Recognizing that gaps in health systems and service delivery impact the improvement of health outcomes for people affected by HIV, tuberculosis and malaria, the Global Fund has been supporting an increasing number of cross-cutting Health Systems Strengthening (HSS) projects. Some 2008 estimates show that 35% of the approved US$ 4 billion financing went to key health systems elements.

In pursuance of its policy to support HSS activities in partner countries, and the recommendations of the WHO Maximizing Positive Synergies project calling for more reliable data on the costs and benefits of strengthening health systems, the Global Fund Secretariat (M&E Unit, Strategy, Performance and Evaluation Cluster) in collaboration with partner institutions and countries undertook multi-country ‘case studies’ to systematically analyze and identify best practices for HSS. As part of this assessment, the GHD project conducted research in Kenya and Haiti from the end of 2008 to January 2010, developing case studies in collaboration with local partners Kenyatta University and Partners In Health-Zanmi Lasante. GHD also provided technical support and guidance in qualitative methods and analysis for the entire project.

Objectives

• Identify system-wide effects/synergies of the Global Fund portfolio and countries’ health systems;
• Illustrate the integration of the Global Fund portfolio with national health systems and disease programs;
• Report the perceptions of stakeholders at the national and regional levels on the strengths and weaknesses of Global Fund-supported programs, and make suggestions for improvement.

Feature publication

• Co-authored by country partners, the country reports will provide an overview of disease programmes in the context of the country’s health system.

Future Work

The country reports will be supplemented with cross-case analysis at the regional and international level to identify key thematic issues that will inform policy makers, practitioners and Global Fund partners to better target their efforts in order to improve health outcomes.

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