Health systems strengthening

1
Health systems strengthening

• Lee-Nah Hsu
• Chair Health Systems Action Network
• Senior Technical Advisor FPH

2
Mutuality of GF and HS

• GF creates an opportunity window to strengthen
  health systems
• Strong health systems facilitate GF
  performance
• HIV, TB and malaria are here to stay
• ? some lessons on how well we seize the
  opportunity

3
Starting point- to strengthen systems

• How are the current systems? From medical to
  public health
• Policy framework national and health sector
  plans
• Where is health in the national development
  plan?
• How is HIV, TB or Malaria figured in health
  sector plan?
• what do HIV, TB Malaria responses relate to
  existing health services?
• Who are the stakeholders?
• Financing
• How does GF support relate to national health
  care financing?
• The costing - Adjust to the specific situation
• Shifting from projects to programme performance
  -gt sustainability is not just on funding
• ? select based on alternative scenarios

4
Management coordination among systems

• Penitentiary with primary community health
  systems----
• TB Challenge of MDR and XDR
• TB and HIV
• HIV and Malaria
• HIV Hepatitis B, Hepatitis C
• Counselors mental health
• Nutrition support and income generation
• HIV link with other health medical services
• ? Essential partnerships of GO, NGO,
  international entities

5
The measure of GF contribution to country health
systems

• Filling gaps but not substitution
• access, appropriateness, responsiveness, quality,
  safety
• Improved health coverage (universal access)
  mobile populations?
• Integration of GF mechanism w national system
  structure
• Cost-effectiveness balanced with equity
  efficiency
• ? sustainability strategy for post-GF

6
International community
Non-health sectors
Communication
Human resources Capacity building
Communicable diseases
non-communicable diseases
Partnership Coordination
Finance Accounting reporting
Quality Accountability
Monitoring Evaluation
Research Technology Commodity
Logistics information Infrastructure
health systems governance
Created by Lee-Nah Hsu, Dec 08