6 June 2022

Lessons from health systems partnerships and initiatives

Supporting countries to get universal health coverage on track

The COVID-19 pandemic has underscored the importance of accelerating progress towards universal health coverage (UHC) and health for all, and with the mid-point of the sustainable development goals (SDGs) fast approaching, it is a pivotal time for global health. The UHC movement is calling for global leaders to seize the moment ahead of the United Nations high-level meeting (UN HLM) on UHC in September 2023. To support this wider effort, here are some lessons of how UHC2030’s Health Related Initiatives, a group of international health systems networks and partnerships, are helping countries strengthen their health systems with emphasis on primary health care (PHC) and accelerate progress towards UHC.

Broad support to reorient health systems towards PHC:

Focusing on a PHC approach as the best and most cost-effective way to reorient health systems, the UHC Partnership, hosted by the WHO Special Programme on Primary Health Care, serves as a country support instrument covering all health systems technical areas, with over 120 policy advisors working mostly in WHO country offices or seconded to ministries of health. In practice, it covers a wide range of activities related to the development of national plans and strategies, financial protection, governance, health information, evidence and research, medicines, health security and preparedness, noncommunicable diseases, essential health services, health workforce, etc. Working at global, regional and country levels, the UHC Partnership is also instrumental in conveying the efforts developed by other networks and partner agencies, while ensuring that actions at country level are fully aligned with the political advocacy led by UHC2030.

Several related initiatives are also supporting countries to strengthen health systems based on PHC. For example, the Primary Health Care Performance Initiative’s (PHCPI) Vital Signs Profiles, have helped more than 25 countries to visualize the strengths and weaknesses of primary health care in their health systems and focus actions and investments where they are needed most. The Alliance for Health Policy and Systems Research (the Alliance) is also assessing and documenting how PHC has been affected by the ongoing COVID-19 pandemic, to provide evidence on best practices for countries to strengthen their health systems.

Lessons based on specific support and guidance from other thematic networks:

1. Invest in and protect the health workforce

The COVID-19 pandemic reinforced the importance of investing in the health workforce to address gaps, ensure relevant skill-mix and competencies, and provide safe and decent conditions for health workers. The Global Health Workforce Network’s (GHWN) Labour Markets Hub uses analyses of the impact of COVID-19 on health workers and related policy responses in Bolivia, Colombia, Chile, Ecuador, Peru, Belize, Grenada and Jamaica to inform workforce approaches in the WHO’s Americas region. GHWN’s Data & Evidence Hub guidance for National Health Workforce Accounts is also helping to strengthen and extend the use of human resources for health data and intelligence in planning and policy making at national and regional levels. The Community Health Worker Hub supported uptake in countries of the WHO Guidance on the role of community health workers in COVID-19 vaccination.

2. Align partner investments with national priorities

Reducing fragmentation of support is important to ensure efficient use of resources, especially for those countries that remain heavily dependent on external funding. Facilitating joint technical assistance, knowledge exchange and alignment at the country level is one the priorities of the Global Network for Social Health Protection and Health Financing for UHC (P4H). In 18 countries, P4H country focal persons are facilitating policy dialogues amongst relevant stakeholders to promote alignment to national health financing policies and accelerate progress towards UHC through sustainable, effective, efficient and equitable health financing systems.

3. Strengthen national data and health information systems

Well-functioning health information systems help monitor the impact of the pandemic on population health outcomes and track the needs of communities that are often left behind. For instance, the Health Data Collaborative (HDC), through its technical working groups, is supporting strengthening health information Civil Registration and Vital Statistics systems in Kenya, Uganda, Tanzania, Botswana, Zambia, Cameroon, Malawi and Nepal.

4. Ensure health governance that empowers people and communities

The Health Systems Governance Collaborative (HSGC) and its partners are developing country studies to showcase how participatory governance mechanisms leveraged in the COVID-19 response increased cooperation with communities and civil society during the crisis. Additionally, the collaborative will soon release an online glossary of Health Systems Governance Terms, including explanations how these terms may be understood differently by different stakeholders and applied to their day-to-day life and practice.

5. Use evidence- and knowledge-based decision-making processes

It is essential that policymakers in countries translate evidence into policies and actions, and some related initiatives are helping bridge this gap between theory and practice. The Joint Learning Network for Universal Health Coverage (JLN) is hosting an eLibrary of shared resources on COVID-19 patient pathways, flows and triage. The Joint Learning Network Health Budget Execution Learning Exchange supports lessons and learning on strengthening budget execution in several countries. Additionally, the COVID-19 National Coordination of Pandemic Responses Collaborative is sharing evidence and lessons learned from Bangladesh, Ethiopia and Kenya. Health Systems Global (HSG) is organizing the 7th  Global Symposium on Health Systems Research (HSR2022) a forum that brings together policymakers, practitioners and researchers to jointly discuss innovative solutions for recovery and resilience and for stronger, more robust and resilient health systems, and to be better prepared for future health crises.  

The UN HLM on UHC in September 2023 will be a key milestone to review commitments and accelerate progress towards UHC. To support this process, UHC2030’s Health Systems Related Initiatives will continue to jointly promote priority messages aligned with shared goals across the UHC movement’s partners.

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