Implementing health system strengthening projects at USAID: Findings from five cases using an integrated framework.

Evidence on the implementation of health systems strengthening (HSS) interventions is scarce. Donors need this information to prioritise investments and lobby for continued financial support. To develop a deeper understanding of the implementation dynamics of robust HSS interventions, we retrospectively compared five USAID-supported projects in the Dominican Republic, Ethiopia, Kazakhstan, Rwanda, and Zambia.

Realizing their potential to become learning organizations to foster health system resilience: opportunities and challenges for health ministries in low- and middle-income countries.

The burgeoning literature on resilient health systems in low- and middle-income countries (LMICs) provides limited insights into the practice of resilience-building. To address this operational shortcoming, we explore the potential of health ministries to become 'learning organizations' to help foster resilience. We adopted a multi-stage, iterative methodology comprising multiple purposive literature searches, the selection and application of a conceptual framework from the 'learning organizations' literature, and expert opinion to expand on the framework with illustrative examples from LMICs.

Health system strengthening: prospects and threats for its sustainability on the global health policy agenda.

In 2013, Hafner and Shiffman applied Kingdon's public policy process model to explain the emergence of global attention to health system strengthening (HSS). They questioned, however, HSS's sustainability on the global health policy agenda, citing various concerns. Guided by the Grindle and Thomas interactive model of policy implementation, we advance and elaborate a proposition: a confluence of developments will contribute to maintaining HSS's prominent place on the agenda until at least 2030.

Strategic partnering to improve community health worker programming and performance: features of a community-health system integrated approach.

Background: There is robust evidence that community health workers (CHWs) in low- and middle-income (LMIC) countries can improve their clients' health and well-being. The evidence on proven strategies to enhance and sustain CHW performance at scale, however, is limited. Nevertheless, CHW stakeholders need guidance and new ideas, which can emerge from the recognition that CHWs function at the intersection of two dynamic, overlapping systems - the formal health system and the community.

A Community Health Worker "logic model": towards a theory of enhanced performance in low- and middle-income countries.

Background: There has been a resurgence of interest in national Community Health Worker (CHW) programs in low- and middle-income countries (LMICs). A lack of strong research evidence persists, however, about the most efficient and effective strategies to ensure optimal, sustained performance of CHWs at scale. To facilitate learning and research to address this knowledge gap, the authors developed a generic CHW logic model that proposes a theoretical causal pathway to improved performance.