NEWS

As part of its strategy to strengthen the hospital sector in the Eastern Mediterranean region, the World Health Organization (WHO/EMRO) has developed a management training program for hospital executives. Having been successfully deployed in Iran, Yemen and Jordan, the program was to be extended to other countries in the sub-region, notably Tunisia.

With this in mind, WHO asked AEDES to help organize a training of trainers seminar, which was held in Tunis from September 9 to 14, 2024. In addition to handling the logistical aspects, AEDES was responsible for mobilizing international experts specialized in various fields. In all, seven specific themes were addressed: (1) Leadership and general hospital management, (2) Human resources management, (3) Financial management, (4) Hospital information systems, (5) Quality of care and patient safety, (6) Supply chain management, (7) Crisis and emergency management.

For one week, each international expert mobilized by AEDES worked in close collaboration with a team of seven national experts, selected by the Tunisian Ministry of Health. This enabled them not only to strengthen their skills in adult education, but also to adapt the training modules to the specific needs of the Tunisian context.

Following this training, the Tunisian teams trained by the experts we have mobilized are now in a position to replicate this hospital management program within the management teams of the country's 180 or so hospitals. Deployment of this training program is scheduled for early 2025.

Find below 3 articles published by Expertise France on evaluation missions conducted by AEDES and financed by EF.

Enjoy your reading 📰

• Evaluation of the improvement of the overall management of tuberculosis and HIV in prisons in Madagascar. Evaluation carried out by two international experts from AEDES between 10/2019 and 09/2023.

• Cross-cutting evaluation on the theme of the management of supplies and stocks of health products (GAS). This evaluation was carried out by the European Agency for Development and Health (EADH) between March 2017 and March 2018. It involved a team of two pharmacist experts specialising in supply and stock management issues.

• Final evaluation of five projects financed by the 5% Initiative to strengthen the skills of healthcare staff. This evaluation was carried out between March and December 2016 by a team of two international public health experts (AEDES), assisted by an educationalist specialising in skills development, and several local consultants.

https://linitiative.expertisefrance.fr/ressource/resume-devaluation-prise-en-charge-globale-tuberculose-vih-milieu-carceral-madagascar/

https://linitiative.expertisefrance.fr/ressource/renforcement-des-competences-du-personnel-de-sante/

https://linitiative.expertisefrance.fr/ressource/gestion-des-approvisionnements-et-des-stocks-des-produits-de-sante/

AEDES' mission

As part of the preparation of its new strategic framework for intervention in health and social protection, AFD has entrusted AEDES, in association with IRAM, with the task of carrying out a capitalisation exercise on its portfolio of activities in health and social protection in the Greater Sahel.

Six countries were involved: Burkina Faso, Niger, Mali, Mauritania, Senegal and Chad. The work, which was carried out by two consultants over a six-month period between 2022 and 2023, involved an analysis of the available documentation, numerous interviews with players on the ground and, finally, several successive brainstorming sessions at head office involving the most senior managers in AFD's SAN division. 

Some results

Over a 10-year period, 47 projects were analysed. They represented a financial volume of €282m. Overall, there has been an increase in the amount invested in the region. However, with the change in the security context and the implementation of the MINKA initiative, as well as the COVID-19 crisis, there has been a paradigm shift, with fewer institutional support projects and more projects led by private entities - international NGOs, Expertise France - as well as an increase in AFD's contributions to multi-donor programmes.

From a thematic point of view, the issue of sexual and reproductive rights was given greater prominence, to the detriment of more traditional projects aimed at improving the provision of maternal health care. Universal health coverage was in vogue for a time, particularly with the Sahel Health Initiative projects, but towards the end of the period interest in this type of project waned. On the other hand, social protection projects such as social safety nets, operated within the framework of multi-donor programmes, made significant progress from 2018 onwards. On this occasion, AFD was able to gain expertise in this area, which had previously been poorly mastered. Finally, the capitalisation process carried out by our consultants has shown sustained interest from stakeholders in the sector-wide approach, with the Common Fund in Niger as a model in the region, which until recent political events remained a benchmark in the Sahel. 

All in all, AFD's health and social protection operations in the Sahel are well aligned with France's 2022-2028 global health strategy.

As part of its project channel, the Initiative launched́ in 2018 a call for projects aimed at strengthening care for populations vulnerable to the three diseases.

Three of these projects were to be the subject of an evaluation after 2022. The special feature of this assessment was that it was carried out entirely remotely, using new information technology resources.

‘AEDES took part in the 6^th Montreux Collaborative meeting on fiscal space, public financial management and health financing towards universal health coverage (UHC), organised by the World Health Organisation (WHO) from 14 to 16 November 2023 in Switzerland.

The meeting provided an opportunity for experts and partners to share their experiences of the role of public financing and public financial management in progress towards UHC, to discuss some of the reforms underway in the countries represented and to draw lessons for improving health budgets. The meeting focused on i) lessons learned from public finance reforms in response to covid19, ii) improving understanding of PFM for effective financing of primary health care, and iii) analysing problems related to budget execution and proposing joint solutions between finance and health. AEDES contributed to the discussions by presenting the study ‘Financial autonomy of facilities providing primary health care services: a review of the literature and expert consultations’ conducted for the WHO in 2023.