health systems strengthening Tag

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Resilient and Stable: Building Strong Health Systems to Protect Women, Adolescents, and Children

Organized by
MSH, Global Health Council, Johnson & Johnson, and Syrian American Medical Society

September 18
1:00 PM – 1:30 PM (Lunch) & 1:30 PM – 3:30 PM (Program)
Harvard Club, 35 W 44th Street
New York, New York


In countries facing humanitarian crises, whether torn by war or civil unrest, or affected by natural disasters or epidemics, shocks and stresses often undercut the health care system. These systems struggle to provide basic health care needs in the face of instability, often enduring a decimated workforce, damaged facilities and infrastructure, and broken supply chains. Those most impacted – women, adolescents, and children – are also the most vulnerable.

As nations emerge from periods of crisis, systems adapt in an attempt to recover from shocks and opportunities arise to leverage existing tools and approaches that communities are already using.

This session will dive into approaches for strengthening and rebuilding health systems in especially challenging contexts, through integrated programs that increase the adaptive capacity of health systems and protect the health of those most vulnerable while unlocking their individual and collective capacity to rebound from crises stronger than before.

Strengthening Sierra Leone Health Systems: Applying Lessons from the 2014 Ebola Outbreak to Future Emergencies

This guest post was written by Laurentiu Stan (, MD,MPH, MBA, Chief of Party, Advancing Partners and Communities (APC) Project, Sierra Leone, JSI Research & Training Institute, Inc. John Snow, Inc., a member of Global Health Council (GHC), and the nonprofit JSI Research & Training Institute, Inc., are public health management consulting and research organizations dedicated to improving the health of individuals and communities in the US and around the globe.

Zainab Jalloh, holding her one-year-old daughter Khadijatu, at the Gbanti Community Health Post (CHP) on April 3, 2017 in Bombali District, Sierra Leone.

I’ve lived in Sierra Leone for almost two years, working to help this country’s long-battered health system recover from the Ebola outbreak that took the lives of more than 200 health professionals. Now the country has been affected by an epic landslide. Despite these tremendous setbacks, health systems and health indicators are improving.

Even before the Ebola Virus Disease (EVD) outbreak, Sierra Leone had the world’s highest maternal mortality ratio: 1630 of 100,000 live births (UNICEF, 2010). By 2015, the ratio had dropped to 1360, but Sierra Leone still held the top spot in this dismal measurement. Ebola compounded the problem because about 1 in every 4 women stopped coming to clinics for prenatal care and delivery. In fact, although almost 4,000 Sierra Leoneans died due to the EVD outbreak (between May 2014 and January 2016), during that same period more than 4,500 women died in childbirth.

The Ministry of Health and Sanitation (MOHS) focused its post-Ebola health recovery priorities on strengthening the health system’s capacity to safely detect and prevent diseases and respond to future epidemics in cooperation with its neighbors. It also recognized the need to contribute to global health security to improve health and economic opportunities.

A health facility water pump before APC revitalization. Photo courtesy/ JSI Research & Training Institute, Inc.

Between September 2015 and August 2017, under the umbrella of the USAID-funded and JSI-managed Advancing Partners & Communities (APC) project, I have helped implement a number of programs that are contributing to MOHS recovery objectives by improving primary care service delivery in the communities hardest hit by Ebola. APC has revitalized 305 primary care facilities, ensuring access to basic health services—with a focus on improving quality of maternal health services—for almost 2 million Sierra Leoneans, including the 3,400 registered Ebola-survivors.

A health facility water pump after APC revitalization. Photo courtesy/ JSI Research & Training Institute, Inc.

APC’s community health facility upgrades dramatically improved water and sanitation standards, installed solar power systems, provided basic equipment, and trained more than 900 health professionals and 1,500 community health workers (CHWs) on reproductive, maternal, newborn, and child health and as—importantly, given how Ebola was spread—infection prevention and control practices. Today, more than 2 million Sierra Leoneans in five districts have access to revitalized primary care and community health services in these primary care units and their catchment villages.
We know that another epidemic or emergency could come at any time, and while the Sierra Leone health system is going through significant transformations as part of the five-year recovery plan, it is better equipped now to address it.

