par Martini, Jessica ;Paul, Elisabeth;Berthé, Issa;Samake, Salif;Dujardin, Bruno
Référence Global Symposium on Health System Research (2: 31/10/2012 - 03/11/2012: Pékin, chine)
Publication Non publié, 2012-10-31
Poster de conférence
Résumé : Introducing bottom-up approaches into policy-making processes can be a good pathway towards improving aid and development effectiveness. At this regard, the case of Mali is emblematic because health plans are elaborated through decentralised mechanisms: committees at local level elaborate annually their own operational plans; these are then presented at regional level and traduced into regional plans, which are finally aggregated at the central level into the national plan, according to the national policy guidelines. In 2011, the elaboration of the new health programme for the period 2012-2022 enabled to strengthen planning capacities and coherence through the introduction of new bottom-up mechanisms improving stakeholders’ participation and better taking stock of local experiences. Indeed, for policies to be really effective, two key components of the policy-making process are particularly important. Firstly, past experience should be better taken into account and evidence should be used to inform new strategies. This requires the integration of learning dynamics all along the policy process, where stakeholders’ experience and local evidence become essential inputs for planning new strategies and plans. For this evidence to be successfully translated into policies, the influence of individual, organisational and system capacities and resources should be also considered. Secondly, a mindset shift is needed from a linear to a systemic understanding of development. This requests stakeholders to accept that development and health results are multifactorial and that they should be rather expected over the long term. Based on lessons learned from the Malian experience and on literature review, our presentation introduces a framework for action that highlights key determinants and constraints related to the use of bottom-up mechanisms in policy-making in the health sector in a context of aid dependence.