ADVOCACY FOR AN AFRICA HEALTHY COMMUNITIES MOVEMENT

Generally described as the Dark Continent, Africa currently trails behind the rest of the world; its part of world trade is insignificant. While many nations are emerging as a force to be reckoned with; our aircrafts are still waiting on the tarmac unable to fulfil conditions for take off. We must overcome the deep seated effects of slavery and colonization, persistent underdevelopment following independence and an intolerable burden of disease. Good health standards are associated with socio-economic development whilst poverty invariably goes with ignorance and disease. The effects of development on health can be analysed from two levels, namely, macro and sectoral.

When there is overall socio-economic development in the country, its impact on the health sector would include the following: availability of resources (especially finance) to embark on health development; supplies of modern medical technology; increased access of the population to basic health services as well as housing, sanitation, food supply and nutrition; improvements in the quality of life and the health status of the people; changes in production, the distribution of the proceeds of socio-economic development and consumption patterns; and availability of employment opportunities for individuals which would lead to an increase in economic and social well being and, hence, to sustenance of good health status.

Some of the ways in which health contributes to socio-economic development and, hence could be regarded as ‘a prerequisite for socio-economic development’ are briefly summarized as follows: a reduction in absenteeism and, hence an increase in the number of man hours of labour and learning at school; an increase in the quality as well as productivity of the existing labour force; elimination of disease vectors make feasible the development of previously  unsettled regions; changes in the attitudes, habits and behaviour of people and, consequently, promotion of both innovation and entrepreneurship (both ‘qualities’ foster growth creating activities); and mental development i.e. improvement in learning capacity which facilitates human capital development. Because of the linkages between health and development, health development should be considered as an integral part of overall socio-economic development. In order words, socio-economic development policies should incorporate health policies, and strategies to implement socio-economic policies should also foster the implementation of health policies. Because poor health is delaying socio-economic take off in Africa, there is an urgent need for all Africans to engage in the fight for survival.

The development process requires in addition to healthy people, some other factors to bring about socio-economic development: Africa faces the challenges of developing strong resilient health care systems, well managed and sustained by appropriate training and research institutions.

The African Health Development Framework (WHO 1985):
Promotes community health initiatives by individuals, households and community groups or villages;
Recognizes the ‘district’/local council area as the operational unit for organizing primary health care, by district/local health systems with a basic package of services for all communities promoted within the district or local government area;
Encourages linkages between health care and related institutions at all levels of the national hierarchy into a supportive network for health and development.

The joint implementation of health and development activities, which would be mutually supportive, would accelerate the achievement of health for all goals as well as promote millennium development goals. This would be best done in local government areas (or districts) where a partnership can be established between people, their government and development partners.

Africa’s problems are mutually reinforcing vicious circles which must be tackled together in a holistic manner. This is why we need a healthy communities movement for attaining “development through health”. The movement will help ensure that resources for health and development reach local populations; that communities are empowered to participate in project implementation; and in so doing, build their capacities and acquire democratic corporate behaviours, consolidate health related achievements and gain fundamental community benefits. The movement will not seek to create new programmes (a wide spread problem is one of unfinished projects), but will rather contribute to existing community health services, public, private or voluntary, building local capacity through interrelated interventions, especially:
expertise (continuing education of local personnel, supportive supervisions leading to management improvements, operational research (finding solutions to major obstacles), infrastructures/technologies(maintenance/renewal of buildings, maintenance/renewal of equipments, provision of affordable technologies) Sustainable development activities (monitoring, documentation, evaluation of impact of achievements and feedback followed by corrective action).

The UN General Assembly in the year 2000 proposed eight millennium development goals. Three of the eight goals fall squarely on the health sector. Two others are closely related and the other three goals are essential for the achievement of the health goals. The Health Millennium Goals will ensure community benefits – child survival (MDG4), safe motherhood (MDG5), healthy workforce (MDG6). These are linked inseparably with human development (MDGS 2&3), human settlements (MDG7) and human populations (MDGS 1&8).

An African Healthy Communities Movement targeting local councils supports the current decentralisation exercise. It will mobilize African communities in community health and development partnerships for necessary resources, ensuring stewardships for transparent management and identifying effective leaders for community development, targeting the millennium development goals. Communities will meet the challenges of self reliance with the help of support groups, members of community health associations. Twinning between local councils in Africa and other continents as well as help from the African diaspora would be determinant.

The network of actors would include a tripartite of local communities (within council areas), their support structures (national/ diaspora) and “governing” bodies. The actors will undertake mobilization, allocation and tracking of resources, with the help of executive management; sharing the burden of work and targeting excellence. The initiative will promote resource mobilization; ensure transparent management, and leadership. District health team members and district health committees would be briefed on how they would collaborate with District Development Committee members and District Administration officials and vice versa. They will all collaborate with local (community) residents: primary producers of wealth – active in basic education (teachers), in agriculture (farmers), in industry (craftsmen) and commerce (traders) as well as local community based organizations such as youth clubs, women’s groups and workers associations.

The foregoing is the basis for this initiative which is in line with and represents an approach to the implementation of the 1987 Declaration of Heads of State and Government of the Organization of African Unity entitled ‘Health, a foundation for development’ and the 2000 UN millennium development goals. This initiative, development through health, is considered expedient and very urgent since it aims at overcoming a fundamental obstacle to capacity building for socio-economic development in Africa.

The principal network components of this movement would include member communities (local community entities, dialogue structures, and multidisciplinary health experts), support structures (community support groups, health development centres, partner/twin communities), governance and leadership (Honorary Patrons, Board of Trustees, Executive management team).

The Movement Website, maintained by the executive team is the virtual market place. It will link up networks of autonomous groups of actors in many countries and across international frontiers. It would display information on: Resource needs of participating communities, their structures and institutions Goods and services proposed by investors, providers, manufacturers, health and business enterprises.

Resources, goods and services, provided by dialogue support groups at home and abroad, to participating communities.

Modern information and communication technology will link participating communities with community support groups, elites, resource (development) centres and the Board of Trustees.    Broad goals and objectives would ensure that resources reach local populations, whilst improving corporate behaviour, facilitating priority programmes and monitoring community benefits. The movement will assist communities, government and partners achieve project implementation and avoid duplication of efforts.

The expected outcomes of this movement are communities achieving autonomy and self reliance with the support of a network of Africans and friends living at home or abroad. Examples of community initiatives in favour of health and development in Africa include self managed revolving funds for essential drugs and other marketable commodities, drinking water filtration in the control of guinea-worm, community self help for insecticide treated bed nets and window blinds in mosquito control, community-based rehabilitation; IVERMECTIN distribution for the control of river blindness; community participation in child immunization; various income generating community projects like farming, animal husbandry, small businesses, etc. These and similar initiatives would in future be expanded into a holistic framework for tackling together the mutually reinforcing vicious circles that make up Africa’s problems.

 Empowered communities will achieve better health, promoters/ investors will do more business because of increased exchanges and professionals will get better incentives to remain and work at home.

We will all gain and Africa will be the winner!