A mission to supervise the activities of the Governance Pool of the Cadre de Concertation, de Coordination et d'Actions de plaidoyer de la Société Civile (3CAP-Santé) visited Saint-Louis Thiès, Kaolack, Ziguinchor and Dakar (Pikine and Guédiawaye) to monitor the implementation of activities carried out in the various zones.
The team was made up of staff from ENDA Santé, NPI EXPAND, STP and the two sub-recipients, the Association des Femmes Médecins du Sénégal (AFEMS) and the Réseau National des Personnes vivant avec le VIH (RNP+), in collaboration with members of local committees in the above-mentioned areas. During the mission, she met with administrative and local authorities (governors, local elected representatives, MCR, MCD, Departmental Council, civil society players and grassroots community organizations) to assess and discuss with them the results, effects and challenges, gather recommendations from the players concerned, and discuss the outlook for the 3CAP-Santé initiative.
Based on the information gathered in the field, the team observed the implementation of good practices at several levels. Experiences at local level, which show that health stakeholders are working hard to improve health governance and leadership.
Good governance practices observed in the field
Since our training on health governance and leadership, we've improved a lot in terms of reporting, sharing information, holding regular meetings and involving young people in our activities. We now share our activity reports with the MCD and the prefect. Our members also attend our meetings regularly and on time.Khoudia Sylla, member of the Association des relais Polyvalents/Soxali sa Gox in Thiès
In Saint-Louis, we met Souadou Faye at the Goxu Mbacc health post. She is President of the Regional Network of Community Health Actors. In addition to sharing the knowledge acquired during the governance training with the members of her network, Souadou Faye says she has taken a big step forward with her members.
We have decided to organize the renewal of our governing bodies. I can say that it was the training on health governance, organized by the Governance Pool of 3 CAP-Health, that was the trigger for starting this process, and we have already informed our members.Souadou Faye, Bajenu Gox at the Goxu Mbacc health post.
Beyond these experiences, the supervisory team noted in certain zones perfect examples of collaboration and effective participation of civil society in the local health effort. In Thiès, for example, the young scouts who benefited from the training went out to meet the CDS in their area.
We made them understand the role we intend to play in these bodies from now on. They were a little wary, but after several discussions they understood that we were in this together. Since then, we attend and participate in the monthly meetings.Mor Ndiaye, Regional Commissioner of the Muslim Scouts and Coordinator of the Thiès Headscarf Movement
Better still, these young people take the initiative and organize weeding awareness sessions in cemeteries and health posts.
Local committees, an advocacy and promotion mechanism for 3CAP-Santé
Another positive effect of the Governance Pool's activities in the areas visited is the promotion of 3CAP-Santé and its activities among administrative, health and local authorities. 3CAP-Santé's initiatives through the Governance Pool are now on the agenda of local authorities. Even if in some areas the commitments made by the authorities are slow to materialize, we have noted a clear willingness to support the local committees in their mission.
In Thiès Est, the municipality is aware of the dysfunctions noted in the CDSs. As part of the solution, it has suggested that municipal councillors should be given training in the texts governing the functioning of the CDSs, to enable them to exercise their role and responsibilities correctly. Initiatives to improve access to healthcare were also noted, particularly for adolescents and young people. The municipality has decided to make RH care for adolescents free of charge at the 8 health posts in the commune. According to the local committee, this decision represents the beginning of a solution to the demand expressed by the local population.
In Kaolack, we also noted a good dynamic on the part of all the players to act in the direction of greater involvement and efficient participation in the health effort.
The Deputy Governor undertook to discuss with the Regional Chief Medical Officer the integration of the local committee into the Regional Development Council (CRD). As for the Departmental Council, it promised to involve the local committee in the choice and nature of this support, and in the implementation of reforestation activities in the health posts. In addition, Kaolack Town Hall proposed that the local committee draw up a partnership agreement with the Town Hall to formalize the partnership.
Everywhere, a better understanding of the challenges of healthcare governance is beginning to emerge. However, a number of challenges remain:
- The dysfunction noted in some CDSs,
- The absence of town halls from CDS meetings,
- Lack of respect for and knowledge of the texts governing the operation of the CDSs, particularly for the new teams of advisors in the 5 zones involved in the 3 CAP-Santé initiative.
In the face of these difficulties, recommendations were made. These include :
- Capitalize on actions carried out by CBO/CSO actors ;
- Strengthen the technical capacities of CDS actors and local authorities with regard to the texts governing CDS;
- Support technical staff (health, administration) to ensure synergy of actions.