messages as well as specific examples from Ethiopia included:

  • Country leadership: The host country’s leadership role is vital for engaging relevant stakeholders toward a common goal. Countries need to make use of the available workforce, in light of developing future health leaders and managers, by providing opportunities to current health workers to lead initiatives and programs.
  • Capacity to drive planning and programming: In general, the health workforce plays a significant role in leading the planning, implementing, and monitoring of the health sector’s responses in a given country. Notably, Ethiopia’s health sector enters into negotiations continually to ensure that any foreign assistance is aligned with the country's short- and long-term needs.
  • Unified planning process: A unified process gathers the yearly district-based plans together with the regional plans and then compiles all of them at the central planning office. This has helped development partners identify key issues for providing assistance to the health sector. Currently underway, Ethiopia is building local capacity to achieve the goal of one national plan, one report, and one budget.
  • Coordinated implementation: Developing countries receive technical and financial support from various sources and funds with multiple earmarks. It is then the responsibility of the countries to guide the coordination process through the effective use of their workforces.
  • Trust: Development partners need to trust the host country’s vision and plan while providing financial and technical support.

Senegalese health workersGlobal and country partnerships
Building local capacity in countries starts with addressing the health workforce crisis. CapacityPlus is partnering with the World Health Organization and the World Bank to develop a retention roadmap and the Rapid Discrete Choice Experiment Tool for assessing health workers' preferences. The tool was implemented in Uganda and will soon to be deployed in Lao People’s Democratic Republic. In these countries, CapacityPlus is also collaborating with the health sector leadership to build health workers' capacity to lead similar activities and facilitate evidence-based decision-making.

Investing in human resources now will address not only the existing crisis, but also serves as a shortcut to strengthening the health system and accelerating country ownership.

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 Photo 1 by Crystal Ng. Photo 2 by Trevor Snapp. (Senegalese health workers)