Impact and Expertise

"For me, an area of moral clarity is: you're in front of someone who's suffering and you have the tools at your disposal to alleviate that suffering or even eradicate it, and you act."

Paul Farmer

  1. Human Resources: planning, financing, and mobilization

    Developing countries suffer from a chronic shortage of trained health workers. HSI provides tools, technical assistance and training to senior MOH Directors and other stakeholders in HR planning and financial modeling. We carry out assessments of training institutions to determine costs and strategies for scale-up of training for doctors, nurses and community health workers.  We examine the types of incentives and policies necessary to retain a skilled workforce. We undertake staffing or workload analyses to determine the optimal staffing mix and the benefits of task shifting when resources are constrained.  For scale-up of disease specific programs, we are experienced in estimating HR costs and modeling the impact on MOH budgets and pay scales.

  2. Financing Health Services: economic analysis and costing toolkits

    HSI provides strategic guidance to health systems managers on mobilizing resources to fund health services. We look at the impact of national and private insurance schemes, fee for service programs, and mobilizing the private sector.  We provide training in financial management and help lead teams that carry out costing studies and cost effectiveness analysis.  For example, we developed financial models for the World Bank and WHO to estimate the global resource requirements for prevention of HIV transmission. We developed costing toolkits and trained staff in Zimbabwe and Thailand to evaluate the costs of establishing a safer national blood banking and blood transfusion system. We developed cost benefit models to evaluate the impact of home-based care models to expand treatment for patients living with AIDS in Barbados and Zambia.

  3. The Global Fund: Health System Strengthening

    The Global Fund now plays a critical role in providing financial resources for health care in developing countries providing over $3 billion per year in funding. MOH leaders now have to contend with multifaceted grant application and organizational requirements in order to meet GF criteria. HSI has extensive experience in providing technical support for winning proposals.  We provide training to MOH team members and facilitate the collection of data and financial analysis essential to building a strong case for funding.

    For Global Fund applications HSI has worked closely with Country Coordinating Mechanisms and civil society in several countries to develop their capacities to effectively win and implement GF proposals. This includes Malawi, Zambia and the Asian countries attending the Asia-Pacific Action Alliance workshop on GF Round 7 Application. HSI provided lead technical support for Zambia’s Global Fund Round Six proposal with a focus on human resource capacity development. The Malawi Global Fund Coordinating Committee (MGFCC) requested HSI to support development of CCM capacity, and to conduct stakeholder consultations at provincial and constituency levels.

  4. Performance Monitoring and Evaluation

    HSI has strong analytical and M&E capabilities including development and implementation of best practice Project Management and PMIS systems, as well as rapid information dissemination mechanisms.  For example, HSI was a sub-contractor on the 5-year USAID project “Jamaica Healthy Lifestyles” that included responsibility for M&E activities.  Under this sub-contract, HSI implemented a M&E system that routinely provided activity and outcome data to stakeholders.

    HSI also has experience in carrying out project specific assessments and monitoring and evaluation (M&E):

    • Manpower and hospital evaluation studies in Bangladesh and Dhaka as well as inter-sectoral analyses in Bangladesh
    • MOH analysis at central and provincial levels aimed at improving financial and managerial capacity in Mozambique
    • HSI provided monitoring and evaluation technical support for the Zambian malaria program including defining measurable indicators

  5. Policy Reform

    HSI provided policy analysis and options for the Ministry of Health in Ghana to examine the feasibility of social insurance plans. HSI is experienced in the deployment of toolkits to carry out political mapping and policy environment assessments. 

    We examined the regulatory framework in South Africa to enhance municipal partnerships for delivery of health services.

    Through close collaboration with the Romanian Ministry of Public Health, Health Strategies International succeeded in developing secondary legislation to support new primary health care reform laws and helped to bridge local and state policymaking processes by strengthening decentralized policy development, fostering a demonstrably greater sense of community responsibility for public health. Additionally, through the implementation of specialized training programs for General Practitioners and the establishment of an efficient patient data management system, the RHCRP increased the overall capacity of Romanian primary health care centers and improved access to integrated quality services.

  6. Training and capacity building

    In China, we provided training and technical assistance to increase decentralized financial management of health care budgets. In Russia, HSI provided training for municipal managers. We provided technical assistance to managers in Mexico to utilize new techniques for evaluating health service effectiveness.

Impact

  • Malawi

    HSI helped stakeholders and the Government of Malawi develop a ten-year plan to improve training, compensation and retention of health care professionals. Health Strategies created a financial model to analyze the costs, tax revenues, and retention impact of alternative compensation plans. HSI helped mobilize over $300 million in donor resources to support the new comprehensive Human Resources Plan.

  • Romania

    In Romania, we supported the development and implementation of health sector reform policies, including private insurance schemes and the Basic Benefit Package. We were active participants in the dialogue between developing country stakeholders and international donor agencies on the need for health system strengthening, stakeholder capacity building, advocacy and decentralization.

  • Ethiopia

    In November 2008, The Global Fund announced the Round 8 Awards which included a $148 million grant to the Government of Ethiopia for malaria control and Health Systems Strengthening (HSS). Health Strategies International provided the technical leadership for the HSS component that was benchmarked by the TRP as a best practice model and a case study for other countries.

  • Barbados

    HSI worked closely with the senior management of the principal hospital to consider the feasibility and cost effectiveness of establishing non-hospital based care for persons living with AIDS (PWAs). After 24 months of working with the local community and health care practitioners a dedicated residential facility was established to accommodate the special needs of PWAs. This program also produced significant cost savings though the reduction of unnecessary hospital stays.