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
This certificate certifies that Vijayakumar Munirathnam has fulfilled the requirements to be certified as a Lean Six Sigma Black Belt by GreyCampus Inc. as of August 5, 2016. GreyCampus is a global leader in training and certification with customer support available at customersupport@greycampus.com.
Where in USAID’s Health Systems Strengthening (HSS) Approach is the Community...CORE Group
The document discusses USAID's approach to health systems strengthening (HSS) and how communities fit within that framework. It describes HSS as strategies to improve health system performance in order to sustainably improve health outcomes. The community is involved in several areas of the HSS framework, including leadership and governance, financing, information, human resources, medical products and technologies, and service delivery. At the outcomes level, a strengthened health system should provide financial protection, quality services, population coverage, and responsiveness for communities. Ultimately, effective health systems are aimed at ensuring mothers and children do not die from preventable causes.
This document summarizes a meeting discussing how to better incorporate communities into existing models of health system strengthening. The World Health Organization's six building blocks model was used as a starting point. Meeting participants reviewed each building block and considered how communities could be more explicitly included. They identified several key areas missing from current models, such as an emphasis on community-based health services and civil society engagement. The overall goal was to stimulate discussion on better representing communities and community health in global health frameworks and funding.
Summary – Future Health Solutions in Emerging Market Service (Vietnam), Team ...Team Finland Future Watch
This document summarizes the key findings of a study on the healthcare market in Vietnam. It finds that while public healthcare has improved due to increased investment, more is needed especially in rural areas. The population is growing more health conscious and mobile penetration is high, indicating potential for mHealth adoption. However, infrastructure and literacy challenges exist, especially for ethnic minorities. The report also finds openness to personalized medicine among patients, but concerns around cost and accuracy. It provides demographic details on Vietnam's population distribution and diversity.
Visual Design Basics: The Building Blocks of a Great SlideChiara Ojeda
This document provides tips for improving presentation slides. It suggests making slides more visually appealing by using images, charts, and color to engage the audience. A website is referenced that offers additional resources for learning how to refine slide design and content.
The document discusses business model design and testing. It emphasizes that business plans often fail upon contact with customers, so business models need to be tested through prototypes and by talking to customers to validate hypotheses. The document encourages designing business models systematically using tools like the Business Model Canvas, and iterating models through testing and pivoting based on customer feedback.
The document outlines the development of core nursing competencies in Massachusetts to establish a seamless progression through all levels of nursing education and transition nurses into practice settings. A working group composed of nursing educators and leaders developed competencies based on a review of other state and national standards. The competencies are intended to serve as a framework for a competency-based nursing education model. Feedback is being sought from nursing faculty and practitioners to refine the competencies.
Here is a draft essay applying Peplau's nursing theory to the implementation of electronic health records:
Introduction:
Hildegard Peplau developed the interpersonal relations theory, one of the early nursing theories focused on the nurse-patient relationship. Peplau's theory outlines four phases of the nurse-patient relationship: orientation, identification, exploitation, and resolution. This theory provides a useful framework for examining how nurses can support patients through the transition to electronic health records (EHRs).
Orientation Phase:
When EHRs are first implemented, both nurses and patients will be in the orientation phase. Nurses will need training on the new system while patients may feel confused or anxious about the changes in documentation. It
This certificate certifies that Vijayakumar Munirathnam has fulfilled the requirements to be certified as a Lean Six Sigma Black Belt by GreyCampus Inc. as of August 5, 2016. GreyCampus is a global leader in training and certification with customer support available at customersupport@greycampus.com.
Where in USAID’s Health Systems Strengthening (HSS) Approach is the Community...CORE Group
The document discusses USAID's approach to health systems strengthening (HSS) and how communities fit within that framework. It describes HSS as strategies to improve health system performance in order to sustainably improve health outcomes. The community is involved in several areas of the HSS framework, including leadership and governance, financing, information, human resources, medical products and technologies, and service delivery. At the outcomes level, a strengthened health system should provide financial protection, quality services, population coverage, and responsiveness for communities. Ultimately, effective health systems are aimed at ensuring mothers and children do not die from preventable causes.
This document summarizes a meeting discussing how to better incorporate communities into existing models of health system strengthening. The World Health Organization's six building blocks model was used as a starting point. Meeting participants reviewed each building block and considered how communities could be more explicitly included. They identified several key areas missing from current models, such as an emphasis on community-based health services and civil society engagement. The overall goal was to stimulate discussion on better representing communities and community health in global health frameworks and funding.
Summary – Future Health Solutions in Emerging Market Service (Vietnam), Team ...Team Finland Future Watch
This document summarizes the key findings of a study on the healthcare market in Vietnam. It finds that while public healthcare has improved due to increased investment, more is needed especially in rural areas. The population is growing more health conscious and mobile penetration is high, indicating potential for mHealth adoption. However, infrastructure and literacy challenges exist, especially for ethnic minorities. The report also finds openness to personalized medicine among patients, but concerns around cost and accuracy. It provides demographic details on Vietnam's population distribution and diversity.
Visual Design Basics: The Building Blocks of a Great SlideChiara Ojeda
This document provides tips for improving presentation slides. It suggests making slides more visually appealing by using images, charts, and color to engage the audience. A website is referenced that offers additional resources for learning how to refine slide design and content.
