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Working with the “institutional” health system: HAI’s model of health systems strengthening,[object Object],Emily deRiel, MPH – deriel@u.washington.edu,[object Object],CORE Spring Meeting,[object Object],April 30, 2010,[object Object]
Outline,[object Object],Importance of public-sector institutional health system,[object Object],How HAI works,[object Object],Examples: Timor-Leste, Côte d’Ivoire,[object Object],Opportunities to strengthen whole health system (institutional and community),[object Object]
Importance of the public-sector institutional health system,[object Object],Scalability,[object Object],Equity and access (vs private sector),[object Object],Challenges of private sector: no quality advantage, greater cost, hard to regulate, doesn’t reach the poorest,[object Object],Specialized services and referral system,[object Object],Trust,[object Object],Kruk et al, 2010: “a functioning, equitable health system can have important health and statebuilding benefits in post-conflict countries.”,[object Object]
How HAI works,[object Object],Key areas,[object Object],Integration of services into primary health care,[object Object],Leadership and management,[object Object],Health systems research,[object Object],Community linkages,[object Object],Advocacy,[object Object]
WHO building blocks,[object Object],Everybody’s Business: Strengthening Health Systems to Improve Health Outcomes,[object Object],WHO, 2007,[object Object]
HAI areas and WHO building blocks,[object Object]
HAI example: Timor-Leste,[object Object],Improving maternal and newborn care, child spacing,[object Object],Development of birth-friendly facilities,[object Object],Leadership and management,[object Object],On-site training and mentoring of MCH District Program Officers; supervision tool,[object Object],Support for district midwives and CHWs through monthly SISCa events,[object Object]
HAI example: Timor-Leste,[object Object],Health systems research,[object Object],Formative research/assessments, evaluations,[object Object],Operations research workshop in fall 2010,[object Object],Community linkages,[object Object],SISCa activities (as above),[object Object],Health promotion materials,[object Object]
HAI example: Timor-Leste,[object Object]
HAI example: Côte d’Ivoire,[object Object],Integrating HIV care and treatment into antenatal, outpatient, TB svcs,[object Object],On-site training and mentoring,[object Object],Procurement systems technical assistance,[object Object],Electronic health info system pilot in 4 sites with MOH,[object Object],[object Object]
  Regional/district assessment meetings
  Site visits with district supervision teams
  Protocol development/updates,[object Object]
Some opportunities to strengthen whole health system,[object Object],Services,[object Object],Integrated package of services based on community needs,[object Object],Stronger referral systems,[object Object],Demand generation,[object Object],Workforce,[object Object],Ongoing supervision and support/payment of CHWs,[object Object],Training and advancement opportunities,[object Object]

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Working with the “institutional” health system: HAI’s model of health systems strengthening

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  • 11. Regional/district assessment meetings
  • 12. Site visits with district supervision teams
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