The Country Cooperation Strategy for Suriname 2012-2016 (CCS) is the planning mechanism for the
PAHO/WHO Country Office in Suriname (CO), which states the aligned regional and global strategic
orientations and priorities along with the jointly agreed upon priorities. The CCS outlines the main
health priorities (Section 2) and captures the outcomes of the dialogue generated by the CCS process
(Sections 3 and 4). Based on these elements, the CCS presents the strategic agenda for PAHO/WHO
cooperation (Section 5) and reviews the added value contributed by all levels of the Secretariat to
implement this agenda (Section 6). This document is the first CCS to be signed between the Ministry
of Health and PAHO/WHO in Suriname and will foster current and future health achievements through
successful implementation.
Health Priorities
Similar to global trends, the shift from a high communicable disease burden towards an increasing
burden of non-communicable diseases is apparent. The country is in the midst of a national noncommunicable
disease epidemic as cardiovascular diseases, cancers and diabetes have been the
main causes of death for years; this is expected to continue as lifestyle and behavioural risk factors
including tobacco use, alcohol abuse, unhealthy diets and physical inactivity are frequent. This
epidemic also accentuates the heightened significance of other health conditions (specifically mental
health, injuries and violence), and emphasizes the need for integration of disease-specific programs
into primary health care.
Even with an ongoing epidemiological shift towards non-communicable diseases, some communicable
diseases, such as HIV, tuberculosis and dengue are still a concern. Furthermore, the Ministry of
Health has committed to the elimination of neglected tropical diseases (chagas disease, leprosy,
leptospirosis, schistosomiasis, soil-transmitted helminths). Ongoing efforts are needed to build on the
successes related to communicable diseases, specifically related to integrating vertical programs into
primary health care, where appropriate.
Establishing a continuum of care approach to family health that integrates programs for different
stages of life is important to achieve optimal health over the life course. Priorities are clear at each
stage of life, such as reducing infant mortality, decreasing vaccine preventable diseases in children,
investing in protective factors in adolescents and youth, improving maternal health and decreasing
mortality rates by further increasing the percentages of deliveries attended by skilled health personnel
in all parts of the country, and improving the health of the elderly.
Improving the integration of vertical programs into public health care is needed to strengthen health
systems and services. The Primary Health Care model emphasizes empowering frontline primary
health care workers to increase outreach for prevention and early diagnosis, as well as reinforcing the
referral system to reach all levels of treatment, prevention and care. This model offers many programs
to increase coverage, reduce inequalities and promote efficiency and effectiveness including
strengthening health planning and health services, optimizing health financing, establishing an optimal
mix, number and distribution of human resources for health and supporting the increase and use of
health information.
Underlying the previously stated priorities, addressing the determinants of health is of tremendous
importance as they are the fundamental causes of poor health and they intensify health inequalities.
Global, regional and national changes, increased environmental health threats, living and working
conditions, and emergencies, disasters preparedness and response require strengthening national
capacities to address these priorities. These determinants are quite complex and they are largely
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overlooked despite their significance; therefore, it is necessary to advance on the social determinants
of health agenda.
Outcomes of the Dialogue Generated by the CCS Process
In addition to the identified health priorities, determining the strategic agenda was also based on the
positioning of PAHO/WHO as related to the role of other development cooperation partners and a
review of PAHO/WHO cooperation in the past.
Historically, the Netherlands was the principal development partner in Suriname and provided a
significant amount of resources. In recent years, considerable changes have occurred and there is
now a heightened presence of other development partners. This increase requires strong platforms
and mechanisms for coordination for aid effectiveness. The strategic positioning of the country office
will enable the Organization to play a lead role in the coordination of donor partners to facilitate
championing health in all policies.
In the absence of a signed CCS, strategic dialogues were conducted to review previous PAHO/WHO
performance. Reviews with stakeholders found that the technical cooperation provided by PAHO/WHO
was strategic, relevant, timely, and strongly aligned to national priorities. Additionally, an internal
review among staff found many strengths and opportunities, including that the office was a strong
development partner that occupies a lead role in providing technical cooperation on heath. Challenges
identified were mainly related to limited human and financial resources and the evolving leadership
and governance role of national counterparts.
PAHO/WHO Strategic Agenda (2012-2016)
The centerpiece of the CCS strategic agenda is the introduction of comprehensive primary health care
based on the integrated management approach. Comprehensive primary health care is considered the
most sustainable and equity-enhancing mode of health care delivery system. This is highly applicable
for the country as inequities remain and there is a high demand for integrated approaches to care.
Three strategic priorities are established:
ƒ Reducing the burden of disease: Reducing the burden of both non-communicable diseases
and communicable diseases; strengthening community-based mental health; enhancing family
health over the life course; reducing violence and injuries.
ƒ Strengthening health systems and services based on primary health care:
Strengthening health planning and health services; optimizing health financing, enhancing
human resources for health; increasing the strategic production and use of health information.
ƒ Addressing the determinants of health: Strengthening national response to environmental
health threats; strengthening capacity and coordination to address workers’ health; improving
the management of emergencies and disasters; advancing on social determinants of health.
The strategic agenda continues to uphold the core values of PAHO/WHO of equity, excellence,
solidarity, respect and integrity, while implementing both core and cross-cutting functions of the
Organization. Full implementation of this strategic agenda and appropriate response to country
priorities requires full coordination between all levels of the Organization to reinforce the strengthsand
respond efficiently to the needs of Suriname.