The tragic August 14 landslide was just such an emergency—and the new systems that the U.S. government has invested in are working. The emergency coordination and resource mobilization mechanisms put in place with CDC support reacted well and fast. Mental health nurses who were trained to support Ebola survivors are providing psychosocial support to the several-thousand people who lost homes and relatives: more than 1,000 people died in the landslide. The CHWs recently trained by APC have undergone a 15-day social mobilization exercise to identify and convey messages on the prevention of cholera and other waterborne diseases to at-risk populations. With USAID and DfID support, JSI is assisting the MOHS relief efforts with emergency delivery of essential pharmaceutical and medical consumables to one area hospital and six primary care units.

This most recent tragedy has demonstrated that the country’s service delivery system has improved. One year after the outbreak ended, the MOHS data showed about a 10% positive change in uptake of facility deliveries and outpatient services in the four districts where 70% of Ebola survivors live. Now that health facilities have been revitalized, and health care workers are providing higher-quality services, we are seeing more and more Sierra Leoneans returning to their local health facilities.

There is still much to be done, of course. But Sierra Leone is on its way to a health system that meets the needs of its people—and, given the toll that Ebola took, is ready to confront the next infectious disease—be it Ebola or some other virus—with stronger, better prepared health services. And that helps us all.

World Health Assembly (#WHA70) Social Media Alerts

Day 1: Monday, May 22, 2017

Highlights from Yesterday

Check out the best of our social media coverage from our Welcome Reception and Women in Global Health’s Heroines of Health Dinner. Please share as much as you can.

{RETWEET} @globalgamechngr: Great kickoff to #WHA70, starting with @GlobalHealthOrg delegate mixer & capped off by @womeninGH partnership celebrating “health heroines.”

{RETWEET} @RonPiervincenzi: Excited to be here at #WHA70, looking forward to connecting with #globalhealth delegates and partners at @GlobalHealthOrg Welcome Reception

{RETWEET} @GlobalHealthOrg: A great start to #WHA70! Thank you to GHC board member @lenrubenstein for his inspirational remarks at our delegates Welcome Reception.

{RETWEET} @GlobalHealthOrg: We need to create an enabling environment for women – #WHODG candidate @SaniaNishtar #WomeninGH

{RETWEET} @FHWCoalition: Ugandan #nurse Samalie honored as #healthheroines2017 @ #WHA70 for inspiring work fighting #heartdisease. Her story:

{RETWEET} @womeninGH: Great to see @davidnabarro at #healthheroines2017 celebrating #womeningh. #Genderequality in #globalhealth needs great leadership! #wha70

{RETWEET} @PeterASinger: .@DrTedros — a champion of gender equality & #SRHR — with Heroines of Health #wha70

{RETWEET} @davidnabarro: Thank you @womeninGH for inviting me to #heroinesofhealth2017 event. Committed to #genderequality across WHO if I am #NextDG

In addition, GHC delegate Joseph Harris took some notes from yesterday’s Introduction to the World Health Assembly: A Briefing for Delegates at the Graduate Institute. Feel free to review and share!

Today’s Events

Today at 4 PM CET, we continue to cast a light on women leadership in global health with our event: Enabling Global Health Security through Health Systems Strengthening: Perspectives from Women Leaders. Help us spread the word:

{SHARE} #WHA70 kicks off today! A priority item on today’s agenda is #GlobalHealthSecurity. Join us for this discussion:

{SHARE} Join us today at 4 PM CET to hear women leaders share their perspectives on #GlobalHealthSecurity:  #WHA70

{SHARE} Women leaders offer unique perspectives on #GlobalHealthSecurity at #WHA70. Watch the live stream at 4PM CET:

Facebook Post:

{SHARE} In an increasingly interconnected world, where diseases know no borders, #GlobalHealthSecurity efforts are vital to protecting both health around the world and the health of American citizens. Follow us today as women leaders share unique perspectives on advancing global health security. #WHA70

Finally, please continue to use our #WHA70 Social Media Toolkit to generate content throughout the week, and if you have any items you would like us to include in our next alert, please email them to