The document discusses business model design and testing. It emphasizes that business plans often fail upon contact with customers, so business models need to be tested through prototypes and by talking to customers to validate hypotheses. The document encourages designing business models systematically using tools like the Business Model Canvas, and iterating models through testing and pivoting based on customer feedback.
The document outlines the development of core nursing competencies in Massachusetts to establish a seamless progression through all levels of nursing education and transition nurses into practice settings. A working group composed of nursing educators and leaders developed competencies based on a review of other state and national standards. The competencies are intended to serve as a framework for a competency-based nursing education model. Feedback is being sought from nursing faculty and practitioners to refine the competencies.
Here is a draft essay applying Peplau's nursing theory to the implementation of electronic health records:
Introduction:
Hildegard Peplau developed the interpersonal relations theory, one of the early nursing theories focused on the nurse-patient relationship. Peplau's theory outlines four phases of the nurse-patient relationship: orientation, identification, exploitation, and resolution. This theory provides a useful framework for examining how nurses can support patients through the transition to electronic health records (EHRs).
Orientation Phase:
When EHRs are first implemented, both nurses and patients will be in the orientation phase. Nurses will need training on the new system while patients may feel confused or anxious about the changes in documentation. It
Heather Dawe: Applications of risk estimationNuffield Trust
The document discusses applications of risk estimation in healthcare. It summarizes that clinical indicators use risk adjustment models to estimate expected patient outcomes based on casemix and other factors. These expected outcomes are compared to actual observed outcomes to monitor quality and performance across providers and over time. It notes challenges in ensuring risk estimation models appropriately account for variables like innovative treatments and in identifying new indicators to monitor.
The document summarizes HIV prevention efforts in the SADC region. It notes that the region remains heavily affected by HIV/AIDS and outlines various regional commitments to address the epidemic. While some progress has been made, including declines in prevalence in some areas, prevention efforts still lag and programs are not implemented at sufficient scale. The document calls for strengthening prevention through priorities like social science research, leadership, evidence-based responses, and partnerships across multiple sectors.
Exploring the Relationship between HTA and Knowledge Management.HTAi Bilbao 2012
This document explores the relationship between health technology assessment (HTA) and knowledge management (KM) and how they are interrelated processes that support evidence-informed decision making. It provides definitions of HTA, KM, and knowledge translation. The document outlines four strategies to advance the relationship between HTA and KM: 1) disseminating evidence to connect people to decision making, 2) providing skills to apply evidence through the knowledge cycle, 3) engaging stakeholders to share HTA knowledge, and 4) facilitating, reviewing, and implementing best and innovative HTA practices. Challenges to building a knowledge sharing culture are also discussed.
This document discusses the 2010 WHO guidelines for preventing mother-to-child transmission of HIV. It summarizes EGPAF's programs in 16 countries that help implement the guidelines. The guidelines represent progress in HIV services and an opportunity to improve care. They will require increased logistical support, long-term follow-up, and integration between programs. If implemented widely, they could virtually eliminate pediatric HIV infections. EGPAF is developing toolkits to help countries adapt and apply the guidelines, and providing technical support for implementation.
Delivered by Craig Brammer at CITIH 2011. Focus on discussion of regional and national initiatives and opportunities for regional partners to leverage them for driving healthcare improvements, public health and research.
This session will provide a broad perspective on the many initiatives related to HIT. Experts from the regional and national level will discuss data models, privacy concerns and adoption strategies from their different perspectives. Also addressed will be planning for NHIN direct adoption as a complimentary strategic to full HIEs.
Stewart Mercer: Evaluation of primary care integration and transformation in ...STN IMPRO
This document summarizes the evaluation of primary care integration and transformation efforts in Scotland. It discusses Scotland's vision for placing primary care at the heart of the healthcare system with multidisciplinary teams providing integrated care. It outlines the need for evaluating the "middle ground" between practice and research. The Scottish School of Primary Care is evaluating Scotland's Primary Care Transformation Fund and new models of primary care through case studies and a long-term research program to support ongoing transformation efforts.
This is the abstract presentation of Sayantan Chowdhury of UNFPA Bangladesh, which was presented as part of the 9th session of #APCRSHR10 Virtual, on the theme of "Humanitarian response and sexual and reproductive health and rights (SRHR) in Asia and the Pacific".
C H A I R
Chonghee Hwang
Senior Manager, Family Planning 2020 (FP2020)
P L E N A R Y S P E A K E R
Tomoko Kurokawa
Humanitarian Advisor, UNFPA Asia Pacific
"Building Resilience across the Humanitarian Development Peacebuilding Nexus"
A B S T R A C T P R E S E N T E R S
* Sahlil Ahmed | Challenges Health Workers Face While Providing Sexual and Reproductive Health Services to Rohingya Refugees in Refugee Camps in Cox’s Bazar, Bangladesh: A Qualitative Study
* Sayantan Chowdhury | Genesis of maternal mortality surveillance and response in the Rohingya refugee crisis
* Sigma Ainul | Contraceptive non-use among the Rohingya and changing dynamics in post-displacement to Bangladesh
* Manju Karmacharya | Transitioning from Minimum Initial Service Package to Comprehensive SRHR services responding Rohingya crisis in protracted Emergency in Cox’s Bazar, Bangladesh
For more information on this session go to www.bit.ly/apcrshr10virtual9
#SRHR #sexualhealth #reproductiverights #familyplanning #womenshealth #genderequality #SDGs #BodilyAutonomy #humanitariancrisis #humanitariandisaster #pandemic
1) Current state of quality and safety in healthcare is poor, with routine safety processes failing regularly and preventable adverse events occurring commonly.
