Country Cooperation Strategy 2004-2007

 

[Country Cooperation Strategy]
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WHO/PAHO’s Country Cooperation Strategy (CCS) for Guyana focuses on the priority needs of the country that the Organization is best placed to address through its technical cooperation. It outlines a strategy for working with national counterparts, government agencies, non-governmental organizations and other development partners for national health development in Guyana, while harmonizing the internal Organizational mechanisms to provide seamless technical cooperation with the country. The CCS implies a commitment that WHO/PAHO looks forward to fulfilling. Guyana is one of the Heavily Indebted Poor Countries (HIPC) in the Region of the Americas and is earmarked for special attention in the PAHO Strategic Plan 2003-2007.

Situation Analysis

The critical development issues and challenges facing Guyana include: governance, affected by continuing political conflict and escalating violence; widespread poverty, inequity and disparities between social, ethnic and geographic groups; migration of qualified professionals, e.g., teachers and health professionals; and slow economic growth and lack of investment, despite abundant natural resources

Guyana continues to experience a high burden of communicable diseases, as well as high levels of both non-communicable diseases and injuries. Compared to the other countries in the Americas, Guyana has a higher burden of disease per capita for all three groups of diseases.

The main critical health sector development issues and challenges include: strengthening the public health leadership capacity; ensuring availability and access to information on the epidemiological situation and system performance; ameliorating the highly inequitable access to health care; improving allocative efficiency; to improve the managerial capacity of the sector in order to increase technical efficiency, i.e., productivity and quality; developing a human resource policy and plan for the sector, which ensures optimal utilization of the available manpower.

Critical donor coordination issues and challenges include: imbalance in distribution of health development aid; low absorptive capacity for health development programs in the public sector and civil society; tendency for development agencies to bypass government and over-stretch the same limited capacity in the non-government sector; development agency drive for showing short- and medium-term results which tend to sacrifice development of longer-term sustainable capacity; and weak management of development assistance in the health sector which leaves coordination to individual approaches and initiatives.

The main challenges facing the WHO/PAHO country program include: maintaining technical leadership in public health with limited technical and financial resources; attracting and maintaining a critical cadre of technical staff; limited human resources nationally, affecting the availability and capacity of counterparts at national level and the sustainability of programmes; coordination of the contribution of the subregional programmes to Guyana; and working collaboratively with other agencies and partners in the health sector.

Strategy Formulation

The mission of WHO/PAHO in Guyana is to provide technical leadership in public health and bring together local, regional and international partners to strengthen national capacity for health development. WHO/PAHO’s work in Guyana is based on a belief in the rights of all individuals to basic conditions for health, irrespective of gender, race, age, religion or sexual orientation and on the values of the Organization.

The prime function of WHO/PAHO in Guyana during the strategic period is to provide specific policy advice; serve as broker; and influence policy, action and spending. In realization of the limited information available, this function needs to be supported by research and development, and monitoring of health sector performance. The third most important function in the strategy is information and knowledge sharing, i.e., providing generic policy options, standards, and advocacy.

For each of the functions defined in the strategy, specific criteria for engagement, priorities, critical success indicators, as well as targets are defined.

Compared to the current situation, during the strategy period, greater emphasis is placed on: influencing policy, action and spending; strengthening the brokerage role of the Country Office between the multiple partners in health working towards a common agenda; improving the quality of technical evidence to support shifts in policies/strategies; filling information gaps in areas where effective public health intervention exists; monitoring health sector performance; building capacity in the Ministry of Health for implementation of evaluation methodologies; and resource mobilization

Four areas of gap in technical capacity in the Country Office are identified as: health systems development; epidemiology, biostatistics, and research; disease prevention and control (communicable and non-communicable); and Maternal and Child Health (MCH).

The success of the CCS depends heavily on the recognition that the locus and responsibility for the coordination of all WHO/PAHO technical activities in Guyana lies in the Country Office. It also means that the technical cooperation needs are defined at the country level, which in turn calls upon support and assistance from sub-regional, regional and global levels of the Organization. This might require a change in the method of working and emphasis on a country focus approach throughout the Organization.

Overall WHO/PAHO needs to continue and possibly accelerate the development of global systems and mechanisms to facilitate intra-organizational networking and information sharing throughout the Organization on initiatives and lessons learned in other countries relevant to the situation in Guyana. Finally, to increase the technical capacity in the Country Office in Guyana, it will likely be necessary to shift technical resources from the global to the country level.