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
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
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
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
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
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
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?
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