2) High reliability organizations like commercial aviation have achieved much higher levels of safety through effective process improvement, a strong safety culture, and principles of collective mindfulness.
3) The Joint Commission aims to transform healthcare into a high reliability industry through initiatives like robust quality measurement, establishing accountability criteria for measures, and promoting high reliability principles.
NHS Improving Quality and NHS England are working nationally with the Academic Health Science Networks to provide support and opportunities for the Collaboratives to learn from each other, ensuring the most effective and successful solutions are rapidly spread and adopted across England.
For the next five years, each Collaborative will support individuals, teams and organisations to build skills and knowledge about patient safety and quality improvement to create space and time to work on the challenges, and provide opportunities to learn from each other.
The programme is borne out of Professor Don Berwick's report last year into the safety of patients in England and builds on learning from the Francis and Winterbourne View recommendations. The report, A Promise to Learn - a commitment to act, made a series of recommendations to improve patient safety; and called for the NHS ''to become, more than ever before, a system devoted to continual learning and improvement of patient care, top to bottom and end to end.'
Aligned with and supporting the 'Sign up to Safety' campaign, the programme aims to make the NHS the safest healthcare system in the world by creating the culture to support a system devoted to continuous learning and improvement.
This resource summarises the Patient Safety Collaboratives current priority plans. Some of these plans are in consultation with partner organisations and may be subject to change. - See more at: http://www.nhsiq.nhs.uk/resource-search/publications/safety-collaborative-plans.aspx#sthash.O5lUFIQf.dpuf
The Strategy Unit was commissioned to create an evidence-based resource to support local primary care development strategies in the West Midlands. They conducted an evidence review on quality aspects of primary care that impact health outcomes and service utilization. The resulting resource provides a framework to guide discussions between commissioners, providers, and stakeholders on local priorities. It identifies key themes from the patient, clinical, and practice perspectives. Initial feedback indicates the resource will be useful to prompt conversations with patients on their vision for primary care excellence and help co-produce quality indicators for GP contracts. The Unit aims to inform ongoing primary care work through their methodology of rapidly conducting evidence reviews to balance rigor and timeliness.
Documenting Sexual and Reproductive Health Best Practices in SADCRouzeh Eghtessadi
This document proposes a framework for documenting and sharing best practices in sexual and reproductive health (SRH) in the Southern African Development Community (SADC) region. It summarizes findings from a desk review of SRH practices, guidelines, and progress in SADC member states. The review found limited systematic documentation and sharing of SRH best practices. The proposed framework would establish standardized criteria and processes for identifying, documenting, and exchanging SRH best practices to promote their adoption across the region. It outlines recommendations on SRH policies, practices, and a structure for the framework that defines essential criteria and integration into programming.
The document provides an introduction to a research report that compares perspectives and measures of quality in early years education and care. It discusses three approaches to measuring quality that are examined in the research: Ofsted inspection reports, the Environment Rating Scales (ECERS and ITERS), and quality assurance schemes. The introduction outlines the background context on the importance of quality early years provision. It defines different stakeholders involved in improving quality, including parents, local authorities, early years providers, and central government. It then presents the research questions focusing on stakeholder perspectives of quality and the associations between the different quality measures. The structure of the report is outlined across seven chapters, with the remainder providing context on approaches to measuring quality, the research methodology,
The how of a design, for health care quality improvement, made simple, would help constructing bridges for and effectively acceptable template for a better performance.
The role of real world data and evidence in building a sustainable & efficien...Office of Health Economics
This presentation defines RWD and RWE in the context of digital health, and looks at potential uses for RWD and RWE. It briefly sets out the current landscape in Malaysia and looks at the challenges in using RWE. In particular, the issues of access, governance and ensuring good quality are considered.
What Does Commissioning and Quality Improvement Mean to Me?Sarah Amani
This was a good question which got me thinking: there are so many buzz words in healthcare sometimes its good to unpack what we mean. As one of the areas I cover, Cornwall and the Isles of Scilly are of huge importantance and interest to me so I was really happy to be invited to meet with their impressive commissioning and quality improvement team to discuss this topic
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.
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.
More Related Content
Similar to Setting the Stage for Health Systems Strengthening: What We Have Learned from Doing Over 30 Health Systems Assessments
Heather Dawe: Applications of risk estimationNuffield Trust
The document discusses applications of risk estimation in healthcare. It summarizes that clinical indicators use risk adjustment models to estimate expected patient outcomes based on casemix and other factors. These expected outcomes are compared to actual observed outcomes to monitor quality and performance across providers and over time. It notes challenges in ensuring risk estimation models appropriately account for variables like innovative treatments and in identifying new indicators to monitor.
