The Health Finance and Governance Project is a global initiative led by Abt Associates in collaboration with various partners, including Avenir Health, Broad Branch Associates, and the Johns Hopkins Bloomberg School of Public Health. The project is funded by the United States Agency for International Development (USAID) under cooperative agreement AID-OAA-A-12-00080. The project’s primary objective is to address the challenges facing health systems worldwide, with a focus on increasing domestic resources for health, improving resource management, and reducing system bottlenecks to enhance access to and use of priority health services.
The project’s methodology for impact modeling involves a rigorous exercise to estimate the impact of health systems strengthening activities on the overall goal of increased use of priority health services. Avenir Health and the project team used Spectrum, a suite of modeling tools, to quantify the impact on mortality and morbidity based on changes in health system performance. The modeling process involves a causal pathway diagram, which illustrates the relationships between health system inputs, outputs, and outcomes.
Country results from the project’s impact modeling exercise are presented in the report. Interventions for expanded packages of essential health services are discussed, including the scale-up of the essential services package in Bangladesh, which resulted in an estimated 27% increase in maternal and child health services coverage. The report also presents results for interventions aimed at improving human resources for health, such as the expansion of the Scale-up for Impact (SUFI) program in Nigeria, which led to an estimated 15% increase in the number of healthcare workers.
In addition, the report discusses interventions aimed at improving insurance coverage and service quality, including the implementation of community-based health insurance (CBHI) in Ethiopia, which resulted in an estimated 25% increase in health insurance coverage. The report also presents results for interventions aimed at improving the quality of health services, such as the introduction of task sharing in Cote d’Ivoire, which led to an estimated 20% reduction in maternal and child mortality.
The project’s impact modeling exercise also estimated the number of deaths averted and healthy life years gained due to the scale-up of essential services packages in various countries. For example, the report estimates that the scale-up of the essential services package in Bangladesh averted an estimated 27% of maternal and child deaths between 2017 and 2022. Similarly, the report estimates that the implementation of CBHI in Ethiopia averted an estimated 15% of deaths due to non-communicable diseases between 2013 and 2020.
The project’s findings and lessons learned are presented in the report, highlighting the importance of measuring the impact of health systems strengthening activities and the need for continued support to achieve universal health coverage. The report concludes that the Health Finance and Governance Project has made significant contributions to improving health systems and increasing access to priority health services, and that its impact modeling exercise has provided valuable insights into the effectiveness of various interventions.