1. 1 The Duke Global Health Institute’s Health Systems Strengthening Areas of Expertise Caroline Hope Griffith Associate in Research Aisha Jafri Associate in Research Triangle Global Health Consortium Collaboration Workshop for Global Health System Strengthening Wednesday, December 2, 2009

2. 2 Duke Global Health Institute (DGHI) DGHI, created in 2006, works to reduce health disparities in our local community and worldwide. As a university-wide institute, DGHI works with faculty and students from all nine schools at Duke in the areas of research, education, service and policy. Signature Research Initiatives: –Cardiovascular Disease –Global Aging –Global Environmental Health –Gender, Poverty and Health –Emerging Infectious Diseases –Health Systems Strengthening

3. 3 #1: Private Sector Responses African Health Care Worker Shortage: Forum on Private Sector Responses Organized and sponsored by the Health Sector Management program at Fuqua School of Business, DGHI, and the Global Health Workforce Alliance (WHO) in 2007 Addressed the following topics: –analysis of the labor force shortage –impact of the shortage on existing African health-oriented initiatives –incentives and the economics of private sector involvement –future directions and priorities

4. 4 #1: Private Sector Responses (cont.) Global Health Workforce Alliance Private Sector Task Force –Accelerate scaling and cross ‐ border implementation of private health sector initiatives which increase health worker supply, effectiveness or retention –Build the capacity of health systems in select African countries to interact more effectively with the private health sector –Target countries: Kenya, Zambia, Mali

5. #1: Private Sector Responses (cont.) 5

6. 6 #2: Management and Leadership Capacity Building Uganda Health Systems Strengthening Partnership Support and enhance the performance of Uganda’s national health system by improving leadership and management capacity in the health sector Foster the partnership between public and private-not-for-profit (PNFP) health facilities Target population: Leaders with governance responsibilities (e.g. board members of PNFP facilities, DHOs) from both PNFP and public facilities and religious leaders who work on health Anticipated short-term outcomes may include increased knowledge, improved skills, and/or intent to practice: –Human resources management –Strategic planning, including building vision and mission –Monitoring health systems and evidence-based decision making –Negotiation and securing support from stakeholders –Financial management –Principles of effective leadership and team building

7. 7 #3: Education and Training Landscaping Study on the Supply of Health Systems Management, Policy, and Financing Training Programs and the Demand for Health Systems Experts Assessed the supply of health systems training programs Explored the demand for health systems experts, including –What is their current availability? –What is the need for them? –What competencies in health systems management, policy, and financing are important? –What are the potential job markets, career trajectories, and retention issues for health systems experts?

8. 8 #3: Education and Training (cont.) Health System Competencies and Curriculum Initiative (HSCCI) The international Health Systems Competencies and Curriculum Initiative Task Force, is made up of deans and senior faculty members from schools of business, medicine, and public health, as well as leaders from national and multilateral institutions from around the world. Last month, the task force convened in Durham to analyze lessons learned about health systems-related education models and proposed recommendations for health systems curricula for professional schools and training institutions.

9. 9 #3: Education and Training (cont.) Partnership to Improve Maternal and Child Health in Rwanda –Partnership with the Faculty of Medicine of the National University of Rwanda to improve maternal and neonatal health outcomes in Rwanda –Training of medical faculty and postgraduate trainees, medical students, and practicing physicians in Rwanda’s 32 district hospitals in the areas of maternal and neonatal care using ALSO (Advanced Life Support in Obstetrics) curriculum –Pre and post training assessments and e-competency assessment to measure retention of knowledge and application of skills

10. 10 #4: Interdisciplinary Approach Duke’s Interdisciplinary Approach to HSS Comprehensive approaches for complex problems in the health sector DGHI is working closely across schools and departments to find ways to leverage the skills and resources of other disciplines to address development challenges in a holistic way Specifically, DGHI is exploring the intersection between faith, management, and health services provision through dialogue and development of collaborative interventions

11. 11 #4: Interdisciplinary Approach (cont.) Uganda Health Systems Strengthening Partnership The Duke University Team can offer expertise as educators and researchers who work at the intersection of faith, business, and health to promote health sector management The team is also helping Uganda Martyrs University improve its health sector management and leadership curriculum by building a relationship between its health sciences faculty and faculty of business Health Systems Competencies and Curriculum Initiative The task force discussed ways to improve education in health systems management, policy and financing by creating an interscholastic curriculum that draws from the schools of business, medicine, and public health.