Regional conference on ‘Health districts in Africa: Progress and Prospects 25 years after the Harare Declaration’ – Dakar, 21-23 October 2013

Bruno Meessen & Belma Malanda

In one month from now, an unprecedented meeting will be held in Dakar, featuring district medical officers, national directors, researchers, technical assistants, social entrepreneurs and innovators. The aim is to rethink local health systems in West and Central Africa. The program looks very promising, to say the least.

Twenty-five years after the ‘Harare Declaration on Strengthening District Health Systems Based on Primary Health Care’ (1987), it is time to reflect on the role of health districts (also known today as “local health systems” or “health zones”), their design and implementation as well as the upgrade that needs to happen in the context of a fast changing Africa.

Experiences in several countries have shown that the health district system was a suitable platform to implement the strategy of Primary Health Care. It will also play a key role in the implementation of Universal Health Coverage through equitable and effective coverage of populations and high coverage of essential interventions, and by facilitating greater responsiveness to the needs and demands of local populations.

Therefore, in order to look back on the past 25 years, take stock of the current situation and above all, make projections for the future with players on the ground in African countries and their partners, the Health Service Delivery Community of Practice, in collaboration with several HHA agencies (UNICEF, WCARO, WAHO, WHO, etc.) and Because Health, and with the financial support of the French Muskoka Fund, will hold a regional conference on the 25^th anniversary of the Harare Declaration. The event will take place in Dakar (and not in Saly, as originally planned), from 21 to 23 October 2013.

The organizing committee is currently finalizing the program (you can access the provisional program here). We are looking forward to three days of intense reflection on local health systems.

Among the many topics covered, we can already mention: the consequences of urbanization in Africa on the organization of local health systems, the challenge of integrating the private for-profit sector, experiences with medicalization of first line services, a new vision for community action, the role Performance Based Financing and contracting can play in the management of local health systems, the challenge of the multisectoral approach…

The conference will be largely based on the intervention proposals that have been submitted by African experts, more in particular through the communities of practice of Harmonization for Health in Africa. The selection turned out to be quite difficult as the quality of the submitted proposals was generally high. No complaints there, of course. Our final program will thus feature experiences from many countries in Africa, from Western and Central Africa of course, but also from East African countries. We owe this enriching mix of experiences to researchers and to projects supporting health districts, but also to several district medical officers who have innovative experiences to share.

In Dakar, we will also have the pleasure to welcome several international actors who will show us that local coordination of health providers is a universal challenge. The country delegations will be invited to develop a new vision for their local health systems.

Therefore we expect intense exchanges built on diverse experiences but also a conceptual update (over the past 25 years, there have also been a number of developments at the conceptual level)

Of course, we will keep you abreast of all these developments on this blog and through the online Google discussion group of the CoP. This is a long term project that will not end when the evening falls on October 23, obviously…  We count on your thoughts and contributions, even if you can’t join us in Dakar.