Updated approach on Health Systems

1. Health Systems Strengthening:
Key priorities from a Global perspective
Juan Seclen, MD, MHPM
March 21, 2014

2. Why do we need to strengthen Health
Systems?
• ‘The poor state of Health Systems in many parts of the
world is one of the greatest barriers to increasing access
to essential health care’ (WHO, 2007)
• ‘We will not be successful in our efforts to end deaths
from AIDS, malaria, and tuberculosis unless we do more
to improve the health systems around the world’ (US
President, 2009)
• ‘There is an increasing recognition that efforts to
improve global health cannot be achieved without
stronger health systems’ (Chee and cols., 2012)

3. What do Health Systems Strengthening
mean?
• HSS is any array of initiatives, strategies, or activities that
improves one or more of the core functions of the health
system—labeled “Building Blocks” by the World Health
Organization (WHO, 2007)
• Quite simply, HSS is about permanently making the system
function better, not just filling gaps or supporting the system
to produce better short terms. The WHO definition of HSS
(WHO, 2007) fully support this.
• HSS is a mean to an end, not an end in itself
• The end is better performance HS: health universal coverage

4. Distinguishing between Support and
Strengthening Health Systems
• Support: Any activity to improve inputs into HS
• Strengthening: To facilitate comprehensive changes to
HS performance drivers such as policy and regulations,
organizational structures, and relationships to motivate
changes in behavior.

5. The Health System viewed as a Cube

6. Priorities for facilitating HSS
• Health workforce
• Cost-effective interventions and service delivery
models (PHC)
• Progressive and Smart Health Management
Decentralization
• Results-based financing
• Enhanced and integrated management
approaches