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Resource Allocation Strategies to Increase the Efficiency and Sustainability of Gavi’s Health System Strengthening Grants

BACKGROUND: Despite the increase in Health System Strengthening (HSS) grants, there is no consensus among global health actors about how to maximize the efficiency and sustainability of HSS programs and their resulting gains. To formally analyze and compare the efficiency and sustainability of Gavi’...

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Autores principales: Mimche, Honoré, Squires, Ellen, Miangotar, Yodé, Mokdad, Ali, El Bcheraoui, Charbel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Williams & Wilkins 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5916462/
https://www.ncbi.nlm.nih.gov/pubmed/29278610
http://dx.doi.org/10.1097/INF.0000000000001848
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author Mimche, Honoré
Squires, Ellen
Miangotar, Yodé
Mokdad, Ali
El Bcheraoui, Charbel
author_facet Mimche, Honoré
Squires, Ellen
Miangotar, Yodé
Mokdad, Ali
El Bcheraoui, Charbel
author_sort Mimche, Honoré
collection PubMed
description BACKGROUND: Despite the increase in Health System Strengthening (HSS) grants, there is no consensus among global health actors about how to maximize the efficiency and sustainability of HSS programs and their resulting gains. To formally analyze and compare the efficiency and sustainability of Gavi’s HSS grants, we investigated the factors, events and root causes that increased the time and effort needed to implement HSS grants, decreased expected outcomes and threatened the continuity of activities and the sustainability of the results gained through these grants in Cameron and Chad. METHODS: We conducted 2 retrospective independent evaluations of Gavi’s HSS support in Cameroon and Chad using a mixed methodology. We investigated the chain of events and situations that increased the effort and time required to implement the HSS programs, decreased the value of the funds spent and hindered the sustainability of the implemented activities and gains achieved. RESULTS: Root causes affecting the efficiency and sustainability of HSS grants were common to Cameroon and Chad. Weaknesses in health workforce and leadership/governance of the health system in both countries led to interrupting the HSS grants, reprogramming them, almost doubling their implementation period, shifting their focus during implementation toward procurements and service provision, leaving both countries without solid exit plans to maintain the results gained. CONCLUSIONS: To increase the efficiency and sustainability of Gavi’s HSS grants, recipient countries need to consider health workforce and leadership/governance prior, or in parallel to strengthening other building blocks of their health systems.
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spelling pubmed-59164622018-05-02 Resource Allocation Strategies to Increase the Efficiency and Sustainability of Gavi’s Health System Strengthening Grants Mimche, Honoré Squires, Ellen Miangotar, Yodé Mokdad, Ali El Bcheraoui, Charbel Pediatr Infect Dis J Original Studies BACKGROUND: Despite the increase in Health System Strengthening (HSS) grants, there is no consensus among global health actors about how to maximize the efficiency and sustainability of HSS programs and their resulting gains. To formally analyze and compare the efficiency and sustainability of Gavi’s HSS grants, we investigated the factors, events and root causes that increased the time and effort needed to implement HSS grants, decreased expected outcomes and threatened the continuity of activities and the sustainability of the results gained through these grants in Cameron and Chad. METHODS: We conducted 2 retrospective independent evaluations of Gavi’s HSS support in Cameroon and Chad using a mixed methodology. We investigated the chain of events and situations that increased the effort and time required to implement the HSS programs, decreased the value of the funds spent and hindered the sustainability of the implemented activities and gains achieved. RESULTS: Root causes affecting the efficiency and sustainability of HSS grants were common to Cameroon and Chad. Weaknesses in health workforce and leadership/governance of the health system in both countries led to interrupting the HSS grants, reprogramming them, almost doubling their implementation period, shifting their focus during implementation toward procurements and service provision, leaving both countries without solid exit plans to maintain the results gained. CONCLUSIONS: To increase the efficiency and sustainability of Gavi’s HSS grants, recipient countries need to consider health workforce and leadership/governance prior, or in parallel to strengthening other building blocks of their health systems. Williams & Wilkins 2018-05 2017-12-22 /pmc/articles/PMC5916462/ /pubmed/29278610 http://dx.doi.org/10.1097/INF.0000000000001848 Text en Copyright © 2018 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Original Studies
Mimche, Honoré
Squires, Ellen
Miangotar, Yodé
Mokdad, Ali
El Bcheraoui, Charbel
Resource Allocation Strategies to Increase the Efficiency and Sustainability of Gavi’s Health System Strengthening Grants
title Resource Allocation Strategies to Increase the Efficiency and Sustainability of Gavi’s Health System Strengthening Grants
title_full Resource Allocation Strategies to Increase the Efficiency and Sustainability of Gavi’s Health System Strengthening Grants
title_fullStr Resource Allocation Strategies to Increase the Efficiency and Sustainability of Gavi’s Health System Strengthening Grants
title_full_unstemmed Resource Allocation Strategies to Increase the Efficiency and Sustainability of Gavi’s Health System Strengthening Grants
title_short Resource Allocation Strategies to Increase the Efficiency and Sustainability of Gavi’s Health System Strengthening Grants
title_sort resource allocation strategies to increase the efficiency and sustainability of gavi’s health system strengthening grants
topic Original Studies
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5916462/
https://www.ncbi.nlm.nih.gov/pubmed/29278610
http://dx.doi.org/10.1097/INF.0000000000001848
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