Health systems strengthening

From Wikipedia, the free encyclopedia
Jump to navigation Jump to search

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]

Organizations that use health systems strengthening[edit]

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]


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[edit]


  1. ^ "Health Systems Strengthening Glossary". World Health Organization. Retrieved June 14, 2016.
  2. ^ Glassman, Amanda. "Conversation with Amanda Glassman on August 27, 2013" (PDF). GiveWell. Retrieved June 14, 2016.
  3. ^ "New Perspectives in Health Systems Strengthening" (PDF). USAID.
  4. ^ a b "Systems Thinking for Health Systems Strengthening" (PDF). World Health Organization. 2009.
  5. ^ a b c d e f g Marchal B, Cavalli A, Kegels G (April 28, 2009). "Global Health Actors Claim To Support Health System Strengthening—Is This Reality or Rhetoric?". PLOS Medicine.CS1 maint: uses authors parameter (link)
  6. ^ "USAID's Vision for Health Systems Strengthening" (PDF). USAID. Retrieved June 14, 2016.
  7. ^ Karen Grepin (April 29, 2009). "Are health system strengthening efforts just hype?". Retrieved June 14, 2016.
  8. ^ Peter Berman (June 2009). "Unpacking Health System Strengthening" (PDF). World Bank. Retrieved June 14, 2016.