Presentation on theme: "Overview of Health System Strengthening"— Presentation transcript:
1 Overview of Health System Strengthening DLI HSS workshopAnn LionAugust, 2011
2 Session ObjectivesUnderstand the WHO Building Blocks as a foundation for health systems strengtheningUnderstand the difference between supporting and strengthening the health system
3 What is a Health System?A health system consists of all organizations, people and actions whose primary intent is to promote, restore or maintain health.
4 WHO Health System Framework Source: World Health Organization. Everybody’s Business: Strengthening health systems to improve health outcomes—WHO’s Framework for Action. Geneva: WHO, 2007, page 3.
5 1) Service Delivery Good health services delivery… Quality Access Drugs, supplies, andequipment in stockEquitable and efficientfinancingHealth workers paid,supervised, motivatedRational planning, professionalmanagement based on data
6 2) Health Workforce A well performing health workforce consists of… HR Management;HR skillsHR policiesAdequate drugs and supplies for effective workforceData tracking of human resourcesFinancing to hire adequate staff in National budget
7 3) Health Information System Link use of data to resource allocation, measurement of health worker performanceA well performing health information systemEnsures the production, analysis, dissemination and use of timely an reliable informationShare data with communityNational Health Financing information informing policyPhoto: David Lubinski, HMN
8 4) Medical Products, Vaccines and Technologies Procurement and supply programs need to ensure…Equitable accessAssured qualityCost-effective use.Pro-poor financing of essential productsLocal capacity to enforce regulationsHealth workers trained in cost-effective prescribing practices
9 5) Financing A good health financing system… Raises adequate funds for healthProtects people from financial catastropheAllocates resources and purchases good and services in ways that improve quality, equity, and efficiency.Payment systems to reward health worker distribution and retentionPro-poor financing of essential productsUse data to allocate resources
10 6) Leadership and Governance Effective leadership and governance ensures…strategic policy frameworks existeffective oversight and coalition-buildingprovision of appropriate incentivesattention to system-design, and accountability.Availability of accruate data for policy and advocacyRegulation of health workers and medical productsAccountability to patientsFinancing that empowers consumers
11 The 7th Building Block – People Individuals, households, and communities as:Civil societyConsumersPatientsPayersProducers of health through knowledge, attitudes, behaviors, and practicesGraphic: Bob Emrey, USAID
12 When a patient is sick…Treat patient’s symptoms?Strengthen the patient’s health?
13 What is Health Systems Strengthening? improving [the] six health system building blocks and managing their interactions in ways that achieve more equitable and sustained improvements across health services and health outcomesBeyond a single diseaseBeyond a single building block - harness the interactions between the building blocksBeyond the life of the intervention - sustained improvementsCountry ownership
14 Support vs. Strengthening - Examples TrainingNet distributionImmunizing babiesART distributionStrengtheningAdd technical content to nursing school curriculaAdd nets to national health budget and procurement plansAdd immunization and ART training to pre-service curricula, ensure available supplies
15 3. Obstacle: Weak governance Disease/Service Specific ResponseHealth System StrengtheningShort term training workshops and tools to plan and manage focal programs Parallel governance structures and information systems for focal servicesCommunity oversight of health facilitiesRational allocation of health funds based on need, not politicsPolicymaker accountability to constituents
16 A way forward: Harness earmarked health funds to strengthen health systems to sustain results
17 The truth about health system strengthening Not prescriptiveObjective, evidence-based and tailored to the countryIndirect link between HSS and health outcomesAttribution difficultFew photo opsDonor coordination REALLY mattersLong-term process
18 Group Exercise – Systems Thinking Scenario: US NGO distributes condoms at the community level.Task:At your table, discuss whether this program supports or strengthens the health system, and why.Propose ways the condom distribution activity can be developed as a systems strengthening programYou have 10 minutesReport-out
19 ResourcesWHO Everybody’s Business: Strengthening Health Systems to Improve Health Outcomes.USAID Sustaining Health Gains – Building Systems.2010. Implementation of the Global Health Initiative: Consultation Document.
20 Reports related to this presentation are available at www.HS2020.org Thank youReports related to this presentationare available at
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