Stronger Health Partnerships for Stronger Health Systems: The future of health partnerships

“Good morning ladies and gentlemen, I am delighted to be here today. Thank you for the opportunity to share some reflections on the benefits and impact of health partnerships, and how these align closely to DFID and cross-government global health objectives.

I came into my current ministerial role in June 2017, and am immensely proud of the role the UK is playing in international development. We lead the way globally in eradicating extreme poverty, creating global prosperity, strengthening security and good governance, and building resilience.

We live in times of unprecedented challenge, and despite the great progress made to date across some of the Millennium Development Goals and now the Sustainable Development Goals, there is clearly much more to do.

We’ve just heard from Dr Tedros, and universal health coverage is one of the key objectives for the World Health Organisation going forward. Universal Health Coverage is critical to the achievement of Sustainable Development Goal 3, and the UK Government fully supports this global agenda. Particularly crucial for the most marginalised and vulnerable is to ensure ‘no-one is left behind’.

I’ll spend a few minutes describing DFID’s health objectives, including how we work across government to meet these. I’ll describe how health system strengthening is critical in progressing towards Universal Health Coverage, and the central role the health workforce plays within this. I’ll then outline some of the different ways in which DFID invests in health worker training, and the impact and future potential of health partnerships in supporting this work

DFID health priorities and cross HMG working

 DFID has three main health objectives:

• Firstly, by directly addressing key diseases and health needs. This includes TB, malaria, neglected tropical diseases, HIV, family planning, saving the lives of children and mothers, polio and vaccine-preventable diseases.
• Secondly, by tackling threats to global health security including infectious disease outbreaks and anti-microbial resistance.
• Thirdly, by helping countries build stronger, more resilient health systems.

To do these successfully, we also need to work with the international system, especially the World Health Organisation, and to support its reform – which I know Dr Tedros is pushing forwards as he takes up his role.  We also invest in world-leading research and product development.

The Health Partnerships Scheme

The Health Partnerships Scheme is an important part of delivering on these objectives, particularly the third – supporting countries in their own development, by supporting the improvement of their health systems and workforce.

DFID has been pleased to work with THET in delivering the Health Partnership Scheme since 2011.

During this time, as Dr Tedros referred to in his statement, we’ve now seen 180 partnerships delivering 249 projects across 31 countries in Africa and Asia. Over 2,000 NHS staff have volunteered overseas, and trained 84,000 health workers. These partnerships have strengthened the health workforce across areas such as NCD’s, maternal and child health, mental health, surgery and anaesthesia, patient safety and infectious diseases.

This has come about due to our investment of over £30m in strengthening health systems, through supporting partnerships between UK and low and middle-income health institutions, building health worker capacity and sharing skills – and because of the hard work of people like you, and the organisations that support this work.

I am pleased that the new agreement between DFID and THET is in place and starting implementation, and will run to early 2019. The focus during this period is on sustainability, scale-up and access.  We want to ensure that skills and innovation are embedded in a long-term manner, that they can be scaled up across regions and countries, and are always focused on driving greater access to quality healthcare for the poorest people.

This phase of the programme will also enable us to implement key recommendations from an external evaluation of the programme in 2016, which emphasised the need for partnerships to more closely and strategically align with government health system strengthening efforts. This will clearly enhance efforts for outcomes to be sustainable and scalable, reduce risk of duplication, as well as focus a drive on reaching the poorest.

I am also delighted to announce today that I have approved a new programme to take us into the future. This new programme will support partnering between UK and developing country health institutions beyond 2019, through to 2023. I believe in partnerships like yours. DFID is proud to be continuing to support these now, and to make a substantial commitment for the future the benefits they bring to those living in the most underserved communities and also back to our NHS, showing Global Britain at its best.

The new programme is called Stronger Health Partnerships for Stronger Health Systems – emphasising the end result that we are all, together, aiming to achieve.

A competitive process will of course need to take place to identify the precise means of delivery of the programme, and we look forward to sharing details of that with you all over the next few months.

