Implementing health system strengthening projects at USAID: Findings from five cases using an integrated framework.

Evidence on the implementation of health systems strengthening (HSS) interventions is scarce. Donors need this information to prioritise investments and lobby for continued financial support. To develop a deeper understanding of the implementation dynamics of robust HSS interventions, we retrospecti...

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Publicado en:Global Public Health Vol. 14; no. 12; pp. 1829 - 1847
Autores principales: Koon, Adam D., Conrad, Abigail, Naimoli, Joseph F., Saxena, Sweta, Connor, Catherine, Rodriguez, Daniela C.
Formato: research tables/charts Journal Article
Publicado: Taylor & Francis Ltd Dec2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2019
      vid: 14
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      pub: Taylor & Francis Ltd
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        atl: Implementing health system strengthening projects at USAID: Findings from five cases using an integrated framework.
      aug:
        au:
          Koon, Adam D.
          Conrad, Abigail
          Naimoli, Joseph F.
          Saxena, Sweta
          Connor, Catherine
          Rodriguez, Daniela C.
        affil: Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
      sug:
        subj:
          Government Agencies Administration
          Health Care Delivery
          Government Programs
          Financing, Government
          Conceptual Framework
          Implementation Science
          World Health
          Human
          United States
          Program Implementation
          Retrospective Design
          Dominican Republic
          Ethiopia
          Kazakhstan
          Rwanda
          Zambia
          Interviews
          Financial Support
          Accountability
          Health Services Accessibility
          Low and Middle Income Countries
          Funding Source
          Case Studies
          Data Analysis Software
          Interview Guides
          Quality Improvement
          Audiorecording
          Triangulation
          Planning Techniques
          Leadership
          Collaboration
          Multidisciplinary Care Team
          Health Policy
          Medically Underserved
      ab: Evidence on the implementation of health systems strengthening (HSS) interventions is scarce. Donors need this information to prioritise investments and lobby for continued financial support. To develop a deeper understanding of the implementation dynamics of robust HSS interventions, we retrospectively compared five USAID-supported projects in the Dominican Republic, Ethiopia, Kazakhstan, Rwanda, and Zambia. A document review and key informant interviews (n = 44) were conducted, coded, and analysed in each of the five cases using an integrated implementation framework. The framework was organised by four phases of implementation. For the pre-condition phase, data-driven HSS interventions were nested in a range of political contexts and with differing levels of financial support. In pre-implementation, cases relied on diverse teams that created a data-informed, inclusive, and transparent project ethos for implementation. Implementation was located at multiple tiers of the health system, used interventions as catalysts for government initiatives, supported governance/accountability initiatives, and responded nimbly to contextual changes in the implementation climate. There was less evidence of maintenance and evolution but all cases were designed with an eye towards sustainability. This research yields important insights about the dynamics of HSS, identifying ways donors can better support countries to achieve universal health coverage.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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