AusAID’s approach to health in developing countries

HIV infection
Under-nutrition
Weak health system
Artemisinin resistance
Poor maternal health and child health
Noncommunicable diseases
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Maps: Lonely Planet

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> USD 54 per person on health annually required to meet health
MDGs
> In 2009, health spending was USD 25 per person in lowincome countries

USD 10 paid by patients
‘out-of-pocket’
50
40
30
20
10
0
Health spending need
2009 average spend
Funding gap:
USD 29 per person per year
2009 outof-pocket spend
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But funding alone is insufficient: donors must engage countries on health policy and reform
> ODA accounts for only around 0.3% of total expenditures on global development health
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> Child mortality rates generally highest within the poorest 20% of a population
> Poor coverage and quality of health services and poor
“health seeking behaviour”
> Influenced by wider social determinants
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And build equitable health systems to improve maternal and child health
Health centres
Sufficient funding
Data on maternal health needs
Trained midwives
Maternal health policy
Essential medicines
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Health assistance must also work within a complex international health ‘architecture’
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Greater access to quality maternal and child health services
Objective: to save the lives of poor women and children through:
Large scale disease prevention, vaccination and treatment
In addition, Australia aims to improve public health by increasing access to safe water and sanitation
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> Improving people’s health is a critical aim of international development
> Good health helps achieve other development goals, such as economic growth and poverty reduction
> Australia can contribute to improving the health of the poorest people, particularly in Asia and the Pacific
> Investing in health is in Australia’s national interest
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Australia is focusing on six priorities for our health investment, guided by four key principles
1. Supporting health services for poor people
2. Closing the funding gap
3. Empowering poor people to improve their health
4. Working across sectors
5. Addressing regional and global threats
6. Maximising the impact of our investment
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Australia has six priorities for our health investment, guided by four key principles poorest 2. Closing the funding gap
3. Empowering poor people to improve their health
4. Working across sectors
5. Addressing regional and global threats
6. Maximising the impact of our investment
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Australia has six priorities for our health investment, guided by four key principles poorest 2. Closing the funding gap
3. Empowering poor people to improve their health
4. Working across sectors
5. Addressing regional and global threats
6. Maximising the impact of our investment
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Australia has six priorities for our health investment, guided by four key principles poorest 2. Closing the funding gap
3. Empowering poor people to improve their health
4. Working across sectors
5. Addressing regional and global threats
Context-
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Australia has six priorities for our health investment, guided by four key principles poorest 2. Closing the funding gap
3. Empowering poor people to improve their health
4. Working across sectors
5. Addressing regional and global threats
ContextBacked by
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1. Australia is supporting health services for poor people
> Advocating for health systems that provide equitable access to quality health services
> Supporting partner countries to identify and respond to their own health priorities
> Promoting cost-effective interventions
> Targeted support in humanitarian and fragile situations
> Supporting multilateral agencies
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Context
> Fragile state emerging from conflict
> Communicable diseases major cause of death
> Maternal mortality rate: 440 per 100,000 live births
> AusAID is largest donor for health, but significant UN and other development partner presence Map: Lonely Planet
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Mixed modalities approach
> Estimated $10 million for health in 2010-11
> Strengthening government systems (through World Bank trust fund)
> Supporting NGOs to provide direct service delivery (in partnership with
USAID)
> Filling gap in specialised surgical services
Impact
> Skilled birth attendance has increased from 35% (2008) to 46.7% (2009)
> Infant mortality has decreased from 60 deaths per 1,000 live births (2003) to 44 deaths per 1,000 live births
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> Increased resources through a range of avenues

Health budget support

Pooled funding arrangements

Working with other donors on joint programs
> Advocating for increased, and better targeted, national health budgets

Reducing out-of-pocket payments

Better use of non-state sector
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Context
> Post-conflict state
> Weak health system
> Malaria endemic region
> Rising non-communicable diseases
> Australia is the major donor for the health system
Map: Lonely Planet
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Budget support approach
> Estimated $18 million for health in 2010-11
> Sectoral budget support, providing 40% of annual health budget
> Focus on supporting Solomon Islands Government to deliver effective, efficient and equitable health services
> Long-term and predictable financial support to government systems
> Work with other development partners
> Pacific regional mechanisms
Impact
> Malaria cases have more than halved between 2003 and 2009
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3. Australia is empowering poor people to improve their health
> Supporting poor and vulnerable people to demand and access affordable, quality health care

Supporting civil society to demand quality care

Providing incentives for people to access health care (eg.
Voucher schemes, conditional cash transfers)

Reducing ‘out-of-pocket’ payments
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4. Australia is tackling the broader causes of ill health
> Social determinants of health include: income, education, gender inequality, food (in)security
> Multi-sectoral efforts to reduce non-communicable diseases
> Working across education, rural development, social protection, gender inequality to address broader causes of ill-health
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5. Australia is reducing the impact of global and regional health threats
> Pandemic preparedness
> Tackling malaria drug resistance
> Responding to natural disasters
> Adapting to climate change
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6. Australia is maximising the impact of Australia’s investment
> Aligning assistance to national priorities
> Coordinating with other donors
> Ensuring multilateral agencies are effective
> Building the evidence base
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Context
> Least developed country
> Malnutrition major problem
> Increasing non-communicable diseases
> Busy donor environment: World
Bank, DFID, USAID, GTZ, Asian
Development Bank, JICA, AusAID
> Government budget allocation to health progressively increased
(7% GDP)
Map: Lonely Planet
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Pooled funding approach
> Estimated $10 million for health in 2010-11
> Contribute to Nepal’s health sector program through joint financing arrangement
> Good donor coordination mechanism
> AusAID influences health outcomes at policy level
Impact
> Under five mortality rate decreased from 61 per 1,000 live births in 2006 to 50 in 2009
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Australia’s focus is on the Asia-Pacific region, with increasing support to Africa
Pacific Islands
• Strong health system
• Delivering health services
• Maternal and child health and high-burden infectious diseases
• Prevention and control of non-communicable diseases
• Building a sustainable health workforce
South and
South-East Asia
• Working with partner governments
• Supporting quality health services for the poorest people
• Strengthening health systems
• Focus on communicable diseases and maternal and child health
Africa
• Targeted support for maternal and child health, focusing on East
Africa
• Working with experienced to strengthen the delivery of health services.
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