Learning from the past: HIV, TB and the Science of Service DeliveryPATRICK OSEWE
WORLD BANK
JULY 24, 2014
Why is HIV so important?
HIV is unprecedented among epidemics A persistent pandemic that has global reach Garnered sustained global attention for more than a
decade More money mobilised than any other disease Generated many useful lessons for service delivery and
access
What we have learnt from HIV?
Strategic planning
Drug procurementM&E
Civil society involvement
Universal access
Life-long treatment
Targeting high risk groups
Gender Advocacy
ResultsDonor/government involvement
CostingModes of transmission
Behaviour change
Efficiency
What did we learn from reproductive health?
Health systems
M&E
Civil society involvement
Equal access
High risk groups
Gender Advocacy
Results
Donor/government involvement
Behaviour change
How to learn lessons? The example of the Science of Service Delivery Problem-driven approach Context sensitive Feedback loops, evidence and knowledge Multi-sectoral and multidisciplinary approach Adaptive leadership and change management Partnerships
Application to HIV and TB in the mining sector TB in the mines an emergency for 100 years Driven by poor living conditions, occupational risks,
circular migration, and, most recently, HIV Multi-sectoral, cross-border problem Public and private sector cooperation essential
Science of Service Delivery: solutions Targeting of high-risk groups Migrant outreach, multiple countries Testing and extension of occupational health services Contract tracing and family/community involvement Community mobilisation Stakeholder coordination Multi-sectoral, multi-partner approach All have common features with aspects of the HIV response
The South Africa Knowledge Hub Established between the World Bank and the Government of South
Africa in 2012 To extract best practices from South Africa to share with other
countries To bring international best practices to this region Establish a platform for consistent and productive south-south
knowledge exchange Eg, Knowledge Hub events in Pretoria (Sept 2013), Melbourne
(July), Cape Town (Oct)
The South Africa Knowledge Hub (2)
The way forward Encourage active participation by practitioners, implementers, and policymakers:◦ Identify and document lessons learnt – failures and successes◦ Assisted documentation through support services◦ Share experiential knowledge and disseminate best practices◦ Writing and publication workshops
THANK YOU
CONTACTS: ◦ Patrick Osewe, World Bank ([email protected])◦ Hannah Kikaya, Strengthening Health Systems