Health Systems in Action: an eHandbook for Leaders and Managers

Foreword
Over the past decade, the imperative of building strong national health systems
has gained heightened global attention. The unprecedented resources made
available for global health, and particularly for combating the major pandemics,
have enabled countries to significantly expand the reach of life-saving health interventions.
Yet, in many countries, efforts to scale up these programs have been impeded by
weak health systems. If the six health system building blocks defined by the World Health
Organization in Everybody’s Business offer countries a broad perspective on health system
components, this practical electronic handbook goes further by providing health program
managers with some of the essential nuts and bolts for strengthening health systems.
Turning the pages, I was struck by just how much of the knowledge contained in this
volume resonates with our experience in Ethiopia, particularly since we embarked on
a radical systemwide effort to reform our health sector. We recognized early on that an
integrated health system approach to service delivery was the only feasible strategy for
reaching the ambitious targets in our Health Sector Development Program (HSDP).
Created by the Federal Ministry of Health in 1997, the HSDP constitutes a core component
of our Government’s cross-sectoral Plan for Accelerated and Sustained Development
to End Poverty. The HSDP focuses on addressing the country’s most pressing health
problems. Directly aligned with the health-related Millennium Development Goals, the
current third phase of our HSDP prioritizes the high-impact health system-strengthening
interventions needed to accelerate scale-up and coverage of key health services in child
health, maternal health, HIV/TB, and malaria. Underpinning this approach is our Government’s
firm commitment to a community-centered effort to ensure universal access to
primary health care.
This national objective is being driven by our Health Extension Program (HEP), which
has rapidly trained and deployed 30,000 health extension workers (HEWs) throughout the
country—two HEWs for every village—almost doubling Ethiopia’s health workforce in only
three years. The engagement of HEWs as full-time salaried civil servants marks an important
shift away from the volunteerism model, a change that we believe has been crucial to
HEP’s rapid progress and will foster its long-term sustainability and success. Using social
mobilization and an innovative “model family” approach, our HEWs are promoting healthy
behaviors in their communities and improving access to and use of basic health services.
www.msh.org/resource-center/health-systems-in-action.cfm HeAltH SySteMS In ACtIon
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