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Working with the “institutional” health system: HAI’s model of health systems strengthening<br />Emily deRiel, MPH – derie...
Outline<br />Importance of public-sector institutional health system<br />How HAI works<br />Examples: Timor-Leste, Côte d...
Importance of the public-sector institutional health system<br />Scalability<br />Equity and access (vs private sector)<br...
How HAI works<br />Key areas<br />Integration of services into primary health care<br />Leadership and management<br />Hea...
WHO building blocks<br />Everybody’s Business: Strengthening Health Systems to Improve Health Outcomes<br />WHO, 2007<br />
HAI areas and WHO building blocks<br />
HAI example: Timor-Leste<br />Improving maternal and newborn care, child spacing<br />Development of birth-friendly facili...
HAI example: Timor-Leste<br />Health systems research<br />Formative research/assessments, evaluations<br />Operations res...
HAI example: Timor-Leste<br />
HAI example: Côte d’Ivoire<br />Integrating HIV care and treatment into antenatal, outpatient, TB svcs<br />On-site traini...
  Regional/district assessment meetings
  Site visits with district supervision teams
  Protocol development/updates</li></li></ul><li>HAI example: Côte d’Ivoire<br />Health systems research<br />Operations r...
Some opportunities to strengthen whole health system<br />Services<br />Integrated package of services based on community ...
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Working with the “institutional” health system: HAI’s model of health systems strengthening

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

Emily deRiel, Health Alliance International

CORE Group Spring Meeting, April 30, 2010

Published in: Health & Medicine
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Transcript of "Working with the “institutional” health system: HAI’s model of health systems strengthening"

  1. 1. Working with the “institutional” health system: HAI’s model of health systems strengthening<br />Emily deRiel, MPH – deriel@u.washington.edu<br />CORE Spring Meeting<br />April 30, 2010<br />
  2. 2. Outline<br />Importance of public-sector institutional health system<br />How HAI works<br />Examples: Timor-Leste, Côte d’Ivoire<br />Opportunities to strengthen whole health system (institutional and community)<br />
  3. 3. Importance of the public-sector institutional health system<br />Scalability<br />Equity and access (vs private sector)<br />Challenges of private sector: no quality advantage, greater cost, hard to regulate, doesn’t reach the poorest<br />Specialized services and referral system<br />Trust<br />Kruk et al, 2010: “a functioning, equitable health system can have important health and statebuilding benefits in post-conflict countries.”<br />
  4. 4. How HAI works<br />Key areas<br />Integration of services into primary health care<br />Leadership and management<br />Health systems research<br />Community linkages<br />Advocacy<br />
  5. 5. WHO building blocks<br />Everybody’s Business: Strengthening Health Systems to Improve Health Outcomes<br />WHO, 2007<br />
  6. 6. HAI areas and WHO building blocks<br />
  7. 7. HAI example: Timor-Leste<br />Improving maternal and newborn care, child spacing<br />Development of birth-friendly facilities<br />Leadership and management<br />On-site training and mentoring of MCH District Program Officers; supervision tool<br />Support for district midwives and CHWs through monthly SISCa events<br />
  8. 8. HAI example: Timor-Leste<br />Health systems research<br />Formative research/assessments, evaluations<br />Operations research workshop in fall 2010<br />Community linkages<br />SISCa activities (as above)<br />Health promotion materials<br />
  9. 9. HAI example: Timor-Leste<br />
  10. 10. HAI example: Côte d’Ivoire<br />Integrating HIV care and treatment into antenatal, outpatient, TB svcs<br />On-site training and mentoring<br />Procurement systems technical assistance<br />Electronic health info system pilot in 4 sites with MOH<br /><ul><li> Leadership and management
  11. 11. Regional/district assessment meetings
  12. 12. Site visits with district supervision teams
  13. 13. Protocol development/updates</li></li></ul><li>HAI example: Côte d’Ivoire<br />Health systems research<br />Operations research course August 2009<br />Follow-up course June 2010, build capacity of MOH staff to train others<br />Studies on barriers to care for HIV+ women<br />Community linkages<br />Women’s support groups, nutrition program<br />
  14. 14. Some opportunities to strengthen whole health system<br />Services<br />Integrated package of services based on community needs<br />Stronger referral systems<br />Demand generation<br />Workforce<br />Ongoing supervision and support/payment of CHWs<br />Training and advancement opportunities<br />
  15. 15. Some opportunities to strengthen whole health system<br />Products/Vaccines/Technologies<br />Procurement systems that extend to community level<br />Info<br />Data collection and input mechanisms and reporting<br />Financing<br />Mechanisms that ensure poorest have access<br />Leadership/Governance<br />National priorities, standards, protocols<br />Coordination of activities within national plan<br />Planning/needs at community level informs national plan, and vice versa<br />
  16. 16. Small group discussion<br />What models or frameworks of the health system do you find most useful for your work?<br />and/or<br />What improvements can be made to existing models to better incorporate the community role in health systems?<br />
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