CORE Group Global Health Practitioner Conference Fall 2017

1. Moving Beyond the Building Blocks:
Guiding Policymakers toward
Community Health Investments to
Strengthen Health Systems
CORE Fall Global Health Conference September 27, 2017

2. Part 1: Presentation of excerpts from
Beyond the Building Blocks: How health systems must address
community health to improve maternal, newborn and child health
Draft paper by Emma Sacks, Melanie Morrow,William
Story, Katharen Shelley, David Shanklin, Minal Rahimtoola,
Joseph Petraglia,Alfonso Rosales, and Eric Sarriot
Presented by Melanie Morrow, MCSP/ICF

3. Health Systems Strengthening is Foundational to
Achieving Global Health Goals and Initiatives
• UN’s Global Strategy for Women’s and Children’s
Health
• Community health identified as an “essential component of
health system resilience” and community engagement is “one
of the nine action areas (p.54)”
• Every Woman Every Child agenda
• USAID’s Acting on the Call

4. Health Systems Frameworks Reviewed for Community
• Review of 41 different HSS frameworks developed from 1972-
2011 (Hoffman et al, 2012)
• Most lacked reference to “communities” and “community
health” or lumped them under “context” or “population”
• In 2014, CORE Group organized a panel with reps from UN
agencies and USAID on the representation of community in
health systems models
• Conclusion: community was everywhere tacitly and
nowhere explicitly (Golding, 2014).

5. Building Blocks of the WHO Health System Framework
“A health system
consists of all
organizations, people
and actions whose
primary interest is to
promote, restore or
maintain health. This can
be analysed in its totality
by using different groups
or blocks.”
Source:
http://www.wpro.who.int/health_services/health
_systems_framework/en/

6. Community Health Frameworks
• CORE Group model for Community/Household IMCI model
(Winch, LeBan, Casazza,Walker and Pearcy 2002)
• Global Fund Community Systems Framework
• Future Health Systems’ “Unlocking Community Capabilities”
• People Centered Health model (WHO 2015)
• USAID’s Community Health Framework
• WHO’s 6 building blocks + 7th block for “community”

7. “Beyond the Building Blocks” Model

8. Community Organizing
• Community organizations are the practical construct through
which health systems can engage with communities as scale
• Community engagement, mobilization, participation and capacity
building
• Amplify the work of CHWs
• Leverage volunteerism
• Build trust, respect, negotiate priorities
• Not specific to the “how” – various approaches
• Participatory women’s groups, Care Groups, peer support,
committees, volunteers…

9. Societal Partnerships
• We refer to societal partnerships when a systematic policy is
established to encourage official agreements or systematic
working arrangements with non-profit associations, civil
society groups, and service providers (public or private).
• Collaboration is needed across organizations and sectors:
• Education, economic development, livelihood, social protection,
nutrition, agriculture, employment, and water and sanitation
• Context specific but requires intention with dedicated
intellectual, human and financial resources.

10. Part 2: Panel Discussion
Practical Examples of Community Organizing and Societal
Partnerships in Health Systems
Moderator
• Eric Sarriot
Discussants
• Jahangir Hossain, CARE Bangladesh
• Laura Altobelli, Future Generations Peru
• Karen LeBan, Independent

11. “Beyond the Building Blocks” Model

12. For more information, please visit
www.mcsprogram.org
This presentation was made possible by the generous support of the American people through the
United States Agency for International Development (USAID), under the terms of the Cooperative
Agreement AID-OAA-A-14-00028. The contents are the responsibility of the authors and do not
necessarily reflect the views of USAID or the United States Government.
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