Achievements
Service Delivery | Workforce | Information | Pharmaceutical Management | Financing | Governance
Service Delivery
- Making improvement part of service delivery. Pioneered the adaptation of modern Quality Improvement (QI) approaches in developing countries, carried out by regular health providers.
- Using Quality Improvement approaches. QI methods demonstrate that health service delivery can improve even without new resources by better organizing the process of care.
- Using market forces. Developed social marketing and expanded private sector partnerships.
Health Workforce
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Human Resources for Health (HRH) Action Framework. First published in the 2006 World Health Report, this Web-based framework/tool provides a comprehensive approach to addressing HRH challenges at the country level. The result of collaboration among multilateral and bilateral agencies, donors, partner countries, nongovernmental organizations (NGOs), and the academic community, it has now been applied in at least four countries, with support from USAID and the Global Health Workforce Alliance (GHWA). It also served as the basis for GHWA’s Kampala Global Forum on HRH, held in March 2008.
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Human Resource Information Systems (HRIS). A suite of three databases to 1) track worker training, certification, and licensure; 2) manage and deploy personnel; and 3) provide long-term workforce modeling and planning, designed using free and open source software to avoid licensing and other long-term expense and maintenance issues. They are being implemented in eight countries to date, supported by a constellation of activities, including the formation of participatory stakeholder leadership groups and training in data-driven decisionmaking for strengthening the health workforce.
Health Information
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| Source: MEASURE DHS Project |
USAID’s Demographic and Health Survey (DHS). For the past 25 years, DHS has been the “gold standard” in household survey methodology, innovating in data collection, analysis, and dissemination, such as the use of biomarkers, the application of geographic information systems, and the offering of the Web-based STATcompiler for access to datasets.
- Global Standards for Health Information Systems and Monitoring & Evaluation (M&E). Leadership in creating the framework for the Health Metrics Network, the Routine Health Information Network, and the Performance of Routine Information System Management toolkits. Technical leadership in M&E of health, population, and nutrition programs, including M&E manuals and indicator guides.
- Support of the “Third One." Provided technical leadership and collaborative/coordinated efforts in support of the “Third One” to strengthen country capacity and HR in M&E for effective and efficient use of resources and results-based management.
Medicines and Technologies
- GH Toolkit. GH tools and approaches continue to dramatically improve supply chain management and the availability of contraceptives and essential medicines, thereby reducing stockouts and assuring continuing contraception and effective treatment for HIV/AIDS, malaria, TB, and MCH programs worldwide.
- WHO Global Strategy for the Containment of Antimicrobial Resistance (AMR). USAID provided technical and financial support to develop this landmark WHO document, which provides a comprehensive set of evidence-based, consensus recommendations for AMR containment. USAID also has supported the development of successful country-specific AMR intervention packages involving health providers, patients, education reform, the media, governments, and health systems based on the strategy.
- Quality Assurance (QA) of Medicines. GH's continuing advocacy regarding the critical importance of medicines quality has moved United States Government (USG) regional and country programs and other international initiatives to focus specifically on QA system issues. For example, USAID-supported postmarketing surveillance data and training were instrumental in facilitating the successful Interpol-led “Operation Storm” in the Greater Mekong Region. About $6.7 million of counterfeit medicines were confiscated in Cambodia, China, Laos, Thailand, Indonesia, Vietnam, and Singapore. Government actions also led to the banning of selected products, manufacturers, and distributors.
- Drug and Therapeutics Committees (DTCs). USAID-supported training and follow-up programs have capacitated hospitals to implement evidence-based and cost-effective selection and use of medicines. Nineteen courses have trained 861 participants from 71 countries, resulting in the establishment or restructuring of more than 92 DTCs worldwide and the implementation of hundreds of DTC-related interventions.
- Mobilizing Resources. USAID technical assistance supported a Global Fund to Fight AIDS, Tuberculosis, and Malaria decision to fund more than $2.4 million for contraceptives in Rwanda for 2008–2010. This decision was the first of its kind in the world and a major breakthrough for leveraging new funding sources for contraceptives.
Financing
- Performance-Based Financing (PBF). USAID experience contributed to Norway's decision to grant $105 million to the World Bank for PBF in developing countries. The USAID manual Paying for Performance in Health: Guide to Developing the Blueprint is used widely, including by the World Bank, for global training.
- Private sector loans. USAID leveraged $90 million in commercial lending (14 times the obligated funds) for private providers of reproductive health, family planning, and other health services in Nicaragua, Nigeria, Peru, the Philippines, Romania, and Uganda.
- National Health Accounts (NHAs). More than 100 developing countries have applied NHAs. Developing countries now lead the planning for the sixth global NHA symposium. USAID work has attracted substantial grant funding from The Bill & Melinda Gates Foundation to this area of work. Countries including Malawi and Rwanda have used NHA results to improve health policy.
Leadership and Governance
- Health system assessment approach. Increase of country-driven application. In 2008, the West Bank, Namibia, Vietnam, Nigeria, and Senegal adopted the approach.
- Private sector assessment approach. Country application of the approach creates awareness of enabling or constraining environment for private sector participation in health.
- Health System Action Network. Global health systems strengthening peer network now routinely sought out by global initiatives for advice and input.
- Virtual Leadership Development Program (VLDP). Teams from the public sector, NGOs, faith-based organizations, CSOs, and Cooperating Agencies from 53 countries in LAC, Africa, Asia, Europe and Eurasia, and the Middle East have participated since 2002.
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