HIV/AIDS
Health Systems 20/20 is working at the country level to conduct comprehensive analysis of available and required human resources to scale up and sustain HIV/AIDS services and to facilitate solutions to address human resource shortages.
Responding to the HIV/AIDS Epidemic through Health Systems Strengthening Efforts
As countries work to scale up successful HIV/AIDS country programs, weaknesses in national health systems have grown increasingly apparent. Repeatedly, health system weaknesses, ranging from acute shortages of trained health workers to weak health management information systems to the inadequate integration of HIV services into basic health service provision, have threatened the successful scale up of urgently needed HIV and AIDS services.
What is the Health System?
A health system consists of all organizations, people, and actions whose primary intent is to promote, restore, or maintain health. Health Systems 20/20 incorporates the health systems strengthening framework of the World Health Organization in its approaches to health systems strengthening. The framework identifies the six building blocks of a health system as: service delivery, human resources for health, health information systems, pharmaceuticals, health financing, and governance. Each of Health Systems 20/20’s activities examines one or more of these building blocks in the context of HIV/AIDS programming at the country level.
Health Systems 20/20 Approaches and Current Activity Highlights
Health Systems 20/20’s holistic approach to health systems strengthening allows it to link research to real-world applications, and address the spectrum of HIV-related prevention, treatment, care, and support needs. The project works closely with a diverse set of local partners including central ministries of health, district health managers, grassroots private groups, and others, to address those priorities.
For example, Health Systems 20/20 works with ministries of health, USAID country missions, and other local country partners, to apply our Health Systems Assessment Tool to rapidly assess health systems needs in the six WHO health systems strengthening areas and to prioritize responses.
Health Systems 20/20 also uses the HIV/AIDS Program Sustainability Analysis Tool (HAPSAT) to assess the current financing and scope of HIV/AIDS services in countries by estimating the cost of sustaining a prioritized set of HIV/AIDS services over a five-year period. The HAPSAT considers the total costs of sustaining programs including ARV drugs, infrastructural costs, equipment costs, M&E, and the cost of developing the human resources necessary to deliver HIV/AIDS services.
Health Systems 20/20 provides technical assistance in costing national HIV/AIDS strategies. As countries become increasingly interested in costing their three to five year HIV/AIDS strategies, this costing exercise provides strategic planning information by assessing the resource requirements for sustaining and scaling up HIV/AIDS programs. Leveraging the successful HIV/AIDS costing study done in Liberia and the ART costing studies done under the USAID-funded PHRplus project, Health Systems 20/20 is supporting development and costing of national HIV/AIDS strategies in five countries.
Health Systems 20/20 has several large activities focused on human resources for health using targeted approaches to improve the retention, performance, and motivation of health workers. These include a study in Ethiopia comparing financial and non-financial incentives to improve HIV/AIDS counseling and testing performance; an assessment in Uganda comparing performance, retention, human resource management practices and motivation at faith-based organizations and public sector facilities; an activity in Swaziland using non-financial incentives to improve retention and performance; and a study in Zambia testing productivity improvement among health workers.
The project has also been working on improving strategic information to inform program planning and decision making for service delivery by using GIS technology. GIS mapping and analysis is a key component of this process since it enables visualization of key program data within a geographic context. Health Systems 20/20 promotes the use of GIS mapping and analysis tools to graph health survey data, identify geographic trends, and promote optimal allocation and positioning of resources to address health needs.
HAPSAT Nigeria: Policy Modeling to Support Strategic Planning for Sustainable HIV/AIDS Services
Type: Brief
Country: Nigeria
Using HAPSAT for HIV Program Sustainability Analysis: An Introductory Guide
Type: Tool
HAPSAT Non-Clinical Service Provider Questionnaire
Type: Tool
Health Systems 20/20 Work in Haiti
Feb 1 2010Health Systems 20/20 Contributes to Lancet Article Examining Interactions between Global Health Initiatives and Health Systems
Aug 18 2009Over the past two decades the emergence of several large disease-specific global initiatives (GHI) has shifted the way development assistance in public health is provided. To help assess the interaction between GHIs and country health systems, Health Systems 20/20 staff Susna De, Wenjuan Wang, Jenna Wright, and Takondwa Mwase participated in the WHO Maximizing Positive Synergies Collaborative Group. Their multiple-country analysis on financing HIV/AIDS work contributed to the Group’s report, the highlights of which appear in a recent Lancet article.
More...From Health Labor Market Analysis to Result-Based Financing: Insights from a Post-Conflict Country, Cote d'Ivoire
Jan 28 2009As in most African countries, Cote d’Ivoire is facing a crisis in human resources for health (HRH) worsened by a high HIV-AIDS prevalence (4.7%) and a civil war from 2002 to 2007. Many health workers have fled from the northern regions to seek refuge in the capital city, Abidjan. At a World Bank event on January 14, 2009, Gilbert Kombe shared insights from Health Systems 20/20 work to develop innovative and sustainable interventions to address the health labor crisis.
More...New Toolkit!
Using Round 9 of the Global Fund for Health Systems Strengthening
Oct 27 2008Health Systems 20/20 and the Health Workforce Advocacy Initiative have teamed up to develop a toolkit of materials to help Global Fund applicants better understand how they can use Round 9 of the Global Fund to strengthen their countries’ health systems as well as what resources are available to support them in doing so.
More...Why Strengthening Health Systems Matters
Oct 21 2008
USAID's flagship health systems strengthening project, Health Systems 20/20, was invited to share their experience with the Office of the U.S. Global AIDS Coordinator (OGAC) related to building health systems at the country level.
More...
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Photos from the IAC
Health Systems Assessment
