2009 Volume 24 Issue 4 Pages 299-308
On 8 March 2009, the Workshop on Infectious Diseases Control Programmes and Health System Strengthening (HSS) was conducted in the 24th East Japan Regional Conference of the Japan Association for International Health. This article reports the discussion in the Workshop and the internet-based open forum that followed.
After four presentations reflecting on the field-based experiences regarding the relation between disease-specific programmes and HSS, following three aspects were discussed: 1) health system-wide barriers perceived through the implementation of disease-specific programmes; 2) shortcomings of the disease-specific initiatives in light of the HSS; and 3) how the disease-specific initiatives can contribute to the HSS.
As the system-wide barriers, insufficient quantity and quality of health human resources, lack of health infrastructure and material resources and limitation of the technology applicable to community level of developing countries were commonly perceived. Shortfall of disease-specific programmes in light of the HSS included the lacked coordination between different programmes and donors, duplicated heavy workload put on community health workers especially in recording and reporting, dissociation between local health needs and programme priorities, lack of contributions to strengthening mid-level health administration, deviation of resources to the priority programmes and lack of sharing of potentially sharable material resources. It was proposed that the disease-specific initiatives should contribute to resource mobilization, programme management models, capacity building of mid-level health administration, supplementing personnel cost and presenting hardware and software outcome resources to the HSS.
The disease-specific initiatives need to pursue the above mentioned practical contributions to the HSS. At the same time, a wider scope addressing political and policy-wise justifications of the form of the overall health system needs to be further discussed with developing countries stakeholders.