Program Activities
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A health worker gives immunizations to children in Yemen. Source: Cherri Rassas/USAID |
USAID’s assistance in the area of health systems is an integral part of creating effective basic services in maternal and child health and other priority services. Since the inception of the program, USAID’s approach to health systems strengthening has combined field-level assistance with technical leadership and development of innovative solutions to health system problems. Most USAID country assistance health programs include health systems strengthening activities. In addition, at headquarters, USAID operates resource center projects focused on improving health system architecture and the six health system building blocks: Service Delivery, Health Workforce, Health Information, Pharmaceutical Management, Health Financing, and Leadership/Governance. The headquarter projects described below are included in the Bureau for Global Health’s (GH’s) Global Health Systems Program.
Office of Health, Infectious Disease, and Nutrition
Promoting the Quality of Medicines (PQM) improves quality assurance and quality control for medicines and health commodities for HIDN priority health interventions. As the primary HIDN mechanism for cross-cutting drug quality assurance assistance, the PQM mandate is to provide technical assistance to developing countries to strengthen their quality assurance systems and mechanisms; to work with international prequalification mechanisms and selected manufacturers to increase the supply of good-quality essential medicines; to promote and support evidence-based actions and approaches to combat substandard and fake medicines; and to provide technical leadership and global advocacy regarding the importance of medicines quality assurance.
Health Care Improvement (HCI) adapts modern quality improvement (QI) approaches, such as those used in the U.S. health system, for use in USAID-assisted countries. QI methods address the process of delivering health care, including following evidence-based guidelines and the organization of services. QI addresses issues related to efficiency, coverage, community-level services, and human resources. QI provides a new strategy to strengthen the impact of provider training and material inputs.
Health Systems 20/20 Project (HS 20/20) improves health financing, governance, and operations and establishes approaches that work in fragile, transformational, and graduating states. HS 20/20 finance goals are to increase access to PHN priority services by reducing financial barriers, increasing financing for health, and ensuring health resources are rationally allocated to maximize health impact. Governance goals are to improve health governance, particularly in fragile states, by helping policymakers effectively define and defend cost-effective strategies and investments to improve health. Improving health governance will ensure that health systems are transparent and accountable and encourage stakeholders to participate actively in shaping PHN priority services. Operations goals are to ensure health systems effectively budget and implement priority programs using effective financial and human resource management and planning systems. Sustainable organizational capacity-building goals are to improve skills, knowledge, and tools so finance, governance, and operations continue to support health impact by enabling developing country stakeholders to solve health system constraints to achieve the global health agenda, as well as building local sources of ongoing support in health financing, governance, and operations.
Strengthening Pharmaceutical Systems (SPS) improve the availability of medicines/health commodities of assured quality for priority interventions and promote their appropriate use. The new international health environment, characterized by ambitious treatment targets and vastly increased resources for medicines, offers unprecedented opportunities for health program development while posing unique challenges. SPS employ innovative approaches to strengthen pharmaceutical systems and foster south-to-south capacity-building. In the pharmaceutical governance arena, SPS further the U.S. Government agenda, including combating corruption, promoting transparency and accountability, and protecting the public health by assuring the quality, safety, and efficacy of medicines. Addressing the growing public health threat posed by accelerating antimicrobial resistance and removing barriers impeding access to medicines, including the need for sustainable financing strategies, will be major areas of work. Continuing the technical leadership agenda of the RPM Plus Program, SPS provide pharmaceutical management support to global health initiatives, enable donor coordination, facilitate harmonization of tools, and disseminate best practices.
DELIVER/AI is designed to procure, manage, ship, track, and provide logistics technical assistance to ensure that avian influenza (AI) containment commodities are available in-country to support the strengthening of AI outbreak surveillance, response, and containment.
