FCAS: Delivering UHC in Frontier Economies – Multi Sectoral Approaches
Organized by the Government of Switzerland in Kenya.
Despite the great achievements of the Millennium Development Goals, with over 21 million additional lives estimated to have been saved, achievements have spread unevenly, leaving behind the most vulnerable, both within national contexts, as well as globally. According to the predictions of the 2018 OECD report on the states of fragility, “without action, more than 80% of the world’s poorest will be living in fragile contexts by 2030”. That is, the highest pressure to achieve Sustainable Development Goal (SDG) targets by 2030 is paradoxically left in the hands of the most distressed health systems.
These so-called fragile and conflict-affected settings (FCAS) in fact may offer unique opportunities. “The multiplicity of actors and agendas, typical of disrupted environments, must be turned into strength, i.e., a source of innovation and competition between alternative ways of delivering health services. Risk-taking, frankness, experimentation, operational freedom, speed, and sensitivity to political factors are among the elements needed to foster the systemic recovery of a disrupted health sector”. (Pavignani & Colombo, 2009). However, these states cannot be unlocked by keeping to the same pace and using more of the same approaches to health systems. Innovation is needed at various levels, ranging from accepting new formats of health systems governance or new approaches to service delivery, to operating/promoting a shift in global mentality about social and market behaviour in the health sector, to changing the perception of FCAS from failed contexts to spaces of unusual opportunities and actors.