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Summary of The National Civil Society Health (CSOs) Forum 2009

Introduction & Background
The National Civil Society Health Forum was conceived as a platform where the Ghana Coalition of NGOs in Health and civil society groups in the health sector could come together annually. The purpose was to deliberate on identified current public health issues, critically assess them in the light of government policy, budgeting and actions and interest of individuals and communities and decide on actions to take towards addressing the issues for achieving improved health status for the citizenry. These are presented as Civil Society’s position. The theme for this year 2009 was: Reaching the Unreached- the Role of Civil Society.

Participants
The meeting brought together approximately 50 NGOs from the ten regional branches of the Coalition and three members from each of the 14 Civil Society Networks, for a duration of 2 days.


Meeting Objectives
The objectives of the forum were to:

  1. Bring together active partners in the health sector
  2. Gather information from the presentations on current health issues identified
  3. Compare with the situation on the ground as experienced by CSOs
  4. Make recommendations to the government to inform the preparation of the 2010
  5. MoH Program of Work

Opening Remarks
The Opening Session of the Forum was chaired by Dr. Elias Sory, Director General of the Ghana Health Service. He indicated that the major purpose of the Forum was to create a platform for Civil Society Organizations (CSOs) operating in the health sector to deliberate on health issues and assess the inputs that can be made by CSO to further improve health delivery to the people of Ghana. The Director General said that it was clear that the State could not provide effective and efficient health care all by itself, and that the role of Civil Society in partnership with the State should be well defined and acknowledged to help the country achieve its health goals.

Welcome Address
In her welcome address, the Chairman of the Ghana Coalition of NGOs in Health (the Coalition), Dr. Cecilia Bentsi, stressed the unfortunate situation in health service delivery where varying degrees of inequality exist as a result of inadequacies and mal-distribution of resources (both human and financial), poverty, stigma and discrimination, and over reliance on the state sector. CSOs could make a difference as they are closer to the people and therefore, the state will deliver better if partnerships with CSOs are institutionalized.

Goodwill Messages Message from the Embassy of the Kingdom of Netherlands.
The Embassy of the Kingdom of Netherlands in its message emphasized its belief in the role of civil society in the overall development of the state and the need to support civil society organizations. The Embassy has therefore supported a number of CSOs through the G-RAP and other programs and specific health areas such as maternal health. The Embassy indicated that in 2008, its support to the Coalition was a result of the fragmentation and weak nature of CSOs operating in the health sector which limited their participation in effective dialogue with the state. The Embassy acknowledged the need for diversity in dialoguing on issues affecting the country. The Coalition now seems to be gaining more vibrancy and is active during the Ministry of Health (MOH) annual Health Summits. It is also becoming more “visible” through its issuing of press statements on topical health issues. This and its timely reporting on collaborations with the Embassy have justified the support. There is however the need to do more by;

Message by WHO Country Representative
WHO emphasized its appreciation to the Coalition for making it part of the process of its formation and development. It made it clear that the role of CSOs is critical in achieving health goals in the country especially in this situation where assessments indicate that only six (6) African countries are on track to achieving Millennium Development Goal (MDG) 4 and no African country is on track to achieving the MDGs. Sustaining progress can however be achieved only through strengthening health systems, improving and expanding primary health care. WHO recognizes the role of CSOs in responding to the needs of the vulnerable in the society? This critical role of CSOs is represented in the roles and recognition given them in the Global Fund and IHP+. The increased allocation of resources at the global level to NGOs/CSOs is a demonstration of international recognition of the role of CSO in sustained development.

Theme Address by Dr Esther Ofei Aboagye, the Director of the Institute of Local Government Studies (IGLS)
Dr. Esther Ofei-Aboagye, Director of the Institute of Local Government Studies (ILGS). In a speech that put into perspective the theme for the Forum, she indicated that everyone had the right to the necessities of life such as health, shelter, adequate food, well-being, security, freedom of movement, participation in decision making and others. Government, however, has the responsibility of providing and facilitating the provision of these necessities.

