Health Systems Strengthening

Overall, sub-Saharan Africa has the world’s highest burden of disease and death and has made the least progress towards achievement of health systems related MDGs focused on child health, maternal health and HIV/AIDS.

Despite notable progress in reducing childhood mortality over the last two decades, sub-Saharan Africa continues to exhibit relatively high levels of child deaths.

The region also accounts for the largest share of global maternal deaths and is disproportionately affected by HIV/AIDS.

Over 53 million married women in sub-Saharan Africa who would like to postpone the next birth or stop childbearing altogether are not using an effective method of contraception.

Consequently, a sizeable proportion of births are unplanned, which is one of the key drivers of the region’s high fertility levels. Lack of access to reproductive health services is most acute among young people and the poor.

Resilient health systems are essential to deliver the preventive services and other care a country’s population needs to stay healthy and productive.

Our work in this theme focuses on translating evidence and promoting its use in order to support health system

The World Health Organisation defines health systems strengthening as “the process of identifying and implementing the changes in policy and practice in a country’s health system such that the country can respond better to its health and health system challenges, and any array of initiatives and strategies that improves one or more of the functions of the health system and that leads to better health through improvements in access, coverage, quality, or efficiency.”

Our work is in two road areas – strengthening application of research evidence to improve outreach and quality of services to address specific health challenges and strengthening health information systems.

a) Knowledge translation to strengthen policies and action on key health issues

In the first sub-theme, we translate research and related evidence to strengthen political will and commitment, increase resource allocation, and inform design of effective intervention programmes to ensure universal access to services in the following areas:

  • Reproductive health (including family planning, child health, maternal health and adolescent sexual and reproductive health);
  • HIV/AIDS, with particular focus on improving prevention and care among uniquely vulnerable populations such as cross-border populations, the poor, and young people;
  • Emerging diseases and health challenges, including non-communicable diseases

We also generate evidence to inform decision-making on how to reinforce linkages and integration of services related to these health issues.

b) Strengthening health information systems and use of evidence in decision-making

One of the central components of a health system is the health information system, an integrated effort to collect, analyse and use health data to inform policies and programs.

Robust data and research evidence are vital for improving policy and programme actions; however, local capacity to generate and use evidence to strengthen the individual components of health systems and their effective interaction is weak.

Our work in this area focuses on strengthening data collection, processing and analysis systems as well as addressing institutional bottlenecks and individual capacity gaps to enable increased use of data and research evidence in decision-making.

Over the next five years, AFIDEP will directly generate evidence to inform decision-making processes, while also enhancing the capacity and role of health information systems more generally and working to promote the role of evidence in improving the performance of health systems.

We will place particular emphasis on strengthening monitoring and evaluation systems in the health sector and addressing institutional and individual level bottlenecks that prevent decision-makers from accessing and using research evidence.