General country health policies
Public policies in the health sector, together with those in other sectors, have a huge potential to secure the health of communities. They represent an important complement to universal coverage and service delivery reforms. Unfortunately, in most societies, this potential is largely untapped and failure to effectively engage other sectors is widespread. Looking ahead at the diverse range of challenges associated with the growing importance of ageing, urbanization and the social determinants of health, there is, without question, a need for a greater capacity to seize this potential. That is why a drive for better public policies forms a third pillar supporting the move towards primary health care, along with universal coverage and primary care (see figure).
The following policies must be in place:
- Systems policies – the arrangements that are needed across health systems’ building blocks to support universal coverage and effective service delivery. These are the health systems policies (related to essential drugs, technology, quality control, human resources, accreditation, etc.) on which primary care and universal coverage reforms depend.
- Public health policies – the specific actions needed to address priority health problems through cross-cutting prevention and health promotion. Without effective public health policies that address priority health problems, primary care and universal coverage reforms would be hindered. These encompass the technical policies and programmes that provide guidance to primary care teams on how to deal with priority health problems. They also encompass the classical public health interventions from public hygiene and disease prevention to health promotion.
- Policies in other sectors – contributions to health that can be made through intersectoral collaboration. These policies, which are of critical concern, are known as “health in all policies”, based on the recognition that a population's health can be improved through policies that are mainly controlled by sectors other than health. The health content of school curricula, industry’s policy towards gender equality, or the safety of food and consumer goods are all issues that can profoundly influence or even determine the health of entire communities and that can cut across national boundaries. It is not possible to address such issues without intensive intersectoral collaboration that gives due weight to health in all policies.
This section of the health system profile is structured as follows:
Decentralization is the major cornerstone of the Government of the Gambia's Poverty Reduction Strategy 2007–2011 to improve service delivery to the poor. Decentralization involves the creation of regional health teams, which currently are headed by directors. Regular meeting between the regional teams is an entry point to revitalize primary health care in the regions.
Public health policies have been formulated by the Ministry of Health and Social Welfare to engage all disciplines for effective management of the population`s health and well-being. The National Health Policy serves as the basis for all other policies in the health sector. The Health is Wealth 2011–2020 Policy covers areas of health system strengthening as well as new inputs resulting from gaps identified in the previous policy.
Reproductive health, drugs and medical supplies, noncommunicable diseases, mental health and the National Policy on Blood Transfusion address specific needs in the sector.
The Social Welfare Policy, the Policy for the Elderly and the Child Protection Policy are currently guiding the delivery of services to vulnerable groups.
The primary goal of the various policies is to provide direction to the Ministry of Health and Social Welfare to deliver on its mandate. At times, lack of funding for certain activities limits the usefulness of these policies.
The importance of a well-functioning health system for the delivery of quality services is recognized and specific policies on human resources, maintenance of physical structures and vehicle management are in place to strengthen the health system.
Health issues are also dealt with in various other policies, the elaboration of which involves health sector actors, including the Education, Agriculture, Trade, Sanitation, Nutrition and Agriculture Policies.
These policies are sometimes not widely disseminated within and between sectors and therefore collaboration is not maximal. Policy updating is also a major weakness of some sectors, leading to delays in implementation of new strategies. The Planning Directorate of the Ministry of Health and Social Welfare should therefore initiate and strengthen intersectoral policy dialogue for the smooth implementation of the health components of policies from other sectors.
Overview of major policy reforms
Public health policies
Health system policies
Policies in other sectors and intersectoral policies
Priorities and ways forward
Endnotes: sources, methods, abbreviations, etc.
- ↑ Systems thinking for health systems strengthening (pdf 1.54Mb). Geneva, World Health Organization, 2009
- ↑ Final report of the mid-term review of the Poverty Reduction Strategy Paper (PRSPII) 2007–20011 (pdf 580.60kb). IMF Country Report No. 11/27. Washington DC: International Monetary Fund, International Development Support Services; 2011