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Collaboration Workshop for Health System Strengthening. Triangle Global Health Consortium December 2, 2009. FHI Experience with HSS. FHI has many years of HSS experience through its management of public health programs and conducting public health research in developing countries
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Collaboration Workshop for Health System Strengthening Triangle Global Health Consortium December 2, 2009
FHI Experience with HSS • FHI has many years of HSS experience through its management of public health programs and conducting public health research in developing countries • The programs have not always been labeled HSS • The following are illustrative examples of FHI’s work under each of the 6 health system building blocks
Service Delivery • Organization & Integration of Services • Integration of FP & TB services into HIV services • Creation of referral networks: KIDMAP for OVC in Nigeria, HIV program referral model in Zambia • Study on effects of HIV/AIDS services on use of other services in Rwanda* • Quality Improvement Efforts • Strengthened TB services in Senegal • Reduction of mother-to-child transmission of HIV, improved continuity of AIDS treatment, & increased cure rate of TB in Mozambique & Tanzania *Price, Jessica E., Leslie, Jennifer Asuka, Welsh, Michael and Binagwaho, Agnès'Integrating HIV clinical services into primary health care in Rwanda: a measure of quantitative effects', AIDS Care, 21: 5, 608 — 614
Work Force Development • Development of Training Curriculum for Capacity Building of Health Workers • HIV/AIDS, STI, FP, RH, OVC services • QA/QI, data management & analysis, research methods • Piloting of Innovative Solutions to Address Health Workforce Gaps • “Retired but not tired” program in Tanzania • Research on task-shifting in Rwanda • Training of local staff in operational and clinical research and research utilization in Kenya, India, and Vietnam
Health Information Systems • Development of Electronic HIS • Patient-tracking systems: LAMIS in Nigeria, Smart Care in Zambia • Data management systems: CAMIS in Cambodia, SISE in Senegal • Support for Surveys, Surveillance, M&E Systems • National IBBS in Nigeria & Vietnam • Conduct of data quality audit (DQA) in many countries
Governance • Support to Development of National Policies, Strategies, & Guidelines • Palliative care policy in Ivory Coast • National HIV/AIDS strategies in many countries • National STI management guidelines in India • Advocacy • Advocacy for direct state financing & leveraging of resources in India • Advocacy for essential drugs to be included in New Rural Health Insurance Mechanism in China
Medical Products, Vaccines, & Technologies • Product Quality Compliance • Comprehensive quality assurance of contraceptives & drugs • Support to procurement & distribution systems • Training of product quality lab personnel and assessing quality control of manufacturers producing public health commodities in developing countries • Lab Services Strengthening • Clinical research • Service delivery
Health Financing • Measuring incremental costs of interventions • Incremental cost of community-based PMTCT in Nepal • To inform budgeting process of MoH or part of CEA • Microeconomics & average costs of Studies • Costs of clinic-based HIV/AIDS services in Zambia • Costing of scaling-up services • Studies on financial sustainability of services in developing countries • Training NGOs in cost-recovery in many African and Latin America countries
Challenges • Few sponsors fund holistic HSS programs that effectively address all 6 building blocks • The contribution of current disease-control programs to HSS is not well documented • Not enough evidence on the best ways to design a HSS strategy • Should there be an HSS program or an HSS component of a vertical disease-control program?