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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
PEPFAR, health system strengthening, and promoting sustainability and country ownership
Journal of Acquired Immune Deficiency Syndromes, Volume 60, No. SUPPL.3, Year 2012
Notification
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Description
Evidence demonstrates that scale-up of HIV services has produced stronger health systems and, conversely, that stronger health systems were critical to the success of the HIV scale-up. Increased access to and effectiveness of HIV treatment and care programs, attention to long-term sustainability, and recognition of the importance of national governance, and country ownership of HIV programs have resulted in an increased focus on structures that compromise the broader health system. Based on a review published literature and expert opinion, the article proposes 4 key health systems strengthening issues as a means to promote sustainability and country ownership of President's Emergency Plan for AIDS Relief and other global health initiatives. First, development partners need provide capacity building support and to recognize and align resources with national government health strategies and operational plans. Second, investments in human capital, particularly human resources for health, need to be guided by national institutions and supported to ensure the training and retention of skilled, qualified, and relevant health care providers. Third, a range of financing strategies, both new resources and improved efficiencies, need to be pursued as a means to create more fiscal space to ensure sustainable and self-reliant systems. Finally, service delivery models must adjust to recent advancements in areas of HIV prevention and treatment and aim to establish evidence-based delivery models to reduce HIV transmission rates and the overall burden of disease. The article concludes that there needs to be ongoing efforts to identify and implement strategic health systems strengthening interventions and address the inherent tension and debate over investments in health systems. Copyright © 2012 by Lippincott Williams & Wilkins.
Authors & Co-Authors
Palen, John G.H.
United States, Cambridge
Abt Associates, Inc.
El-Sadr, W. M.
United States, New York
Mailman School of Public Health
Phoya, Ann
Malawi, Lilongwe
Ministry of Health Malawai
Imtiaz, Rubina
United States, Atlanta
National Center for Hiv, Viral Hepatitis, Std, and tb Prevention
Einterz, Robert M.
United States, Bloomington
Indiana University School of Medicine-bloomington
Quain, Estelle E.
United States, Atlanta
National Center for Hiv, Viral Hepatitis, Std, and tb Prevention
Blandford, John M.
United States, Atlanta
National Center for Hiv, Viral Hepatitis, Std, and tb Prevention
Bouey, Paul
United States, Washington, D.c.
U.s. Department of State
Lion, Ann
United States, Cambridge
Abt Associates, Inc.
Statistics
Citations: 48
Authors: 9
Affiliations: 6
Identifiers
Doi:
10.1097/QAI.0b013e31825d28d7
ISSN:
15254135
Research Areas
Health System And Policy
Infectious Diseases