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Strengthening Health Systems: Moving beyond Supporting the Health System

Strengthening Health Systems: Moving beyond Supporting the Health System






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    Strengthening Health Systems: Moving beyond Supporting the Health System Strengthening Health Systems: Moving beyond Supporting the Health System Presentation Transcript

    • 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)
    • 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
    • Strengthening vs. supporting health systems
    • 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
      Policies and regulations
      Organizational structures
      Behaviors of HS actors
    • A “cube” view of the health system
      © Abt Associates, 2001
    • 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
    • Inputs vs. other key HSS performance drivers
      © Abt Associates, 2001
    • © Abt Associates, 2001
    • 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
      Joe Kutzin
      Marty Makinen
      David Evans
      Tahgreed Adams
    • Thank you