Strong Health Systems Increase Access to Quality Health Care for All

5 minutes read time
Liberian health workers in light protective gear during the Ebola outbreak.
Liberian health workers in light protective gear during the Ebola outbreak, which also decimated the country’s workforce. USAID and partners are supporting the Government of Liberia to rebuild its health system. K. Ochel/MI, Courtesy of Photoshare)

Strong Health Systems Increase Access to Quality Health Care for All

When people are healthy, nations have a chance to prosper and develop. If mothers die in childbirth and newborns do not make it to their fifth birthday, nations suffer because they are deprived of their most important asset: their people.

Let’s face it: In the 21st century, no one should die of preventable causes, let alone because of childbirth or an infectious disease that can easily be treated. And being poor should not be a barrier to accessing quality health services.

For these reasons, USAID works with countries to ensure that populations, especially the poor and marginalized, have access to safe, effective and quality health care services and that the burden of out-of-pocket health care spending is minimized.

This work embodies the concept that health care systems must be accessible by all in ways that meet people’s needs for services at prices they can afford. USAID works to achieve this concept by supporting access to primary health care systems and ensuring systems can respond and adapt as necessary to changing needs.

In practice, we do this through a range of interventions which seek to understand the underlying country context and take advantage of opportunities to use health systems strengthening to drive toward our health outcome goals  --  whether it is investing in the health workforce, strengthening service delivery, building strong information systems, supporting policy-makers, mobilizing domestic resources for health, or ensuring the efficient delivery of life-saving medical products and technologies.

Christine Joy was able to deliver her daughter in a hospital in Biňan City in the Philippines that received a bank loan thanks to a USAID loan guarantee. Through the Development Credit Authority, USAID provides access to finance for health services that reach underserved populations or populations that need specialized care. / Bobby Neptune, USAID

Christine Joy was able to deliver her daughter in a hospital in Biňan City in the Philippines that received a bank loan thanks to a USAID loan guarantee. Through the Development Credit Authority, USAID provides access to finance for health services that reach underserved populations or populations that need specialized care. (Bobby Neptune, USAID)

When we partner with national governments and other donors to help with health systems strengthening strategies, we see significant improvements in maternal and child survival, care and treatment of patients living with HIV, and preventing the spread of infectious diseases.

Let me give you a concrete example. The 2014–2015 Ebola outbreak in Liberia devastated an already weak health system. During the outbreak, Liberia struggled to simultaneously manage the outbreak and maintain access to routine health care services. More than 10,000 people were infected with Ebola and many health care workers contracted this fatal disease while caring for patients, further decimating an already small workforce.

In response to the Ebola outbreak, USAID and partners worked to quickly restore essential health services and rebuild the health system. USAID and partners also helped the Government of Liberia institute a new strategy for community health, which will allow for more adaptability in the event of future shocks.

USAID is also helping the Government of Liberia to procure, store and deliver commodities; ensure health workers are being compensated; rehabilitate health services; and provide services for Ebola survivors. All of this is being done with an eye toward long-term sustainability and enabling the health system to make continued improvements on its own.

Slowly but steadily, we are seeing people regaining confidence in their health system and returning to health facilities for essential services. This means more antenatal care visits with trained providers, more women giving birth with skilled birth attendants, and more babies overcoming common childhood illnesses and reaching their fifth birthday.

A Profam franchisee clinic in Mubende District, Uganda. Some of the high-performing Profam clinics are part of the Tunza Family Network. / Kalungi Kabuye, Courtesy of JSI

A Profam franchisee clinic in Mubende District, Uganda. Some of the high-performing Profam clinics are part of the Tunza Family Network. ( Kalungi Kabuye, Courtesy of JSI)

Liberia is one of 25 USAID/Global Health priority countries. These are countries that account for the greatest share of the world’s communicable disease burden and health care needs. These countries are where weaker health systems can threaten the lives of mothers and babies, and where there is still a lot of work to do to “ensure healthy lives and promote well-being for all at all ages,” as stated in the SDGs.

USAID recognizes that a well-performing health system is one that achieves sustained health outcomes in population coverage, financial protection and access to high-quality essential services that respond to people’s needs with dignity and respect.

The TUNZA Family Network in East Africa, which is supported by USAID, is an example of creating more choice for patients. Our work here ensures that private providers follow clinical standards for disease detection and treatment, and that clients have access to quality services.

In Nigeria, USAID supported a Development Credit Authority (DCA) guarantee with two local financial institutions. The DCA’s goal is to ensure that a range of health providers, including small pharmacies and nursing homes, receive financing that enables them to serve traditionally underserved populations. In global health, USAID has used DCA to facilitate 29 health sector guarantees across 18 countries, reaching millions of people with essential services.

Ensuring healthy lives and promoting everyone’s well being takes innovative thinking adapted to the needs of local realities. USAID remains committed to work in partnership to deliver quality health services and reach the most vulnerable and underserved populations. 

About the Author:  Kerry Pelzman is the Deputy Assistant Administrator in USAID’s Bureau for Global Health.

Editor's Note: This entry was adapted from a story that originally appeared in USAID's 2030: Ending Extreme Poverty in this Generation publication on Medium.com.