How to accelerate health systems strengthening and promote health equity

Health and well-being have improved in many parts of the world thanks in part to successful investments in health system performance. But progress toward strong, self-sustaining, resilient health systems has been too slow, and the COVID-19 pandemic created many setbacks. Country leaders and their development partners must embrace holistic solutions that meet their evolving challenges and are adapted to the specific country context. New partnership models must ensure that domestic institutions and technical experts at regional, country, and subnational levels play lead roles in driving health system innovation and improvement, with support from the global ecosystem targeted to accelerate progress.

A proven approach to accelerate health systems strengthening & health equity

The Health Systems Strengthening Accelerator, a six-year global initiative led by Results for Development (R4D) and funded by USAID, the Bill & Melinda Gates Foundation and the Rockefeller Foundation, accelerated health system improvements in 20 low- and middle-income countries. By supporting local leaders in applying a systems lens, connecting local innovations with expertise, and strengthening local ownership, the program enhanced health equity and quality, building the capacity for lasting improvements.

The program’s flexible approach focused on supporting local partners as they articulated their goals, led implementation, and navigated paths to meaningful and lasting health systems change. In addition to traditional technical assistance, the program employed a mix of techniques to ensure that interventions were rooted in the reality of the country context, tailored to promote institutionalization, and owned by relevant local stakeholders.

A wide range of resources and tools for health systems strengthening were co-developed in partnership with country leaders and local and regional partner organizations. Explore the following topics to learn more and discover resources that can be used to inform, improve and implement health systems strengthening initiatives.

1. New approaches to technical assistance to strengthen health systems: Using improved models of technical assistance that center local change agents, engage diverse local actors, and incorporate local and regional expertise to implement reforms.
2. Integrating priority health and disease areas within health systems: Bringing siloed and verticalized health programs into country health systems and integrating non-traditional but pressing health areas that are often underprioritized, such as mental health, rehabilitation and blood safety.
3. Transformative approaches to strengthening primary health care and community health: Supporting countries to strengthen primary health care delivery models, professionalize community health workforces, and increase sustainable financing to improve access to and quality of health care.
4. Strengthening financing for essential health services: Using a combination of inclusive stakeholder dialogue, data analytics, and evidence-driven advocacy to support governments to improve financing for health services, including for primary health care — despite fiscal challenges and highly constrained resources.
5. Incorporating equity, resilience, and social and behavioral change concepts into health systems strengthening: Incorporating these and other cross-cutting concepts into health systems strengthening is crucial, because health systems are built around people and their diverse behaviors and interactions. Addressing social norms and behaviors is essential for driving meaningful and sustainable improvements in health systems.

Resources for health systems strengthening