Why should improving the efficiency of a country’s health system be the first step in improving health outcomes?

Ensuring that a country’s health system works efficiently is the first step to achieve SDG3

To achieve Sustainable Development Goal 3 (SDG3), that is, to achieve universal coverage and meet the health needs of every citizen, every country’s health programs must work through a network of efficient public and private health facilities and services that reaches every citizen. In this way, services required to meet the SDG3 targets can be provided in clinics, hospitals, schools and even the patients’ homes as necessary. We call this network of programs, facilities, providers and the institutions they work for a health system. Ensuring a country’s health system works like a well-oiled machine must be the goal of every country’s government and their donor-partners.

It is already known that having an efficient health system that can deliver quality healthcare to all is vital, however there is little consensus about what to do first to help a country improve health outcomes and thereby achieve SDG3.   There are many donor-funded projects and initiatives in most developing countries, and each seems to have their own way of doing global health. Likewise, every donor and country government I work with has questions about the sustainability of the results of these projects and initiatives. Their questions need to be answered if a country is to achieve SDG3.

Here are the most burning questions my clients ask me:

1. What is the most effective way to help a country own the improvements brought on by global health projects and donors? Do we need another project or partner?
2. What is the most effective way to ensure a country will sustain the improved health outcomes a project has achieved and expand to ensure universal coverage of the improvements by 2030?
3. What is the most effective way to ensure a country can benefit from donor assistance, learn from effective and unsuccessful practices, and avoid duplication of efforts?

The answer to these questions is simple, not easy, but simple indeed. The first step of any global health project or initiative in a country must be to improve how the health system works in that country. Everything we do in global health to improve a country’s health sector must contribute and account for improvements to its health system. Depending on resources, the scope of interventions to improve the health system can be at national, regional and /or community levels. It is also expected that what a donor-funded project or organization does to improve the care of TB, Malaria, AIDS or Ebola patients must ensure that the country’s respective TB, Malaria, AIDS or Ebola programs perform better and are able to continue the work after the project ends or the funding runs out.

For a health system to work, it needs three essential elements:

1. Effective Program Managers that manage each program, such as, MCH, FP, TB, Ebola, etc. efficiently.
2. Effective Standard Operating Procedures for clinics, hospitals and community-based services to be delivered consistently according to quality standards.
3. Effective health professionals that have the training, tools and job aides to deliver these services while also enjoying their work.

Next week, I will talk about the 8 changes that need to take place for a health system to function efficiently and sustainably.

Write to programs@realizingglobalhealth.com to learn more about RGH’s Health System Improvement program. The program includes:

1. Tools for program managers to manage resources to achieve better health outcomes;
2. Effective standard operating procedures for health facilities to work efficiently, and;
3. All the job aides for health professionals to consistently deliver quality healthcare every day and enjoy their jobs again.