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 systems moving beyond supporting the health system

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

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

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

Strengthening vs. supporting health systems


What is not health system strengthening

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

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

A “cube” view of the health system

© Abt Associates, 2001


The 3 dimensions of health systems1

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

Inputs vs. other key HSS performance drivers

© Abt Associates, 2001


Goal of this

© Abt Associates, 2001


How to design hss interventions

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

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

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

Thank you

www.HealthSystems2020.org


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