Proceedings of the 13th Meeting of the
COMCEC Poverty Alleviation Working Group
8
OIC Strategic Health Programme of Action (OIC-SHPA) for 2014-2023 and Middle-Eastern and
North-African region (MENA) initiative.
This was followed by a short question and answer session. There were no major disagreement
among the participants regarding the contents of the presentation. The session ended with a rich
discussion around the complexities of understanding access to health and how can we engage with
bottom up approach and people’s awareness of services more effectively.
Questions and Comments:
Question: What would be the determining factor that describes the variation between OIC and non-
OIC countries for the indicators mentioned in the presentation and solution to these differences?
Answer: Dr. Ahmed stated that since the international database has been used in the research,
there is no way to answer easily to this question. However, there is no restriction to make some
predictions on them. For example, cultural values are effective in HIV indicators in OIC countries.
Compared to non-OIC countries at the same level, OIC countries are doing well. On the other hand,
out-of-pocket expenditures in OIC countries are higher than the ones in non-OIC countries. Heavy
presence of private sector contributes to this increase. There are countries in the OIC region who
are doing good although they suffer from budget constraints. There are mechanisms like COMCEC
in the region which can convince governments to act based on the evidence that is listed in these
studies.
Comment: The primary healthcare and improvement of the infrastructure in primary health care
were underlined.
Question: It was pointed out that demand for health services is always mentioned, however how
the real demand can be measured if the awareness is low is not easy to answer.
Answer: Dr. Ahmed agreed with the comment on the importance of primary healthcare and
mentioned some good examples such as Turkey to show how bottom-up approach worked well in
this case. Dr. Ahmed replied the comment on the awareness by emphasizing how challenging to
measure the real demand in the field. Awareness and perception are, for example, two important
indicators that display real demand but they have to be measured with the fieldwork and analysis.
Comment: Another comment was about the relationship between poverty and health. If the pro-
poor policies are promoted then health related problems could also be solved. Economic growth
sometimes cannot enable the development in health if it is not pro-poor.
3.2. Lessons Learnt from the Selected Case Studies and the Policy Options
In the second part of the presentation, Dr. Ahmed presented the status of access to health care in
four case countries. Considering the geographic distribution of the OIC member countries, access
to health-wise, two struggling cases, Indonesia and Uganda and two well performing cases, Turkey
and Tunisia was chosen to capture the variations in terms of health outcomes and health inequities.