Health Systems Strengthening
A health system consists of all organisations, people and actions whose primary intent is to promote, restore or maintain health. In the context of CIDRZ’s vision to improve health outcomes in Zambia, health systems strengthening refers to a range of activities and initiatives designed to improve the underlying health system or manage interactions between components of the system in ways that help ensure more equitable and sustainable health services and health outcomes.
CIDRZ Health Systems Strengthening Programming and Research
CIDRZ began engaging in targeted health systems work in 2004 through its HIV-specific programmes and research. With U.S. PEPFAR funding coordinated through the Centers for Disease Control and Prevention, CIDRZ developed and implemented a range of selective health system interventions to enable emergency scale-up of HIV care and treatment. These included involvement in Technical Working Groups supporting Ministry of Health policy-making, development and roll-out of a perinatal and adult HIV electronic medical record system, investment in infrastructure, and ongoing professional development and in-service training for Zambian healthcare professionals.
As the Zambian HIV epidemic matured and in response to both a global shift towards a more comprehensive health system strengthening approach, CIDRZ’s initial focus on emergency service scale-up for HIV was realigned to support longer-term investments in a range of health system components.
Projects embodying this shift in CIDRZ focus include: integration of HIV and outpatient services in Zambian primary health centres; expansion of the Zambian national cold chain infrastructure capacity to accommodate new vaccines; conduct of the Better Health Outcomes through Monitoring and Assessment (BHOMA); and the Zambian Prisons Health Systems Strengthening project (ZaPHSS).
Operations research linked to these system-strengthening projects has variously demonstrated broader service coverage, reduced stigma and improved quality and responsiveness of service delivery overall. Ongoing research is designed to understand how mechanisms of leadership and governance may be strengthened to improve service and health outcomes in the Zambian setting.