Frameworks and Approaches for Health Systems Strengthening

While there are multiple discussions regarding what HSS is, the most popular and cited definition is that of the World Health Organization (WHO). It says: “HSS is the process of identifying and implementing the changes in policy and practice in a country’s health system, so that the country can respond better to its health and health system challenges. Additionally, it is also an array of initiatives and strategies that improves one or more of the functions of the health system and that leads to better health through improvements in access, coverage, quality, or efficiency” (WHO, 2019, p. 11). Scope of this rapid review: The aim of this rapid review is to provide a rapid synthesis of the different frameworks and approaches that have been designed and proposed for HSS. The synthesis includes frameworks conceptualised by international development and health agencies as well as those proposed by individual researchers and smaller organisations. While there are multiple frameworks, many of these frameworks build upon the WHO (2007) HSS framework and adapt this as per their needs and perspectives. Furthermore, considering the shake-up of health systems due to the COVID 19 pandemic, this review also includes frameworks which have reconceptualised HSS in response to the pandemic’s impact on health systems. Key findings: The rapid review found that a multitude of HSS frameworks exist in the public health literature. Some of these frameworks are modified from the WHO (2007) building blocks frameworks or use this framework as a basic conceptual foundation to propose new frameworks. Furthermore, there is some conflation of health systems frameworks and HSS frameworks in the literature. This review, however, has focused specifically on HSS frameworks. Evidence base: The frameworks and approaches were extracted from agency documents, journal articles and grey literature.