Health Systems Strengthening

The overall goal of the Health Systems Strengthening unit is, through providing technical support to health districts and developing communities, to strengthen the district health system using a comprehensive primary health care approach and establishing sustainable ‘good practice’ and learning sites in selected districts. This is facilitated through the strategic use, analysis and distribution of health and related information to enhance evidence-based management. The uniqueness of this approach is that HST facilitators are based at the districts and work closely with health district management teams and health-care workers, thereby transferring skills.

The Health Systems Strengthening unit grew out of the Initiative for Sub-district Support (ISDS) established in 1996 to support the implementation of the District Health System in South Africa and, more recently, out of the activities of the District Support and Community Development (DSCD) cluster and the Health Management Information System (HMIS) section. ISDS developed ‘good-practice districts’ in 21 district sites in all nine provinces of South Africa. Important lessons were learnt and fed into policy for the benefit of the entire health system. Many of these sites won awards, indirectly acknowledging HST for its support for District Health System development.

Health Systems Strengthening provides an excellent entry point into the entire health system by focusing on strengthening district, sub-district and facility management, also emphasizing strengthening community development and community involvement in primary health care.

The district management-related activities facilitate and support the implementation of health programmes in primary health care facilities by providing technical and managerial support to district management teams and frontline service providers. The community development component of the unit was established in 2001 to support selected districts in social development partnerships with community-based organisations and was successful in developing models for community development around key health issues.

In 2005 the unit was contracted to strengthen the National Health Information System in South Africa and built up a team of skilled staff working at national, provincial and district levels throughout the country to improve the quality of health information and the capacity of managers to use health information for planning and management.

The unit’s current projects can be viewed in the ‘Our Projects’ section of our ‘About Us’ webpage. Although Health Systems Strengthening and Health Systems Research are listed as separate operational units, this division is not too apparent in organisational practice as many projects are implemented on a collaborative cross-unit basis drawing on the skills of individuals from the organisation as a whole.