The document summarizes HIV prevention efforts in the SADC region. It notes that the region remains heavily affected by HIV/AIDS and outlines various regional commitments to address the epidemic. While some progress has been made, including declines in prevalence in some areas, prevention efforts still lag and programs are not implemented at sufficient scale. The document calls for strengthening prevention through priorities like social science research, leadership, evidence-based responses, and partnerships across multiple sectors.
Exploring the Relationship between HTA and Knowledge Management.HTAi Bilbao 2012
This document explores the relationship between health technology assessment (HTA) and knowledge management (KM) and how they are interrelated processes that support evidence-informed decision making. It provides definitions of HTA, KM, and knowledge translation. The document outlines four strategies to advance the relationship between HTA and KM: 1) disseminating evidence to connect people to decision making, 2) providing skills to apply evidence through the knowledge cycle, 3) engaging stakeholders to share HTA knowledge, and 4) facilitating, reviewing, and implementing best and innovative HTA practices. Challenges to building a knowledge sharing culture are also discussed.
This document discusses the 2010 WHO guidelines for preventing mother-to-child transmission of HIV. It summarizes EGPAF's programs in 16 countries that help implement the guidelines. The guidelines represent progress in HIV services and an opportunity to improve care. They will require increased logistical support, long-term follow-up, and integration between programs. If implemented widely, they could virtually eliminate pediatric HIV infections. EGPAF is developing toolkits to help countries adapt and apply the guidelines, and providing technical support for implementation.
Delivered by Craig Brammer at CITIH 2011. Focus on discussion of regional and national initiatives and opportunities for regional partners to leverage them for driving healthcare improvements, public health and research.
This session will provide a broad perspective on the many initiatives related to HIT. Experts from the regional and national level will discuss data models, privacy concerns and adoption strategies from their different perspectives. Also addressed will be planning for NHIN direct adoption as a complimentary strategic to full HIEs.
Stewart Mercer: Evaluation of primary care integration and transformation in ...STN IMPRO
This document summarizes the evaluation of primary care integration and transformation efforts in Scotland. It discusses Scotland's vision for placing primary care at the heart of the healthcare system with multidisciplinary teams providing integrated care. It outlines the need for evaluating the "middle ground" between practice and research. The Scottish School of Primary Care is evaluating Scotland's Primary Care Transformation Fund and new models of primary care through case studies and a long-term research program to support ongoing transformation efforts.
This is the abstract presentation of Sayantan Chowdhury of UNFPA Bangladesh, which was presented as part of the 9th session of #APCRSHR10 Virtual, on the theme of "Humanitarian response and sexual and reproductive health and rights (SRHR) in Asia and the Pacific".
C H A I R
Chonghee Hwang
Senior Manager, Family Planning 2020 (FP2020)
P L E N A R Y S P E A K E R
Tomoko Kurokawa
Humanitarian Advisor, UNFPA Asia Pacific
"Building Resilience across the Humanitarian Development Peacebuilding Nexus"
A B S T R A C T P R E S E N T E R S
* Sahlil Ahmed | Challenges Health Workers Face While Providing Sexual and Reproductive Health Services to Rohingya Refugees in Refugee Camps in Cox’s Bazar, Bangladesh: A Qualitative Study
* Sayantan Chowdhury | Genesis of maternal mortality surveillance and response in the Rohingya refugee crisis
* Sigma Ainul | Contraceptive non-use among the Rohingya and changing dynamics in post-displacement to Bangladesh
* Manju Karmacharya | Transitioning from Minimum Initial Service Package to Comprehensive SRHR services responding Rohingya crisis in protracted Emergency in Cox’s Bazar, Bangladesh
For more information on this session go to www.bit.ly/apcrshr10virtual9
#SRHR #sexualhealth #reproductiverights #familyplanning #womenshealth #genderequality #SDGs #BodilyAutonomy #humanitariancrisis #humanitariandisaster #pandemic
1) Current state of quality and safety in healthcare is poor, with routine safety processes failing regularly and preventable adverse events occurring commonly.
2) High reliability organizations like commercial aviation have achieved much higher levels of safety through effective process improvement, a strong safety culture, and principles of collective mindfulness.
3) The Joint Commission aims to transform healthcare into a high reliability industry through initiatives like robust quality measurement, establishing accountability criteria for measures, and promoting high reliability principles.
NHS Improving Quality and NHS England are working nationally with the Academic Health Science Networks to provide support and opportunities for the Collaboratives to learn from each other, ensuring the most effective and successful solutions are rapidly spread and adopted across England.
For the next five years, each Collaborative will support individuals, teams and organisations to build skills and knowledge about patient safety and quality improvement to create space and time to work on the challenges, and provide opportunities to learn from each other.
The programme is borne out of Professor Don Berwick's report last year into the safety of patients in England and builds on learning from the Francis and Winterbourne View recommendations. The report, A Promise to Learn - a commitment to act, made a series of recommendations to improve patient safety; and called for the NHS ''to become, more than ever before, a system devoted to continual learning and improvement of patient care, top to bottom and end to end.'
Aligned with and supporting the 'Sign up to Safety' campaign, the programme aims to make the NHS the safest healthcare system in the world by creating the culture to support a system devoted to continuous learning and improvement.
