The document discusses using a health systems strengthening (HSS) framework to improve maternal, neonatal, and child health outcomes. It describes the framework's elements including financing, organization, and regulation of the health system. It also discusses how the framework can be used as an assessment, programming, evaluation, and advocacy tool. The framework examines how national policies and health interventions impact communities and vice versa.

1. Strengthening Health Systems to improve Maternal, Neonatal & Child Health Outcomes A Framework Alex Ergo Nirali Shah Core Fall Meeting September 14, 2010

3. Impact on Maternal, Neonatal and Child Mortality and Morbidity Financing Organization Regulation Communication Health System Control Knobs Coverage & Quality of MNCH Interventions Community Physical Environment Population density Climate / terrain Social Environment Gender inequality Social cohesion/homogeneity Poverty/social inequality Cultural/social norms Health Care Sector Enabling Environment & Governance Leadership Oversight Policies and regulations Financing Provider payment Service Delivery Organization Infrastructure Health workforce Information Medical products Vaccines and technologies Households Household Characteristics Size and composition Wealth / Education Intra-household power relations Individual factors Biological factors Psychological factors Behavioral factors Other Sectors External Shocks Health System

4. Impact on Maternal, Neonatal and Child Mortality and Morbidity Financing Organization Regulation Communication Health System Control Knobs Coverage & Quality of MNCH Interventions Community Physical Environment Population density Climate / terrain Social Environment Gender inequality Social cohesion/homogeneity Poverty/social inequality Cultural/social norms Health Care Sector Enabling Environment & Governance Leadership Oversight Policies and regulations Financing Provider payment Service Delivery Organization Infrastructure Health workforce Information Medical products Vaccines and technologies Households Household Characteristics Size and composition Wealth / Education Intra-household power relations Individual factors Biological factors Psychological factors Behavioral factors Other Sectors External Shocks Health System 1. “What is” – Elements of the HS

5. Impact on Maternal, Neonatal and Child Mortality and Morbidity Financing Organization Regulation Communication Health System Control Knobs Coverage & Quality of MNCH Interventions Community Physical Environment Population density Climate / terrain Social Environment Gender inequality Social cohesion/homogeneity Poverty/social inequality Cultural/social norms Health Care Sector Enabling Environment & Governance Leadership Oversight Policies and regulations Financing Provider payment Service Delivery Organization Infrastructure Health workforce Information Medical products Vaccines and technologies Households Household Characteristics Size and composition Wealth / Education Intra-household power relations Individual factors Biological factors Psychological factors Behavioral factors Other Sectors External Shocks Health System 2. Tools - HSS

6. Strengthening the Health System Interventions within the health system Health System Strengthening Initiatives Scope and degree of policy-change involved

7. Impact on Maternal, Neonatal and Child Mortality and Morbidity Financing Organization Regulation Communication Health System Control Knobs Coverage & Quality of MNCH Interventions Community Physical Environment Population density Climate / terrain Social Environment Gender inequality Social cohesion/homogeneity Poverty/social inequality Cultural/social norms Health Care Sector Enabling Environment & Governance Leadership Oversight Policies and regulations Financing Provider payment Service Delivery Organization Infrastructure Health workforce Information Medical products Vaccines and technologies Households Household Characteristics Size and composition Wealth / Education Intra-household power relations Individual factors Biological factors Psychological factors Behavioral factors Other Sectors External Shocks Health System Dynamic Perspective

8. Impact on Maternal, Neonatal and Child Mortality and Morbidity Financing Organization Regulation Communication Health System Control Knobs Coverage & Quality of MNCH Interventions Community Physical Environment Population density Climate / terrain Social Environment Gender inequality Social cohesion/homogeneity Poverty/social inequality Cultural/social norms Health Care Sector Enabling Environment & Governance Leadership Oversight Policies and regulations Financing Provider payment Service Delivery Organization Infrastructure Health workforce Information Medical products Vaccines and technologies Households Household Characteristics Size and composition Wealth / Education Intra-household power relations Individual factors Biological factors Psychological factors Behavioral factors Other Sectors External Shocks Health System

9. Impact on Maternal, Neonatal and Child Mortality and Morbidity Financing Organization Regulation Communication Health System Control Knobs Coverage & Quality of MNCH Interventions Community Physical Environment Population density Climate / terrain Social Environment Gender inequality Social cohesion/homogeneity Poverty/social inequality Cultural/social norms Health Care Sector Enabling Environment & Governance Leadership Oversight Policies and regulations Financing Provider payment Service Delivery Organization Infrastructure Health workforce Information Medical products Vaccines and technologies Households Household Characteristics Size and composition Wealth / Education Intra-household power relations Individual factors Biological factors Psychological factors Behavioral factors Other Sectors External Shocks Health System

11. 2000 2010 Snapshot 1 Snapshot 2 Health Systems Strengthening initiatives Changes Main challenges Actions taken Remaining challenges Possible actions Other sectors and external shocks Improvements

14. Rose dies Henderson in nursing school Zandile attempts abortion SWAp Emergency HR program Pre-service training plan SLA’s with CHAM facilities Decentralization act CHAM salary MOU New president; Decentralization progress improves Community based MNH TBA role change EHP developed Infection Prevention interventions IP becomes govt program SBM-R for MNH National RH strategy Road map for MNH Global fund HSS grant ART provided for free HSAs provide DMPA Gladys gives birth Health System Strengthening Initiatives: Timeline 2010 2000 2004 2008 2006 2002

16. Impact on Maternal, Neonatal and Child Mortality and Morbidity Financing Organization Regulation Communication Health System Control Knobs Coverage & Quality of MNCH Interventions Community Physical Environment Population density Climate / terrain Social Environment Gender inequality Social cohesion/homogeneity Poverty/social inequality Cultural/social norms Health Care Sector Enabling Environment & Governance Leadership Oversight Policies and regulations Financing Provider payment Service Delivery Organization Infrastructure Health workforce Information Medical products Vaccines and technologies Households Household Characteristics Size and composition Wealth / Education Intra-household power relations Individual factors Biological factors Psychological factors Behavioral factors Other Sectors External Shocks Health System

19. Impact on Maternal, Neonatal and Child Mortality and Morbidity Financing Organization Regulation Communication Health System Control Knobs Coverage & Quality of MNCH Interventions Community Physical Environment Population density Climate / terrain Social Environment Gender inequality Social cohesion/homogeneity Poverty/social inequality Cultural/social norms Health Care Sector Enabling Environment & Governance Leadership Oversight Policies and regulations Financing Provider payment Service Delivery Organization Infrastructure Health workforce Information Medical products Vaccines and technologies Households Household Characteristics Size and composition Wealth / Education Intra-household power relations Individual factors Biological factors Psychological factors Behavioral factors Other Sectors External Shocks Health System

23. Impact on Maternal, Neonatal and Child Mortality and Morbidity Financing Organization Regulation Communication Health System Control Knobs Coverage & Quality of MNCH Interventions Community Physical Environment Population density Climate / terrain Social Environment Gender inequality Social cohesion/homogeneity Poverty/social inequality Cultural/social norms Health Care Sector Enabling Environment & Governance Leadership Oversight Policies and regulations Financing Provider payment Service Delivery Organization Infrastructure Health workforce Information Medical products Vaccines and technologies Households Household Characteristics Size and composition Wealth / Education Intra-household power relations Individual factors Biological factors Psychological factors Behavioral factors Other Sectors External Shocks Health System

25. The preceding slides were presented at the CORE Group 2010 Fall Meeting Washington, DC To see similar presentations, please visit: www.coregroup.org/resources/meetingreports