SBAIC News

Innovations in Global Health: How to strengthen health systems

Elvira Beracochea, President & Founder, Realizing Global Health

What is RGH’s view of a health system?

A health system is the vehicle countries have to deliver the healthcare services that people need. It is composed of various sub-systems: government, private sector, civil and faith-based organizations and academic institutions. They all deliver services and need to do it in a coordinated and efficient manner.

This is not the case in most countries, and that is why RGH developed tools to provide more coordination and greater efficiency within health systems. RGH designs, implements and evaluates projects that apply these tools, as well as train health professionals and managers among the various sub-systems to use them. RGH’s mission is to develop sustainable and self-reliant health systems. Our job is to help our clients achieve sustainable results through the delivery of quality health services. 

How do you strengthen a health system?

Our main tool for strengthening health systems is called the Project - Program - System (PPS) framework. The PPS is a framework for strengthening each part (sub-system) of the health system, so that clients can deliver quality healthcare.

What is the PPS framework?

The PPS is summarized by a simple statement:

Projects improve programs that make the system work for everyone everywhere everyday.

How does PPS work?
Every country has a number of disease prevention and control programs that are implemented through a network of clinics, hospitals and community-based workers, but are not always organized to communicate with each other. 

When RGH designs a global health project, the project is designed to ensure that the country’s system and programs improve, in order to keep delivering better services to more people - after that project ends.  For example, when RGH designs a HIV/AIDS project, we ensure that the project will not only provide quality HIV prevention, treatment and care services, but also will improve how the country’s HIV/AIDS program works. Therefore, that country’s health facilities will be empowered to deliver more and higher-quality HIV/AIDS services.  

In this way, the country will continue delivering services at the same level achieved by the project, even after it ends.  For maternal and child health projects, RGH ensures, first of all, that these projects will increase the number of mothers and children that have access to timely and quality MCH services.  A second intent is to ensure that the project enables the country’s authorities and MCH program managers to manage the country’s MCH program more efficiently.  An RGH project design also ensures that a definite number of facilities and the communities are being served, and that these communities have the necessary tools and skills to continue delivering quality MCH services, after the project ends.

How do we do it?

RGH has developed tools to ensure that all high-impact, life-saving interventions known to work in global health, are effectively and efficiently transferred to local programs, organizations and their staff. In this way, projects are successful in achieving their deliverables.  And, by using our tools, country program managers and health facility staff can attain - and sustain success.

The PPS framework also encourages innovation in project design and implementation, which, in turn, promotes more efficient healthcare delivery procedures.  In this way, a country’s programs are strengthened to achieve defined quality standards and population coverage targets. The health system works better, due to increased facility and staff capacity, while using daily output metrics and monthly outcome measures contribute to demonstrated improvements in the program’s accountability and overall performance.