ReBUILD at FCDO’s health system strengthening position paper launch

14 December 2021

Today Professor Sophie Witter, of ReBUILD for Resilience and Queen Margaret University, spoke at the launch of the UK government’s new position paper on health systems strengthening (HSS).

Health Systems Strengthening for Global Health Security and Universal Health Coverage is the Foreign, Commonwealth and Development Office’s outline of how it will contribute to global health system strengthening and resilience, both of which have been severely tested in this time of COVID-19.

The event – Leaving no-one behind: Strengthening health systems and ending preventable deaths to achieve health for all – was co-hosted with Action for Global Health, and also launched the FCDO’s approach paper on Ending Preventable Deaths of Mothers, Babies and Children. The session was attended by parliamentarians, UK Government partners, civil society organisations, private sector partners, research and academic partners, international organisations and partners, donors and embassy representatives.

The case for health system strengthening

Professor Witter spoke alongside panellists from Plan International UK and Unilever, with the keynote address delivered by Wendy Morton MP, Minister for Europe and Americas. Representatives from UNICEF and WHO also contributed virtually.

In her short delivery, Professor Witter described health systems as the backbone of health provision, and that without strong health systems it is all but impossible to deliver and sustain Universal Health Coverage, Global Health Security and the end of preventable deaths.

She went on to explain that the evidence base for HSS and its importance is considerable, though there remain important gaps to fill. We know that well-designed interventions improve quality of care, save lives and improve responsiveness and financial protection. For example, there is good evidence for:

• Engaging communities with health structures through social accountability processes.
• Leadership development interventions.
• HSS processes working across stakeholders, with clear long term reform goals.
• Well-designed performance management for staff and task shifting.
• More pooled and universal health financing, from domestic and external sources.
• Strengthening PHC, including Community Health Worker-based models, with strong referral systems.
• Integration of services, especially mother and child health interventions.

Traditionally, the UK has been at the forefront of this work and Professor Witter argued that we need to continue in that vein. This has achieved this by:

• Setting clear priorities focused on poverty and equity.
• Working closely with national and country stakeholders.
• Working in the areas where needs are greatest, including fragile and conflict-affected settings.
• Leveraging our support to international organisations to improve collaboration on these priorities.
• Funding the production of and then using evidence.

Professor Witter said that the FCDO’s new position paper articulates the priorities well, with highlights being:

• No HSS investment works unless you start from the perspective of the communities.
• We need to clearly articulate the qualities that define a ‘strong health system’.
• HSS has to be context specific.
• We have been somewhat successful in increasing coverage with core UHC services across the world, but need to expand our focus on neglected services, eg mental health, palliative care, and address equity and gender barriers for marginalised communities.
• Our data for tracking UHC needs to be improved.
• Working in this way takes considerable technical skill but also political skills.
• Finally, it takes resources and political commitment, an area where the UK has been a leader in the past and will, we hope, continue to lead in future.

Further information

• The full report can be downloaded here.
• Earlier this year ReBUILD for Resilience held a webinar on health system strengthening which also featured Sophie Witter – watch it here
• Several members of the ReBUILD team (Sophie Witter, Maria Bertone also of QMU and Sushil Baral of HERD International) are part of the Itad Health Systems Strengthening Evaluation Collaborative – read about their work here [opens new tab].
• Other ReBUILD health system strengthening resources can be accessed here.