Health Systems 2020 Overview 2011
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Health Systems 20/20 is a cooperative agreement led by Abt Associates with a ceiling of $125 million from 2006-2012. It focuses on financing, governance, operations, and capacity building in global health systems. It provides technical assistance to numerous countries in Africa, Asia, and Latin America on issues like national health accounts, health insurance schemes, performance-based financing, and evaluating HIV/AIDS programs. It aims to disseminate findings and best practices through workshops, conferences, and its website.
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This document summarizes key findings from National Health Accounts conducted in Egypt between 1994-2009. It finds that private out-of-pocket spending remains the largest source of health financing. While total health spending has increased over time, government spending as a percentage of total health spending and of the overall government budget is among the lowest in the region. There are also inequities in spending between rich and poor and urban and rural populations. The document calls for increased public investment in health and reforms to address these inequities and increase the role of comprehensive insurance.
Eastern Caribbean Health Systems Assessment
The document summarizes health system assessments conducted in 7 Eastern Caribbean countries in 2011. The objectives were to improve sustainability of health systems and HIV/AIDS programming with diminishing donor funds, provide an overview of each country's health sector, and develop recommendations. Key findings for Antigua and Barbuda included strengths in primary care and health workers, but weaknesses in strategic planning, legislation, quality assurance, and data management. Top recommendations were to invest in financial analysis and strategic planning, prioritize legal updates, improve efficiency and quality, and engage the private sector as a partner.
Lessons Learned in Organizational Capacity Building under Health Systems 20/20
This document discusses lessons learned from organizational capacity building efforts to strengthen health systems. It defines capacity building at the individual, organizational, and system levels. It then summarizes Health Systems 20/20's work strengthening over two dozen organizations across multiple countries over six years. Key lessons include: focusing capacity building on organizations that strengthen health systems; taking a comprehensive approach across all organizational competencies; ensuring partner buy-in and flexibility; and maximizing local expertise. Measurement of impact remains a challenge.
Setting the Stage for Health Systems Strengthening: What We Have Learned from...
Setting the Stage for Health Systems Strengthening: What We Have Learned from...Health Systems 20/20
The HSA approach is an innovative tool designed to provide a rapid yet comprehensive assessment of a country’s health system. With experience in conducting HSAs in Asia, Africa, and the Caribbean, presenters will highlight how HSA results are being used to strengthen health systems.
Presenter: Michael Rodriguez, Danielle Altman
NHA Production Tool: Streamlining the NHA Estimation Process
This presentation introduces the NHA Production Tool and covers key features and the development process. The NHA Production Tool is a desktop software application that guides teams through the steps of conducting National Health Accounts.
Comprehensive Approach to Building Afghanistan Health Economics & Finance Dir...
Comprehensive Approach to Building Afghanistan Health Economics & Finance Dir...Health Systems 20/20
The document discusses Afghanistan's health system challenges and a comprehensive approach to building a sustainable system. It outlines challenges like dependence on donors, high out-of-pocket costs, and low public spending. The proposed approach includes mobilizing local resources by training staff, gradually decreasing donor dependence through new revenue and improving budget execution, coordinating aid, and ensuring sustainability by transitioning donor-funded staff and improving salaries. The presentation reflects on designing a new system from scratch in post-conflict countries.Health Systems Strengthening in the DRC
The document discusses Health Systems 20/20's activities in the Democratic Republic of Congo (DRC) to strengthen health systems and policies. The program aimed to build capacity of national entities to improve health financing and management over 4 years with $7.3 million. Activities included national health accounts, developing performance-based financing policies, and strengthening institutions like the Kinshasa School of Public Health. Challenges in DRC included weak capacity, donor dependency, lack of local experts, and economic insecurity. The program worked to address these by building sustainable management skills, leveraging multiple donors, and creating incentives for performance and resources. Strengthening institutions and using tools like national health accounts and performance-based financing were seen as
Health Systems Strengthening in Fragile and Conflict-affected States: Introdu...
