Bamako logoRegional Conference on “Health district in Africa: Progress and Prospects 25 years after the Harare Declaration”

Organized by the Community of Practice Health Service Delivery in conjunction with HHA agencies and Be-Cause Health

October 21 – 23, 2013 in Saly, Senegal

Abstract submission deadline: May 15, 2013 midnight (CET +1)

Submit your proposals to:

Selection notifications will be e-mailed to submitters by June 30, 2013

Abstract submission is now open for the Regional Conference on “Health district in Africa: Progress and Prospects 25 years after the Harare Declaration”. We welcome abstracts for oral presentations or posters. Please mark your calendars for this conference. 


About the Conference

Twenty-five years after the “Harare Declaration on strengthening the district health systems based on Primary health care” (1987), it is time for some reflection on the health district system (also known today as “local health system”), on how it has been formulated and implemented in Africa and on the necessary updates in a fast changing continent.

The experience from several countries has shown that the district health system is an adequate hub to implement the Primary Health Care (PHC) strategy. It will also be a key building block in the new agenda of Universal Health Coverage by ensuring an equitable and effective coverage with essential interventions.

Yet, there is also a need to move away from a perhaps too ‘administrative’ vision to a more open one involving new actors such as civil society groups, private providers and households themselves.

The overall objective of the 2013 Conference is to have “a fresh look on the role of the Health District (local health systems) in achieving universal coverage for essential interventions and its implications”.

The conference will identify what has changed in Africa, in terms of context, needs and practices, compared to 25 years ago. It will identify the implications of these changes for the health district strategy in African countries.  It will highlight innovative approaches and explore their relevance for the whole continent.

Conference attendees

The conference will bring together over 100 experts, including district managers, clinicians, policy makers, public health specialists, scholars, technical assistants, NGO representatives, health activists and community actors.

 About this call: topics and related sessions

“The Local Health System (LHS) can be conceived as an operational and managerial space that is situated at the meso level in the national health system. It is situated at the balance of two important considerations. Firstly, the LHS needs to be, at the same time, “sufficiently large” – out of efficiency considerations and given the need to come to economies of scale – and sufficiently “small” so as to guarantee social proximity with the population / community the LHS serves. Secondly, the LHS is in terms of planning situated at the interface between top-down planning (from the central level and from specific programs, with a focus on essential interventions) and bottom-up planning on the basis of locally felt needs. It is at that level that these two planning logics meet and need to be optimized.” (Bart Criel 2013)

The conference program will consist of keynote speakers, plenary sessions, parallel sessions, working groups and poster presentations. We refer interest persons to the concept note of the conference: District health in Africa: Progress and Prospects 25 years after the Harare Declaration. (Full concept note of the conference available here.)

The organizers welcome submission of propositions for the parallel sessions and poster presentations. Submissions will be orientated towards the main focus of the conference, and more particularly the following topics and focuses:

a)      Convergence between the Harare and Tunis declarations: planning and allocating resources for accountable, efficient and equitable local health systems.

Focus: the health district is expected to organize the synthesis of the national policy and priorities with the demands coming from the local communities. We are looking for theoretical, methodological or actual experience contributions susceptible to guide on how to reconcile the concern for ‘value for money’ and equity at national level with the need for responding to local needs and demands. The different stages of the cycle (consultation, formulation, prioritization, planning, budgeting, purchasing, monitoring, evaluation and reporting to citizens) can be covered. Technological solutions are welcome. Presentation should be relevant for an audience of local health cadres.

b)      Regulation, incentives and coordination of health actors for performing pluralistic local health system: how and by whom?

Focus: in many countries, the health district systems have often been implemented with a too restrictive focus; complexity of the local settings (e.g. cities) and the variety of health actors have been overlooked. We are looking for African experiences which have been successful in (1) aligning private / loosely regulated providers on public priorities such as effective, quality, efficient and accessible health services, including preventive ones; (2) coordinating providers in urban settings; (3) developing partnership on high impact interventions with non-public health actors; (4) building on recent intragovernmental decentralization; (5) granting greater autonomy to public health facilities. Effectiveness and replicability will be key criteria.

c)      Individuals, households and the community as co-producers of their own health: an untapped potential?

Focus: in many countries, the health district systems have focused on health facilities and tapped insufficiently the possible contribution of communities: their preferences, agency and creativity. We are looking for original operational strategies to empower individuals, households or communities in the provision of curative, promotional, preventive, or rehabilitative services in low or middle-income countries. Presentations should provide evidence on effectiveness and replicability, but also cover implications for the local health system actors, including the district management teams and first and second-line health facilities. Experiences involving technology are welcome, if it involves local health managers.

d)      Doctors in first line health services: opportunities and challenges.

Focus: because of the scarcity of skills and a top-down planning approach, the approach so far in sub-Saharan Africa was not to appoint medical doctors at first line services. We are looking for reports from countries which have loosened this restriction. Attention can be on implications in terms of human resources for health (e.g. career management), definition of the package of activities, teamwork, relationships with district management teams or hospitals…

e)      Inter-sectorial collaboration (social determinants of health).

