« We help rural healthcare centres but also ministries in the capital »

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Three questions for Paul Bossyns
Coordinator Health unit, Enabel Brussels

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Why is health important for development?

First and foremost: Health is a valuable good as such. In addition, healthy people are more productive and therefore contribute more to the development of their country. In developing countries, like elsewhere, the state is responsible for health policies and the organisation of health care. We can help the state by strengthening its ministries and its public services and by supporting a network of qualitative healthcare service providers. In the sector this is known as the ‛referral/counter-referral system’. Each level can, if necessary, refer to a higher level and vice versa. In the fight against maternal deaths, for instance, such referral systems are vital.
Public health insurance is the only way people can enjoy necessary health care without financial jeopardy.
How does Enabel stand out in the health sector?

In the countries where we operate we have a close tie with the operational level of the health service providers. We are privileged witnesses of what works and what does not. While other governmental organisations are mainly active at the central level and NGOs focus on the local level, we are embedded at both levels. The policy of Belgium is to also remain present at the local level and to witness reality. This is necessary to conduct a credible institutional and policy dialogue as well on the local as on the highest political level, supported by the Attachés at the Belgian embassies.

Another pillar, in addition to central instances and the local network, is public health insurance. It is the only way to guarantee health care without imposing the financial risks on the population.

Another characteristic point is the explicit way in which we work with partnerships. All plans, actions and adjustments are discussed with the Belgian and partner country persons implied, in a continuous process of joint reflection.

We try to involve all stakeholders as much as possible: the ministry of health, civil society, health staff, civil servants, religious communities and organisations that are active in the health sector. In this regard, development cooperation can be a facilitator and have these different groups enter into a dialogue to achieve a common goal. 


What are Enabel's specific niches?

Over time, Enabel has specialised in various important health sector niches.

First, Enabel supports reforms in healthcare financing in several countries by gradually developing universal health insurance coverage. The goal is to provide the poorest with access to health care but also to increase transparency and effectiveness and to make healthcare units accountable.

Enabel also pays much attention to decentralisation, which is to bring public health and education services closer to the population. Enabel also supports private initiatives in the health sector, especially private not-for-profit institutions, and finally, Enabel also always checks where digitisation can bring solutions to making health services more efficient. 

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