Returns on investments in health are low where governance issues are not addressed. Bribery, corruption, and inefficiency undermine health care delivery and contribute to poor health outcomes. If hospitals fall apart because the repair funds are stolen, if a mother is not able to get medicine for her child without paying a bribe, if counterfeit and sub-standard medicines are sold without any regulation, the poor pay most heavily for it, often with their lives and the lives of their children.
Poor governance happens all over the world, and the Middle East and North Africa (MENA) is no exception. Voice and accountability help communities to be involved in decisions and as a result hold their governments accountable for health care delivery. Citizens in the region recognize the necessity for greater transparency and accountability
“With the Arab Spring, we have an opportunity to think outside the box, to promote more participation and more engagement in decision-making,” said Dr. Ahmad Galal, Director, Economic Research Forum, Egypt, and former Chair of the MENA Health Policy Forum.
The momentous events in the MENA Region reflect the desire of citizens to challenge political and economic exclusion, to have a say in their governments, and to benefit more equitably from economic and social development in their countries. “There is a need to strengthen the quality of public governance in the Middle East and North Africa,” said Marilou Bradley, Senior Operations Officer, World Bank Institute (WBI). “Governments must become more accessible to citizens who have a stake and want to participate in state processes, and citizens must hold their governments to account on the use of their authority and public funds.”
To bridge this gap between governments and citizens and create an enabling environment for human development and social stability, the MENA Health Policy Forum (HPF), an independent, non-profit research organization brought together state and non-state actors from twelve countries in the MENA region at the first Regional Multi-stakeholder Symposium on Improving Governance and Accountability in Health Systems from June 8-9, 2012 in Tunis, Tunisia. The symposium created a safe space for the participants to engage with each other and share experiences about improving the governance of health systems within the region.
“The Arab Spring has taught us that it is not business as usual. It has taught us to not come with any forms of restrictive and prescriptive policies, but to learn to listen to regional and national experiences,” said Dr. Tamer Samah Rabie, Senior Health Specialist, World Bank MENA Human Development Unit (MNSHD).
Moving Forward With a Plan
Representatives from governments, civil society organizations, academia, the private sector, and media formed national teams to identify concrete actions to improve governance of the health system in their countries. The teams designated national champions who could sustain this work through continued coordination and communication in their countries. Some participants said the symposium motivated them to continue working on these issues in their countries.
A report along with key recommendations of country delegations and partners will be shared with symposium participants. Additional multi-stakeholder dialogues and knowledge exchanges are being planned to sustain the dialogue and learning beyond the event.
The MENA HPF 2012 Regional Symposium was organized by the MENA HPF in partnership with the MNSHD, the Health Systems Practice of the World Bank Institute (WBIHS), and the MENA Regional Office of the World Health Organization. Support was also provided by the International Development Research Center, the Global Health Research Initiative, and the UK Department of Health. Countries represented in the symposium include Algeria, Egypt, Iran, Jordan, Kuwait, Lebanon, Morocco, Saudi Arabia, Tunisia, Palestine, Yemen, and United Arab Emirates.
Watch a Video: “The Voice of the People: Aspirations for the Future”