Focus: maybe because of the focus on health facilities, the health district system has mainly consisted in defining and implementing standard package of activities, without much room for flexibility at local level  Economic growth in Africa will lead to more non-communicable diseases, more unhealthy livelihoods and greater health inequity; this may require to update the package of activities. More fundamentally, this transition calls for innovative strategies addressing social determinants of health in low- or middle income African countries, with a particular attention on how to engage at local level with other sectors, such as education, welfare, agriculture, industry…

f)       Quality of care: obstacles and opportunities for patient-centered care

Focus: in some countries, the health district has been implemented as a quite bureaucratic strategy, with insufficient attention to professionalism, client responsiveness and integration of services. We are looking for knowledge on how to implement patient-centered care in sub-Saharan Africa; experiences of management of chronic diseases in poor resource settings are welcome; focus should be on implications on the organization of local health systems and health care facilities. 

g)      Capacity building strategies for stronger district management teams

Focus: the health district system postulated a strong capacity of district managers to arbitrate priorities and take the most from the local context to the benefit of the health of the district population. In some countries, managers have adopted a rather administrative mode, with limited commitment, creativity and initiative. We are looking for scientific presentations on experiences on how to build capacities of health district management teams in poor resource settings. Lessons should focus on initial diagnosis, objectives, implementation issues and results.

h)      Roles of technical and financial partners to strengthen local health systems.

Focus: health district projects were quite popular in the nineties among aid agencies. The role of aid actors has evolved over the last 25 years. We are looking for new ways of strengthening local health systems, especially by addressing weaknesses of the standard project approach and by taking into account the new aid environment.

Abstract submission instructions

You are invited to submit abstracts for oral or poster presentations. Slots for the parallel sessions are limited. The organizers will select and orientate presentations according to the quality of the proposition and the coherence of the contribution in the overall agenda of the event. Presentations by African experts are particularly welcome.

You do not need to be a member of the Community of Practice service Delivery (CoP HSD) to submit an abstract. However, if your abstract is accepted for presentation, the presenting author MUST become a CoP HSD individual member (it will be our main channel for communication, before, during and after the conference).

Applicants are strongly recommended to read the concept note of the conference to understand the objectives, focus and spirit of the event.

Submission of an abstract implies a commitment to present at the Regional Conference, therefore, please make sure you understand the requirements before submitting an abstract. Speakers based in Africa and without institutional support will receive priority in terms of assistance to cover the costs of the conference (travel and conference fees).

Please follow the abstract guidelines:

1. Please submit abstracts using the official form by May 15, 2013. Access the abstract submission form from here.

Incomplete forms will not be accepted. Submit completed form by email to Dr. Belma Malanda   at

2. Proposals are sought for two kinds of presentation:

    • An individual paper for oral presentation for which an abstract of no more than 1,000 words (two A4 pages)
    • A poster presentation for which an abstract of no more than 200 words is required.

Abstracts accepted for the Regional Conference on Health District may be presented in the form of either an oral or poster presentation.

 3. Abstracts must be submitted in English or French. Oral presentations will generally be allocated 15 minutes, followed by 5 minutes for discussion. Poster presentations will be provided with space for one board; there will be time for conference participants to tour the posters.

4. In your abstract, do not include tables, graphics or illustrations. Please spell out abbreviations and acronyms when first used. Structural parts should summarize the main results and conclusions of the work (Background, Methods, Results, Conclusion).

5. If you would like to discuss the content of your abstract please contact the organizing committee of the conference (see the list of persons at the end of the concept note) or contact them at


Abstract review process

All submissions will be peer-reviewed by selected international reviewers to assist the organizing committee in the final selection of papers. The members of the organizing committee will make their selections for the program based upon the scores and comments submitted by reviewers and the possible coherence of the whole conference. Their decision will be notified to the main author by email in late June 2013.

Each abstract will be reviewed according to the following criteria: (1) implications for health services organization at local level; (2) relevance to the theme of the conference; (3) relevance for the audience of the conference; (4) quality of the evidence reported; (5) clarity and completeness of abstract.

Additional criteria:

6) Is the practice innovative?

7) Is the design of the practice appropriate?

8) Can the practice be used in other countries/settings?

9) Are there lessons to be learned?

We look forward to your participation and encourage you to share this Call for Abstracts announcement with your colleagues and within your professional network.


For questions or any inquiries concerning abstract submission and/or participation grants, please contact the Conference Secretariat at 

Annex: Abstract submission form

Please complete the submission form (download pdf from here) and return it to You will receive a confirmation from us. Resubmit your abstract if you do not get our confirmation message. Please remember that the final deadline for receipt is Wednesday May 15, 2013 midnight (CET +1). Abstracts received after this date will not be considered.  


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