Post on 01-Dec-2014
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Karen Cavanaugh USAID 10-16-14
Where in USAID’s Health Systems Strengthening (HSS) Approach is the
Community
October 16, 2014 Karen Cavanaugh
Director, Office of Health Systems USAID
Vision: USAID partners with countries to...
Protect poor and underserved people
From illness, death and extreme
poverty
By providing sustained,
equitable access
To essential high-quality services that
are responsive to their needs without financial hardship
Karen Cavanaugh USAID 10-16-14
Health Systems and Health Systems Strengthening
Health system: all people, institutions, resources, and activities whose primary purpose is to promote, restore, and/or maintain health. They are complex and adaptive.
Health systems strengthening: strategies, interventions and activities designed to sustainably improve health system performance.
HSS Inputs, Processes, HSS Outcomes HSS Impact and Outputs
Sustained improvements in health for EPCMD and
AFG
Improved health systems performance
Financial Protection
Essential Services
Population Coverage
Responsiveness
Leadership & Governance
Finance
Information
Health Workforce
Medical Products, Vaccines & Technologies
Service Delivery
Private sector,
eHealth, Prevention / Promotion
UHC
Karen Cavanaugh USAID 10-16-14
GHI HSS Framework
GHI Health Systems Strengthening Framework
Health System Inputs and processes
Health System Outputs
Health System Outcomes
Health Outcomes
Karen Cavanaugh USAID 10-16-14
Strategic priorities for inter-related health system functions
Governance & Leadership
Finance
Information
Health Workforce
Medical Products,
Vaccines, & Technologies
Service Delivery
Karen Cavanaugh USAID 10-16-14
Priority Objectives
1. Create a culture of evidence-based decision making
2. Improve and increase uptake of major tools, e.g. DHS, NHA, iHRIS
3. Support improvements in countries’ health information systems vital for EPCMD and AFG
Examples
RHIS: Implemented Performance of Routine Information System Management (PRISM) framework and toolkit in 22 countries (16 EPCMD/AFG)
mHealth: DHS is using tablets to collect data in 17 surveys,
Illustrative Example for Information
Vision: The collection, analysis, dissemination and use of timely and high quality information by the health system
Karen Cavanaugh USAID 10-16-14
•Design policies, oversee implementation
•Set terms of private sector engagement
•Enforce accountability, transparency
Leadership & Governance
• Drive resource allocation through voting, taxes, purchasing decisions
• Set social values underlying risk pooling
• Enforce accountability, transparency Financing
•Demand and use information for oversight
•Generate and share information Information
• Identify ,provide & support community workers
• Partner with facility-based health workers for effective services
• Provide feedback on health worker performance (recruit, supervise & pay) Human Resources
• Buy and use medicines effectively
• Promote vaccine coverage
• Enforce accountability, transparency
Medical products, vaccines, technology
• Set standards for essential service package
• Promote access & use of services
• Provide prevention, promotion services locally Service delivery
The Community in HSS Inputs and Processes
Karen Cavanaugh USAID 10-16-14
• Community ensures system rewards good performance, sanctions poor performance
• Public & private actors are held accountable for results
Leadership & Governance
• Locality has enough money to pay for community’s health needs. Risks are spread, costs are shared.
• Health funds go to high quality, high impact services. Financing
• People in community have timely, reliable , complete information. Information
• Local health workforce provides quality services that satisfy patients without discrimination. Human Resources
• Community residents have safe, effective, high quality medicines they need when and where they need them.
Medical products, vaccines, technologies
• Community residents can choose safe, quality services in public & private sector when needed. Service delivery
The Community in HSS Outputs
Karen Cavanaugh USAID 10-16-14
Where is the Community in HSS Outcomes?
Karen Cavanaugh USAID 10-16-14
Financial protection: Community members use all needed services. No one in community becomes impoverished.
Quality services: Community members get all needed prevention, promotion, treatment & care services delivered with high quality.
Population coverage: Poor, marginalized, underserved, high priority community members of community get same services as rest of community.
Responsiveness: Community members have choice, treated with dignity, confidentiality, autonomy, promptness, social support.
What health outcomes of effective health system performance mean for the community
Mothers and children are no more likely to die than their counterparts
in OECD countries.
The next generation will live free from the threat of HIV/AIDS.
Karen Cavanaugh USAID 10-16-14
Thank you!
Karen Cavanaugh USAID 10-16-14