OpiniãoThe consultation process specifically addressed implementation. The group suggested that implementation should begin with consultation with the regions regarding how best to promote implementation.
It was decided that regional offices must assume responsibility to develop relevant adapted implementation plans. Country ownership is necessary for governments to commit funds to provide essential services. Ministries of health, labour, and finance; national professional bodies, civil society and unions must be involved in the formulation of implementation strategies. Specifically, it was recommended that a regional advocacy meeting with WHO, ministries of health, finance and labour should occur, as well as national advocacy meetings, with involvement of all parties.
It was recommended that the regional consultations, as well as the national advocacy occur by December 2010.
It was also recommended that a monitoring and evaluation group should be established within ILO/WHO, which would oversee the development of a detailed implementation plan, followed by a series of dissemination meetings at the country level. Concrete time frames for implementation and dissemination should be set at the regional level. This group would, of course, have to consider funding and timing issues when planning these meetings.
Virtual meetings and other innovative suggestions were advanced, with the aim of prioritizing funds for implementation and adaptation at country level. WHO and ILO must build capacity to provide support at the country level to allow for implementation and specific funding should be allocated for the task of rolling out implementation as allocation of existing funds has already been set for current country priorities.
While there are different parties involved it was decided that one document would be best, with a focal point/leadership presenting guidance, and a committee established at the country level.
Existing technical working groups should be utilized as a first point for implementation of guidelines and roles and responsibilities must be adopted by country officers to initiate stakeholder discussion and empower key players to adopt and translate guidelines. Implementation of the recommendations into national programmes should be considered in conjunction with an action plan for implementation at the facility level.
The discussion stressed that an adaptation approach was needed to promote the formulation of the new policy needed. It was stressed as well as "buy-in" and ownership by partners and unions is essential. Relationship building and shared principles are required to ensure success and to ensure that cultural and economic differences of individual countries are considered.
There should be a political campaign to encourage and motivate adoption of recommendations. Political mobilization is necessary, provided the allocation of resources, given the complex political dimension of issues such as stigma and discrimination.
Advocacy work with donors is recommended to ensure health workers are a priority and that adequate funds are secured for implementation.
Successes and challenges of this a complex package of recommendations must be measured. A work plan linked to targets with measurable results and the coordination of distribution policies must be considered.