Health Systems Development

What is it?

A hot-button term in the international health community, health systems development, or health systems strengthening, refers to programs that address the actual infrastructure of health care delivery.

Brief History

IMA World Health (IMA) has a long history of managing programs/projects to strengthen health systems, resulting in improved access to health care, better quality of services and sustainable systems managed by the nationals. IMA collaborates with governments, faith-based organizations, national organizations, and the private sector to ensure integrated comprehensive and quality services while building the capacity of local and national leaders and managers. In addition to developing and strengthening financial and human resources management, drug procurement and technical skills development, interventions such as nutrition, water and sanitation, gender-based violence are also integrated in several health systems strengthening projects. IMA’s innovative approach and participatory engagement of stakeholders for an effective decentralized health model has improved and saved the lives of millions in the Democratic Republic of Congo (DRC), Haiti, and South Sudan.

What We Do

IMA World Health's health systems development programs operate on the premise that when services are better financed, budgeted, planned, implemented and monitored—systematically—then the overall quality of health care will improve as well, allowing the system to serve more people, and better.

Democratic Republic of Congo:

IMA began working in the DRC in 2001 through the USAID SANRU III ($25M) program in which IMA rebuilt 56 FBO co-managed health zones. IMA continued to revitalize and build capacity in the health zones through the $60M follow on Project AXxes from 2006 to 2011. The main goal of AXxes was to provide integrated development assistance for primary health care health systems strengthening based on the “Appui Global” strategy of the Ministry of Health (MOH). The project assisted 57 health zones in four provinces of eastern and southern DRC with a catchment population of approximately 8 million. IMA increased access, quality and demand for maternal health services including vaccinations, prevention of mother to child transmission of HIV, volunteer counseling and testing, HIV prevention, water and sanitation, family planning, and disease-specific interventions including malaria and tuberculosis, among others. Project AXxes found that with appropriate support, new and non-functional health zones could be transitioned to become operational and highly functional. AXxes was recognized for many achievements including:

• Increased SBA assisted deliveries from less than 60% baseline to almost 90% by project end.
• Established over 900 well-functioning family planning sites.
• Recognized as 3rd largest provider of fistula care and repair in the DRC, with a total of 1,276 fistulas repaired.
• Achieved rapid and significant increased compliance for prevention of mother to child transmission (PMTCT) of HIV testing and treatment through the identification and application of best practices across all PMTCT sites.

South Sudan:

IMA has been supporting the government to improve health system for delivery of primary health care in South Sudan since 2008. IMA is currently managing the expansion of the Basic Package of Health Services (BPHS) funded by the Multi Donor Trust Fund ($9.6M) in Jonglei and Upper Nile states. The BPHS is a standard package of care including preventive, primary, and reproductive health services such as immunization, micronutrient supplementation, Maternal and Newborn Child Health, family planning, malaria prevention and treatment, HIV/AIDS sensitization/treatment, and curative services for diarrhea and tuberculosis. IMA coordinates with the State Ministry of Health to build core capacities of the 24 County Health departments in supervision, monitoring and support to health facilities to provide essential services. A new health management information system (HMIS) to improve data management, reporting, and decision making was rolled out and is the only statewide functioning system in the country. A performance Based Contracting system is fostering good results. Essential newborn and delivery equipment, antenatal care and family planning supplies; and V-Sat technology including communication materials, (over 8,000 messages have been distributed) and trainings have helped in improving BPHS implementation.

Despite extremely challenging conditions, by being proactive in providing trainings, impressive treatment results are being maintained: 106,585 under-fives were treated for malaria, 497,924 children are receiving Vitamin A, and more than 130 health personnel have been trained in the new health management information system. Additionally, IMA is developing systems to ensure that primary health care services continue uninterrupted while new mechanisms focused on strengthening the government systems are implemented.

Where We Work