Global Health: Health systems strengthening
4.02.2019
A “health system” is described as all the organizations, institutions, resources, and people whose primary purpose is to improve health (World Health Organization [WHO], 2010). Health system strengthening (HSS) is a global health term which represents the activities and actions targeted towards the improvement of a country’s health care system. It is a broad term which includes various activities such as funding for health infrastructure, conversations to improve health policy, attempts to achieve universal healthcare and other forms of health improvement measures. It is important to note that strong, flexible and well-resourced health systems are essential to achieving universal health coverage as well as ensuring global health security, including resilience in the context of health and other emergencies.
Lately, there has been a shift in the global health agenda from disease-specific approaches to HSS; this improves the effectiveness of health services. WHO has also placed emphasis on the significance of health systems in delivering effective and affordable care so as to achieve increased health equity, especially for poorer populations. More so, WHO and global partners have developed a framework for measuring HSS; comprised of six core components or building blocks: service delivery, health workforce, health information systems, access to essential medical products, vaccines and technologies, health financing and leadership and governance. Furthermore, USAID in a recent article termed strengthening health systems a strategic imperative and highlighted the importance of investing in HSS in the present time. A strong health system is also the best insurance developing countries can have against an unstable and unpredictable disease burden.
Health systems- being the resources and activities that work together to improve the health of populations, ensures quality across most or all of the six building blocks of WHO mentioned above. The needs of patients and health care professionals are the driving forces for the system to continually improve and evolve. Understanding these needs aid and position governments to prioritize HSS by providing high-quality, comprehensive health care to all citizens. Consequently governments partner with private and public organizations in order support their efforts in strengthening health systems, as well as improve care for all, especially the poor and vulnerable.
A practical example of HSS is the partnership between United States Center for Disease Control and Prevention and Nigeria in a program called: The Nigeria Field Epidemiology Laboratory Training Program (N-FELTP). The N-FELTP is a program designed by CDC to strengthen the public health workforce in Nigeria. N-FELTP trains residents in various fields such as public health laboratory, epidemiology and veterinary epidemiology to work in leadership and technical positions in the Nigeria Federal Ministry of Health (FMOH), Agriculture and Rural Development (FMARD) and state levels. This two-year program helps to strengthen health systems within the country by increasing knowledge and skills in field epidemiology and laboratory science as well as building a team of skilled and well-trained health professionals in Nigeria. Since its commencement in 2008, N-FELTP has assisted in the detection, investigation and response to more than 70 disease outbreaks including lead poisoning in Zamfara State, multi-state outbreaks of Lassa fever and cholera, as well as polio eradication efforts.