DAY 2: TUESDAY, MAY 23, 2017

Highlights from yesterday

Yesterday, Dr. Margaret Chan gave her final address as WHO Director-General, and GHC co-hosted important conversations on two key agenda items: Global Health Security and Research & Development. Special thanks to all our partners for putting together informative discussions. Here are some of the day’s highlights:

{RETWEET} @globalgamechngr: GREAT to hear @HHSGov Secretary Price reiterate USG commitment to #globalhealth security, curbing impact on economy & stability. #WHA70

{RETWEET} @GlobalHealthOrg: Listen to civil society. Civil society can give citizens a face and voice – Dr. Margaret Chan @WHO DG #wha70

{RETWEET} @FHWCoalition: Building strong #healthsystems is necessary to prevent, detect & respond to #GlobalHealthSecurity threats -Ug health minister Aceng @ #WHA70

{RETWEET} @MBNalab: @BethCameron_DC: Synergized action & coordination among heath, security, finance sectors is needed to further GHS @GlobalHealthOrg#WHA70

{RETWEET} @GlobalHealthOrg: ICYMI: Here is a recording of our #GlobalHealthSecurity #WomenLeaders panel discussion: #WHA70

{RETWEET} @JBayNishi: Sabine Campe of SEEK: Need new mechanisms to incentivize private investments in global health R&D #wha70 @GHTCoalition

{RETWEET} @LibbyInTheSky: Are you at the World Health Assembly? Welcome to Geneva! We are @GlobalHealthOrg at #WHA70. Follow our live updates: 

Also check out and share GHC delegate blogs on Monday’s WHA side-events:

Enabling Global Health Security Through Health Systems Strengthening: Perspectives from Women Leaders – Anne Bell, USP

Attacks on healthcare. Where do we stand one year after the adoption of United Nations Security Council resolution 2286? – Len Rubenstein, Johns Hopkins University, Bloomberg School of Public Health

Today’s Events

Today at 12 PM CET GHC is co-hosting a discussion on Priorities for the Next WHO Director-General with partners: Dentons, Harvard Global Health Institute, Management Sciences for Health (MSH), and U.S. Pharmacopeia (USP). Secretary Thomas Price, U.S. Secretary for Health and Human Services, will be our keynote speaker. This event will belive streamed. Please promote widely:

{SHARE} Day 2 at #WHA70: We are looking forward to the outcome of the #NextDG #WHOElection. Good luck to all the candidates!

{SHARE} The live webcast of today’s #WHA70 sessions begins at 9 AM CET. Tune in to follow the #NextDG #WHOElection:

{SHARE} Join us for a critical discussion on the #NextDG’s priorities – with keynote speaker @SecPriceMD @HHSgov. #WHA70

{SHARE} The #NextDG of @WHO should foster stronger relationships with civil society to advance #globalhealth: #WHOElection

{SHARE} What priorities should the #NextDG of @WHO work to address? @SecPriceMD @MarianMSH @j_heals weigh in at #WHA70.

Facebook Post:

{SHARE} With the World Health Organization (WHO) slated to elect a new Director-General during the Seventieth World Health Assembly (WHA70), what is the potential impact new leadership can bring? Today, panelists from U.S. government, academia, the NGO community, and the private sector will hold a discussion on the implications of this election and its potential impact on the current fault lines of global health.

DAY 3: WEDNESDAY, MAY 24, 2017

Highlights from yesterday

Yesterday, after three rounds of voting, member states elected Dr. Tedros Adhanom Ghebreyesus as the next Director-General of the World Health Organization (WHO). He will take over from Dr. Margaret Chan on July 1, 2017.

Earlier this month, GHC hosted a small group discussion with Dr. Tedros, during which he expressed his commitment to working with civil society to address global health challenges. We look forward to connecting with Dr. Tedros and continuing to foster a valuable relationship with WHO under his leadership.

If you haven’t already, please join us again in congratulating Dr. Tedros with this easy {RETWEET}.

Below are more highlights from the WHO Director-General Election, including statements and reactions from some of our delegates and members.

