The second meeting of Directors of Policy and Planning and of Public Health Programs from the Ministries of Health of 27 countries gathered in Kintele, Brazzaville, Republic of Congo, from 22nd to 24th November 2017, to deliberate on how to take forward the Regional Actions Framework on strengthening health systems for UHC and SDGs. They worked along with the WHO technical staff from the Health Systems and Services Cluster at all the three WHO levels as well as staff from other Clusters at the Regional Office;

This followed the First Regional Forum that was held in Windhoek, Namibia from 12th to 13th December 2016. In this Forum, the draft framework was presented and discussed by the representatives of the Ministries of Health from all the 47 countries, the representatives of Development Partners including members of the UN System, representatives of the Regional Economic Communities (RECs), Donors, NGOs and civil society. The theme of the First Forum was “Healthy Systems, Healthy People: Making universal health coverage (UHC) work for Africa”. The Forum then agreed that each year there would be a Directors of Planning meeting to monitor progress on Strengthening Health Systems for UHC and SDGs, and build a sustained platform to continue to exchange ideas, lessons and experiences;

The Regional Actions Framework for strengthening health systems for UHC and SDGs, the product of the Windhoek Forum, was presented to and adopted by  the 67th Regional Committee of Health Ministers in August 2017, in their meeting held in Victoria Falls, Republic of Zimbabwe and the Ministers pledged to support its implementation;

The Directors’ meeting discussed the recently adopted framework and took note of the actions therein for the countries to undertake to move the implementation of the framework forward. The meeting further reviewed the framework in the context of the countries’ current status of health systems, agreed on immediate actions to be taken by countries and identified technical support required from AFRO and WHO at large;

The Directors agreed that for long, synergy between health programs and health system strengthening efforts has been sub-optimal and has been accentuated by the predominant vertical program-based funding. They proposed various strategies to enhance the synergy between health programs and health systems strengthening;

Recognizing the importance of tracking the progress being made over time, the meeting proposed an appropriate monitoring and accountability framework between the Member States in the Region and AFRO. Furthermore, the meeting identified appropriate health systems strengthening investments and platforms for learning and sharing experiences across countries;

The Directors of Planning and those of Public Health from the Ministries of Health welcomed the UHC flagship initiative by the WHO of the African Region and expressed interest to be fully involved in its implementation. The UHC flagship initiative will start with 10 countries and will gradually be rolled out to all countries in the Region, with an additional 10 countries each year.

For the African Region to swiftly make significant progress towards UHC and contribute to attaining the SDGs, and to ensure that no country or population is left behind:

The countries are encouraged to:

• Adapt the framework and develop country specific roadmaps for its implementation
• Review their health sector strategic plans and the health program strategies to ensure their alignment to the thrusts of the Regional Actions Framework for strengthening health systems for UHC and SDGs;
• Review and/ or redefine their essential packages of health care in line with UHC and SDGs;
• Orientate the health service delivery systems to focus on the person in order to optimize synergy between health programs and health systems;
• Assess their health services and systems to establish the baseline as well as identify the key gaps that need to be tackled to strengthen the health systems in their countries;
• Set appropriate targets, strengthen monitoring of progress through periodic reviews for appropriate course of action at policy and programmatic levels;
• Advocate at high levels of their Governments for priority consideration of increased domestic resource mobilization and efficient utilization of both domestic and donor funds to strengthen health systems for UHC and SDGs;
• Explore appropriate ways and mechanisms to strengthen inter-sectoral action and partner coordination to address other determinants of health and to contribute to overall national development

WHO is encouraged to:

• Sensitize the countries on the new Regional Actions Framework adopted at the 67th Regional Committee of Health Ministers;
• Provide countries with the necessary tools and guides to support implementation of the Regional Actions Framework to strengthen health systems in order to accelerate progress to UHC and SDGs;
• Provide technical support to countries to strengthen and build capacity for national health information systems, eHealth and research.;
• Strengthen country capacity for assessment, planning, implementation, monitoring and evaluation for effective implementation of the Regional Actions Framework;
• Provide clear definition of the health programs – health systems interface including appropriate approaches for its operationalization;
• Support sharing of good experiences in implementation of the Regional Actions Framework amongst countries
• Advocate for coordinated support to countries from the partners and donors and support resource mobilization;

It is proposed to hold the next meeting of Directors of the Ministries of Health within one year to allow countries and WHO to report on progress made, share experiences, lessons learnt and agree on the priority collaborative actions for the following year.