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Health System Strengthening Workshop

A discussion on definitions, frameworks, measurement and moving towards improved donor coordination
Location:   MC13-121
Begins:   Jun 25, 2009 08:30
Ends:   Jun 27, 2009 14:00

The World Bank (Health Nutrition, and Population (HNP), World Bank Institute (WBI), Health Systems Global Expert Team (HSGET)), along with The GAVI Alliance and The Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund), hosted a Technical Workshop on Health System Strengthening in Washington D.C. from June 25 to June 27. The meeting was called in response to the High Level Task Force on Innovative International Financing for Health Systems recommendation that the three organizations create a platform for more effective Health System Strengthening. This workshop was the first joint action by the World Bank, GAVI and the Global Fund to meet the Task Force’s call.

Workshop organizations wrote five papers and put forth the following four questions for consideration:

  • What constitutes health systems strengthening?
  • What elements are needed to contribute to progress and success in health systems strengthening?
  • What are the roles of capacity building and leadership development for health system strengthening? What constitutes a solid capacity building strategy for HSS?
  • How can health system strengthening actions and results be better measured?

These questions were not posed with the intention of finding definitive answers, but with the idea of soliciting input on the importance and weight that should be given to these issues and how to move forward on the Task Force’s recommendation. Participants from Ministries of Health, representatives from Europe and Central Asia (ECA), Africa, South Asia and Latin America, Health Systems Experts from WHO, The Global Fund, GAVI, Harvard, The World Bank, and Representatives of European and U.S. Donor Agencies and Representatives from International Civil Society Organizations spent two and half days listening to various presentations and perspective and debating these questions.

The workshop proved very useful in drawing out a diversity of views on Health Systems and Health Systems Strengthening. A couple of points became clear – that while there are a variety of HS frameworks they tend to have common elements; there was little enthusiasm for developing a new “common” HS framework or for more “debate” among frameworks. But participants also expressed that there is value in understanding what HSS means to the various donors and in those organizations enumerating what exactly they are funding through their HSS windows. Participants were also strong in their insistence that, in moving forward with any joint mechanism, the country perspective must take center stage.

Background paperspresentations and session notes can all be found below. Summary notes and an outline of next steps in particular can be found in the Day 3 power-points. Please contact Peter Berman ( or Katherine Brouhard ( with any questions or feedback.

Day 1 – June 25, 2009
08:00 - 08:30 Breakfast and registration
08:30 - 09:15

Opening Remarks:

  • Joy Phumaphi, World Bank
  • Sanjay Pradhan, WBI
  • Rifat Atun, The Global Fund
  • Carole Presern, GAVI
Theme 1:     Health Systems and Health Systems Strengthening
Chair: Tim Evans, WHO

Background Papers

09:15 – 09:45

Explaining Health Systems Strengthening

09:45 - 10:30 

Panel Discussion

  • Craig Burgess, GAVI
  • Bob Emery, USAID
  • Stephan Karengera, Director of Policy and Planning, Rwanda
  • Rashid Jooma, Ministry of Health, Pakistan
10:30 - 10:45Coffee Break
10:45 - 11:00

Primary Health Care and Health System Strengthening (PDF 558KB)
Wim van Lerberghe, WHO

11:00 - 12:00

Facilitated group discussions (break into small groups)

12:00 – 12:30Brief Group Reports
12:30 – 13:00In Search of a Common Conceptual Framework for Health System Strengthening (PDF 63.4KB)
Comment: William Hsiao, Harvard University
Developing a Synthetic View on the Theme (Session Chair)
13:00 – 14:00 Lunch
Theme 2:     Measuring Health System Strengthening
ChairRifat Atun, The Global Fund

Background Paper

14:00 – 14:20Technical Introduction to the Theme
Measuring Health Systems Strengthening (PDF 1.45MB)
Ties Boerma, WHO
14:20 – 14:30Measurement Challenges for Monitoring Health Systems Strengthening (PDF 279KB)
Eduard Bos, World Bank
14:30 – 15:15Panel Discussion
15:15 – 15:30Coffee Break
15:30 – 17:15Plenary Discussion
17:15 – 17:45Comment: Dan Kress, BMGF
Developing a Synthetic View on the Theme (Session/Panel Chair)
Day 2: June 26, 2009
Theme 3:     Building Leadership and Capacity for Health System Strengthening - World Bank Institute
Chair – Bruno Laporte (WBI)

Accompanying Paper

09:00 - 09:20Introduction to the theme: New Strategies for Building Capacity.

Sanjay Pradhan (VP, WBI)

09:20 - 09:40

Building Capacity for HSS: The Flagship Program Experience (PDF 231KB)

  • Paul Shaw (WBI)
  • Bill Hsiao Presentation of the Flagship Framework.
10:00 - 10:20Discussion and Q and A (chair)
10:20 - 10:40Coffee Break
10:40 - 11:25

Panel 1: Partner and Donor Perspectives of the Flagship Program: Building Capacity in the Health Sector.

11:25 - 11:40Q and A (chair to moderate)
11:40 - 12:20

Panel 2: Country and Regional Perspectives of the Flagship Program: Building Capacity in the Health Sector.

12:20 - 12:30Q and A
12:30 – 12:45Commentary: Developing a Synthetic View on the Theme. Stefan Nachuk, Associate Director, Rockefeller, Foundation
12:45 – 14:00Lunch: Regional Lunch Tables (1 table for each region) with Brief Presentation on Innovative HSS Work in that region during lunch then discussion hosted by World Bank Health Systems Global Expert Team (HSGET)
Theme 4: Country and donor perspectives on Progress in Health Systems Strengthening
Chair: Carole Presern, GAVI Alliance
14:00 – 14:15Technical Introduction to the Theme
Jenny Amery, DfID
14:15 – 15:15 

Three Country Cases exemplifying different types of HSS with Q&A:

15:15 – 15:30Coffee Break
15:30 – 16:30

Donor panel perspective:

16:30 – 16:45Multi lateral perspective: Ian Pett, UNICEF
16:45 – 17:15Comments from Chair
Day 3: June 27, 2009

Bringing it all Together
Chair – Julian Schweitzer, World Bank

09:00 – 09:15Opening Comments – Julian
09:15 – 10:00Summary of Results Themes 1- 4
Notes in Summary...for Discussion (PDF 42.6kb)
Peter Berman; and Discussion
10:00 – 10:30Presentation of an Outline Towards a Joint Position Paper on Four Themes of the Meeting and Next step: How Do We Move Towards a Common Operational Framework for HSS (PDF 675kb), George Shakarishvili
10:30 - 10:45Coffee Break
10:45 – 11:45Plenary Discussion
11:45 – 12:30Hard Talk Q&A with WHO, GFATM, GAVI, World Bank –How Will We do Better on HSS?
EMCEE: David de Ferranti, Results for Development
12:30 – 12:45WHO Perspective – Tim Evans
12:45 - 13:00Summary and Closing -- Chair
13:00 – 14:00 Lunch and departures

Session Notes


Last updated: 2009-07-13

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