PAHO/WHO COUNTRY COOPERATION STRATEGY 2004 -2007 GUYANA

1. PAHO/WHO COUNTRY COOPERATION STRATEGY 2004 -2007 GUYANA Dr. Bernadette Theodore Gandi Guyana Day October 4, 2004

2. What is a Country Cooperate Strategy CCS? • Expresses WHO’s corporate strategy at country level for the medium term 3 – 5 yrs. • Represents a sound balance between country needs, regional and global priorities • Constitute a framework for WHO cooperation in and with the country concerned • Clarifies WHO’s role at country level in supporting broad based development approaches, Poverty reduction and sector programs

3. CCS: guiding principles • Being more selective – fewer priorities • Fostering strategic thinking • Performance of WHO secretariat versus Member States • Ownership by the entire Organization; guardianship by the PWR • Deepening “preferred partner” relationship • Working with development partners based on our comparative advantage.

4. Why did Guyana conduct a CCS? • Challenges to Technical Cooperation • Opportunities in Country • Time to undertake a critical review/evaluation of work done • Re-define vision • Re-align Country Office to achieve vision

5. Opportunities • Guyana is a beneficiary of the HIPC initiative • A priority country in the PAHO Strategic Plan • Focus on MDGs • Benefits from a significant increase in bilateral donor aid in the last two years • Thematic groups in priority areas including health to monitor and evaluate implementation of the PRSP • PAHO/WHO provides the secretariat to the Theme Group on Health chaired by the Minister of Health • Re- assignment, End of Contracts, migration within country office

6. Country chapter on the Health in the Americas • Health Systems Profile • Health Sector Analysis • National Health Plan 2003 – 2007 • Evaluation of the Essential Public Health Functions • Poverty Reduction Strategy Paper • National Development Strategy Methodology • Identification of Team • Desk Review of Documents • First Mission: Consultative • Complementary data from other partners

7. Methodology Second Mission: • Defining PAHO/WHO strategic agenda for Guyana • Conducting a performance audit • Gap analysis • Integration

8. Critical Development Challenges • Governance: including continuing political conflict and escalating violence • Widespread poverty, inequity and disparities between social, ethnic and geographic groups • Migration of qualified professionals, including teachers and health professionals • Slow economic growth and lack of investment

9. Critical Health Challenges • Selected NCDs: Cardiovascular diseases, diabetes and asthma • Major communicable diseases - HIV/AIDS, malaria and tuberculosis • Maternal and child health, reproductive health issues, nutritional deficiencies and ARI

10. Critical Health Challenges • Mental disorders, especially depression and substance abuse • Unintentional and intentional injuries • Reduction of behavioural and environmental risks, including occupational health hazards

11. Health Sector Development Strategic Issues • Establishing clear priorities for which services will be provided using public resources • Improving the managerial capacity of the sector in order to increase productivity and quality • Developing a human resource policy and plan for the sector

12. Health Sector Development Strategic Issues • Strengthening of public health leadership and advocacy capacity • Improving availability and access to information on epidemiological situation and system performance for policy and planning • Addressing the inequitable access to health care

13. External Assistance Challenges • Imbalance in distribution of health development aid • Low absorptive capacity for health development programs in the public sector • Development agency drive for short and medium term results may sacrifice long term sustainability

14. Challenges for Country Office • Providing technical leadership in public health • Supporting/facilitating partnerships amongst development partners to achieve common goal • Technical Capacity

15. PAHO/WHO Strategic Agenda For Guyana VISION: By 2007, PAHO/WHO will be the lead international technical partner for health development in Guyana, recognized by all actors working for health in the country as an honest broker and the premier source of technical guidance and information in public health.

16. MISSION To provide technical leadership in public health and bring together a wide range of local, regional and international partners to strengthen national capacity for health development.

17. VALUES PAHO/WHO’s work in Guyana is based on a belief in the rights of all individuals, irrespective of gender, race, age, religion or sexual orientation to basic conditions for health and on the values of the Organization.

18. WHO COUNTRY FUNCTIONS • Function 1: Supporting long-term implementation of routine activities • Function 2: Catalysing adoption and adaptation of technical strategies; seeding large-scale implementation • Function 3: Supporting research and development; monitoring health sector performance

19. WHO COUNTRY FUNCTIONS • Function 4: Information and knowledge sharing; providing generic policy options; standards; advocacy • Function 5: Providing specific policy advice; serving as broker; influencing policy, action, and spending

20. Strategic Directions • SD1 Reducing excess mortality, morbidity and disability, especially in poor and marginalized populations. • SD2 Promoting healthy lifestyles and reducing risk factors to human health that arise from environment, economic, social and behavioural causes.

21. Strategic Directions SD 3 Developing health systems that equitably improve health outcomes, respond to people’s legitimate demands, and are financially fair. SD4 Framing an enabling policy and creating an institutional environment for the health sector.

22. Order of Priority • F5 Providing specific policy advice; serving as broker; influencing policy, action and spending • F3 Supporting research and development, monitoring health sector performance • F4 Information and knowledge sharing; providing generic policy options; standards; advocacy • F2 Catalyzing adoption and adaptation of technical strategies; seeding large scale implementation • F1 Supporting long term implementation of routine activities

23. Greater Emphasis on … • Influencing policy, action, and spending • Brokering role • Provision of technical evidence to support shifts in policies/strategies • Filling data gaps • Monitoring health sector performance • Building capacity for evaluation • Resource mobilization

24. Function 5 Providing specific policy advice; serving as broker; influencing policy, action and spending Rational • Multiple donors Skills need • Ability to create strategic alliances • Networking and negotiating skills • Technical capacity • Information management

25. Function 3 Supporting research and development; monitoring health sector performance Rationale: • Commitment to MDGs • Fundamental function to support F5 Skills needed: • Increased technical capacity to collect analyze data to identify inequities • Increased capacity in development of indicators of success

26. Function 4 Knowledge in information sharing and providing specific policy advice Rationale: • CO must offer evidence based advice, examples of best practice • Tailor messages to specific audiences e.g. counterparts/policy makers Skills needed: • Social communication and advocacy

27. Function 2 Catalyzing adoption and adaptation of technical strategies Rationale: • CO: hub for organizational knowledge regarding technical solutions • Aware of relevant initiatives in priority areas that have been implemented in other areas • Seek opportunities to tap into activities of other development agencies that can be of mutual benefit Skills needed: • Increased – Advocacy Programme Implementation Networking Skills

28. Function 1 Supporting long term implementation of routine activities Rationale: • Direct technical support to routine programs on an on-going basis e.g. EPI • Strengthening national capacity to manage programs Skills needed: • Program Planning and management • Human Resource Management • Epidemiology

29. RECOMMENDATIONS • Review the human resource capacity of the CO • Increase in financial resources of the CO • Integrating project funds into main stream programs

30. Addressing Weaknesses • Review Basic Agreement with the GOG to ensure that it is supportive of the CCS • Communication Strategy to be developed • RE-aligning administrative support to provide M & E • Defining the cost of technical cooperation to Guyana

31. Implication for PAHO/WHO • Success factors • The locus responsibility for all technical cooperation activities is the country office • Technical cooperation defined at the country level with support from RO and HQ • Increase mobilization and sharing of resources (financial and technical)

32. Actions to date • Post of Health Systems Advisor filled • STP Epidemiology recruited • STP for Maternal and Child Health recruited • STP to address malaria issues recruited

33. SUMMARY • Many challenges • Many opportunities • One Goal • One Team • TOGETHER WE WILL MAKE A DIFFERENCE