Helping all peoplelive healthy lives

Country Ownership of Health A Private Sector View

Krista Thompson VP/GM, Global Health, BD

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About BD

Legal EntitiesPlant locationsCorporate Office

(Becton, Dickinson & Co)

Medical technology company

• $7.5B

• 29,000 employees

Four Areas of Focus

1. Reducing the spread of infection

2. Advancing global health

3. Enhancing therapy

4. Improving disease management

Products relevant to HIV/AIDS

AD Immunization Syringes Blood Collection CD4 Testing TB Diagnostics

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Private Sector View of Country OwnershipPresentation Outline

1. Why country ownership is important to the private sector1. Why country ownership is important to the private sector

2. What BD has learned from health systems strengthening efforts2. What BD has learned from health systems strengthening efforts

3. How to leverage private sector competencies to build capacity3. How to leverage private sector competencies to build capacity

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Why does the private sector care about health?

Healthy Economy

Healthy Workforce

Market Development

Healthy Community

Healthy Economy

Needed to develop markets

Healthy Community

Creates a better economy

Healthy Workforce

More productive workforce

For Healthcare companies (like BD)

Functioning Health Systems

Needed for healthcare markets

Specifically large multinational corporations

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Representing the Private Sector

Employee Program

Community HealthcareStrengthening Healthcare Systems

Financial and Project Management Support

Random sampling of just a few companies working in this area

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Country ownership through the private sector lensSome common themes

Critical to sustainability of collective efforts

Define country ownership at the right level Too high—nothing will move forward

Too fragmented—not replicable or sustainable

Attract and build more in-country resources

Needed for effective utilization of resources Must have integrated processes within countries

Define performance metrics at country level for common benchmarks

Help eliminate waste

Not just about what countries should do to take ownership What are we doing to encourage/inhibit effective country ownership?

We need to care about the communities in which we work

“If we define country ownership such that the government serves as the steward for the health of its citizens, we have a chance at success.”

Stefaan VanderBorght, Heineken

“Engagement from associates on the ground is a crucial first step.”

David Pitts, Standard Bank

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Private Sector View of Country OwnershipPresentation Outline

1. Why country ownership is important to the private sector1. Why country ownership is important to the private sector

2. What BD has learned from health systems strengthening efforts2. What BD has learned from health systems strengthening efforts

3. How to leverage private sector competencies in capacity building3. How to leverage private sector competencies in capacity building

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Strengthening Laboratory Systems

DevelopHuman resources

Build Alliances to Develop Local Capacity &

Ownership

Network Laboratories

Ensure Quality

Improve Infrastructure & Maintain it

Introduce New Technology

Develop Leaders

Plan Strategically

Fundamental Building Blocks

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BD/PEPFAR Public Private PartnershipsBuilding capacity in support of ARV programs

Laboratory Strengthening 2007 $18MM over 5 years

ICN Wellness Centers 2008 $1.25MM

Safer Blood Collection 2009 Train up to 10,000 healthcare workers

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Laboratory Strengthening Program

Goals

1. Support country-specific programs to develop laboratory systems and quality improvement strategies

2. Improve the quality of laboratory diagnostics through health personnel training

3. Implement quality control and assurance guidelines

4. Strengthen TB reference sites

5. Improve access to TB diagnostics

Original Framework of MOU

Country Operational PlanMinistry of Health

BDCDCMOH Other

MOA

Work plan

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Laboratory Strengthening Program

Technical Assistance

Process Improvement

Resource Utilization

Strategic Facilitation

Training Classroom and Field

Trainer Mentorship

Quality Management

Specimen Referral

Curriculum Development

Leadership Development

Planning Meeting Facilitation

Project Management

Evolution of activities and outcomes

MozambiqueUganda South Africa Cote d’Ivorie Ethiopia

Implementation Phase Initiation Phase Planning Phase

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ChallengesExecution a bit harder than it looks on the slide

Country Operational PlanMinistry of Health

BDCDCMOH Other

MOA

Work plan

Prioritizing capacity building in the face of short-term crises

Defining what needs to be done and alignment

Getting commitments

Coordinating multiple stakeholder efforts

Keeping commitments

Funding restrictions—due to multiple processes

Per-diem system prevents reaching the “right people”

Budgeting for implementation following successful pilots

Embracing institutional change

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Safer Blood Collection

Started by focusing on one country – Kenya

Launched in June 2010 – pilot training in eight facilities

Post training assessments showed significant improvement

Implementation planning, surveillance, training reinforcement, best practice model development all underway

Country ownership off to a good start

“The MOPHS recognizes the need for partnerships between the private, development partner and the government to achieve its goal of providing quality health services”

“…acknowledge with gratitude the role BD has been playing for the successful implementation of the Kenya Safe Phlebotomy Project”

Improving safety for HCW and patients

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Private Sector View of Country OwnershipPresentation Outline

1. Why country ownership is important to the private sector1. Why country ownership is important to the private sector

2. What BD has learned from health systems strengthening efforts2. What BD has learned from health systems strengthening efforts

3. How to leverage private sector competencies to build capacity3. How to leverage private sector competencies to build capacity

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Private Sector Competencies

Management and Leadership Development

Project Management

Budget Oversight and Financial Management

Governance

Procurement Systems

Human Resources

Communications

Capabilities that may be needed for effective country ownership

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Engaging the private sector in capacity buildingPoints for all parties to consider

INCENTIVES

Demonstrate corporate social responsibility and global citizenship

Boost workforce productivity, morale and attract better employees

Invest in capacity and establish long-term business presence in developing markets

In a global economy, strengthen links with wider range of overseas partners and collaborators

DISINCENTIVES

Need for “quick wins” to overcome skepticism on both sides

Reputational risk of failed programs

Challenging to measure success

Transition to and sustainability of local ownership for program efforts

SUMMARY

Country ownership of health is critical, but is certainly not a one-sided problem

The private sector has 1) an economic and human interest; 2) the needed competencies; and 3) the willingness to participate in building the capacity to make effective country ownership a reality

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Thank You