Where in USAID’s Health Systems Strengthening (HSS) Approach is the Community_Cavanaugh

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


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


GHI HSS Framework

GHI Health Systems Strengthening Framework

Health System Inputs and processes

Health System Outputs

Health System Outcomes

Health Outcomes


Strategic priorities for inter-related health system functions

Governance & Leadership

Finance

Information

Health Workforce

Medical Products,

Vaccines, & Technologies

Service Delivery


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


•Design policies, oversee implementation

•Set terms of private sector engagement

•Enforce accountability, transparency


• 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


• Community ensures system rewards good performance, sanctions poor performance

• Public & private actors are held accountable for results


• 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


Where is the Community in HSS Outcomes?


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.


Thank you!


Where in USAID’s Health Systems Strengthening (HSS) Approach is the Community_Cavanaugh

Government & Nonprofit

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