This resource summarises the Patient Safety Collaboratives current priority plans. Some of these plans are in consultation with partner organisations and may be subject to change. - See more at: http://www.nhsiq.nhs.uk/resource-search/publications/safety-collaborative-plans.aspx#sthash.O5lUFIQf.dpuf
The Strategy Unit was commissioned to create an evidence-based resource to support local primary care development strategies in the West Midlands. They conducted an evidence review on quality aspects of primary care that impact health outcomes and service utilization. The resulting resource provides a framework to guide discussions between commissioners, providers, and stakeholders on local priorities. It identifies key themes from the patient, clinical, and practice perspectives. Initial feedback indicates the resource will be useful to prompt conversations with patients on their vision for primary care excellence and help co-produce quality indicators for GP contracts. The Unit aims to inform ongoing primary care work through their methodology of rapidly conducting evidence reviews to balance rigor and timeliness.
Documenting Sexual and Reproductive Health Best Practices in SADCRouzeh Eghtessadi
This document proposes a framework for documenting and sharing best practices in sexual and reproductive health (SRH) in the Southern African Development Community (SADC) region. It summarizes findings from a desk review of SRH practices, guidelines, and progress in SADC member states. The review found limited systematic documentation and sharing of SRH best practices. The proposed framework would establish standardized criteria and processes for identifying, documenting, and exchanging SRH best practices to promote their adoption across the region. It outlines recommendations on SRH policies, practices, and a structure for the framework that defines essential criteria and integration into programming.
The document provides an introduction to a research report that compares perspectives and measures of quality in early years education and care. It discusses three approaches to measuring quality that are examined in the research: Ofsted inspection reports, the Environment Rating Scales (ECERS and ITERS), and quality assurance schemes. The introduction outlines the background context on the importance of quality early years provision. It defines different stakeholders involved in improving quality, including parents, local authorities, early years providers, and central government. It then presents the research questions focusing on stakeholder perspectives of quality and the associations between the different quality measures. The structure of the report is outlined across seven chapters, with the remainder providing context on approaches to measuring quality, the research methodology,
The how of a design, for health care quality improvement, made simple, would help constructing bridges for and effectively acceptable template for a better performance.
The role of real world data and evidence in building a sustainable & efficien...Office of Health Economics
This presentation defines RWD and RWE in the context of digital health, and looks at potential uses for RWD and RWE. It briefly sets out the current landscape in Malaysia and looks at the challenges in using RWE. In particular, the issues of access, governance and ensuring good quality are considered.
What Does Commissioning and Quality Improvement Mean to Me?Sarah Amani
This was a good question which got me thinking: there are so many buzz words in healthcare sometimes its good to unpack what we mean. As one of the areas I cover, Cornwall and the Isles of Scilly are of huge importantance and interest to me so I was really happy to be invited to meet with their impressive commissioning and quality improvement team to discuss this topic
Similar to Setting the Stage for Health Systems Strengthening: What We Have Learned from Doing Over 30 Health Systems Assessments (20)
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.
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 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.
NHA Production Tool: Streamlining the NHA Estimation Process Health Systems 20/20
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...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.
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 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.
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 HAPSATHealth Systems 20/20
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
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.
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.
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 ActionHealth Systems 20/20
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 SystemHealth Systems 20/20
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...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 EthiopiaHealth Systems 20/20
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 EgyptHealth Systems 20/20
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.
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?Health Systems 20/20
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...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.
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7shruti jagirdar
Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
to be treated is characteristically a disease of aging ( e.g., Alzheimer's disease) or
because the population to be treated is known to include substantial numbers of
geriatric patients (e.g., hypertension).
Know the difference between Endodontics and Orthodontics.Gokuldas Hospital
Your smile is beautiful.
Let’s be honest. Maintaining that beautiful smile is not an easy task. It is more than brushing and flossing. Sometimes, you might encounter dental issues that need special dental care. These issues can range anywhere from misalignment of the jaw to pain in the root of teeth.
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)MuskanShingari
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
How to Control Your Asthma Tips by gokuldas hospital.Gokuldas Hospital
Respiratory issues like asthma are the most sensitive issue that is affecting millions worldwide. It hampers the daily activities leaving the body tired and breathless.
The key to a good grip on asthma is proper knowledge and management strategies. Understanding the patient-specific symptoms and carving out an effective treatment likewise is the best way to keep asthma under control.
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
Lecture 6 -- Memory 2015.pptlearning occurs when a stimulus (unconditioned st...AyushGadhvi1
learning occurs when a stimulus (unconditioned stimulus) eliciting a response (unconditioned response) • is paired with another stimulus (conditioned stimulus)
DECLARATION OF HELSINKI - History and principlesanaghabharat01
This SlideShare presentation provides a comprehensive overview of the Declaration of Helsinki, a foundational document outlining ethical guidelines for conducting medical research involving human subjects.
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montreal
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Setting the Stage for Health Systems Strengthening: What We Have Learned from Doing Over 30 Health Systems Assessments
1. better systems, better health
Setting the Stage for Health Systems
Strengthening: What We Have Learned from
Doing Over 30 Health System Assessments
Better Health Systems: Strategies that Work
Presentation Series at the Global Health Council
Michael Rodriguez, MA
Danielle Altman, MA
March 6, 2012
Abt Associates Inc.
