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      Strengthening health systems in low-income countries by enhancing organizational capacities and improving institutions.

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          Abstract

          This paper argues that the global health agenda tends to privilege short-term global interests at the expense of long-term capacity building within national and community health systems. The Health Systems Strengthening (HSS) movement needs to focus on developing the capacity of local organizations and the institutions that influence how such organizations interact with local and international stakeholders.

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          An assessment of interactions between global health initiatives and country health systems.

          (2009)
          Since 2000, the emergence of several large disease-specific global health initiatives (GHIs) has changed the way in which international donors provide assistance for public health. Some critics have claimed that these initiatives burden health systems that are already fragile in countries with few resources, whereas others have asserted that weak health systems prevent progress in meeting disease-specific targets. So far, most of the evidence for this debate has been provided by speculation and anecdotes. We use a review and analysis of existing data, and 15 new studies that were submitted to WHO for the purpose of writing this Report to describe the complex nature of the interplay between country health systems and GHIs. We suggest that this Report provides the most detailed compilation of published and emerging evidence so far, and provides a basis for identification of the ways in which GHIs and health systems can interact to mutually reinforce their effects. On the basis of the findings, we make some general recommendations and identify a series of action points for international partners, governments, and other stakeholders that will help ensure that investments in GHIs and country health systems can fulfil their potential to produce comprehensive and lasting results in disease-specific work, and advance the general public health agenda. The target date for achievement of the health-related Millennium Development Goals is drawing close, and the economic downturn threatens to undermine the improvements in health outcomes that have been achieved in the past few years. If adjustments to the interactions between GHIs and country health systems will improve efficiency, equity, value for money, and outcomes in global public health, then these opportunities should not be missed.
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            The effects of global health initiatives on country health systems: a review of the evidence from HIV/AIDS control.

            Regien Biesma, Ruairí Brugha, Andrew Harmer … (2009)
            This paper reviews country-level evidence about the impact of global health initiatives (GHIs), which have had profound effects on recipient country health systems in middle and low income countries. We have selected three initiatives that account for an estimated two-thirds of external funding earmarked for HIV/AIDS control in resource-poor countries: the Global Fund to Fight AIDS, TB and Malaria, the World Bank Multi-country AIDS Program (MAP) and the US President's Emergency Plan for AIDS Relief (PEPFAR). This paper draws on 31 original country-specific and cross-country articles and reports, based on country-level fieldwork conducted between 2002 and 2007. Positive effects have included a rapid scale-up in HIV/AIDS service delivery, greater stakeholder participation, and channelling of funds to non-governmental stakeholders, mainly NGOs and faith-based bodies. Negative effects include distortion of recipient countries' national policies, notably through distracting governments from coordinated efforts to strengthen health systems and re-verticalization of planning, management and monitoring and evaluation systems. Sub-national and district studies are needed to assess the degree to which GHIs are learning to align with and build the capacities of countries to respond to HIV/AIDS; whether marginalized populations access and benefit from GHI-funded programmes; and about the cost-effectiveness and long-term sustainability of the HIV and AIDS programmes funded by the GHIs. Three multi-country sets of evaluations, which will be reporting in 2009, will answer some of these questions.
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              Institution, institutional change and economic performance

              DC North, D., C. North, D.C North … (1990)
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                Author and article information

                Journal
                Journal ID (iso-abbrev): Global Health
                Title: Globalization and health
                Publisher: Springer Nature
                ISSN (Electronic): 1744-8603
                ISSN (Print): 1744-8603
                Publication date (Electronic): Feb 12 2015
                Volume: 11
                Affiliations
                [1 ] Department of Health Sciences, Brigham Young University, Provo, UT, 84602, USA. swancitos@gmail.com.
                [2 ] Department of Global Health and Population, Harvard School of Public Health, Harvard University, 665 Huntington Avenue, Boston, MA, 02115, USA. ratun@hsph.harvard.edu.
                [3 ] Vancouver Coastal Health Research Institute, 6975 Marine Drive West, Vancouver, BC, V7W 2 T4, Canada. allan.best@in-source.ca.
                [4 ] Health Systems Action Network, K-57 A, Sheikh Sarai Phase -II, New Delhi, 110017, India. arvindcb@gmail.com.
                [5 ] Nucleus of Research in Public Health, Faculdade de Medicina da UFMG, Avenida Alfredo Balena, 190, Belo Horizonte, MG, Brasil. camposfr@medicina.ufmg.br.
                [6 ] National Health Foundation, Building 1, 1st Floor, Office of the Permanent Secretary, Ministry of Public Health, Tivanond Road, Nonthaburi, 11000, Thailand. nhf1chun@gmail.com.
                [7 ] World Medical Association, 13 Chemin du Levant, Bâtiment A, le John Keynes, 01210, Ferney-Voltaire, France. tea.collins@wma.net.
                [8 ] Warwick Business School, The University of Warwick, Coventry, CV4 7AL, UK. graeme.currie@wbs.ac.uk.
                [9 ] George Institute for Global Health, Level 10, King George V Building, 83-117 Missenden Rd, PO Box M201, Camperdown, NSW, 2050, Australia. sjan@georgeinstitute.org.au.
                [10 ] Queen Mary University, London, Blizard Institute, Barts and The London School of Medicine and Dentistry, 4 Newark Street, London, E1 2AT, England. d.mccoy@ucl.ac.uk.
                [11 ] African Centre for Global Health and Social Transformation, Plot 13 B Acacia Avenue, P.O.Box 9974, Kololo, Kampala, Uganda. omaswaf@achest.org.
                [12 ] School of Public Health, University of Western Cape, South Africa, Private Bag X17, Bellville, 7535, Republic of South Africa. sandersdav5845@gmail.com.
                [13 ] National Health Systems Resouce Centre, NIHFW Campus, Baba Gangnath Marg, Munirka, New Delhi, 110067, India. sundararaman.t@gmail.com.
                [14 ] Institute of Tropical Medicine, Antwerp, Belgium and University of Western Cape, Sint-Rochusstraat 2, 2000 Antwerpen, Belgium, South Africa. wvdamme@itg.be.
                Article
                Publisher Item ID: 10.1186/s12992-015-0090-3
                DOI: 10.1186/s12992-015-0090-3
                PMC ID: 4340278
                PubMed ID: 25890069
                SO-VID: 2a1a4016-e307-47b4-bd77-e173d4022149
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