Local Health Committees back to the fore of Mauritius’ Primary Health Care approach

In line with the Mauritian Government’s Health Sector Strategic Plan 2020-2024 which recommends the setting up of Local Health Committees (LHCs) across the country, WHO recently supported the Ministry of Health and Wellness (MOHW) in the preparation and validation of a national policy for LHCs.

By giving fresh impetus to LHCs, this European Union-funded project aims to enable communities to be responsible for their own health, ensure that they have access to quality health services and actuate the behavioural changes required to tackle the rising burden of noncommunicable diseases (NCDs).

LHCs can be characterized as the interface connecting the Primary Health Care (PHC) system and local communities, ensuring that the latter have access to the health services they need. Founded on partnerships between the health authorities and members of the community, each LHC is attached to the PHC facility serving its catchment area.

In addition, due to their proximity to local realities on the ground, LHCs provide useful platforms for health awareness campaigns, a potential example being public sensitization on the recrudescence of vector borne diseases, such as dengue, due to climate change.

During the multistakeholder national validation workshop, which was held on June 21, the WHO expert on health systems, Azmach Gebregiorgis, explained that each LHC will be composed of respected members of the local community under the leadership of an elected chairperson.

In the words of the national policy, community engagement is “both a process and an outcome”, involving five levels of participation, namely informing, consulting, involving, collaborating and empowering. Once the national policy is approved, an ambitious nationwide capacity building programme will be launched to provide training to the members of LHCs ahead of their operationalization.

Mauritius has long been a staunch supporter of the notion that PHC should form the cornerstone of a quality, equitable health care delivery system. The country was an early signatory of the Alma-Ata Declaration in 1978 which recognized the centrality of PHC, with the country going on to build no less than 50 Community Health Centers (CHCs) between 1986 and 1988.

The effectiveness of this approach is reflected in a Universal Health Care (UHC) service coverage index of 66, which is significantly higher than the rest of the region. But community-centered health is also about empowering members of the community to make their own decisions concerning their health. 

Although community-centered engagement has remained at the heart of the health system, the popularity of LHCs has fluctuated over the years. Starting in 2014 however, they were revitalized with the resumption of the involvement of LHC leaders in health promotion activities and in the implementation of the 2015 NCD survey, community awareness creation and social mobilization for NCD screening campaigns. On the global stage, the Declaration of Astana reaffirming the commitments of the Declaration of Alma-Ata of 1978 and the 2030 Agenda for Sustainable Development was adopted in 2018.

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