In collaboration with:
I Aga Khan Foundation I Bitrán y Asociados
I BRAC University I Broad Branch Associates
I Deloitte Consulting, LLP I Forum One Communications
I RTI International I Training Resources Group
I Tulane University’s School of Public Health
3. Health System Assessment Approach
Broad USAID’S Health System
health Assessment Approach
system
Scope
Focused
R
A
Pr
A
Pr
D
Pr
ec
ss
na
ec
og
io
of
om
es
ly
is
rit
ra
i le
sm
si
io
m
iz
m
s
s
n-
en
at
en
m
m
io
da
in
t
ak
n
g
tio
in
ns
g
Decision-Making Process
4. Objectives and Use of Health System
Assessments
HSA approach piloted in Angola, Benin, and Azerbaijan in
2005-2007
Rapid yet comprehensive/integrated approach
Findings inform stakeholders of critical
system strengths and constraints
Recommendations developed that cut
across the building blocks
HSS interventions prioritized
6. Steps in the Health System Assessment
Approach
Validation/prioritization workshop and final report
4 •Validate findings and prioritize recommendations at
stakeholder workshop
•Produce final report
Analyze findings
•Analyze findings by building block
3 •Develop cross-cutting findings and recommendations
•Prepare preliminary report of key findings and recommendations
Data collection and launch workshop
2 •Review background materials and compile data on quantitative indicators
•HSA launch workshop for in-country stakeholders
•Interview key informants
Shape the assessment
1 •Identify needs and priorities of client
•Agree on scope and use of assessment
•Choose indicators within each module to answer client’s priority questions
7. Documented Uses of HSA Results
Ukraine: Inform health
reform agenda
Lesotho: Inform MOHSW
Eastern Caribbean: Support health system activities
implementation of US- through Millennium Challenge
Caribbean Regional HIV and Account; USG Partnership
AIDS Partnership Framework in Framework; National Health
6 countries Policy and Strategic Plan
8. Documented Use of HSA in Senegal
HSA Recommendation HSA Action Item
Improve technical coordination at MOH; Create department of planning, research, monitoring and
strengthen the planning unit evaluation at the MOH
Devise strategies to relieve HRH Change health system at peripheral level, so that health
shortages district coordinators do not also head district health
centers. Separate district health offices from health centers
Strengthen regional health districts Change design of health system at intermediate level by
transforming regional health offices to regional
departments of health with more power over human
resources management, financial management, and
service delivery
Improve planning around health Draft a law to enable pooling of funds for free-care
insurance services and health insurance
9. Evolution of the HSA Approach
2005 - 2012
Incorporate assessment of private sector
Build capacity in HSA methodology
Standardize and strengthen stakeholder
engagement approach
10. Evolution of the HSA Manual
Version 1.75
25 countries
Version 1.5
Tanzania, Uganda,
Ukraine, Mozambique,
Ethiopia, Benin, St.
13 countries
Kitts and Nevis,
Vietnam, Namibia,
Antigua, St. Vincent
Version 1.0 Nigeria, Senegal, Cote
and the Grenadines,
d’Ivoire, Lesotho,
Grenada, Dominica,
3 pilot countries Zimbabwe, Angola,
and St. Lucia
Benin, Angola, Kenya, Guyana
Azerbaijan
2005 – 2007 2007 – 2010 2011 – 2012
11. Incorporating Private Sector into HSA
Approach
Governments face constraints in delivering essential health services
Harnessing private sector can help relieve public sector constraints
and can result in:
Increased efficiencies in management
Expanded health workforce and service delivery infrastructure
Additional resources
Increased responsiveness to consumer preferences
Broader market for health promotion messages
Better/more creative policymaking
Particularly critical to help sustain HIV response as countries face
static or declining external aid for HIV/AIDS
Source: International Finance Corporation 2007; Barnes et al. 2009
11
12. Recognizing Private Sector Role In Health
Systems Strengthening
Source: Arur A. et al. 2010. Strengthening Health Systems by Engaging the Private Health Sector: Promising HIV/AIDS Partnerships. 12
SHOPS Project, Abt Associates.
