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Strengthening Health Systems: Moving beyond Supporting the Health System

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  • 1. Strengthening Health SystemsMoving Beyond Supporting the Health System
    Ann Lion
    Health Systems 20/20 Project Director, Abt Associates
    Global Health Council Satellite Session
    Health Systems Strengthening:
    What is Everyone Doing?
    June 13, 2011
  • 2. Goal of this presentation
    Clarify existing HSS definition
    Supporting vs. strengthening health systems
    Propose criteriato distinguish what activities are HSS interventions (support vs. strengthen)
    Scope
    Longevity
    Approach
  • 3. What is health system strengthening?
    Strengthening health systems goes beyond supporting the system
    Supporting focuses on filling gaps to produce better short-term outcomes
    Strengthening is about making the system function better in the long term
  • 4. Strengthening vs. supporting health systems
  • 5. What is not health system strengthening
    Most common misunderstanding of HSS is that it is any activity that supports a HS building block
    Focus tends to be on increasing inputs
    Often covers only one HS block or disease area
    Tends to be short-term solution
    Misconception of HSS often leads to investment in activities that, in effect, only support the system temporarily but posture as HSS
  • 6. The 3 dimensions of health systems
    1)Health system building blocks
    2)Program/disease areas
    3)Performance drivers
    Inputs
    Policies and regulations
    Organizational structures
    Behaviors of HS actors
  • 7. A “cube” view of the health system
    © Abt Associates, 2001
  • 8. The 3 dimensions of health systems
    But focus on performance driver tends to be on inputs, while the remaining drivers are often overlooked by HSS programs
  • 9. Inputs vs. other key HSS performance drivers
    © Abt Associates, 2001
  • 10. © Abt Associates, 2001
  • 11. How to design HSS interventions?
    There is no “menu” of HSS interventions
    Design will be affected by a number of factors specific to country context and system constraints
    A health system strengthening intervention should:
    Include all 3 dimensions shown in the HS cube illustration
    Affect more than one program/disease area
    Address country-specific constraints
  • 12. Guidance for identifying HSS interventions
    Is it Health System Strengthening?
    Does the intervention have cross-cutting benefits beyond a single disease?
    Does the intervention address policy and organizational constraints or strengthen relationships between the building blocks?
    Will the intervention produce long-term systemic impact beyond the term of the project?
    Is the intervention tailored to country-specific constraints and opportunities with clearly defined roles for country institutions?
  • 13. Acknowledgements
    Grace Chee**
    Nancy Pielemeier
    Catherine Connor
    Mark McEuen
    Sheila O’Dougherty
    Hong Wang
    ** lead drafter
    SlaveaChankova
    Joe Kutzin
    Marty Makinen
    David Evans
    Tahgreed Adams
    AbdoYazbeck
  • 14. Thank you
    www.HealthSystems2020.org