Health Systems Strengthening in Fragile and Conflict-affected States: Introdu...Health Systems 20/20
Health systems in fragile and conflict-affected states face significant challenges including limited availability of services, supplies, funding, infrastructure, and trained workers. Weaknesses are exacerbated in these settings and can indicate state fragility when service coverage is below average for countries with similar incomes or access is inequitable. To reduce fragility, health systems strengthening interventions in these contexts must meet population needs, build sustainable local capacity, enhance state legitimacy, and reinforce state authority.Lessons Learned from Health Financing Reform in Liberia
The document summarizes lessons learned from health financing reform in post-conflict Liberia from 2003-2009. It describes how the country's health system was in poor shape after years of conflict. With support from Health Systems 20/20, the Ministry of Health generated evidence on the health system and financing, consulted stakeholders, and developed a new health financing policy focused on equity, effectiveness, sustainability and accountability. This included performance-based contracting, expanding the essential health package, and exploring domestic financing sources. Capacity building helped stakeholders implement and sustain the reforms.
Tackling the Decline in HIV Resources: Lessons Learned from HAPSAT
The political will to achieve universal access of HIV services by 2015 juxtaposed with a decline in HIV donor funding requires HIV programs to rethink efforts to sustain scale-up of quality HIV services. This presentation provides insights into recurring HIV programing sustainability issues that have emerged from use of the HIV/AIDS Program Sustainability Analysis Tool (HAPSAT).
Presenter: Itamar Katz, Wendy Wong
December 2011
A "Cube" View of Health Systems Strengthening
This document proposes viewing health systems strengthening through a "cube" model, with three dimensions: inputs, stewardship functions, and health system building blocks. It suggests that inputs alone do not determine health outcomes and that stewardship functions and strengths across different health system building blocks also drive performance. The cube model provides a comprehensive framework for understanding how different elements interact to impact health system strengthening results.
Strengthening Health Systems: From Global to Local
There is conceptual confusion around health system strengthening (HSS) with multiple approaches being taken. This can lead to fragmentation and lack of agreed upon standards. However, the multiplicity of approaches also allows responsiveness to differing local contexts. Going forward it will be important to embrace more nationally-driven HSS agendas with support for national capacity. National commitment and leadership on HSS may be more important than global funding. Research needs to be more locally-driven and responsive to build an evidence base. Country ownership can motivate local researchers and facilitate links to policymakers.
Strengthening Health Systems Through Research, Education, and Action
The document discusses strengthening health systems through research, education, and action. It describes how Harvard School of Public Health conducts research on major health system topics. It educates students through various programs and executive courses. It also collaborates with governments, international agencies, and NGOs on applied research and health system reforms in many countries. Some examples mentioned include projects on malaria prevention, tuberculosis control in China, management training in Egypt, and using technology to support diagnosis.
Strengthening Health Systems: Moving beyond Supporting the Health System
This document discusses the difference between supporting and strengthening health systems. Supporting focuses on filling gaps for short-term outcomes, while strengthening makes the system function better long-term by addressing policies, behaviors, and relationships between building blocks. True health system strengthening interventions have cross-cutting benefits across disease areas, address organizational and policy constraints, and produce long-lasting systemic impact through country-specific approaches that define local roles. The document proposes criteria to identify health system strengthening and acknowledges there is no single approach, as interventions must consider each country's unique context and constraints.
What is Different in Different Approaches to Health Systems Strengthening?: A...
What is Different in Different Approaches to Health Systems Strengthening?: A...Health Systems 20/20
This document discusses different approaches to health systems strengthening. It notes that while health systems strengthening is a high priority, there is lack of consensus on its definition and how to implement it. The document explores health systems strengthening as having both conceptual dimensions related to principles and frameworks, as well as operational dimensions regarding coordination and implementation. It also examines the Global Fund's portfolio of health systems strengthening, noting common weaknesses in applications and proposing options to improve access and harmonization of health systems strengthening financing.Health Systems Strengthening Programs/Approaches: Experience from Ethiopia
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.
Development and Application of a Workforce Planning Model in Egypt
The document summarizes the development and application of a workforce planning model in Egypt. It outlines the need to better plan health workforce distribution given reforms. An adapted WHO model (WISN) was used to determine staffing requirements based on workloads and activity standards at hospitals. The results showed surpluses and gaps in staffing across specialties, hospitals, and governorates. Next steps include expanding the model to primary care and other sectors to better inform training programs and workforce planning.