That new commitment and programme has come about because of your work and the impact it has had.

I’d like to turn now to talking about that.  There are some wonderful examples of the impact and longer term sustainability of health partnerships. We heard about some of these in Ethiopia, where this all started nearly 30 years ago, from Dr Tedros.

I also recently heard a great example of the impact partnerships make in Uganda, Liberia, Cambodia and Nepal.

The Royal College of Midwives partnered with developing country midwifery associations in Uganda, Liberia, Cambodia and Nepal to improve midwifery training and care for mothers and children in the places that need it most.

This partnership has contributed to the development of 13 official midwifery protocols to enhance care across the countries, including strategic plans for the midwifery associations.

In addition to this, is has led to the development of 17 medical curricula including masters and associate degrees in midwifery.

The creation of strategic plans, curricula and protocols can help ensure quality care. The training of 362 trainers who have gone on to train 3,620 midwives, highlights the sustainable approach the partnership has adopted.

I have a really inspiring quote from one of the midwives from Nepal:

 ‘With the UK volunteer midwives we have worked together, enjoyed together, shared together amongst us the good things and the difficult things.  We have learned how to work with women in providing respectful, woman-centred maternity care. Nepal needs professional midwives so that no more mothers and babies will die because of the lack of skilled human resources.’

The partnership is strengthening midwifery networks with other health institutions around the world, sharing skills and knowledge, and helping to raise the profile of midwifery and the importance of providing safe, quality care for mothers and their children.

The work of the partnership is improving child health abroad, but it is also improving care at home in the NHS. Volunteer midwives from the UK reflect that the skills they have learnt while volunteering are invaluable and inform their practice in the UK upon their return

But it’s not just the stories and individual examples that matter – powerful as they are. What is most important, are what happens as a result. The evaluation we undertook gave us good evidence on this:

• 92% of tested trainees showing improved skills or performance immediately after training or education.
• Health partnerships have contributed to 516 national health policies and plans, and 114 medical education curricula.
• 198 developing country institutions have improved medical equipment, information and communications technology or health information management systems as a result of the Health Partnership Scheme.

These are fantastic results. I feel truly proud of them – and so should all of you.

The other great benefit of these partnerships is the benefit back to the UK health sector. Volunteers develop valuable health professional competencies including leadership, motivation, teamwork, innovation and resourcefulness.

Finally, I just want to say a few things about the wider Global Health Agenda.  DFID does a lot – as I am learning.  But we cannot deliver global health objectives alone:

• DFID works in close partnership with the Department of Health: I was particularly pleased to see this, given that was where I worked last. We work with the Department of Health on the UK investment into the World Health Organisation, and in particular on ensuring the world has good response to global health emergencies, such as disease outbreaks and the very real challenge of Anti-Microbial Resistance.
• DFID also works with the Foreign and Commonwealth Office – I am a Minister in both Departments. On health, FCO leads the Better Health Prosperity Fund programme, which helps achieve health objectives and promote economic growth in developing countries.
• UK Healthcare promotes the UK healthcare sector to overseas markets as well as supporting the healthcare partnerships we are here discussing today.

All these interventions rely on trained health workers, who are such a critical component of a strong and resilient health system. And health partnerships are a crucial lever in creating that skilled and supported health workforce that is so needed in developing countries.

I hope I have been able to let you all know just how critical health partnerships are to DFID’s and indeed government’s global health objectives.

I am proud of the contribution the UK has made and look forward to building on what we have delivered and learned as we go forward.

Most importantly, I would like to thank you all for the fantastic contribution you have made in making these partnerships happen. Thanks to your dedication, commitment and passion, tens of thousands of health workers have been trained, millions of patients are now receiving better care and long-standing links between UK and partner institutions have been established. Thank you also to THET for continued excellent programme delivery over the last 6 years. We should feel very proud of our achievements!

It’s been a privilege to be with you today, and I wish you all the very best with the fantastic contribution you continue to make both at home and around the world.”