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Background
At the request of the U.S. Agency for International Development (USAID)/Angola, a threeperson team performed an assessment of the Angolan health system from August 6-19, 2005. The purpose of the assessment was to inform the Mission’s development of a new health program for 2006-2011. The team comprised team leader Catherine Connor, of the Partners for Health Reformplus (PHRplus); Quality Assurance Project technical specialist Ya-Shin Lin; and USAID health systems and financing specialist Yogesh Rajkotia. Dr. Paula Figueiredo assisted the team extensively with interviews, data collection, and analysis/interpretation.
In addition to assessing the country’s health system for USAID/Angola, the team tested a new Health Systems Assessment Approach that was developed as part of USAID’s Office of Health, Infectious Diseases and Nutrition’s (HIDN’s) global Mainstreaming Health Systems Strengthening Initiative. The purpose of the mainstreaming initiative, launched in September 2004, is to find new
cost-effective ways to put the combined knowledge, expertise, and tools of USAID Global Health Bureau’s health system strengthening projects at the service of USAID’s large bilateral health service delivery projects in order to improve these projects’ capacity to achieve USAID health impact objectives.
PHRplus is developing the assessment approach in collaboration with Rational Pharmaceuticals Management Plus (RPMplus), Quality Assurance Project (QAP), and other Health Systems Division projects. The Health Systems Assessment Approach is meant to:
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Allow Population, Health and Nutrition (PHN) officers to conduct an assessment of a country’s health system, possibly during early phases of program development (with the assistance of experts/consultants if necessary). This will include diagnosing the relative strengths and weaknesses of the health system.
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Help improve the capacity of bilateral projects to achieve USAID’s health impact objectives through increased use of health systems interventions.
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Help health systems officials at USAID to conceptualize key issues, increase the use of health systems interventions in technical program interventions, and improve the role of the Health Systems Division.
The first phase of the work (January–June 2005) entailed conceptualizing, designing, and drafting the approach. The second phase consists of pilot testing it in at least two countries and revisions. Angola is the first country in which the tool is being pilot tested.
Preceding this assessment, in February 2005, a team from USAID/Washington reviewed the Mission’s current health program in terms of its breadth and depth as well as to realign the program to be in sync with Africa Bureau’s Fragile State Strategy and Angola’s transition after 30 years of civil war. The February team’s findings and subsequent discussions recommended streamlining the health program to focus on the following areas: HIV/AIDS, malaria, family planning, structural reform/health system strengthening, and private sector engagement.
On June 30, 2005, Angola was announced as one of the first three countries to be included in the U.S. President’s Initiative on Malaria in Africa. An interagency team conducted a rapid assessment of the status of malaria prevention and treatment interventions in Angola during the same timeframe as the health system assessment (August 8-18). The two teams coordinated data collection and interviews.
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