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
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]