13. Strategies for Strengthening Health Systems
Through Partnerships with Private Sector
Source: Arur A. et al. 2010. Strengthening Health Systems by Engaging the Private Health Sector: Promising HIV/AIDS
Partnerships. SHOPS Project, Abt Associates. 13
14. Building Capacity in the HSA
Methodology
Health Systems 20/20’s capacity building strategy
aims to transition health system strengthening
methodologies to regional partners
Enhance country ownership of HSA process and
recommendations
15. Developing Regional Capacity
Health Systems 20/20 has trained HSPI (Vietnam), IRSP
(Benin), and Makerere University (Uganda) in HSA approach
Health Systems Assessment - Technical Skill Set
Health systems knowledge in six building blocks
Stakeholder engagement
Qualitative data collection and analysis
Technical writing
These institutions will market their skills and use the HSA
methodology without Health Systems 20/20 support
16. Building MOH Capacity in HSA
Guyana
MOH staff shadowed Health Systems 20/20
assessment team and participated in collecting
data for each module
Health Systems 20/20 wrote bulk of report
MOH will use the approach to monitor progress
over time
17. Building HSA Capacity – Lessons
Learned
Participation of MOH staff on HSA enhances
country ownership of HSA recommendations
Intensive training needed, particularly in
qualitative data collection and analysis
Need for long-term strengthening of regional
institutions
Transferring HSA methodology is a long-term
process
18. Strengthening and Standardizing HSA
Stakeholder Engagement Methodology
Engaging Stakeholders in Health System Assessments:
A Guide for HSA Teams
19. Stakeholder Engagement Guide
Guides HSA team in involving a wide range of health
system stakeholders – government,
nongovernmental and civil society groups, research
and academia, and private sector – throughout all
phases of the HSA
Describes stakeholder engagement in greater detail
than the HSA manual
20. Stakeholder Engagement Guide cont’d
Provides user-friendly job aids, tools, and guidance:
During Planning Phase
Drafting potential list of key stakeholders
Planning and coordinating the HSA team participants
Conducting pre-assessment visits
Assessment Phase
Gathering data
Conducting in-country debriefing session on initial findings
Validation Phase
Validating findings with stakeholders
Prioritizing and action planning key proposed interventions
21. Summary
Health system strengthening is not a result, it’s a
process
The HSA methodology sets the stage for health
systems strengthening
The HSA approach highlights linkages across the
building blocks
As HSAs have been completed, results have fed
back into adaption and modification of the
methodology
22. Version 1.5 of the HSAA Manual
Available at the following URL:
http://www.healthsystemassessment.com/
You can register on the site for updates as they are
made
23. better systems, better health
Thank you
Thank you!
www.HealthSystems2020.org
Abt Associates Inc.
In collaboration with:
I Aga Khan Foundation I Bitrán y Asociados
I BRAC University I Broad Branch Associates
I Deloitte Consulting, LLP I Forum One Communications
I RTI International I Training Resources Group
I Tulane University’s School of Public Health
Editor's Notes
Version 1.75 incorporates lessons learned from last five years of conducting HSA What is the added value of the HSA approach? The tool began to be developed in 2005. An approach was needed that helps to: Diagnose health systems strengths and weaknesses Prioritize key constraints and areas for interventions Identify potential solutions for health systems strengthening Existing tools (in early 2005) did not offer comprehensive health systems assessment Some focused on profiles (PAHO, European Observatory) None allowed for integration across health systems functions and development of recommendations with a consistent set of indicators The framework is based on a WHO framework
Based on WHO building blocks Also discuss private sector as an assessment domain that penetrates all 6 building blocks.
MR – do we want to pick a few examples to show how HSA has been used, or just use the big table on the next three slides? Senegal - The HSA assessed the implementation of the ten-year national health strategy that was coming to a close at the time of the assessment. The HSA was tailored to provide input into the upcoming ten-year strategy the MOH was embarking on developing. The HSA approach was particularly suited to the needs of the MOH. At the time of the assessment, the MOH was already seeking a broad snapshot of what had been achieved and not achieved over the previous ten years, and what the bottlenecks were to health system performance. The MOH wanted and to use the results of such an assessment for developing the next ten-year strategy. The HSA was thus tailored to the needs of the MOH. The HSA addressed the following health system constraints: (1) Lack of technical coordination at the MOH; (2) weak planning unit at the MOH; (3) HRH shortages; (4) weak regional health districts; (5) segmentation of funds and responsibilities in the area of health financing; (6) lack of harmonized planning at district-level; and (7) weak planning around health insurance. The new ten-year health strategy responded to nearly every major recommendation in the HSA. The MOH is implementing all major HSA recommendations, including two that were not addressed directly in the ten-year health strategy. Bottlenecks 1 and 2 were addressed through the reorganization of the planning unit at the MOH (IR 2, Sub-IR 2.3, IR 3, Sub-IR 3.3). One issue in relation to bottleneck 3 was addressed by separating district health office management and district hospital management functions. Previously, one district health officer was in charge of managing both the district health office and the district hospital (Sub-IR 3.2). An Abt bilateral is currently implementing this intervention. Bottleneck 4 was addressed by delegating more power to regional health districts and strengthening their capacity (IR 2, Sub-IR 2.3, IR 3, Sub-IR 3.3).. Bottlenecks 5 and 7 are being addressed by the creation of one basket funding mechanism. The MOH is currently drafting the law that will enable the development of this new funding mechanism (IR 1, IR 3, Sub-IR 3.1). Bottleneck 6 is being addressed by improving coordination at the district-level (IR 2). At the time of the assessment, the MOH generally needed strengthened systems for governance and health financing. The MOH was also attempting to deal with the challenges of decentralization. The HSA proposed interventions to overcome major bottlenecks that affect every aspect of the health system (including weak planning at the MOH and fragmentation of health financing). The HSA also proposed smaller scale, easily actionable interventions (such as separating district health office and district hospital management) to relieve smaller scale constraints. In addition, by developing recommendations to resolve health system constraints at the national, regional, and district level, the HSA supported health system strengthening at all levels of the health system. Finally, by providing a comprehensive snapshot of health system performance against a previous ten-year national health strategy in order to inform the next ten year strategy, the HSA became a tool for USAID/Uganda to use in soliciting further health systems strengthening projects that were highly targeted, and in line with larger national health goals and plans. .
