The document discusses health systems strengthening (HSS) programs and approaches in Ethiopia. There is no clear or common understanding of what HSS entails. It can be viewed as focused on health subsystems, diseases, or construction of facilities. The key HSS building blocks experienced in Ethiopia include health financing, workforce, information systems, supply management, and governance. Financing for HSS comes from various global and bilateral partners as well as the Ethiopian government. Recommendations include focusing on the big picture of comprehensive HSS, establishing networking, and promoting harmonization of the HSS concept.