This activity focuses on improving the accessibility of quality health services in pastoral areas.

It consists of:

• ‘ensuring that accessibility of the health service for mobile and settled pastoralists is compatible with the national standard’;
• ensuring ‘that mother child care services and health services are effectively accessible to all’;
• conducting activities to prevent and control communicable disease, following the National Health Service system.
• undertaking ‘activities to expand community, school, and personal hygiene through mobilization of the people’.

COMMENTARY

Ensuring that accessibility is compatible with the national standard. The first point in the description of this implementation activity is about ‘ensuring that accessibility of the health service for mobile and settled pastoralists is compatible with the national standard’. It is clear though that ‘accessibility’ has different meanings for people in settlements and for the mobile people in pastoral systems. In the first case, ‘accessibility’ is about having or not having conventional health services in the settlement, and perhaps about adapting procedures so as to make these services effectively accessible to the local population – for example by not taking for granted literacy or people’s capacity to pay for them. The latter is also true for people in pastoral systems, but in their case ‘accessibility’ also means moving away from conventional service provision and adapting the system of provision to the livelihood conditions in pastoral systems, starting with mobility. In the present case, this means ensuring that accessibility that is ‘compatible with the national standard’ means a commitment to avoiding a trade-off between accessibility and quality. It also means that when some trade-off is unavoidable, there is a commitment to minimize it and give priority to accessibility. Better quality but inaccessible health services are, ultimately, just inaccessible, and the quality of an inaccessible service does not really matter.

h. Improve capability to prevent and control emergency health problems (p.56) »