Pathways to progress in health: lessons from leading performers

5 June 2014 10:00 - 12:30 GMT+01 (BST)
Public event
Streamed live online

​Confirmed speakers include:

Joe Cerrell - Managing Director, Global Policy & Advocacy, Gates Foundation

Dr Fiona Samuels - Research Fellow in Social Development and Health Dimension Lead, ODI

Dr Moses Bockarie - Director of the Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine

Dr Shilu Aryal - Senior consultant Obstetrician /Gynaecology, Ministry of Health and Population, Nepal

Dr Mouzinho Saíde - Public Health Specialist, Director of the Superior Institute of Health Sciences, Mozambique

Prof Andy Haines - Professor of Public Health & Primary Care, London School of Hygiene and Tropical Medicine


Dr Kevin Watkins - Executive Director, ODI 

As the Millennium Development Goals draw to a close, there is increasing interest in taking stock and learning from countries seen as leading performers in diverse sectors, including health. Critical questions and topics to be addressed include examining:

  • Which countries have made significant progress in improving health systems and access to services over the last few decades – often against the odds?
  • What alignment of factors has helped to achieve progress and what are the lessons we should draw from their experience?
  • How can we apply these findings to inform debates around the post-2015 agenda, universal health coverage and the social determinants of health?

ODI’s Development Progress project seeks to better understand what’s working and why by exploring the determinants of progress, using evidence gathered from a series of case studies.

This panel discussion will launch and discuss the findings from four case studies exploring progress in:

  • Tackling Neglected Tropical Diseases in Sierra Leone and Cambodia;
  • Maternal health in Nepal; and 
  • Maternal and child health in Mozambique.

​The event focussed on development progress in health, one of eight dimensions of wellbeing that are being measured through the research project. Participants were reminded of the impacts of universal health coverage not being achieved, and the need for policy makers and donors to keep in mind the effects of the current deficit: second rate health provisions, delayed treatment with fatal and damaging consequences and declines into extreme poverty.

The application of understanding progress that has been made so far in health is to inform the thinking of governments and donors on these critical health issues and demonstrate that with political will and commitment, progress is happening.

Left to right: Joe Cerrel, Dr Shilu Aryal, Hou Kroeun (on screen), Kevin Watkins, Dr Fiona Samuels, Dr Moses Bockarie, Prof Andy Haines.

Joe Cerrell, Managing Director of Global Policy and Advocacy at the Gates Foundation delivered the first talk of the morning, outlining the importance of the work in promoting a positive narrative for development to influence governments, donors and public perception.

With development fatigue and scepticism of ODA on the rise, he stressed the critical need to present evidence-based proof that development is progressing in order to leverage further funding to achieve the MDGs and carry momentum into the post-2015 agenda.

Dr. Fiona Samuels, Research Fellow in Social Development and Health Dimension Lead at ODI, outlined the breadth and depth of research carried out on maternal and child health and neglected tropical diseases throughout the project, and the interplay of factors impacting development in these areas.

Nepal and Mozambique were the focus of case studies on maternal and child health, while NTDs were the focus of the research for Cambodia and Sierra Leone. In each study, the countries selected demonstrated common factors: histories of conflict and struggle, geographical or environmental challenges and high levels of poverty, with predominantly rural populations and experiences of economic growth in recent years. To read the case study reports, summaries and related items please visit

The following three presentations focussed on in-country perspectives and stories of change in tackling maternal and child mortality and NTDs. Hou Kruen, Deputy Country Director at Helen Keller International (HKI) Cambodia joined the conference over video link, providing an overview of an educational project carried out in conjunction with the Ministry of Education in Cambodia to ensure the inclusion of STH prevention and control in the primary school curriculum.

With more than 40% of Cambodia’s children suffering from malnourishment and more than 70% having intestinal worm infections, HKI’s program served to educate over 100,000 primary school children and over 4,000 teachers on infection control and prevention. The key challenges in further upscaling this project lie in limited government resources and difficulties in sourcing further funding, coupled with poor water supply and sanitation in schools, which undermines behaviour change efforts. However, the project has shown that using an evidence-based approach and allocating appropriate resources can drive results in exacting change through education.

Dr. Moses Bockarie, Director of the Centre of Neglected Tropical Diseases at the Liverpool School of Tropical Medicine continued by outlining the key determinants of success in tackling NTDs in Sierra Leone, where an integrated NTD control programme for a range of NTDs including Lymphatic filariasis (also known as elephantiasis) and Onchocerciasis, brought a country-wide endemic down to controllable and treatable levels within three years of implementation.

The main successes for the programme are attributed to a historical government commitment and early links to LSTM – which set up an in-country research centre – as well as an integrated control strategy and cross-sectoral approach in tackling NTDs.

Dr. Shilu Aryal, Senior Consultant Obstetrican/Gynaecology at the Ministry of Health and Population in Nepal, delivered the final country-level perspective by sharing key figures demonstrating a reduction in maternal and child mortality rates through integrating a range of enabling factors into healthcare systems in the country. A variety of factors including service expansion, the empowerment of women and improved economic status have all played their part in significantly reducing child and mother mortality rates in recent years.

Concluding the session, Prof. Andy Haines, Professor of Public Health and Primary Care at the London School of Hygiene and Tropical Medicine, delivered his presentation on pulling the threads together for universal health coverage and its role in the post-2015 agenda. In order to achieve broader health coverage to improve general population health, three dimensions were outlined: extending current levels of coverage to those who are not covered, reducing cost tiering and fees and increasing the delivery of different services.

Haines highlighted the importance of nations finding locally relevant support and carrying out national-level research to ascertain key determinants in improving health within a country context. Tried and tested methods of improving universal health coverage include community engagement, rapid diagnostic tests, home based care and quality improvement. With this in mind, when considering the role of health in the post-2015 agenda, SDG indicators should reflect both progress towards universal health coverage and linkages between environmental sustainability, social determinants and health.