1. AusAID’s approach to health in developing countries
Saving Lives
AusAID’s approach to health in developing countries

2. Significant health issues are facing the region
HIV infection
Under-nutrition
Weak health system
Artemisinin resistance
Poor maternal health and child health
Non-communicable diseases
Maps: Lonely Planet

3. There is a major funding gap for health
USD 54 per person on health annually required to meet health MDGs
In 2009, health spending was USD 25 per person in low-income countries
USD 10 paid by patients ‘out-of-pocket’
Estimates in 2005 US dollars

4. 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

5. To focus health assistance on the poorest
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
Social determinants of health include: income, education, gender inequality, food (in)security

6. And build equitable health systems to improve maternal and child health
Health centres
Data on maternal health needs
Maternal health policy
Essential medicines
Trained midwives
Sufficient funding

7. Health assistance must also work within a complex international health ‘architecture’

8. Saving lives is a goal of Australia’s aid program
Objective: to save the lives of poor women and children through:
Greater access to quality maternal and child health services
Large scale disease prevention, vaccination and treatment
In addition, Australia aims to improve public health by increasing access to safe water and sanitation

9. Australia invests in health because
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

10. Australia is focusing on six priorities for our health investment, guided by four key principles
2. Closing the funding gap
1. Supporting health services for poor people
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

11. Australia has six priorities for our health investment, guided by four key principles
Focussed on the poorest
2. Closing the funding gap
1. Supporting health services for poor people
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

12. Australia has six priorities for our health investment, guided by four key principles
Focussed on the poorest
Country-led
2. Closing the funding gap
1. Supporting health services for poor people
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

13. Australia has six priorities for our health investment, guided by four key principles
Context-specific
Focussed on the poorest
Country-led
2. Closing the funding gap
1. Supporting health services for poor people
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

14. Australia has six priorities for our health investment, guided by four key principles
Context-specific
Focussed on the poorest
Country-led
Backed by evidence
2. Closing the funding gap
1. Supporting health services for poor people
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

15. 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

16. Case study: East Timor 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

17. Case study: East Timor Mixed modalities approach
Estimated $10 million for health in
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

18. 2. Australia is helping to close the funding gap
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

19. Case study: Solomon Islands
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

20. Case study: Solomon Islands
Budget support approach
Estimated $18 million for health in
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

21. 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

22. 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

23. 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

24. 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

25. Case study: Nepal 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

26. Case study: Nepal Pooled funding approach
Estimated $10 million for health in
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

27. South and South-East Asia
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.