1. We, the Health Ministers and representatives of Member States; Non-Governmental Organizations, Civil Societies, Bilateral and Multilateral Agencies gathered in Addis Ababa (from 20 to 22 November 2006) for the Joint UNAIDS, UNICEF, World Bank and WHO International Conference on Community Health in the African Region to ensure universal access to quality health care and a healthier future for the African people.

2. Recalling the Alma Ata Declaration of September 1978 calling on all governments and the world community to protect and promote the health of all the people of the world, the previous conferences held in Kinshasa in 1990 on community health financing and in Brazzaville in 1992 on promoting community health development, the pledge made by African Head of states at the Africa Summit on HIV/AIDS, Tuberculosis and Other related Infectious Diseases(ORID) in Abuja in 2001 to allocate at least 15 per cent of national budget to health by 2015 and the decision of the Heads of States of the African Union in July 2004 in Syrte, Libya to accelerate Child Survival implementation in the African Region.

3. Acknowledging the link between health, poverty alleviation, peace and security, gender meanstreaming, and the global commitment towards universal access to health care to facilitate the achievement of the Millennium Development Goals

4. Noting that over 60 per cent of African households live below the poverty line, and that over sixty percent of African people live in rural to peri-urban communities with limited social infrastructures, deteriorating health services and a high burden of communicable and non communicable diseases

5. Recognizing the opportunities provided by the socio-cultural resources and proven health interventions available for effectively mitigating existing health conditions in the region particularly at community levels in our communities

6. Acknowledging the progress made in the African region in promoting and strengthening community involvement in health development. As a consequence communities are now recognized as key partners in the planning, financing, implementation, monitoring and evaluation of health programmes.

7. Acknowledging the challenges that still remain such as widespread poverty, poor governance, insufficient involvement of communities especially women in the decision-making processes, weak health care delivery systems especially at district level (eg, insufficient availability of motivated and skilled human resources, limited management capacity, weaken interface between the communities and the formal health care delivery systems, etc);

8. Conscious of the fact that investment at household and community levels has enormous impact on reducing morbidity and mortality and that without concerted efforts to effectively engage communities in sustainable health actions the Millennium Development Goals would not be achieved investment and house holds and communities

9. Taking cognizance that one of the key principles of primary health care is the individual and collective involvement and participation of the people in health development.

10. We, the participants reaffirm the Principles of Primary Health Care and dedicate ourselves put people first, to consciously promote increased community involvement and participation in health development to facilitate the achievement of the Millennium Development Goals and improving the welfare of the populations.

11. We commit ourselves to:

• empowering communities and strengthening community management structures, consumer activities and linkages to health services delivery systems
• refining our approaches of community engagement and involvement in the planning, delivery and self monitoring of health care interventions
• strengthening the interactions between health services and the communities being served so as to enhance needs-based and demand-driven provision of services and to promote the sustainability of the various community approaches being implemented
• Putting in place mechanisms for sharing information and experiences among each other for influencing community involvement in health development, for strengthening monitoring and evaluation and promoting operational research including in social science
• Strengthening partnerships and working together to translate global thinking and national policies into concrete actions at community level . in communities

12. We call upon:

  13. All Member States

  .13.1: To creating an enabling environment for community health development by:

• Developing and implementing national policy and strategic plans on community health as part of the national health policy and plans and poverty reduction strategy papers (PRPs)
• Institutionalizing Community Health as an integral core component of the National Health System and increasing the authority and the visibility of the divisions in charge of community health in the ministries of health and training institutions.
• Making decentralization policies functional by enabling communities to effectively contribute to the situation analysis, programs development and implementation and monitoring and evaluation of interventions.
• Respecting the Abuja commitment by allocating 15 per cent of national budget by 2015 to health and by increasing the proportion of funds allocated to community health interventions
• Building capacity at the district and community levels especially by training, incorporating of community health into the curriculum of basic and in-service training.
• Ensuring synergies, coordination and harmonization of the efforts of multiple partners working with communities
• Putting in place appropriate mechanisms for monitoring and evaluation of community health interventions and for promoting operational research

13.2. To undertake concrete actions within the context of health system strengthening aimed at:

• Strengthening of district health systems so as to reach out and support communities
• Supporting communities to scale up proven effective interventions and make them sustainable.
• Incorporating community health workers into the human resource for health development agenda of countries, in general, and districts, in particular, and providing appropriate technical back-up through training, mentoring and support supervision.
• Providing the timely supply and effective administration of appropriate and affordable pharmaceuticals, medicines and supplies at the community level.
• Providing basic social infrastructures (such as water, sanitation, road, transportation…) that encourage and facilitate active community participation in health protection and promotion.
• Developing programs to address social determinants of health such as poverty, cultural practices, illiteracy, malnutrition, lifestyles, etc.
• Promoting and supporting effective collaboration within the health sector and other sectors impacting on health such as agriculture; education; environmental sanitation and water supply.

