Countries are using JANS for three main purposes:

  • To enhance the quality and relevance of the national health strategy.
  • To increase confidence in the strategy and help inform decisions about funding, ensuring that funding is closely aligned to the national health strategy.
  • To reduce transaction costs at country level and cut down multiple assessments and review processes by different agencies.

The JANS approach is structured around four principles:

  • Be driven and led by the country
  • Build on existing in-country processes and experiences
  • Have a strong independent element
  • Be inclusive, involving civil society and other stakeholders in the health sector.

The country carrying out the JANS should decide how best to apply these principles and use the tool to suit the country context and stage of plan development.

The JANS tool examines the soundness and feasibility of a strategy in five areas:

  1. Situation analysis and programming: clarity and relevance of priorities and strategies selected based on a sound situation analysis
  2. Process: soundness and inclusiveness of development and endorsement processes for the national strategy
  3. Costs and budgetary framework for the strategy: soundness and feasibility of the financial framework
  4. Implementation and management: soundness of arrangements and systems for implementing and managing the programmes contained in the national strategy
  5. Monitoring, evaluation and review: soundness of review and evaluation mechanisms and how their results are used.

JANS offers a valuable contribution in endorsing decisions with regard to health systems strengthening activities, performance and characteristics of health systems inputs and processes and consequently funding priorities. The JANS approach is being used in an increasing number of countries. In addition to individual country reports and lessons learned, an overview of how to conduct a JANS based on experiences, review of JANS user needs, quality assurance checklist and an updated detailed combined Joint Assessment Tool and Guidelines are available.


Health Security Assessment

Following the Ebola epidemic the issue of health security has become very important globally and at country level. During a JANS, the health sector’s role in promoting health security is one aspect for consideration (for example, Attribute 3). 

Since the JANS Tool and Guidelines were last updated, work under the Global Health Security Agenda partnership has resulted in elaborate guidelines for conducting a country assessment of health security capabilities including identifying gaps, opportunities and challenges: GHSA Country Assessment Tool 


The JANS process enhanced partners' confidence and provided an inclusive, structured and comprehensive framework for engagement in health strategy development. More development partners, including the US and GAVI, are aligning their plans with our strategy.

Dr Enkossa, Federal Ministry of Health, Ethiopia

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