Resource Type: Report
Authors: Health Systems 20/20
Published: 9/28/2012

Resource Description:

Health Systems 20/20 is the United States Agency for International Development‘s (USAID) flagship project for strengthening health systems worldwide. Launched in 2006, Health Systems 20/20 has responded to more than 250 activity requests in 51 countries, helping to eliminate barriers to the delivery and use of priority health care, such as HIV/AIDS services, tuberculosis treatment, reproductive health services, and maternal and child health care.

Health Systems 20/20‘s four intermediate results addressed the financing, governance, operational, and capacity constraints that block access to and use of priority health services. Over the life of the project, eight strategies emerged to address many of these constraints, which undermine the equity, efficiency, quality, and effectiveness of priority health services and ultimately limit service utilization. Health Systems 20/20 worked with USAID clients and country stakeholders to design programs tailored to meet country-specific challenges and health priorities. In addition, the project institutionalized existing tools, such as National Health Accounts (NHA) and the Health System Assessment (HSA), and developed new ones, including the HIV/AIDS Program Sustainability Analysis Tool (HAPSAT), and specific costing methodologies to generate the evidence needed to improve individual health systems.

From the outset, Health Systems 20/20 recognized that applying a one-size-fits-all approach to partner countries would not work. As a largely demand-driven project, it has been essential for Health Systems 20/20 to look at each country individually, applying the appropriate tools and strategies to clarify their health system constraints and bring new solutions into focus based on the starting point in each country. The project team saw repeatedly that the simultaneous, integrated application of several of these strategies achieves stronger results. Looking back on six years of testing and refining approaches to strengthening health systems worldwide, Health Systems 20/20 has distilled 13 lessons to share with the global health community as it plans for the future of health system strengthening.