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Understanding HSS on the Ground

Health Systems Strengthening Programs/Approaches Experience from Ethiopia Eshete Yilma, USAID/Ethiopia Global Health Council Satellite Session June 13, 2011. Understanding HSS on the Ground. No clear and common understanding of what HSS is

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Understanding HSS on the Ground

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  1. Health Systems Strengthening Programs/Approaches Experience from EthiopiaEshete Yilma, USAID/Ethiopia Global Health Council Satellite SessionJune 13, 2011

  2. Understanding HSS on the Ground • No clear and common understanding of what HSS is • Sub-system-focused approach/strategy (health financing, etc.) • For many development partners, HSS is disease / program-based • For host government, HSS is mainly construction of facilities • Initiatives/programs camouflaging and distorting HSS • No strong networking of HSS groups

  3. Health System Building Blocks: Experience In Ethiopia • Health financing • Health workforce • Health information • Supply management system • Governance • Service delivery

  4. Financing Mechanism for HSS • MCH • GAVI • Global Fund • PEPFAR wrap-around • Bilateral and multilateral development partners • GOE at all levels

  5. 1. Health Sector Financing USAID Response Advocacy (NPA, NHA…) Create policy environment Private sector participation Fee retention-decentralization Health insurance Challenges • Health sector is underfinanced • Misallocation of resources • Large OOP expenditure • Limited participation of private sector • No protection for the poor /vulnerable groups

  6. 2. Health Taskforce Development Challenges • High attrition rate • Understaffed in rural areas • Delayed implementation of HRH strategy (incentive, training) USAID Response • Support public health colleges for a decade • 5,000 health officers trained • Support HEW program • Community health workers… task shifting

  7. 3. Health Information Challenges • Poor HMIS • Decisions not evidence based • No comprehensive surveys/vertical surveys • Inconsistency (variability) of data for same indicator USAID Response • Create center of excellence in focus regions • Initiated and supported HMIS reform • DHS

  8. 4. Supply Management System Challenges • Shortage of essential commodities at the last mile • Weak supply chain • Focus on vertical programs USAID Response • Supported improvement of the supply system • Supporting the design and implementation of Logistic Master Plan as a key partner

  9. Recommendations • Focus on big picture • Work on comprehensive HSS • Establish global/regional networking • Discourage camouflaging of initiatives to distort the HSS concept • Promote harmonization of the concept of HSS (WHO HSS Building Blocks) in terms of sustainability

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