{RETWEET} .@unfoundation Welcomes @DrTedros as the New Director-General of @WHO. #WHOElection #NextDG #WHA70 Read Statement:

{RETWEET} @PATHTweets: PATH congratulates #NextDG @DrTedros and urges his action to address #globalhealth challenges & @WHO reform … #WHA70

{RETWEET} @womeninGH: We congratulate @DrTedros @DrTedros4WHO for his new appointment. We look forward to following up on the commitment on #GenderEquality #WHA

{RETWEET} @davidnabarro: Congratulations to @DrTedros on his new role as Director-General of @WHO. I urge everyone to unite behind him & his vision #WHA70

{RETWEET} @SaniaNishtar: Congratulations @DrTedros on becoming Director-General of @WHO and @davidnabarro for a hard fought election.

{RETWEET} @GlobalHealthOrg: Closing remarks: Special thank you to Dr. Margaret Chan. We look forward to the #NextDG! #WHA70 @RonPiervincenzi@USPharmacopeia

{RETWEET} @USPharmacopeia: Wish list for 1st 100 days of #NextDG = 1) multi-sectoral approach 2)focus on prevention 3)gender equity per @JanMBeagle Exec Dir of @UNAIDS

{RETWEET} @USPharmacopeia: #NextDG needs to look at #globalhealth holistically & connect dots b/w SDGs & development, says @globalgamechngr Pres of @globalhealthorg

{RETWEET} @MBNalab: HHS Secretary Price on priorities for next DG: @WHO should be more effective, accountable, and transparent. @GlobalHealthOrg

{RETWEET} @GlobalHealthOrg: Did you miss our discussion on Priorities for the Next @WHO DG? Revisit the full recording: #WHA70 #WHOElection

As member states convene today to discuss Health Systems Strengthening, we would like to share a recap of our panel yesterday, Against All Odds: Strengthening Health Systems to Better Serve Vulnerable Women and Children.

{SHARE} #WHA70 Recap: Our diverse panel of delegates explores the challenges health systems face in complex settings:

{SHARE} ICYMI: How can we strengthen health systems to better serve women and children in complex settings? #WHA70

{SHARE} #HealthWorkers are critical to #HealthSystemsStrengthening. Our Heroine of Health, Samalie, shares her story: #WHA70

Improving data improving health: Verbal Autopsy for health systems strengthening

Improving data improving health:
Verbal Autopsy for health systems strengthening

October 17, 2016
9:00am – 1:00 pm 

University College London
Gower Street
London, United Kingdom


The majority of deaths in Africa and Asia are never recorded. Verbal autopsy (VA) is a method to determine causes of death using an interview with witnesses of the death, data from which are interpreted to conclude medical causes. In this seminar, we will reflect on innovations in VA including automated and mobile VA, and examine contextualised approaches to understanding why people die outside facilities or without registration. We will also explore how information from VA can be made available as part of a health systems approach. The aim of the event is to consolidate methods that have the potential to bring together communities and policy makers with better data and improved capacity for evaluation. Join participants from the Information, Evidence and Research Unit at WHO, the Umeå WHO Collaborating Centre for VA, the Centre for Global Development at the University of Aberdeen, the Malaria Consortium, the Africa Health Research Institute, University College London Institute for Global Health and Lancet Global Health.


9:00    Coffee and Registration

9:30    Welcome and opening remarks | Prof Ibrahim Abubakar UCL + Dr Zöe Mullan, Lancet Global Health 

9:45    Keynote: Monitoring mortality and causes of death in the SDG era | Dr Ties Boerma, WHO

10:00    Keynote: Learning from mortality: pragmatic approaches to verbal autopsy for better health | Prof Peter Byass, Umeå Centre for Global Health Research

10:20    Mobile VA, technological advances and ethical priorities  | Dr Edward Fottrell, UCL

10:40    Coffee

11:00    Keynote: Social Autopsy, a method to examine barriers to health care, risky behaviours and missed opportunities for health intervention | Dr Karin Källander, Malaria Consortium

11:20    Verbal Autopsy and Participatory Action research (VAPAR): People-centred and action-oriented methods in South Africa | Dr Lucia D’Ambruoso, University of Aberdeen

11:40    Interfacing: making connections within and between states, through data dynamics, and with the international community | Dr Kobus Herbst, Africa Health Research Institute

12:00    Panel discussion, Closing remarks

12:30    Lunch



Lawrence O. Gostin and Eric A. Friedman in The Lancet on How to Build a New Global Health Framework
Lawrence O. Gostin and Eric A. Friedman in The Lancet on
How to Build a New Global Health Framework

May 7, 2015 – Can a true, robust global health framework be created to help prevent tragedies like Ebola while at the same time allow countries to meet everyday health needs?

