Strengthening health systems moving beyond supporting the health system
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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 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


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


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


Strengthening vs. supporting health systems


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


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


A “cube” view of the health system

© Abt Associates, 2001


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


Inputs vs. other key HSS performance drivers

© Abt Associates, 2001


© Abt Associates, 2001


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


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?


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


Thank you

www.HealthSystems2020.org


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