DELIVER/Malaria is designed to support the President’s Malaria Initiative (PMI) and help ensure that the shared objective of the PMI and USAID’s Global Malaria Strategy is met, which is to significantly reduce the impact of malaria, especially in Africa. DELIVER/Malaria has three principal objectives: to improve and expand USAID’s provision of malaria commodities to programs; to strengthen in-country supply systems and capacity for management of malaria commodities; and to improve global supply and availability of malaria commodities.
Office of Population and Reproductive Health
USAID | DELIVER is a worldwide project to design, develop, strengthen, and, upon request, operate safe, reliable, and sustainable supply systems that provide a range of affordable, quality essential health commodities, including drugs, diagnostics, contraceptives, and supplies, to clients in country programs. The project improves the availability of essential health supplies in public and private services by strengthening country supply systems, collaborating with global and regional partners for long-term availability of supplies, and improving USAID’s provision of supplies to country programs.
The Capacity Project’s (HCD’s) purpose is to strengthen the human resources needed to implement quality health programs. It focuses on workforce policy and planning, workforce development, and the support of workforce performance.
Leadership Management & Sustainability (LMS) is designed to improve leadership, management, and sustainability of accessible and quality services and programs by strengthening management systems and increasing leadership capacity; improving the performance of leaders and managers; planning and managing human resources; and building capacity to anticipate and respond to changing external environments.
MEASURE Demographic and Health Survey (DHS Phase III) is USAID/GH’s primary demographic and health data collection project and, as such, seeks to increase understanding of a wide range of health issues by improving the quality and availability of data on health status and services and enhancing the ability of local organizations to collect, analyze, and disseminate such information. In addition to household and health facility surveys, the project collects biomarker data on anemia, HIV, syphilis, vitamin A deficiency, diabetes, and other health conditions. Since its inception in 1984, the MEASURE DHS project has provided technical assistance to more than 200 surveys in 75 countries.
Health Policy Initiative (HPI) – The Policy, Dialogue and Implementation (PDI) project is designed to exercise global leadership and provide field-level programming in health policy development and implementation. PDI Task Order One supports core reproductive health and family planning (RH/FP), maternal health, and HIV/AIDS activities in policy dialogue and formulation, and is also the mechanism designed to accept field support.
Survey and Census Information, Leadership, and Self-Sufficiency (U.S. Census Bureau–SCILS) seeks to provide quality information, methods, and tools for global health. The U.S. Census Bureau shares its expertise in statistical methodology and demographic analysis with counterparts in developing countries with the ultimate goal of improving the planning, collection, processing, understanding, and use of data by decisionmakers, the international community, and the population of each country to affect change.
Private Sector Partnerships-One (PSP-One) seeks to support, expand, and improve private sector service delivery in RH/FP and other priority health areas. Areas of technical expertise include marketing, franchising and private provider networks, behavior change communications, health financing and contracting, business capacity development, quality assurance, systems strengthening, private sector advocacy, health policy, and research monitoring and evaluation (M&E).
MEASURE CDC – the Division of Reproductive Health (DRH) of the U.S. Centers for Disease Control and Prevention (CDC) seeks to increase understanding of key RH/FP issues, improve the quality and availability of appropriate data on RH status and service, and enhance the ability of local organizations to collect, analyze, and disseminate such information.
Banking on Health works to improve the ability of private sector health care providers to access commercial loans, thereby improving their sustainability and capacity to deliver high-quality RH/FP services.
Office of HIV/AIDS
MEASURE Evaluation Phase III provides technical assistance and training to strengthen M&E of host-country programs across the PHN sector; to strengthen routine health information systems; to build capacity in M&E and/or routine health information systems in host-country institutions; to develop new methods for M&E of PHN programs; and to conduct evaluation research.
Supply Chain Management System’s (SCMS’s) purpose is to strengthen or establish secure, reliable, cost-effective, and sustainable supply chains to meet the care and treatment needs of people living with or affected by HIV/AIDS.
For more information on the programs described here, see the Users' Guide to USAID/Washington Health Programs.
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