Addressing Critical Health System Barriers to Improve RMNCAH Services

Let's continue the conversation. Please see EVENT SUMMARY and PODCASTfrom the recent Addressing Critical Health System Barriers to Improve RMNCAH Services event published on New Security Beat.

USAID’s 2017 Acting on the Call Report estimates that investments in evidence-based health system strengthening activities across 25 priority countries would save the lives of 5.6 million children and 260,000 women from 2016-2020. USAID’s Maternal and Child Survival Program (MCSP) supports delivery of high-impact reproductive, maternal, newborn, child, and adolescent health (RMNCAH) services in 25 USAID priority countries. 

There is broad recognition that efforts to improve global health cannot be achieved without stronger health systems. Sustained improvement of RMNCAH outcomes cannot be achieved through a standalone program or individual interventions. It requires high-quality delivery of a complex set of clinical interventions at all levels of the health system from the community to the hospital level, effective referral systems that minimize delay in care and missed opportunities, strong information systems that identify potential problems and enable informed management decisions, and sustained leadership that coordinates available resources to resolve problems. Strengthening health system structures and processes is critical to ensure that high quality RMNCAH services can be sustained at scale. Additionally, addressing health system barriers coupled with specific service delivery targets can provide a strong framework for measuring system strengthening outcomes.

Join the Wilson Center and USAID's flagship Maternal and Child Survival Program (MCSP) on February 27 for a discussion on health systems strengthening in the pursuit of improved reproductive, maternal, newborn, child, and adolescent health services globally.

Join the conversation on Twitter by following @NewSecurityBeat and find related coverage on our blog at NewSecurityBeat.org. 

Selected Quotes 

Grace Chee

“We cannot achieve our goals of ending maternal and child deaths without addressing critical health system barriers around the world.”

“All elements of the health system need to converge in order to deliver quality services…And I think beyond that, we need to go even a step further—beyond service delivery and even beyond engaging all parts of the health system, we need to address the fundamental operations of the system to create sustainable change.”

Dr. Mariam Claeson

“To put the financing behind health system strengthening—getting the services for mothers and newborns and for women, children and adolescents to the front line—needs a new way of thinking about financing. We can’t continue to do it disease or condition by condition or program by program or intervention by intervention. We have to rethink how we finance for development.”

“Clearly we have to find ways of mobilizing the money for mothers and newborns…through other means than just the ODA share…[including] getting countries to spend the budget they already have for the interventions…we proactively mobilize domestic resources, we link to World Bank financing…”

Dr. Stephen Mutwiwa

“Rwanda is actually one of the countries that achieved all the health MDGs, and we have seen a reduction of maternal death from 2005 to 2015 by 72% and child death by 67%...probably you see the reasons why Rwanda has been able to make that kind of progress.”

“The main thing is that we had to make sure that what are we doing…it is something that is nationwide, it is something that is being implemented with one focus. We also had to make sure that people are using data routinely, even at facility level….and the government had the ability to scale up high impact intervention.”

Lee Pyne-Mercier

“Despite a fairly large number or facilities and health workers in [Nigeria], there are very important bottlenecks in the areas of skills, supplies, equipment, and financing. A root cause here…is driven by weak governance. We need to address this as a global community if we wish to achieve sustainable growth in Nigeria.”

“Our evolving approach really complements service delivery investments with work on sustainability and system strengthening…two [WHO building blocks] that are particularly important in Nigeria: they are on governance and financing.”

Dr. Birhanu Getahun

“Both projects [Restoration of Health services (RHS) and Human Resource for Health (HRH) in Liberia]—they have to be sustained and continued. One of the big successes throughout all our implementation strategy, we have engaged the counties and districts so they can own the skill to implement the project.”

“Quick investments to restore confidence in health systems should be complemented with long-lasting investment like infrastructure for health upgrades.”