Transcript How HIV Successes Have Improved South Africa’s Health Care

Learning from the past:
HIV, TB and the Science of
Service Delivery
PATRICK 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?
Behaviour change
Universal access
Strategic planning Civil society involvement
M&E
Costing
Targeting high
risk groups
Drug procurement Modes of transmission
Advocacy
Gender
Efficiency
Life-long treatment
Donor/government involvement Results
What did we learn from reproductive
health?
Behaviour change
Civil society involvement
Health
Advocacy
systems
Donor/government involvement
Equal access
Results
Gender
M&E
High risk groups
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
([email protected])