However, government’s has evolved over the years due to challenges such as post-colonial availability of the requisite resources, external economic impacts on health care, emergence of new diseases in the face of environmental challenges, and persisting issues of poverty, tradition, custom and belief in health and well-being. The role of Civil Society thus becomes central in efforts to reach those geographically unreachable, the socially marginalized, and the vulnerable in society. CSOs must also come to understand their role and consider the best ways to make major and positive impacts. Being closer to the people (both geographically and by association) CSOs have a key role to play in health delivery services through: Information dissemination and advocacy; filling the gaps not covered by state institutions; research for purposes of effective and efficient advocacy; and entry into communities that the health delivery authorities are unable to.

The public [government] must rely on civil society to reach the unreached. CSOs in order to be effective, must work with and be integrated into the sustainable institutions of the state which have the mandate and the responsibility to ensure efficient, equitable, accessible and sustainable quality of life for all.

Presentations
The Forum was organised in two parts; Symposium Sessions and Parallel Sessions. The
Symposium Sessions had eight (8) presentations delivered. These were;

  1. National Health Insurance: The Challenges and the Way Forward - Mr Patrick Apoya (CONIWAS)
  2. The National Health Insurance Scheme (NHIS); Involving CSOs for Greater Impact – Dr. Lydia Dsane-Selby (National Health Insurance Authority)
  3. Overview of the National HIV and AIDS Response – Mrs Cecilia Lodonu Senoo (SWAA Ghana)
  4. Responding to Challenges in Mental Health Delivery – Dr. Akwasi Osei
  5. Promoting Neonatal Health; the Role of Civil CSOs – Dr. Alexandra Osafo
  6. Increased Substance Abuse and its effect amongst the Youth in Communities – Mr Alphonse Amanor, SVD
  7. Promoting Adolescent Rights including Health Delivery: The Role of Civil Society Organisations (Gaps Identified, Achievements, and Constraints) – Mr Albert Wuddah-Martey (PPAG)
  8. Strategies for Promoting Adolescent Health and Development in Ghana – Ms Rejoice Nutakjor (Ghana health service).

There were two parallel sessions as indicated below.
Parallel Session 1

  1. Regulation of Traditional Health Practice in Ghana –Mr F.K. Hlortsi-Akakpo (Traditional Medicine Practice Council);
  2. Integrating Planning at the Decentralised Level –Mr Kwame Quandahor (PPMED, Ghana Health Service); and,
  3. Health Law, Regulations and Ethics – Dr. Divine Ndoubi Banyubala.

Parallel Session 2

  1. Private Sector Contributions to Health (in Sub-Saharan Africa) – Dr. Derek Nii-Armah Aryee;
  2. Occupational Health Hazards: Role of Civil Society – Mrs Rosemary Anderson Akolaa (ISODEC); and,
  3. Nutrition: Reaching the Unreached – Mrs Kate Quarshie (Nutrition Department, (Ghana Health Service).

The Way Forward after 2nd Forum
At the end of the Forum, there was an open forum where participants were given the opportunity to comment on the content, organisation, and delivery of this second Forum. The self assessment was to offer the organisers and the Planning Committee of the Forum the opportunity to hear first hand, comments on their organisation and performance. The following are some of the major issues raised by participants.

  1. Parallel sessions need not necessarily be presentations but could be discussions by members on selected topical areas.
  2. There was a call from the Ghana Health Service for CSOs in Health to initiate a forum between themselves and other stakeholders such as the GHS.
  3. Prior to the forum reports from Regional Forums should be used as areas for further discussion. This will make the Regional Forums more attractive and taken more seriously.
  4. The theme for the Coalition’s forum should be in line the theme of the National Health Summit in the same year so that conclusions reached could fit into the Health Summit. There were too many papers presented thus giving very little time for contributions from participants. In future Forums it was suggested that either the duration of the Form be extended to three (3) days, or the topics be limited to allow for more discussions during plenary.
  5. Selected topics for future forums should also be addressed by two presenters; one from the public sector and one from CSOs. This will offered divergent views on issues and stimulate more productive discussions.
  6. The forum could also be used as a platform to award high performing CSOs during the year. A criterion could be developed for assessing the performance of CSOs who may wish to participate.
  7. To sustain the occurrence of this forum every year, it was suggested that efforts be made to jointly plan the forum with MOH. This could further enhance collaboration between CSOs and the state sector.
  8. In future forums, time should be allocated for the review of recommendations and declarations made during the previous Forum. Results from these reviews could be input into the forum to enrich discussions of the development of the Forum and the Coalition as a whole.
  9. Invitation for participation should be expanded to include other coalitions such as the National Coalition for Persons with Disabilities.

