How Can Disease Control Program Contribute to Health System Strengthening in Sub-Saharan Africa : A Concept Note for Engaging in the Global Debates on Health Systems Strengthening
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World Bank, Washington, DC
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Recently, there has been broad consensus in the global health community on the need for health systems strengthening (HSS) to make further progress toward the Millennium
Development Goals (MDGs) in Sub-Saharan Africa. However, there is still divergence
on how HSS should be framed, what HSS practically entails, and how it should be done.
We set out to clarify HSS for managers of disease control programs (DCPs).
In September 2000, the United Nations
created a new movement in the fight against poverty: 189
countries in the General Assembly expressed their commitment
to the Millennium Development Goals (MDGs) in the Millennium
Declaration (World Health Organization 2004). The
recognition of health as one of the key determinants of
human development is translated in three health-related
MDGs. MDG 4 and 5 focus respectively on children and women
as priority target groups, and MDG 6 focuses on priority
diseases (HIV/AIDS, malaria, and other major diseases),
representing the bulk of the disease burden in low-income
countries. In section two, the author first focuses on how
national health systems can be understood, with their
strengthening in mind, with a special focus on service
delivery and on its pluralistic nature. In section three,
the author uses the Anna Karenina principle to explain an
approach to health systems assessment at the national level.
Finally, in section four, the author develops an approach on
how Disease Control Program (DCP) can contribute to Health
systems Strengthening (HSS) at country level.
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