Common menu bar links
Institutional links
Proactive Disclosure
Canada and Health Systems
OverviewProgress and Challenges in Health Care
The Crisis in Health Systems
Canada's Response Canada's Partners
Links
Overview
A pregnant woman in Sudan receives a tetanus toxoid vaccine supplied by UNICEF.
Progress and Challenges in Health Care
In the past few decades, health care has improved dramatically worldwide. For each of the successes below, Canada has been one of the top donors that helped achieve the following results:
- Measles deaths have declined by 60 percent since 2000.
- River blindness is nearly eliminated in West Africa.
- Research has shown that insecticide-treated mosquito nets have reduced child deaths by approximately 20 percent.
- More than 2.1 million deaths worldwide have been averted since 1998 because of vitamin A programming.
And yet:
- 1.3 billion people worldwide do not have access to basic health care.
- Every year, lack of proper health care kills an estimated 4.5 million children in Africa.
- More than 10 million women die each year from treatable infections and preventable complications of pregnancy and childbirth.
- The HIV/AIDS pandemic is dramatically increasing demand for health services while contributing to a significant decrease in the health workforce.
The Crisis in Health Systems
Health systems can be defined as the people, institutions, and resources involved in health care activities whose goal it is to improve health.Weak health systems are a key factor impeding progress on reducing the large burden of disease in many low-income countries.
Many developing countries recognize that, at the present rate of progress, they will not reach the Millennium Development Goals (MDGs) by 2015. The MDGs, which range from halving extreme poverty to combatting the spread of HIV/AIDS to reducing child mortality, have galvanized efforts to meet the needs of the world's poor.
One of the biggest challenges facing health systems is the lack of human resources for health (HRH). Without adequate human resources, the health sector has difficulty providing services to diagnose and care for those who become ill, let alone provide low-cost preventative interventions or promote health information to keep people healthy.
According to the World Health Organization (WHO), there is a global shortage of almost 4.3 million doctors, midwives, nurses, and support workers. This shortage is most severe in sub-Saharan Africa, which has one quarter of the global disease burden but only 1.3 percent of the world's HRH. This translates to a ratio of 0.8 health professionals (doctors, nurses, and midwives) per 1,000 people-well below the ratio of 2.5, identified as critical to ensuring that the health MDGs are met.
Canada's Response
First, Canada is stepping up efforts to prevent and control diseases linked to poverty by reaching children and marginalized populations, addressing reproductive-health issues, and reducing inequalities between men and women.
Second, Canada is working with developing-country partners to help reduce the burden of disease on health systems. These mutually reinforcing components of preventing and controlling disease take the burden off health systems while building up the health system to help stop the spread of poverty-related diseases.
Third, Canada is collaborating with other donors to support global health partnerships. These partnerships can take the form of joint funding for large health programs, advocacy, or technical support.
Africa
Africa may provide the clearest example of health systems under stress, but it also demonstrates how nations can come together to remedy a health system crisis. In October 2005, the African Union called for African countries to develop concrete plans to strengthen health systems, including in these key areas:
- human resources
- health system research
- harmonization of donor support
Since Africa carries one quarter of the world's health burden, at the G8 summit in 2006, Canada announced funding of up to $450 million over 10 years (2006-2016) for the African Health Systems Initiative. The initiative will support country-led efforts to help improve the capacity of health systems and make progress toward meeting the MDGs in Africa. CIDA is supporting this initiative in partnership with African countries, multilateral organizations, Canadian and international non-governmental organizations, civil society, and research institutions.
Asia
Asia, particularly South Asia, also suffers from weak health systems because of its large population. In Pakistan, CIDA initiated the Systems-Oriented Health Investment Program (SOHIP) to strengthen health systems and improve accessibility for the poor, particularly women. This comprehensive program supports the overall management of the health system through improved policy development, planning, human resource development, and management and accountability systems.
The project works at the:
- district level, where service delivery takes place;
- provincial level, where policy decisions are taken and key programs are managed; and
- inter-district level, to enhance the exchange of information, ideas, and innovations.
Americas
In the Americas, CIDA is supporting the Health System Development Support project (PADESS) in Haiti. PADESS will contribute to the integrated and consistent development of Haiti's health system by helping regulate and streamline the health service delivery provided by the government, private sector, and religious communities. Specifically, PADESS will build the management capacities of key stakeholders and support a shared vision to improve access to quality health care services.
Eastern Europe
In Eastern Europe, CIDA is supporting Serbia, and Bosnia and Herzegovina through the Balkans Primary Health Care Policy project (BPHCP). This three-year, $7-million project is being implemented by the Canadian Society for International Health and Queen's University. After years of civil war in the region, the BPHCP will support the strengthening of primary health care by focusing on stewardship and delivery in Serbia, and on human-resource planning and regulation in Bosnia and Herzegovina.
Canada's Partners
Canada also supports a wide range of international and Canadian non-governmental organizations, professional associations, universities, and other civil society organizations to strengthen health systems in developing countries. For example, the Society of Obstetricians and Gynaecologists of Canada is working with international partners in Uganda, Burkina Faso, Guatemala, and Haiti to support government health strategies for mothers and newborns. This program is building the capacity of more than 70 qualified instructors and 500 health professionals in the delivery of emergency obstetrical care in lower-resource countries.
Private sector organizations also contribute to health systems. Their contribution can include support for greater corporate social responsibility, expertise in logistics, and supply management.
Links
Related CIDA Sites
Government of Canada
- Health Canada
- International Development Research Centre
- Public Health Agency of Canada
- Global Health Research Initiative
- Canadian Institute of Health Research
Related Sites
- World Health Organization
- Global Health Workforce Alliance
- Health Metrics Network
- WHO Regional Office for Africa
- WHO Regional Office for South-East Asia
- PAHO ― Pan American Health Organization
- World Bank
- African Union (PDF format)
- NEPAD Health Strategy ― Executive Summary (PDF format)
- IFAKARA Health Research and Development Centre
- Health Systems Action Network
- Canadian Coalition for Global Health Research
PDF Format
Note: to read the PDF version you need Adobe Acrobat Reader on your system. If the Adobe download site is not accessible to you, you can download Acrobat Reader from an accessible page. If you choose not to use Acrobat Reader you can have the PDF file converted to HTML or ASCII text by using one of the conversion services offered by Adobe.
African Union (PDF 132 KB, 4 pages)
NEPAD Health Strategy - Executive Summary (PDF, 47 KB, 6 pages)
