working with the “institutional” health system: hai’s model of health systems strengthening
DESCRIPTION
Working with the “institutional” health system: HAI’s model of health systems strengtheningEmily deRiel, Health Alliance InternationalCORE Group Spring Meeting, April 30, 2010TRANSCRIPT
Working with the “institutional” health system: HAI’s model of health systems strengtheningEmily deRiel, MPH – [email protected] Spring MeetingApril 30, 2010
HEALTH ALLIANCE INTERNATIONAL
Outline
Importance of public-sector institutional health system
How HAI works Examples: Timor-Leste, Côte d’Ivoire
Opportunities to strengthen whole health system (institutional and community)
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Importance of the public-sector institutional health system
Scalability Equity and access (vs private sector)
Challenges of private sector: no quality advantage, greater cost, hard to regulate, doesn’t reach the poorest
Specialized services and referral system Trust
Kruk et al, 2010: “a functioning, equitable health system can have important health and statebuilding benefits in post-conflict countries.”
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How HAI works
Key areas
1. Integration of services into primary health
care
2. Leadership and management
3. Health systems research
4. Community linkages
5. Advocacy
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WHO building blocks
Everybody’s Business: Strengthening Health Systems to Improve Health OutcomesWHO, 2007
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HAI areas and WHO building blocks
HAI areas of work:
Services Work-force
Info systems
Products/Tech
Fin-ancing
Leader-ship
1. Integrated services
X X X X
2. Leadership & management
X
3. Health systems research
X X X
4. Community linkages
X X
5. AdvocacyX X
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HAI example: Timor-Leste
Improving maternal and newborn care, child spacing Development of birth-
friendly facilities Leadership and
management On-site training and
mentoring of MCH District Program Officers; supervision tool
Support for district midwives and CHWs through monthly SISCa events
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HAI example: Timor-Leste
Health systems research Formative
research/assessments, evaluations
Operations research workshop in fall 2010
Community linkages SISCa activities (as
above) Health promotion
materials
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HAI example: Timor-Leste
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HAI example: Côte d’Ivoire
Integrating HIV care and treatment into antenatal, outpatient, TB svcs On-site training and
mentoring Procurement systems
technical assistance Electronic health info
system pilot in 4 sites with MOH
Leadership and management Regional/district assessment meetings Site visits with district supervision teams Protocol development/updates
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HAI example: Côte d’Ivoire
Health systems research Operations research
course August 2009 Follow-up course June
2010, build capacity of MOH staff to train others
Studies on barriers to care for HIV+ women
Community linkages Women’s support
groups, nutrition program
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Some opportunities to strengthen whole health system Services
Integrated package of services based on community needs
Stronger referral systems Demand generation
Workforce Ongoing supervision and
support/payment of CHWs Training and
advancement opportunities
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Some opportunities to strengthen whole health system Products/Vaccines/Technologies
Procurement systems that extend to community level
Info Data collection and input mechanisms and
reporting Financing
Mechanisms that ensure poorest have access
Leadership/Governance National priorities, standards, protocols Coordination of activities within national
plan Planning/needs at community level informs
national plan, and vice versa
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Small group discussion
What models or frameworks of the health system do you find most useful for your work?
and/or
What improvements can be made to existing models to better incorporate the community role in health systems?