Author: Wendi Lindquist

A WHO report launched in May around the World Health Assembly tackles the issue of noncommunicable diseases (NCDs). The report, titled ‘Saving lives, spending less: a strategic response to NCDs’, makes the case for investing in preventing and treating NCDs such as cardiovascular disease and cancers by calculating the potential cost, cost-effectiveness, and the return on investment (ROI) in terms of deaths averted and economic gain from increased productivity. The report also shows how, if interventions to prevent and treat NCDs are scaled up globally, the world will move much closer to achieving Sustainable Development Goal 3.4; to reduce premature death from NCDs by one-third by 2030.

While NCDs had been considered primarily a problem of the developed world until recently, many developing countries are in epidemiological transition and the rate of NCDs as well as mortality and morbidity due to NCDs are rising on a global scale. NCDs now cause around 71% of all deaths according to the WHO report. In addition, due to the chronic nature of NCDs, treatment is typically long-term and can be expensive; putting a disproportionate burden on the world’s poorest. This new WHO report used cost-effectiveness analysis to make the case for scaling up prevention and treatment; analysis that could be used by policy-makers to advocate for more attention and resources to address these chronic conditions.

Read the WHO press release and the report.

I recently took up a new position in a new programme as the Regional Health Financing and Advocacy Advisor for multiple countries in Africa. In this capacity, my main role is to advocate for prioritisation of women, children and adolescent health in country plans and budgets. Most countries are entirely dependent on donors to sustain these programmes, with few domestic resources allocated to the Reproductive, Maternal, New-born, Child, and Adolescents Health (RMNCAH) continuum of care. Not only am I looking at each country’s allocation, I am also focusing on how to increase efficiency gains in budget implementation; a major challenge in most countries in Africa.

Additionally, my organization has been focusing on building the capacity of citizens, Civil Service Organizations and health care workers to effectively engage in the budgeting and its implementation processes, and this has been taken up very well. Providing evidence that links budget implementation to health outcomes nationally and sub-nationally in-country is influencing leadership and decision-makers. For instance, we linked the budget for blood donation services and the Maternal Perinatal Deaths Surveillance Review and Response (MPDSRR) data, which showed that half of the maternal deaths in one county in Kenya was due to haemorrhage and there was no prioritisation of blood services in the county plans and budgets.  As a result, the governor of the county agreed to prioritise and allocate funds for the construction of a blood satellite centre. However, much still needs to be done to improve RMNCAH services.

The leadership programme has helped me in my new role. Not only have I used the technical aspects such as ‘theory of change’ and others to work towards improving health outcomes of communities.  I have also become more aware of myself when engaging high-level policy-makers such as ministers of health. I have built skills in influencing by negotiating appropriately and pitching issues with senior government officials related to priorities around RMNCAH. I continue to strengthen my capacity in my influencing styles because, at times, I find myself slipping back to my comfort zone – influencing through the use of evidence – being rational. The best part is being aware and working towards the change that one wants.

My policy memo explored how Kenya can ensure quality access to reproductive health services in the context of a devolved system. Access to these services especially for the adolescents in the rural areas is a major challenge; denying them the opportunity to realise their full potential. Certain services such as family planning (FP) are not covered by insurance, neither the public national health insurance fund (NHIF) nor private health insurance in Kenya, and therefore patients have to pay from their pocket to access these services. My recent work has focused on working and advocating for the inclusion of RH services in the national health insurance and private insurance benefit packages. We recently held a meeting with the new minister of health in Kenya to brief her on prioritisation of FP in the NHIF benefit package.

a personal note, my teenagers are growing very fast and they have made me be a better negotiator! I am looking for new pastimes that will keep me busy once they leave for college by 2020. This has made me explore farming and learning how to play the piano, a passion that I have always had since when I was 5 years old. This I believe will help me unwind during my free time. Since December 2017, I have been planting avocado, passion, and tree tomato fruit trees at my farm which is about 50 km from Nairobi. I come from the lower eastern side of Kenya which has fertile soils; however, receives very little rain. It produces very sweet fruits and has some of the sweetest mangoes in the world. Mango season is from December through March each year. I would be more than happy to share the mangoes from northern and lower eastern Kenya  for those visiting around that time of the year.

I think for me the one thing that I have learned since finishing the program, is related to risk-taking and exploring innovative ideas. I can be risk-averse and at times; I would prefer someone else to pilot an idea. Once successful, I would want to pick up the idea for scale-up. In previous assignments this has been the case; where, despite being a risk-taker, I settled in my comfort zone avoiding the risk that comes with exploring innovative ideas. However, since the program, I have been able to receive and adopt innovative ideas from staff.

 

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