USAID Support in Health Systems Strengthening

	A patient proudly displays his insurance membership card after visiting the Mulindi health center in Byumba, Rwanda. Source: Phara Georges Rodrigue

USAID’s health systems strengthening program provides support to ensure that developing country health systems are effective, efficient, and equitable. Working health systems are vital to ensure widespread use of effective health measures.

Fundamentally, a working health system improves health. It delivers the right volume and distribution of services using good provider-client interactions. It operates at the community, local, and national levels. A working health system uses effective organizations and processes. It engages households, governments, the private sector, donors, and global initiatives. It reaches priority groups, including the poor, women, children, urban and rural residents, and the acutely and chronically ill. It responds to people’s needs, protects them from risk, and operates efficiently. It combats priority health issues such as tuberculosis, HIV/AIDS, malaria, and maternal, child, and reproductive health. It works fairly, responsively, and effectively, and offers choice. It employs appropriate incentives and is characterized by strong political will and a viable vision.

Health systems strengthening is a continuous process of implementing changes in policies and management arrangements within the health sector. This process, whether guided by individual governments, nongovernmental organizations (NGOs), or donor agencies, is under way in many countries as their populations’ needs change and grow.

As the U.S. Government’s lead foreign assistance agency working in partnership with other public and private sector agencies and NGOs, USAID applies a cycle of assessment, development, pilot testing, and introduction of products and approaches to tackle the main diseases and health issues of developing countries. This cycle enables USAID to assess needs, solve research and development problems, and improve the effectiveness of health programs that address the main causes of mortality. Health research is integral to USAID’s ability to achieve its health and development objectives worldwide. USAID has developed and introduced affordable health products, policies, and practices appropriate for addressing health-related concerns in developing countries. USAID’s research role, which is aligned with its strengths, is to assess local health conditions, develop and adapt appropriate health products and interventions, and support their field testing and introduction, including strengthening local health systems. Health systems research identifies problems and finds and tests solutions to improve the delivery and accessibility of products and approaches to tackle the main diseases and health issues facing developing countries. Some of this research is carried out within specific programs such as in maternal and neonatal health and nutrition programs. In addition, USAID has a more systemwide program of research that addresses overarching problems such as resource and budget tracking, health insurance, and other coverage approaches; drug and pharmaceutical management; and quality of services.

Over the next five years, USAID plans research activities to develop and apply a few high-priority tools to strengthen health systems and remove key barriers to access to care.