1. Health System Design:
Best approaches for effective/efficient health system
UHC framework (Evans 2012)
Quality
IHI “Triple Aim”

2. Most pressing methodological issues:
1. Joining the “2 knowledges”
Evidence-based Subject Matter Knowledge
The “what”….
Protocols/
Guidelines,
Physical resources,
Clinical Training
Implementation and Improvement
Implementation Knowledge
The “how”….
Ambitious Aim to close the measured gap.
Adaptive Content Theory
Implementation Strategies that are supported by measurement and feedback learning systems

3. Most pressing methodological issues:
2. Getting to full scale – framework to escape from “pilot” thinking
Best Practice exists
Phases of Scale-up
Build Scalable Unit
Test Scale- Up
Set-up
Go to Full-Scale
New Scale-up Idea
Adoption Mechanisms
Leadership, communication, social networks, culture of urgency and persistence
Learning systems, data systems, infrastructure for scale-up, human capacity for scale-up, capability for scale-up, sustainability
Support Systems

4. Improvements in Quantitative Methodology
Data collected in Clinic Registers
Register Data Aggregated into Monthly Reports
Facility sends aggregate report to District
District Health information System 1 2 3 4

5. What happens to routinely collected data?
Register Data vs Monthly Summary
Monthly Summary vs DHIS Report

6. Can routine data systems be fixed?
Register Data vs Monthly Summary
Monthly Summary vs DHIS Report