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Thursday, October 17, 2013

The concept of "Health Systems Strengthening" has received a great deal of attention yet not everyone knows what is meant by the term - let alone how to do it.  In last month's PLoS Medicine a group of researchers have attempted to pull together a list of 10 guiding principles "necessary for effective HSS".



From their article, the 10 principles are:



  1. HOLISM:  Consider all systems components, processes, and relationships simultaneously.  Include all health systems strengthening principles listed below.

  2. CONTEXT: Consider global, national, regional, and local culture and politics.

  3. SOCIAL MOBILIZATION: Mobilize and advocate for social and political change to strengthen health systems and address the social determinants of health.

  4. COLLABORATION: Develop long-term, equal, and respectful partnerships between donors and recipients within the health sector and among other sectors.  Develop and commit to a shared vision among partners by challenging underlying beliefs and assumptions.  Ensure frequent communication among actors.

  5. CAPACITY ENHANCEMENT: Enhance capacity and ownership at all levels, from individuals and households to ministries of health, including leadership, management, institutional strengthening, and problem solving.

  6. EFFICIENCY: Train and supervise the most appropriate personnel to meet health needs. Utilize appropriate technology. Coordinate external aid and activities. Minimize waste. Allocate funds where they are needed most.

  7. EVIDENCE-INFORMED ACTION: Strengthen structure, systems, and processes to gather, analyze, and apply data locally. Make decisions, whenever possible, based on evidence. Monitor progress of programs, and adjust accordingly. Ensure transparency and accountability.

  8. EQUITY: Target those who are disenfranchised. Plan for equity by empowering the disenfranchised, with a particular emphasis on gender. Disaggregate indicators to track disenfranchised groups.

  9. FINANCIAL PROTECTION: Ensure that funding streams are predictable. Consider insurance schemes to protect from financial catastrophes.

  10. SATISFACTION: Respond to needs and concerns of all stakeholders. Demonstrate accountability to constituents. Implement and respond to feedback mechanisms measuring quality and provider/client relationships.
Lots of buzzwords here - but lists and frameworks can be helpful and it appears to be based on a great deal of analysis, so I think this might prove to be a useful tool for others as they embark on HSS activities in the coming years.

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