Closing Remarks
In her closing remarks, the Dr Cecilia Bentsi, Chairman of the Board o Trustees of the Coalition was grateful to all participants for their immense contributions to the successful end of the 2nd Forum. She indicated that it was the responsibility of Civil Society to pursue partnerships with both government and leadership of CSOs must be more proactive in forging closer relationships with all partners.

Communiqué of the 2nd Civil Society Forum
We, the participants of the second Civil Society Health Forum, (from the 22nd to 23rd of
September 2009):

  1. Having affirmed our commitment to efficiently and effectively engage and dialogue with political leadership in ensuring that the health concerns of the people of Ghana are given the requisite priority;
  2.  Focusing more on persons and group of persons who by virtue of their circumstances and conditions are limited in accessing good health care;
  3. Advocating on issues that limit the equitable access of the most vulnerable in the Ghanaian society to good health;
  4.  Building and developing our collective strengths and improving the quality of partnership with government at all levels and Development Partners;
  5.  Advocating for the equitable distribution of national and external resources, and monitoring resource mobilisation, allocation and utilisation at all levels of government; and
  6. Acknowledging efforts by the Government to enhance performance within the health sector through legislation and institutional reforms and also State acknowledgement of the role and contribution of the private sector within the health delivery system; do hereby agree to the conclusion of this Forum and issue this communiqué as follows;

Decision Point 1:
Government in acknowledging the contribution of Civil Society to health delivery in the country should ensure that health data collected are disaggregated to reflect the contributions of Civil Society/private sector to health delivery in Ghana.
Decision Point 2:
Government should as part of the review of legislations governing the National Health Insurance Scheme create adequate space for the contributions and input of Civil Society.
Decision Point 3:
Government should back up its policy of making health services adolescent-friendly, to improve adolescent health and development with financial commitment for effective implementation of the policy. This could significantly reduce maternal and neonatal mortality.
Decision Point 4:
Government should ensure the active participation of Civil Society Organisations in Regional and District Health Management Team (R/DHMT) meetings and establish institutionalised partnerships with Civil Society working within the health sector if health issues are to be addressed holistically, and reflect the views and contributions of all beneficiaries.
Decision Point 5:
Government should expedite action on the passage of the Mental Health Bill, the Occupational Health Bill and the Allied Health Bill if health care is to be delivered in an efficient and effective manner.
Decision Point 6:
Government should begin the process of setting up a fund, drawn directly from the Consolidated Fund, for health activities and interventions being led by CSOs.
Decision Point 7:
Government should review existing health laws and address gaps in them to ensure their harmonisation for efficient health service delivery at all levels.
Decision Point 8:
Civil Society Organizations should focus on developing their human resource base as well as building the requisite skills and capacities to operate efficiently and effectively in the health sector, in order to enhance their capacity to attract resources.
Decision Point 9:
Civil Society Organisations should document their activities and achievements to serve as reference points for attracting resources.
Decision Point 10:
Civil Society Organisations need to position themselves to reflect the views, perceptions, and opinions of communities, to ensure quality health care and equitable access to health care within the structure of the NHIS at both the national and local government levels.
Decision Point 11:
Civil Society should advocate for Consumer inclusion on the National Health Insurance Commission.
Decision Point 12:
Civil Society Organisations to lead the efforts to educate and sensitize communities and individuals to debunk myths and superstitions/misconceptions that negatively affect the health of pregnant women and the unborn child.
Decision Point 13:
Civil Society Organisations need to integrate “adolescent friendliness” components into their programs and activities.
Decision Point 14:
Civil Society Organisations should submit their service data for inclusion into the National data, to reflect clearly the contributions of Civil Society and the private sector to health delivery. This will justify the inclusion of Civil Society Organisations and the private sector in the Ministry of Health’s planning process.
Decision Point 15:
Civil Society Organisations should identify and address issues that generate mistrust between Civil Society Organisations and state institutions.

 

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