Working with the “institutional” health system: HAI’s model of health systems strengthening

Working with the “institutional” health system: HAI’s model of health systems strengthening
Emily deRiel, MPH – deriel@u.washington.edu
CORE Spring Meeting
April 30, 2010

Outline
Importance of public-sector institutional health system
How HAI works
Examples: Timor-Leste, Côte d’Ivoire
Opportunities to strengthen whole health system (institutional and community)

Importance of the public-sector institutional health system
Scalability
Equity and access (vs private sector)
Challenges of private sector: no quality advantage, greater cost, hard to regulate, doesn’t reach the poorest
Specialized services and referral system
Trust
Kruk et al, 2010: “a functioning, equitable health system can have important health and statebuilding benefits in post-conflict countries.”

How HAI works
Key areas
Integration of services into primary health care
Leadership and management
Health systems research
Community linkages
Advocacy

WHO building blocks
Everybody’s Business: Strengthening Health Systems to Improve Health Outcomes
WHO, 2007

HAI areas and WHO building blocks

HAI example: Timor-Leste
Improving maternal and newborn care, child spacing
Development of birth-friendly facilities
On-site training and mentoring of MCH District Program Officers; supervision tool
Support for district midwives and CHWs through monthly SISCa events

Formative research/assessments, evaluations
Operations research workshop in fall 2010
Community linkages
SISCa activities (as above)
Health promotion materials

HAI example: Côte d’Ivoire
Integrating HIV care and treatment into antenatal, outpatient, TB svcs
On-site training and mentoring
Procurement systems technical assistance
Electronic health info system pilot in 4 sites with MOH
Regional/district assessment meetings
Site visits with district supervision teams
Protocol development/updates

HAI example: Côte d’Ivoire
Operations research course August 2009
Follow-up course June 2010, build capacity of MOH staff to train others
Studies on barriers to care for HIV+ women
Community linkages
Women’s support groups, nutrition program

Some opportunities to strengthen whole health system
Services
Integrated package of services based on community needs
Stronger referral systems
Demand generation
Workforce
Ongoing supervision and support/payment of CHWs
Training and advancement opportunities

Some opportunities to strengthen whole health system
Products/Vaccines/Technologies
Procurement systems that extend to community level
Info
Data collection and input mechanisms and reporting
Financing
Mechanisms that ensure poorest have access
Leadership/Governance
National priorities, standards, protocols
Coordination of activities within national plan
Planning/needs at community level informs national plan, and vice versa

Small group discussion
What models or frameworks of the health system do you find most useful for your work?
and/or
What improvements can be made to existing models to better incorporate the community role in health systems?

Working with the “institutional” health system: HAI’s model of health systems strengthening

by jehill3 on May 04, 2010

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Working with the “institutional” health system: HAI’s model of health systems strengthening — Presentation Transcript