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Implementing health system strengthening projects at USAID: Findings from five cases using an integrated framework.
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- Author(s): Koon, Adam D.; Conrad, Abigail; Naimoli, Joseph F.; Saxena, Sweta; Connor, Catherine; Rodriguez, Daniela C.
- Source:
Global Public Health. Dec2019, Vol. 14 Issue 12, p1829-1846. 18p. - Source:
- Additional Information
- Subject Terms: GOVERNMENT agencies; CONCEPTUAL structures; ENDOWMENTS; HEALTH care teams; HEALTH services accessibility; INTERPROFESSIONAL relations; INTERVIEWING; LEADERSHIP; CASE studies; MEDICAL care; HEALTH policy; QUALITY assurance; RESEARCH evaluation; RESEARCH funding; RESPONSIBILITY; WORLD health; GOVERNMENT aid; GOVERNMENT programs; HUMAN services programs; RETROSPECTIVE studies; PLANNING techniques; DATA analysis software; MIDDLE-income countries; LOW-income countries
- Subject Terms:
- Abstract: Evidence on the implementation of health systems strengthening (HSS) interventions is scarce. Donors need this information to prioritise investments and lobby for continued financial support. To develop a deeper understanding of the implementation dynamics of robust HSS interventions, we retrospectively compared five USAID-supported projects in the Dominican Republic, Ethiopia, Kazakhstan, Rwanda, and Zambia. A document review and key informant interviews (n = 44) were conducted, coded, and analysed in each of the five cases using an integrated implementation framework. The framework was organised by four phases of implementation. For the pre-condition phase, data-driven HSS interventions were nested in a range of political contexts and with differing levels of financial support. In pre-implementation, cases relied on diverse teams that created a data-informed, inclusive, and transparent project ethos for implementation. Implementation was located at multiple tiers of the health system, used interventions as catalysts for government initiatives, supported governance/accountability initiatives, and responded nimbly to contextual changes in the implementation climate. There was less evidence of maintenance and evolution but all cases were designed with an eye towards sustainability. This research yields important insights about the dynamics of HSS, identifying ways donors can better support countries to achieve universal health coverage. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Global Public Health is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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