Accountability in health policy and service provision: a blog journey

Posted on 15/05/2019
By Susan Fock-Tave

Blog entry one: the week ahead…

I am Susan from Seychelles. Over the next two weeks I will be in Geneva participating in a number of health governance meetings. On May 13-15 I will be participating in the Commonwealth Foundation’s Health Learning Exchange workshop in my capacity as Chairman of the National Mental Health Advisory Committee. The National Mental Health Advisory Committee was set up to advocate for and conduct the review of the current mental health law in Seychelles and to steer the proposed reforms. I’ll be sharing our experience in Seychelles where we decided to repeal and replace the outdated mental health Act, through the administrative and legislative channels.

I am really looking forward to this learning exchange because it is an opportunity for sharing and exchanging ideas and good practices. Learning from the successes (and failures) of others is always useful. I really want to hear how others engage with a range of stakeholders and involve them in big policy decisions. In my line of work, I am constantly involved in developing new policies and pieces of legislation. To stay true to the ‘Health in all, Health for all and Health by all’ policy, reaching out to non-health stakeholders and civil society organisations is an imperative.

On a day to day basis, I am usually bogged down by the sheer amount of what has to be done. I do not always have a chance to take a step back and look at the how it should be done and who I should be engaging with. The three-day workshop will provide me with an opportunity to do just that – to take stock of the wonderful things I have contributed to, to engage with people who have similar issues, but have worked out ways to better engage with those we perceive to be ‘outsiders’.

Following the learning exchange, I’ll be attending the Commonwealth Civil Society Policy Forum (May 18), the Commonwealth Health Minister’s meeting (19 May) and ending with the World Health Assembly (20 -28 May). Although each meeting will be a very different ‘space’ I expect that there will be many common threads running through. My aim is to leave Geneva not only with new ideas, but most importantly with new friends who I can reach out to for guidance and advice in the future.

I look forward to sharing my experiences along the way.

Blog entry two: thoughts during the exchange:

Blog entry three: concluding thoughts

As I mentioned in my first post, I was in Geneva last month to participate in a learning exchange organised by the Commonwealth. The theme of the learning exchange is relevant to Seychelles context, where the Government, as well as the opposition and the whole of society, is calling for accountability. Very often, the call for accountability is directed at others. We point fingers at others and rarely look inwards to our personal accountability.

I enjoyed the learning exchange and the subsequent civil society policy forum. It was interesting to sit in a room with passionate and very vocal members of civil society organisations, and listen to them talk about their work, their successes, and their frustrations, often directed at governments who fail to be accountable to their citizens.

I am especially pleased that my presentation on the review of Mental Health Legislation in the Seychelles was so well received. It made participants realise that very often while talking about gender and equity issues, mental health is left out of the conversation. Saoyo Tabitha Griffith, from KELIN, realised that she may have missed out on providing valuable input in the revision process for Kenya’s Mental Health Law. I salute her enthusiasm and passion in tracking the bill through the system and recall her relief that she could still make a difference.

I particularly liked Anil Patil’s project. Anil is the Founder and Executive Director of Carers Worldwide. His project was centred on giving a voice to unpaid family caregivers in India. In Seychelles, a member of the family can benefit under a home carer scheme financed by the Agency for Social Protection for taking care of a loved one if the beneficiary meets certain criteria. Families may also opt to have somebody other than a family member take care of their loved one. There is currently a discussion aimed at formally employing the care givers, so they may benefit from all the advantages of full-time employment. I believe we can learn from Anil’s experience with caregivers in India. Carers Worldwide can also learn from our experiences in implementing a home-carer scheme. I am also planning to link several patient support groups (Cancer Concern Association, Alzheimer Foundation and the Stroke Foundation to name a few) with Carers Worldwide, so they can explore possible areas of partnership or cooperation.

After the civil society policy forum, I had the privilege of attending the Commonwealth Health Ministers Meeting and the World Health Assembly. The focus of both meetings was universal health coverage which is clearly relevant to the work we are doing in Seychelles. While it is generally recognised that we have achieved universal health coverage, we do have groups of hard to reach populations, or rather—as was highlighted in the civil society policy forum—groups we have not done enough to reach. Forty years after Alma Ata, the Seychelles is holding a national conference in July this year to revisit its primary health care successes and challenges, and to come up with a concept that will ensure Seychelles meets the goals of SDG 3.8. My experiences in Geneva will certainly influence my participation and contributions to this important event.

Coming into the learning exchange, I did not fully know what to expect. I must say, however, that it was an energising and reinvigorating experience.

Susan Fock-Tave is a consultant ear, nose, and throat Surgeon at the Ministry of Health, Seychelles.