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Child being injected Health centre in Mozambique

Health systems strengthening

We work with national governments to strengthen and build health systems in developing countries. Building health systems involves institutional processes, which are complex, long term and inherently indigenous. We always work in close collaboration with national governments so that they own and are responsible for improving their system well into the future.

Community midwife visit in Pakistan
Pakistan's health systems
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Pakistan's health systems A community midwife carries out a health check.

A health system is made up of several components such as health policy and planning, human resources, financing, information, drugs, service delivery and monitoring and evaluation. This is why strengthening a health system is so complex, needing detailed analysis of the dynamics and constraints in all areas. We work across the project cycle from design and delivery to monitoring and evaluation. We also work in post-conflict and fragile states, where the health system has to be built or rebuilt from very little.

Aid architecture and programme design

We are also proud of our work on aid architecture. We support global level technical and funding sources and agencies to reassess, coordinate and streamline the ways in which aid flows through them to countries – to ensure aid effectiveness. We support countries and development agencies to design and shape health-systems strengthening programmes, presenting options for next steps.

Supporting delivery

We support the delivery of health policies and programmes in a number of ways and through a combination of long- and short-term technical assistance. We focus on building the capacity of health systems through a process of joint analysis, diagnosis and agreement on ways forward between our health systems experts, ministries of health, health sector reform units and other development agencies or stakeholders.

We jointly identify what might be constraining the performance of a health system and find ways to strengthen it. The solutions might lie in changing structures, management, financing arrangements, human resources, information systems, or how different ministries are connected. We also monitor, review and evaluate health programmes against policies and plans.

Added value

  • Supporting Pakistan to improve the health sector: we manage the DFID Technical Resource Facility (TRF), which provides technical assistance to the health sector in Pakistan with a focus on maternal, newborn and child health. Assignments have included a cost benefit analysis of mobile health units in the Punjab – the results of which saved the provincial government 2.5BN rupees.
  • Results based funding for health: results based funding or RBF is the generic name given to any programme linking incentives, such as cash, to the delivery of an agreed set of results. We evaluated the Health Results Innovation Trusts Fund – the largest global effort to test the application of RBF for health.
  • Towards universal health care in South Africa: through the SARRAH programme we're supporting the South African government as it develops national health insurance policies and pilots – a crucial reform in realising universal provision of quality health services free at the point of use.
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