Understanding how the mining sector can contribute to better health in low income countries.
The Mining Health Initiative (MHI) was a multi-county research project undertaken to document good practice in mining health programmes and to identify ways to leverage best practice for a greater public good.
Tthe initiative aimed to enhance the way public-private partnerships (PPPs) within the mining industry can strengthen health services for underserved populations across sub-Saharan African countries. MHI worked with stakeholders to build consensus and identify models for successful mining health programming that provide good value for money from both the company and public perspective.
The first phase involved desk research across literature to develop a framework for measuring benefit incidence of the public consequences of private actors, i.e., to whom “public benefits” accrued as a result of private investment. The second phase was to conduct a set of case studies and stakeholder consultations which took place across 4 countries: Ghana, Madagascar, Mozambique and Zambia. The third focused on development of good practice guidelines and PPP proposals.
With respect to the company side, it was found that many external services (“outside the fence” programmes) were extensions of internal services (“inside the fence” programmes), often planned and managed by occupational health and safety specialists rather than by public health professionals. This explains some of the poor project designs and lack of attention to baseline information and monitoring and evaluation.
On the government side, it was observed that officials are ill-equipped to serve as interlocutors in many of these relationships. While many governments in sub-Saharan Africa have policy frameworks in place, few have capacity to promulgate them with policy instruments. Fewer still have tools in place for district health managers to implement policy, and it is rare to find implementation capacity for PPP regulation at the sub-national or district levels.
A range of issues emerged during the course of the project, these issues we disseminated at an international stakeholder consultation in Cape Town, South Africa. Some countries are enthusiastic about health PPPs and their potential, but governments are struggling to optimise PPPs within national healthcare systems and strategies. In response to country demand, the IFC will consider how to support national and sub-national institutions on new mining health PPPs and how they fit with broader health delivery programmes. The IFC will also advise each country on support available as part of the HANSHEP Pilot Health PPP Facility.
Managed by HPI in partnership with Montrose International, the Mining Health Initiative was funded under the aegis of Harnessing Non-State Actor for Better Health for the Poor (HANSHEP) by DFID. HANSHEP is a group of development agencies and countries established by its members in 2010 with the aim of seeking to work with the non-state sector in delivering better healthcare to the poor. Current HANSHEP members include the Rockefeller Foundation, Bill & Melinda Gates Foundation, DFID, IFC, GIZ/KfW (on behalf of the German Federal Ministry for Economic Cooperation and Development), USAID, the World Bank, the African Development Bank, the Public Health Foundation of India and the Governments of Rwanda and Nigeria