On 15-16 April, the Initiative Prospective Agricole et Rurale (IPAR), a local think tank working at the regional (i.e. West African) level, gathered stakeholders from various fields in Dakar, Senegal. Reflections and discussions focused on results of a pilot research project led by the think tank on measurement of efforts to reach health-related SDGs in three countries: Senegal, Burkina Faso and Ghana.
Funded by Canada’s International Development Research Centre (IDRC) and implemented with the support of the West African Health Organization (WAHO), the project was undertaken through collaboration with the West African Network of Emerging Leaders in Health Policy and Systems (WANEL).
Both the research project and the workshop followed up on a 2017 call made in the same city (Dakar) for establishing a regional and multi-stakeholder platform to reflect and act upon the SDGs. It is a remarkable (and unfortunately, still fairly rare) initiative in the region to collaborate in order to reach common goals and improve people’s lives.
The multi-country study considered eight health-related SDGs (SDGs 2, 3, 5, 6, 7, 11, 13 and 16) and aimed to (i) identify common indicators (i.e. in the respective countries), (ii) examine data availability of relevant indicators and (iii) suggest approaches to improve national and regional monitoring of indicators.
The workshop brought together research teams and stakeholders from civil society, research and policy makers to reflect on the results. In light of the results of the study on Burkina Faso, Ghana and Senegal, participants from the 15 West African countries reflected on their own country experience and assessed how the sectors in which they are working could take up the SDG challenge.
From the workshop, it emerged that countries in the region have not (yet) fully embedded SDGs in the different processes and systems of the health sector. West African countries are in fact at different levels when it comes to (health) SDG implementation of goals and indicators in their national plans, some have done so to a certain extent, others have not done so at all (for example, if their national plans were adopted before 2015, supposedly to last for a decade). There is still a need for information, training and capacity building on the subject for those who work for the government.
From the perspective of researchers, data collection and validation needs to be carefully prepared and planned. Currently, in Senegal, there’s only on 53% of indicators of health related SDG goals & targets information. Ghana (40 %) and certainly Burkina Faso (21 %) perform even worse. One key point would be to leverage cooperation across diverse sectors, so as to receive data from different ministries and government agencies, as it is recognized that health-related SDGs cut across many sectors.
For civil society, the SDGs pose the challenge of building a strong coalition able to dialogue both with government and researchers and echo what happens on the ground. The example of the Ghana Civil society platform on SDGs represented by its secretary at the Dakar workshop, was largely cited and praised as a good practice that should be replicated in all countries.
The SDGs in West Africa: the broader picture & some of the current challenges
Since 2016, sub-Saharan countries have embarked on the journey (or is it a race?) towards SDGs attainment. It’s no different for West Africa. While SDG 3, “Ensure healthy lives and promote wellbeing for all at all ages”, clearly focuses on health, many other goals (listed earlier) address aspects related to health and wellbeing. The SDGs are thus transversal, requiring collaboration across government agencies and ministries, adding an extra layer of complexity as compared to the MDGs. Looking back at this MDG era, which didn’t really go well in West Africa, one could fear the story might repeat itself. It will be important to make sure that the SDGs do not suffer the fate of the MDGs.
Overall, in an ever more connected world, cooperation between ministries and countries will be needed to reach the SDGs, but also exchange and peer learning at regional level.
As for some of the current challenges in the region (in addition to the unfinished MDG agenda, and new ones like the NCDs):
*Recent Ebola outbreaks and epidemics strongly raised the issue of (national and regional) preparedness and responsiveness to adverse events. It is now important, in light of the discussions of the meeting, to question and improve preparedness and responsiveness of our health systems, and make according changes in development goals and policy choices.
*It is worth noting that the region has a certain number of fragile and conflict-affected countries (as per the World Bank classification); 7 of the 15 countries in the region have a Fragile States Index of more than 90 points (i.e. firmly in the ‘warning’ zone, and even close to the ‘alert’ level), according to the Fund for Peace. Recently, health systems researchers, donors and other actors from the region have also pointed to the increasing fragility in the region, among others due to the terrorist threat and the increasing impact of climate change, and set up a working group to try to take this into account in future HSS initiatives. For the time being, it’s clear that this increasing fragility in the region doesn’t bode well for achieving the SDG agenda by 2030.
WANEL’s role in the SDG (health) agenda
After this short update on the current (SDG and other) challenges in the region, let’s quickly go back to the workshop. All in all, discussions were extremely inspiring and informative. Participants agreed and pledged to establish (and operationalize) a multi-stakeholder platform, i.e. one that would necessarily involve actors from diverse backgrounds and perspectives. In a way, this implies that WANEL basically got it right from the beginning!
For the ones among you who are not familiar yet with WANEL, WANEL’s history began in 2015 under the visionary leadership of Professor Irene Agyepong and her team. It is part of a larger initiative on health systems strengthening in the West African region called COMCAHPSS (Consortium for Mothers, Children, Adolescents, and Health Policy and Systems Strengthening). The network encourages collaboration between emerging leaders from diverse backgrounds. It welcomes all competences and currently gathers researchers, policy makers, practitioners, journalists and faculty members. French and English speakers meet up and collaborate, and efforts are being made to also have Portuguese-speaking countries represented.
The common goal is to strengthen the field of Health Policy and Systems Research (HPSR) in the region, especially in some countries, where it’s still fairly weak. As we build the field, we also aim to generate relevant evidence and work towards its dissemination and use by policy makers.
Speaking of which, discussions and reflections during the workshop clearly highlighted the crucial need for evidence generation, communication and use to inform policy making in order to improve people’s lives. There is thus ample room for networks such as WANEL to make a significant contribution to the attainment of the (health related) SDGs in the region. This could be done even better by creating avenues for collaboration with institutions and other stakeholders, as shown during the implementation of the IPAR project. Without any question, the SDG challenge in West Africa will be tough, but WANEL is more than ready to contribute and try to improve the lives and health of West African people in the years to come.