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BMZ Health Sector Strategy

(Health Division)

Framework, principles and thematic areas of German Development Aid for Health

Dr A Stadler – Senior Advisor GTZ Health SectionFebruary 2009

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Introduction

BMZ Health Sector Strategy:

• Conceptual framework for the German Development Aid for Health

• Framework for programme and project type support

• Guidelines for cooperation with partner countries and organisations

• Information tools for the public

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Introduction (2)

Health is mainly determined by:• Effective preventive and curative health

services, health promotion, and rehabilitation• Healthy living conditions, such as water,

housing, nutrition, education• Peace, security and social and economic equity

The current BMZ Health Sector Strategy deals mainly with elements related to health promotion

and health services

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Health Systems

• All organizations, institutions and resources in a country dealing with health

• Public and private sector

• Promotional, preventive, curative and rehabilitative measures

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Health Systems (2)

• Services to be needs-orientated, equally distributed (coverage) and accessible for all

• Performance depends on– available resources (finance, human resources

and infrastructure)– governance (respect of human rights, corruption,

rights of beneficiaries, support)

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Some Essential Components of Primary Health Care (PHC)

• Equitable distribution

• Community participation

• Inter-sectoral cooperation

• Appropriate technology

• Availability of support mechanisms

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Main thematic areas of BMZ Strategy

Health System Strengthening:• Decentralised organization, respect of good

governance principles and human rights• Sustainable health system financing and social

protection in health• Capacity development for planning and

management, training and research• Human resources for health• Infrastructure and technologies

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Main thematic areas of BMZ Strategy (2)

Health System Strengthening (2):• Poverty alleviation through extension of PHC

coverage• Quality and equity through support to different

levels of health system organization - Focus on “horizontal” approaches and on the “district health concept”

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Main thematic areas of BMZ Strategy (3)

Disease Control:• Support to specific or disease targeted actions

via national (bilateral) or via global (multilateral) programmes

• Vertical organization only if appropriate, focus on integration / systemic approach

• AIDS, Malaria, Polio and other Neglected Diseases

• Support to research (but mainly through other Ministries)

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Main thematic areas of BMZ Strategy (4)

Fight against HIV/AIDS (cross-cutting issue):• Special focus of German development aid• Disease control (prevention, diagnostic, treatment,

research)• Social and psychological support• Target group specific activities with focus on

protection of women and children• Mainstreaming HIV into all relevant sectors of

German Development Cooperation

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Main thematic areas of BMZ Strategy (5)

Sexual and Reproductive Health and Rights:• Special focus of German development aid• Family planning, prevention of STI• Safe motherhood (including safe abortions)• Empowerment of young women and girls /

sexual education• Activities related to harm reduction and post-

care (including FGM)• Mainstreaming SRHR into all relevant sectors of

German Development Cooperation

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Core Principles“Health as a Human Right” based approach:• Core elements of this approach:

– Equity in access to and quality of• Health services• Health information• Healthy living conditions

for poor and other marginalised groups– Essential part of poverty reduction strategy

• BMZ supports health system approaches focussing on these core elements

• Governments have the duty to enable the right to health for their people

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Instruments for Implementation (1)

Bilateral Instruments:• Financial Cooperation• Technical Cooperation

– Technical Assistance – Temporary Staff Secondments / Substitution– Voluntary Service (Public, Faith-based organizations)– Capacity Development (Universities, Development

Agencies, Private Sector…)

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Instruments for Implementation (2)

Multilateral Instruments:

• Financial support to international organizations and Global Health Institutions and Initiatives (e.g. IHP, P4H)

Support of DAC-Criteria like:

• Increase of PBA, SWAp-support, Sectoral and General Budget Support, Basket support, Pooling arrangements

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Strategies for Implementation (1)Cross-Cutting Approaches:• Health as Human Right• Focus on inter-sectoral cooperation and mainstreaming of

health related activities (e.g. HIV/AIDS, Health of Children, SRHR) into other sectors (e.g. water, education, civil sector development, decentralisation)

• PHC strategy as essential part of health system development including disease control aspects

Private Sector Support:• Activities implemented through NGOs and faith-based

organizations• Activities implemented and co-financed through private

business (PPP)

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Facts and figures on German Cooperation in Health (1)

• Actually 17 priority countries of cooperation in the health sector – 7 in SSA

• Health related activities in about 58 countries – 21 in SSA

• Major input on different aspects and different levels of health system strengthening in about 30 countries – 15 in SSA– But health system strengthening and PHC part of almost all

integrated approaches (including those with a focus on HIV/AIDS, SRHR or Social Protection)

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Facts and figures on German Cooperation in Health (2)

Development of the German Bilateral ODA in Health (in Million Euro)* without HIV/AIDS, SRHR and Social Protection

2005 2006 2007

Total 7208,9 6890,3 6827,0

Social Infrastructure and Services

1985,9

(27,5%)

2250,6

(32,7%)

2399,0

(35,1%)

Health*Basic Health

Systems / PHC

117,5

68,6

131,3

67,5

156,3

93,6

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Thank you!