Health systems strengthening

FHI 360 programs contribute to improving the performance of health systems and the delivery of high-quality services in resource-limited settings, with a focus on sustainability. Through a continual process of collaboration with local partners and stakeholders, we strengthen health systems functions that are essential to the improvement of public health. Our approach follows a three-step process: 1) measuring the performance of the health system; 2) identifying root causes of performance; and 3) developing solutions with stakeholders.

We customize the application of FHI 360 reference documents to local contexts. The Health System Rapid Diagnostic Tool provides a step-by-step framework, operational guide and metrics for a country team to identify and measure the strength of priority health system functions. The Quality Improvement Handbook provides a scientific approach to address the systemic causes that affect the delivery and quality of health services and to improve the many functions of the health system through solutions that are then replicated to scale. FHI 360 is also testing a framework for the sustainability of results and the transition of its own capacities to stakeholders at the country level.

We apply our systems thinking and systems improvement tools to different situations and programs, such as: reinforcing primary health care in places where we support the delivery of clinical HIV and family planning services; integrating comprehensive care services; building the capacity of community health workers, nurses and laboratory staff through task shifting, clinical mentoring and integrated supervision; strengthening community health committees; and supporting management teams to design ambitious quality improvement efforts.

Our systems strengthening work covers both the public and private sectors and all levels of health systems: national (policymaking and governance), intermediate (management of regional and district health systems) and peripheral (community and facility-based delivery points).

We document and publish our lessons learned to continuously improve the effectiveness and efficiencies of our programs and contribute to the broader goal of generating further evidence for the implementation science that underlies all our programs.

Learn more about our reference documents:

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Health systems strengthening