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Strengthening Health Systems: Moving beyond Supporting the Health System


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Strengthening Health Systems: Moving beyond Supporting the Health System

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