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Strengthening Health Systems Moving Beyond Supporting the Health System

Strengthening Health Systems Moving Beyond Supporting the Health System. Ann Lion Health Systems 20/20 Project Director, Abt Associates. Global Health Council Satellite Session Health Systems Strengthening: What is Everyone Doing? June 13, 2011. Goal of this presentation.

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Strengthening Health Systems Moving Beyond Supporting the Health System

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  1. Strengthening Health SystemsMoving Beyond Supporting the Health System Ann Lion Health Systems 20/20 Project Director, Abt Associates Global Health Council Satellite Session Health Systems Strengthening: What is Everyone Doing? June 13, 2011

  2. Goal of this presentation • Clarify existing HSS definition • Supporting vs. strengthening health systems • Propose criteriato distinguish what activities are HSS interventions (support vs. strengthen) • Scope • Longevity • Approach

  3. What is health system strengthening? • Strengthening health systems goes beyond supporting the system • Supporting focuses on filling gaps to produce better short-term outcomes • Strengthening is about making the system function better in the long term

  4. Strengthening vs. supporting health systems

  5. What is not health system strengthening • Most common misunderstanding of HSS is that it is any activity that supports a HS building block • Focus tends to be on increasing inputs • Often covers only one HS block or disease area • Tends to be short-term solution • Misconception of HSS often leads to investment in activities that, in effect, only support the system temporarily but posture as HSS

  6. The 3 dimensions of health systems 1)Health system building blocks 2)Program/disease areas 3)Performance drivers • Inputs • Policies and regulations • Organizational structures • Behaviors of HS actors

  7. A “cube” view of the health system © Abt Associates, 2001

  8. The 3 dimensions of health systems • But focus on performance driver tends to be on inputs, while the remaining drivers are often overlooked by HSS programs

  9. Inputs vs. other key HSS performance drivers © Abt Associates, 2001

  10. © Abt Associates, 2001

  11. How to design HSS interventions? • There is no “menu” of HSS interventions • Design will be affected by a number of factors specific to country context and system constraints • A health system strengthening intervention should: • Include all 3 dimensions shown in the HS cube illustration • Affect more than one program/disease area • Address country-specific constraints

  12. Guidance for identifying HSS interventions Is it Health System Strengthening? • Does the intervention have cross-cutting benefits beyond a single disease? • Does the intervention address policy and organizational constraints or strengthen relationships between the building blocks? • Will the intervention produce long-term systemic impact beyond the term of the project? • Is the intervention tailored to country-specific constraints and opportunities with clearly defined roles for country institutions?

  13. Acknowledgements • Grace Chee** • Nancy Pielemeier • Catherine Connor • Mark McEuen • Sheila O’Dougherty • Hong Wang ** lead drafter • SlaveaChankova • Joe Kutzin • Marty Makinen • David Evans • Tahgreed Adams • AbdoYazbeck

  14. Thank you www.HealthSystems2020.org

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