Health Systems Strengthening


Health systems strengthening:

  • “involves identifying issues that interfere with provision of services and introducing systems changes that result in sustainable improvements” (FHI-360); and
  • refers to “activities and initiatives that improve the underlying health systems of countries and/or manage interactions between them in ways that achieve more equitable and sustainable health services and health outcomes”. (The Global Fund).

The World Health Organization defines a health system as consisting of all organisations, people and actions whose primary intent is to promote, restore or maintain health. This includes efforts to influence determinants of health as well as more direct health-improving activities. 

The WHO has identified six core health systems functions:

  • Health services must be efficient, effective, and accessible.
  • A number of well-trained staff should be available.
  • Health information systems should generate useful data on health determinants and health system performance.
  • Access to medicines, vaccines, and medical technologies must be equitable.
  • Health financing systems must raise adequate funds for health, ensuring that people can access affordable services.
  • Leadership must guarantee effective oversight, regulation, and accountability.

CEGAA’s Contribution

Focusing mainly on primary health care services offered through State and community health structures, operations and facilities at local, district, provincial, national and regional levels, CEGAA’s projects are designed to work within strategic partnerships to examine and transfer skills in budget formulation and management, with the overall goal of informing policy and influencing decision-makers.   

The WHO also offers a comprehensive glossary of terms and concepts related to health systems strengthening

Among those that relate closely to CEGAA’s work are:

  • Measuring and monitoring the accessibility of health services by people in terms of location, time and ease of approach;
  • Assessing, training and advocating for the accountability of health actors to deliver effective and efficient health services;
  • Studying, analysing, sharing evidence of, and making recommendations for, allocative efficiency in the distribution of resources to ensure optimal health service delivery.


CEGAA Resources:

We have produced a range of resources, including research and analysis reports, country assessments, training materials and tools, and Budget Briefs. For a selection of these, go to our Products page.

Other Related Resources:

Through our project research, communications within our network, and media scanning, CEGAA regularly sources useful material and details of related organisations. For access to these, go to the Policy Documents page, the Useful Links page and our  Media Dossiers.