Georgetown University global health and law experts say it can be done, and in a special issue of “The Lancet” focusing on global health security, they propose specific priorities to transform a fragmented health system into a “purposeful, organized” framework with national health systems at its foundation and an empowered World Health Organization at its apex.

“The Ebola epidemic in west Africa raised the critical question of who is in charge,” says Lawrence O. Gostin, JD, faculty director of the O’Neill Institute for National and Global Health Law at Georgetown University Law Center. He and his O’Neill Institute colleague, Eric A. Friedman, JD, published an analysis of global health security today in The Lancet (“A retrospective and prospective analysis of the west African Ebola virus disease epidemic: robust national health systems at the foundation and an empowered WHO at the apex.”)

“The world is ill-prepared for the next epidemic,” Gostin says. “The need for advance funding, planning and coordination from the national health system up to WHO is at the heart of preparedness, not only for epidemic disease, but also naturally occurring disasters such as the crisis precipitated by the Nepal earthquake.”

In their review, Gostin and Friedman offer a retrospective analysis of the recent Ebola outbreak and the “profound harms posed by fragile national health systems.”

In creating a new framework, the authors say, “The scope of the reforms should address failures in the Ebola response, and entrenched weaknesses that enabled the epidemic to reach its heights.”

They propose a new global health framework that has national health systems as its foundation and an empowered WHO as the “global health leader envisaged at its creation.”

To reach the goal of having an empowered WHO to lead a global health framework, Gostin and Friedman outline priorities for reform:

  • Funding: commensurate with global mandate under WHO Director-General’s control,
  • Technical excellence: diverse staff with multisectoral capabilities,
  • Operational capacities: rapid deployment of economic and human resources,
  • Normative standards: setting priorities and ensuring compliance,
  • Regional offices: regional knowledge and consistency with headquarters, and
  • Engaging non-state parties: harnessing the potential of civil society.

Gostin and Friedman say another critical component to a global health framework are key stakeholders such as the United Nations, The World Bank and NGOs. “In a well functioning global health system, all parties would perform functions suited to their mandate, working cooperatively, and supporting national ownership.”

In addition, the authors point out the need for a strong legal framework to enforce international health regulations: “International law and national implementing legislation can be powerful means for a more effective global health system,” Gostin and Friedman write.

Another key component to a global health framework is to shore up the national health capacities in preparation for a crisis that would better ensure health security, regionally and globally.

“Planning for rapid mobilization should be combined with strengthening health systems to build country capacity,” they say and propose reforms including a global health workforce reserve, and emergency contingency fund, a pandemic emergency facility (like that suggested by The World Bank) and an international health system fund.

“Action now on WHO and other reforms to the global health system is crucial, before the political moment passes,” Gostin and Friedman conclude.   “These reforms would not only keep populations secure against pandemic threats, but would also ensure health and safety for all needs through rights-based universal health coverage.  This is a global health framework that is achievable in the aftermath of a tragic epidemic that needlessly took 10,000 lives in one of the world’s poorest regions.”

About the O’Neill Institute for National & Global Health Law

The generous philanthropy of Linda and Timothy O’Neill established the O’Neill Institute in 2007 to respond to the need for innovative new solutions to the most pressing national and international health concerns. Housed at Georgetown University Law Center in Washington D.C., the O’Neill Institute reflects the importance of public and private law in health policy analysis. The O’Neill Institute draws upon the University’s considerable intellectual resources, including the School of Nursing & Health Studies, the School of Medicine, the McCourt School of Public Policy, and the Kennedy Institute of Ethics.