Health Systems Strengthening

20th September 2022
Author: Dr Kerry Millington, Dr Kim Ozano

COVID-19, Governance, Health, Policy, Politics and Power

Sustainable Development Goals

17.  Partnerships to achieve the Goals, 3.    Good Health and Well-being

Health systems strengthening (HSS) is at the heart of the UK’s approach to its longstanding advocacy for and investment in global health. The Foreign, Commonwealth and Development Office’s (FCDOs) position is that ‘a strong and inclusive health system is a foundation stone to achieving all health outcomes’.

This K4D Learning Package on Health Systems Strengthening offers support to build understanding, capacity, dialogue, and influence in strengthening health systems to improve the health and well-being amongst the poorest and marginalised in low- and middle-income countries.

There is a particular focus on an overview of the evidence for each of the health systems building block, four topics – political economy analysis, strengthening accountability, health financing and universal health coverage (UHC); and two cross-cutting themes – improving quality of care and leave no-one behind.

In addition, reorienting health systems and donor efforts towards integrated people centred health services is a priority expressed by FCDO. Implementation requires a shift across the health system, with regards to how services are organised and delivered at the facility-level, and how they are incorporated into the programming, funding and implementation of national disease programmes. It requires services to be planned so they are not disjointed and are easy for the users to navigate. Evidence on implementing integration for tuberculosis, malaria and HIV services has been synthesised and discussed with FCDO health advisors and others so that it may be used regionally and globally in policy engagement with the Global Fund board, secretariat, with other donors and in country and national coordination mechanisms for advocacy and influencing.

This learning package offers a summary the key evidence on Health System Strengthening (HSS) in a digestible format including:

  • What is meant by health systems strengthening
  • An overview of the evidence for each of the health systems building blocks: Leadership, governance and accountability mechanisms; health financing; safe, quality, affordable and equitable service delivery (also including, if possible, community service delivery models); human resources for health; medical products, vaccines and supplies including supply chains; health information systems
  • Intervention implementation and design factors. A review of different conceptualisations of integrated health care and links with HSS (considering WHO people centred health systems, framework on integrated people-centred health services, UHC/PHC approaches, etc)
  • Recommendations from evidence around policies, coordination groups and practices that can support HSS, such as Human Resource Health (HRH) observatories, country health coordination groups, community health networks, etc.

This learning package offers materials, discussion summaries and guides to support learning and understanding of how to strengthen health systems with practical examples from evidence and implementation experiences across six countries. It also signposts to key reading and areas for further exploration.


The resources below have been selected due to their relevance to the learning package. Explore them to strengthen your understanding of Health Systems Strengthening.

Continents, regions and countries

Global, Africa, Asia