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HIV/AIDS

HIV/AIDSHealth Systems 20/20 is working at the country level to conduct comprehensive analysis of available and required human resources to scale up and sustain HIV/AIDS services and to facilitate solutions to address human resource shortages.

Responding to the HIV/AIDS Epidemic through Health Systems Strengthening Efforts

As countries work to scale up successful HIV/AIDS country programs, weaknesses in national health systems have grown increasingly apparent. Repeatedly, health system weaknesses, ranging from acute shortages of trained health workers to weak health management information systems to the inadequate integration of HIV services into basic health service provision, have threatened the successful scale up of urgently needed HIV and AIDS services.

International donors and national governments are increasingly recognizing the importance of strong health systems for achieving HIV/AIDS program targets and goals, and for providing long-term and sustainable support for prevention and management of one of the world’s deadliest infectious diseases. Health Systems 20/20 utilizes both proven and targeted approaches to strengthen health systems so they are prepared to meet the challenges of the HIV/AIDS epidemic.


What is the Health System?


A health system consists of all organizations, people, and actions whose primary intent is to promote, restore, or maintain health. Health Systems 20/20 incorporates the health systems strengthening framework of the World Health Organization in its approaches to health systems strengthening. The framework identifies the six building blocks of a health system as: service delivery, human resources for health, health information systems, pharmaceuticals, health financing, and governance. Each of Health Systems 20/20’s activities examines one or more of these building blocks in the context of HIV/AIDS programming at the country level.

Health Systems 20/20 Approach and Current Activity Highlights


Health Systems 20/20’s holistic approach to health systems strengthening allows it to link research to real-world applications, and address the spectrum of HIV-related prevention, treatment, care, and support needs. The project works closely with a diverse set of local partners including central ministries of health, district health managers, grassroots private groups, and others, to address those priorities.

For example, Health Systems 20/20 works with ministries of health, USAID country missions, and other local country partners, to apply our Health Systems Assessment Tool to rapidly assess health systems needs in the six WHO health systems strengthening areas and to prioritize responses.

Health Systems 20/20 also uses the HIV/AIDS Program Sustainability Analysis Tool (HAPSAT) to assess the current financing and scope of HIV/AIDS services in countries by estimating the cost of sustaining a prioritized set of HIV/AIDS services over a five-year period. The HAPSAT considers the total costs of sustaining programs including ARV drugs, infrastructural costs, equipment costs, M&E, and the cost of developing the human resources necessary to deliver HIV/AIDS services.

Health Systems 20/20 provides technical assistance in costing national HIV/AIDS strategies. As countries become increasingly interested in costing their three to five year HIV/AIDS strategies, this costing exercise provides strategic planning information by assessing the resource requirements for sustaining and scaling up HIV/AIDS programs. Leveraging the successful HIV/AIDS costing study done in Liberia and the ART costing studies done under the USAID-funded PHRplus project, Health Systems 20/20 is supporting development and costing of national HIV/AIDS strategies in five countries.

Health Systems 20/20 has several large activities focused on human resources for health using targeted approaches to improve the retention, performance, and motivation of health workers. These include a study in Ethiopia comparing financial and non-financial incentives to improve HIV/AIDS counseling and testing performance; an assessment in Uganda comparing performance, retention, human resource management practices and motivation at faith-based organizations and public sector facilities; an activity in Swaziland using non-financial incentives to improve retention and performance; and a study in Zambia testing productivity improvement among health workers.

The project has also been working on improving strategic information to inform program planning and decision making for service delivery by using GIS technology. GIS mapping and analysis is a key component of this process since it enables visualization of key program data within a geographic context. Health Systems 20/20 promotes the use of GIS mapping and analysis tools to graph health survey data, identify geographic trends, and promote optimal allocation and positioning of resources to address health needs.

Kenya NHA 2009/10 - HIV Subaccount Brochure

Jan 2012 | Health Systems 20/20  | Flyer 
Kenya 

HAPSAT 2.0 Software: Hands-on Exercise

Itamar Katz, and Wendy Wong
Jan 2012 | Health Systems 20/20  | Tool 

Target Setting of HIV Services

Itamar Katz, Wendy Wong, and Danielle Altman
Jan 2012 | Health Systems 20/20  | Report 
Nigeria, Sierra Leone, Swaziland, Zambia 

Harmonizing HIV Resource Tracking and Sustainability Planning

Douglas Glandon, Ha Nguyen, and Sharon Nakhimovsky
Dec 2011 | Health Systems 20/20  | Brief 
Vietnam 

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Ukraine Embarks on Major Health Reform

Nov 29 2011
The Ukraine government is currently carrying out its first major health sector reform since the fall of the Soviet Union. Health Systems 20/20 is working with the Ministry of Health as it undertakes this ambitious health reform effort. More...

Commemorating World AIDS Day 2011

Nov 22 2011
As countries work to scale up successful HIV/AIDS country programs, weaknesses in national health systems have grown increasingly apparent. Watch our video interview with HIV expert Dr. John Osika to learn how health systems strengthening can improve HIV prevention and treatment. More...

The Poor Shoulder the Burden of Health Expenses in DRC

Oct 26 2011
Health Systems 20/20, the Democratic Republic of Congo Ministry of Health, and USAID recently released the country’s first National Health Accounts (NHA) estimation, which captures health spending by the public sector, private sector (including households), NGOs, and donors for the years 2008 and 2009. More...

Preparing South Sudan for Global Shortfall in HIV Funding

Oct 19 2011
South Sudan’s HIV response will soon see its major funding sources dry up. Uncertainty exists regarding new funding—funding allocated for all proposals to be approved in Global Fund’s Round 11 is expected to be less than half of the funding available for last year’s Round 10, and a quarter of what was available for Round 8. More...

Seeking a Sustainable Solution for HIV Funding in Kenya

Aug 24 2011
Based on a recommendation from Health Systems 20/20’s HIV/AIDS Program Sustainability Tool (HAPSAT) assessment the Kenyan National AIDS Control Council prepared a Cabinet memorandum in March 2011 which outlines ways to raise funds for HIV programming. Two government staff who helped prepare the memo tell us how it will help Kenya’s 1.5 million citizens living with HIV. More...

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