2008, A variety of factors contributed to the adoption of HSA recommendations into Senegal’s strategic plan: The assessment was requested by the Ministry to feed directly into their planning process; The short timeframe of the assessment allowed for the information to be readily available; Stakeholders were involved throughout the assessment to ensure that the findings were relevant to their needs. The HSA was used to guide the development of the ten-year strategic plan covering the period from 2009 to 2018
HSAs have been adapted in various ways to meet client needs and country context.
For example, findings from the HSAs in the Caribbean reveal a strong reliance on the private health sector as a first source of care, ranging from 23 percent in Dominica to over 40 percent in Antigua. Renewed focus on importance of health system functioning to achieve health goals Despite this, the private health sector–particularly the for-profit sector–tends to be overlooked in health systems strengthening initiatives that are traditionally focused on the public sector. A likely explanation for this is that the private health sector tends to be viewed in isolation and is not often conceptualized in a health systems framework.
Building on the WHO HSS building block framework, the 2012 HSA approach conceptualizes the private sector as an integral part of the health system. The manual presents a framework for incorporating the private sector into the building-block specific and cross-cutting analysis. Key private sector actors, organizations, contributions, and gaps are explored within and across each building block. Private sector stakeholders and engaged and interviewed throughout the HSA. [address Peter’s comments] Doesn’t prioritize which block is more important, and doesn’t show causal relationships First step, increasing awareness of who are key actors and what they are doing or could do HSoptimal way to identify the key actors in a specific country context, and ways that they are engaged or could be in HSS Let’s turn our attention to the different components of a health system and the range of private sector actors. This is diagram – which is on the wall as a reference as well as a handout in your packet – is based on the WHO six building blocks. The six building blocks are in the middle green circle. They include governance; information; financing; human resources and medicine and technology. The outer blue ring illustrates the breadth and scope of private sector providers. Private sector is a cross–cutting theme in each of health system building blocks LIST A FEW BY BUILDING BLOCK As you can note, there are a diverse range of private sector actors beyond private healthcare providers. As mentioned before, the diversity presents a challenge for public sector because the private health sector is often fragmented and not “organized”. The breadth of private sector actors also presents an opportunity, offering a greater range of PPP possibilities that can strengthen the health system. Another important observation is that many of the same private health sector actors are present in multiple building blocks. This signifies that when the public sector can effectively work with the private sector partners it not only helps strengthen one building block but in most cases, several health systems.
SVG and St. Lucia -- Missing private sector data; no population-based surveys; no sero-prevalence surveys. Need to capture statistics on health indicators across the whole population When developing recommendations with stakeholders, opportunities are identified for harnessing the private sector to support health systems strengthening and improve health outcomes. Figure above represents some major strategies to strengthen health systems through the private sector It illustrates the range of policy instruments and mechanisms to engage and partner with the private sector. As the figure illustrates, there are multiple tools and approaches to engage the private sector. Of course the mechanism depends on the element of the health system one is trying to strengthen. For example, MENTION A FEW. It is important to note that: The range of tools illustrated in this diagram reveal that there are many ways to engage the private sector above and beyond just PPPs That most private sector interventions touch/relate to more than one health system building block
Larger capacity building strategy across all HS2020 activities…. As part of a health systems strengthening strategy, once the methodology was solidified, the aim was to start institutionalizing the methodology. We have built MOH capacity in HSA approach, and regional capacity of African research institutions to conduct HSAs
HSPI has conducted two provincial level HSAs in Vietnam Makerere is conducting HSAs in Uganda and Ethiopia IRSP is conducting an HSA in Benin
Goal – build capacity of MOH to coordinate and monitor HSS activities Cote d’Ivoire: Multiple Stakeholder training workshops at the National level, by WB and HS 20/20. Technical work was conducted by national working groups who wrote 90% of the report. The exercise was country led. Bulk of the work was conducted by mid-level technical staff from gov’t agencies. High level decision makers attended a launch and will attend the dissemination country led process, consultative, participatory, results will be used to inform project development by WB and other partners, as well as partnership framework. Cost benefit, capacity built. time, challenges in sustaining momentum/involvement of MOH colleagues, no field level data collection
HSA stakeholder engagement guide – piloted in Guyana and adapted and used all 2010 – 2011 HSAs (17 HSAs in total) Steps in the approach – shaping assessment, launch workshop, key informant interviews, validation and prioritization workshop Emphasize broad range of stakeholders interviewed – government, dev partners, civil society, healthcare providers, and private businesses Wide range – 100+ key stakeholder interviews Regional and district-level site visits and interviews Goal is to enhance country ownership through Interviewing key informants at this scale and at this range requires a structured approach. It is not a standard assessment, in which a team flies in, writes the report, and then calls people together for the dissemination of findings. Stakeholders are engages up front to define objectives, agree on process, participate in data gathering and validation, and continue to be involved through the validation and prioritization process. In order to engage people at this range and scale in the most productive way, a standardized approach was needed.