Results of Brokering Regional PPPs-- more than just money
The document discusses the results and lessons learned from brokering public-private partnerships (PPPs) for health initiatives in Latin America and the Caribbean. It outlines several regional PPP projects that addressed priorities like clean drinking water, nutrition, maternal and child health, and health programming. The partnerships aligned the interests of USAID, companies, and regional implementation partners. Key challenges included navigating multinational structures and timelines, but opportunities existed to bring new resources and technologies to health and development through longer-term, flexible partnerships.
National Health Accounts: What do they Reveal in Cote d'Ivoire?
National health accounts were conducted in Côte d'Ivoire for the first time in 2007 and 2008 to estimate health spending. Total health expenditures increased 9.9% between 2007 and 2008. Households are the main source of health funding, contributing 69% of total health expenditures in 2008, mainly through high out-of-pocket spending on medicines. While total health spending per person is higher in Côte d'Ivoire than other sub-Saharan countries, government and donor contributions per person are much lower than household expenditures. Recommendations include developing policies to reduce out-of-pocket costs and give greater priority to primary healthcare.
Expanding Orphans and Vulnerable Children Support in Haiti: Improving the Def...
Expanding Orphans and Vulnerable Children Support in Haiti: Improving the Def...Health Systems 20/20
This document summarizes a study on supporting orphans and vulnerable children in Haiti. The study aimed to precisely define and cost the services provided to children. It found that while all partners reported providing educational and nutritional support, the type and cost of support varied widely between partners. The document recommends that partners precisely report support descriptions and costs to improve understanding of impact. It also suggests increasing specificity of monitoring and evaluation reporting and piloting output-based financial reporting of community-based care.More from Health Systems 20/20 (20)
Lessons Learned in Organizational Capacity Building under Health Systems 20/20
Lessons Learned in Organizational Capacity Building under Health Systems 20/20
Setting the Stage for Health Systems Strengthening: What We Have Learned from...
Setting the Stage for Health Systems Strengthening: What We Have Learned from...
NHA Production Tool: Streamlining the NHA Estimation Process
NHA Production Tool: Streamlining the NHA Estimation Process
Comprehensive Approach to Building Afghanistan Health Economics & Finance Dir...
Comprehensive Approach to Building Afghanistan Health Economics & Finance Dir...
Health Systems Strengthening in Fragile and Conflict-affected States: Introdu...
Health Systems Strengthening in Fragile and Conflict-affected States: Introdu...
Lessons Learned from Health Financing Reform in Liberia
Lessons Learned from Health Financing Reform in Liberia
Tackling the Decline in HIV Resources: Lessons Learned from HAPSAT
Tackling the Decline in HIV Resources: Lessons Learned from HAPSAT
Strengthening Health Systems: From Global to Local
Strengthening Health Systems: From Global to Local
Strengthening Health Systems Through Research, Education, and Action
Strengthening Health Systems Through Research, Education, and Action
Strengthening Health Systems: Moving beyond Supporting the Health System
Strengthening Health Systems: Moving beyond Supporting the Health System
What is Different in Different Approaches to Health Systems Strengthening?: A...
What is Different in Different Approaches to Health Systems Strengthening?: A...
Health Systems Strengthening Programs/Approaches: Experience from Ethiopia
Health Systems Strengthening Programs/Approaches: Experience from Ethiopia
Development and Application of a Workforce Planning Model in Egypt
Development and Application of a Workforce Planning Model in Egypt
Results of Brokering Regional PPPs-- more than just money
Results of Brokering Regional PPPs-- more than just money
National Health Accounts: What do they Reveal in Cote d'Ivoire?
National Health Accounts: What do they Reveal in Cote d'Ivoire?
Expanding Orphans and Vulnerable Children Support in Haiti: Improving the Def...
Expanding Orphans and Vulnerable Children Support in Haiti: Improving the Def...
Health Systems 2020 Overview 2011
- 1. Health Systems 20/20 Activities
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