20 October 2017-Mbabane: The Ministry of Health, with support from the World Health Organisation (WHO) conducted a sensitisation workshop for technical officers as well as senior officials on the Sustainable Development Goals (SDGs).

The theme of the workshop was: “Making Health Systems Work for Swaziland”. The workshop was in two phases. The first phase included a one day training for Ministry of Health technical officers which was held at Bethel Court Hotel on the 4th of October. The meeting was facilitated by Dr Humphrey Karamagi who is the Health Systems and Services Regional Advisor for the WHO African Region. Public health programme managers, health facility managers, nursing matrons, senior medical officers and hospital administrators attended the workshop. 

The second phase was a high level orientation session held on the 6th of October at Happy Valley Hotel. The session was facilitated by Dr Delanyo Dovlo who is the Director of Health Systems and Services for the WHO African Region. Among the participants were policy makers, senior government officials, heads of development and the Parliament Health Portfolio Select Committee. Present during this meeting were the Minister of Health, Honourable Senator Sibongile Ndlela-Simelane, United Nations Resident Coordinator Mr Israel Dessalegne, WHO Country Representative Dr Tigest Ketsela Mengestu and other heads of United Nations Agencies. 

The purpose of the workshop was to provide a platform for senior health systems technical officials, policy makers and key stakeholders to review, discuss and coordinate the country’s health systems strengthening efforts towards attaining the health SDGs through Universal Health Coverage (UHC). The objectives of the workshop were to sensitise participants on the regional and global instruments on Health Systems Strengthening the SDGs and for UHC; agree on the roles and responsibilities of the health sector in implementing SDGs and UHC; agree on mechanisms for monitoring country’s systems strengthening efforts and progress of SDGs implementation to impact UHC and to engage with partners and donors in supporting health systems strengthening in the context of Swaziland. 

Participants in the technical meeting were taken through the WHO - AFRO integrated Health Systems on SDGs and UHC. The aim for this integration is to move from focusing on the six building blocks to improving performance in the health sector. This means, a shift from vertical implementation of the six building blocks to horizontal integration and identification of options and making sure that service areas respond to population needs through resilient health systems. 

The technical team admitted that achieving Universal Health Coverage comes with some challenges. These include funding constraints of government and equity of care – thus funding does not only serve as a constraint on its own but becomes a great barrier to ensuring equity of access to health. This calls for the need to mobilise funding from other domestic sources without relying on only government sources.

The technical group identified various sectors needed to support the health sector for attainment of health goals. They also suggested the focus areas for inter-sectoral interaction. They identified how successes should be measured within the six domain areas. The roles and responsibilities of other sectors and agencies are expected to help the Ministry of Health achieve total wellbeing for all people living in Swaziland. The meeting also identified the focus areas for the various sectors and how the successes of these sectors could be measured. 

The meeting discussed what in their view constitute essential services and the need to priorities efforts to improve mobilisation for domestic funding in order to provide these essential services.  On the implementation framework of the SDGs and Universal Health Coverage, a number of questions emerged such as how to align with the different stakeholders (collaboration), advocacy to set up a central point that can convene directors in other sector, stakeholder mapping and engagement, governance and having clear direction, as well as building a resilient health system.

On the other hand, the high level meeting took the form of panel discussions, looking at the roles and responsibilities of the Ministries of Economic Planning and Health as well as the United Nations and other donor partners.  At the end of the meeting the participants realised the importance of planning and working together towards achieving UHC and how the Ministry of Health needs to explore priority health issues in other sectoral policies and mainstream those policies into the national development plan. 

Addressing the meeting the Minister of Health emphasised the importance of shared values and common understanding of policies as a basis for implementing the SDGs. The minister further mentioned that measuring progress on the implementation of the SDGs is critical. She therefore advised that a monitoring and evaluation plan be developed. The UN Resident Coordinator pledged the UN’s commitment to continue playing its coordinating role and support with capacity development and technical assistance to enable the attainment of UHC. It was clear that there is need to improve policy and planning in the health sector, ensuring clarity and understanding and making sure that health goals are in line with the National Development Strategy. There is need put mechanisms in place for accountability and national coordination framework. In this way the health sector will be able to achieve a universal coverage that creates wealth and well-being for all. 

The meeting agreed that going forward, the Ministry of Health would need to periodically engage with other sectors on how best to take the discussions forward. This will call for orientation workshops for other healthcare workers; engage frontline health workers to make them understand how these SDGs interact with each other. The Ministry will also need to engage Health Training Institutions – through curriculum reviews to incorporate the principles of the SDGs. Again, as the Ministry reviews the current strategic plan, they need to review the health indicators to reflect the SDGs. The Ministry needs to plan and work together with other sectors and to have regular health sector assessments based on the SDG framework.

Finally, the Ministry of Health, the WHO, the Ministry of Finance and the Ministry of Economic planning will have to come together to move this agenda forward.