13.3. To improve financing for community health programs by:

• Evaluating existing community health financing systems and reorienting to protect the poor and vulnerable groups, ensure equitable access to services and minimizes financial burden on families and communities
• Improving rules and regulations regarding the composition and functioning of health management committees
• Increasing the oversight function of communities over the management of resources for health  

14. Communities to:

• Organize themselves to take ownership of directing, protecting and promoting their own health
• Ensure accountability and stewardship of national governments and international communities on sustainable health development.
• Adopt mechanisms for self-monitoring and providing feedback on the health care delivery and support within their communities.  

15. All partners to : 

• Work within the context of national health policies and plans with the objective of complementing national and local community efforts at meeting their priority health needs
• Commit themselves for the long-term to ensure sustainability of community health interventions
• Increase investments for strengthening of the capacity of national health systems
• Harmonize incentives schemes for community health workers
• Coordinate their technical and financial support towards addressing the health priorities of countries and communities to optimize the effectiveness and efficiency of the support to countries.
• Devise mechanisms for information sharing and joint planning for community-based interventions.
• Increase resources geared towards improving community participation and ownership in health and development

16. Next steps

• National governments to organize at the national level meetings in order to translate the recommendations of the conference into concrete actions
• Partners to establish a follow up mechanism
• Governments in collaboration with partners to document best practices, promote inter country experience sharing and celebrate successes

I have endorsed the steps outlined in relation to establishing a follow- up partnership mechanism

Bienvenue,

La conférence internationale sur la santé communautaire organisée par l'OMS, l'UNICEF et l'ONUSIDA, s'est tenue du 20 au 22 novembre 2006 à Addis-Abeba en Ethiopie.

Pendant la conférence qui regroupait environ 250 personnes venant de tous les horizons, l'idée de créer un Forum international pour la santé communautaire en Afrique (FISCA) est née. Un comité d'organisation a ainsi vu le jour.

Ceci a stimulé la fondation Global Health Dialogue à s'intéresser à promouvoir ledit projet.

Le comité d'organisation a pu concevoir les drafts de statuts, de règlement intérieur qui ont été envoyés aux participants de différents pays pour avis et suggestions ; ceci a suscité un véritable engouement sur le plan international, d'où de nombreuses réponses à l'appel à adhésion.

Les dates du 26 au 28 novembre 2007 ont été retenues pour la tenue d'une assemblée constitutive à Kribi – Cameroun. Ce moment de rencontre permettra aussi de restructurer l'Association Cameroun Santé (CAMSANTE) par la création des antennes dans les provinces.

C'est avec un réel plaisir que le comité d'organisation vous associe à cette assemblée, qui à coup sûr bénéficiera de votre apport et de votre expérience.

Cette rencontre attend les membres de la société civile, les professionnels de la santé et des secteurs apparentés et surtout les membres des structures de dialogue.

Nous pensons aussi à des partenaires au développement, aux associations de santé impliquées dans la lutte contre le VIH/SIDA et autres endémies, à la gestion des districts de santé, aux mutuelles de santé et aux technologies traditionnelles et modernes.

INFORMATIONS PRATIQUES
•   La conférence aura lieu à l'international Dialoque centre derrière l'hôtel Fidelie.
• Arrivée et accueil des participants : 25 avril 2007 à partir de 17 heures
• Inscription : 10.000frs CFA par personne (a Kribi)
• Frais de prise en charge journalière (hébergement et restauration) : 25.000frs CFA par personne. (a Kribi)
• Départ des participants : 28 avril 2007
• Les informations complémentaires- site Web- www.ifcha.org

  N.B  : Pour les participants étrangers, bien vouloir

  Communiquer au comité d'organisation vos plans de vol, afin de préparer votre accueil à l'aéroport.