Health systems strengthening

Health systems strengthening (also health system strengthening, abbreviated HSS) is a term used in global health that roughly means to improve the health care system of a country.^[1] Within this general definition, it can mean increasing funding for health infrastructure, improving health policy, trying to achieve universal healthcare,^[2] or any number of other health measures.

There has been some effort to use a systems thinking approach to health systems strengthening.^[3][4]

Usage

Various health organizations have claimed to use health systems strengthening (while not necessarily agreeing on the definition). Some of these are:

• World Health Organization
• US Agency for International Development (USAID, uses different definition from the one in a 2006 Global Fund-commissioned WHO report);^[5] USAID states that HSS has been "at the core of [its] mission in health for the last 20 years", and defines HSS as "initiating activities in the six internationally accepted core HSS functions – human resources for health; health finance; health governance; health information; medical products, vaccines, and technologies; and service delivery".^[6]
• GAVI Alliance^[5]
• The Global Fund^[5]
• PEPFAR (though less developed)^[5]
• Stop TB Partnership (uses different definition from the one in a 2006 Global Fund-commissioned WHO report)^[5]
• Roll Back Malaria (uses different definition from the one in a 2006 Global Fund-commissioned WHO report)^[5]

Reception

Both the idea of health systems strengthening and the term itself have received attention. Even advocates of health systems strengthening admit that it can often seem like a "distant, even abstract aim".^[4]

Marchal et al., writing in 2009, called the term "vague" and argued that "most current HSS strategies are selective (i.e., they target a specific disease), and their effects may undermine progress towards the long-term goal of effective, high-quality, and inclusive health systems."^[5][7]

Peter Berman, who was the lead health economist at the World Bank, has pointed out that "Almost any support to health interventions can be considered HSS".^[8]

See also

• Timeline of global health