Health Systems Strengthening Training Course

Participants can identify and prioritise constraints affecting health service performance.

• Service readiness assessed using tracer indicators, facility records and client pathways
• Bottlenecks located across demand, supply, quality and governance constraints
• Coverage gaps segmented by geography, wealth, gender, age and disability
• Routine data triangulated with surveys, facility assessments and qualitative evidence
• Root causes separated from symptoms using problem-tree logic
• Baseline statements written with population, location, period and data source

Participants can assess stakeholders, incentives and accountability arrangements affecting reform delivery.

• Stakeholder maps classify influence, interest, incentives, authority and relationships
• Political economy questions identify winners, losers, veto points and reforms
• Power-interest grids guide engagement priorities and communication approaches
• Community accountability channels assessed through feedback, representation and redress
• Provider, purchaser and regulator roles clarified within mixed health systems
• Engagement plans assign messages, owners, timing and escalation routes

Participants can define priority health system problems using evidence and causal analysis.

• Problem trees connect observed service failures to immediate and structural causes
• Evidence statements distinguish verified facts, assumptions, perceptions and unanswered questions
• Priority problems selected using burden, feasibility, equity and stakeholder criteria
• Target populations defined through disaggregation and barrier analysis
• Causal pathways tested against local evidence and implementation experience
• Problem statements specify affected groups, magnitude, causes and consequences

Participants can construct a Theory of Change for a defined health system challenge.

• Theory of Change pathways link interventions, intermediate outcomes and long-term impact
• Backwards mapping starts with intended impact and identifies required preconditions
• Change pathways distinguish service delivery, behaviour, policy and financing mechanisms
• Intervention packages matched to documented constraints and causal mechanisms
• Outcome statements use observable changes rather than activity completion
• Draft diagrams show actors, relationships, sequence and causal logic

Participants can test causal assumptions and prepare risk-based adaptation arrangements.

• Assumptions recorded at each causal link with supporting evidence
• Risk registers rank likelihood, consequence, mitigation owner and review date
• External factors separated from programme-controlled inputs and activities
• Equity risks tested for unintended exclusion, burden or harm
• Scenario analysis examines disruption from financing, workforce, supply and politics
• Adaptation triggers define when implementation plans require revision

Participants can translate a Theory of Change into a logical framework.

• Logical framework columns align goal, outcomes, outputs, activities and inputs
• Results chains distinguish accountability levels and reasonable contribution claims
• Output definitions specify products or services under direct management control
• Outcome hierarchy limits scope while preserving credible causal pathways
• Crosswalks reconcile Theory of Change diagrams with donor logframe requirements
• Result statements meet clarity, measurability, attribution and equity tests

Participants can specify useful indicators, targets and measurement requirements.

• Indicator reference sheets define numerator, denominator, source, frequency and owner
• SMART indicators match outcome statements, decisions and data capacity
• Disaggregation plans specify sex, age, geography, disability and income
• Proxy indicators selected only where direct measurement remains impractical
• Baseline, target and milestone values justified using evidence and feasibility
• Data quality checks address completeness, timeliness, consistency and validity

Participants can design practical arrangements for health data collection and use.

• DHIS2 routine data assessed for reporting flow, metadata and use
• Data collection tools minimise duplicate fields and reporting burden
• Facility registers matched to indicators, reporting periods and aggregation rules
• Sampling approaches selected for client feedback and facility verification
• Data governance assigns access, confidentiality, retention and correction responsibilities
• Dashboards translate indicator trends into management questions and actions

Participants can embed equity and rights considerations in intervention design.

• Equity analysis identifies groups excluded by cost, distance, norms or disability
• Gender analysis examines roles, decision power, safety and care burdens
• Human rights principles applied to availability, accessibility, acceptability and quality
• Community priorities incorporated through participatory consultation and feedback channels
• Distributional effects assessed before selecting targeting and subsidy mechanisms
• Equity markers embedded within outcomes, indicators, assumptions and budgets

Participants can connect service delivery improvements to their Theory of Change.

• Patient pathways map referral, diagnosis, treatment, follow-up and continuity
• Service readiness gaps identify infrastructure, equipment, commodities and protocols
• Quality improvement cycles test changes using plan-do-study-act methods
• Referral designs define eligibility, transport, feedback and counter-referral arrangements
• Integrated service packages coordinate primary care, community and hospital functions
• Care standards translated into measurable process and experience indicators

Participants can address workforce constraints within a health system intervention package.

• Workload analysis estimates staffing needs from service volumes and task times
• Skill-mix reviews align cadres, scopes, supervision and delegation
• Competency gaps inform training, mentoring, deployment and retention actions
• Supportive supervision plans define observation, feedback, coaching and follow-up
• Absenteeism and vacancy data inform workforce risk assumptions
• Human resource outputs linked to service quality and coverage outcomes

Participants can assess financing mechanisms and develop costed workplans.

• Health financing functions distinguish revenue collection, pooling and purchasing
• Budget impact estimates connect intervention costs, volumes and unit assumptions
• Costed workplans assign inputs, quantities, timing and funding sources
• Provider payment incentives examined for quality, access and efficiency effects
• Financial protection indicators track out-of-pocket spending and catastrophic expenditure
• Funding gap analysis informs sequencing, prioritisation and donor discussions

Participants can account for commodity constraints within health system strengthening plans.

• Commodity security pathways link forecasting, procurement, storage, distribution and dispensing
• Consumption data inform quantification assumptions, reorder points and buffer stock
• Stockout indicators distinguish reporting errors from supply-chain failures
• Cold-chain requirements incorporated into intervention design and risk management
• Medicine availability measures linked to treatment adherence and service credibility
• Procurement lead times tested against implementation milestones and contingencies

Participants can establish governance structures and accountability arrangements for implementation.

• Governance arrangements specify decision rights, accountability and reporting lines
• Steering committees receive terms of reference, membership and decision calendars
• Accountability matrices assign responsible, accountable, consulted and informed roles
• Policy alignment checks identify approvals, standards and regulatory dependencies
• Anti-corruption controls address procurement, payments, data and conflicts of interest
• Escalation protocols set thresholds for unresolved operational and political issues

Participants can convert an intervention design into a managed delivery roadmap.

• Implementation roadmaps sequence activities, dependencies, milestones and responsible owners
• Critical-path analysis identifies tasks that determine feasible delivery dates
• Work breakdown structures convert intervention packages into manageable workstreams
• Resource plans reconcile staffing, commodities, funding and partner commitments
• Change management actions address adoption barriers among providers and managers
• Quarterly review cycles connect performance evidence to corrective decisions

Participants can establish routines that convert performance evidence into decisions.

• Monitoring plans link each indicator to collection, analysis and use
• Performance review meetings use variance analysis and action trackers
• Data-use routines assign decision questions before dashboard production
• Learning agendas frame priority uncertainties, evidence needs and review points
• Adaptive management protocols document decisions, rationale, changes and consequences
• Feedback loops return findings to facilities, communities and governing bodies

Participants can define evaluation questions and select credible evidence approaches.

• Evaluation questions distinguish process, outcome, impact, equity and value claims
• Contribution analysis tests whether observed change follows the stated causal pathway
• Mixed-method designs combine routine data, surveys, interviews and document review
• Comparison strategies address selection bias, confounding and plausible alternatives
• Evaluation matrices align questions, indicators, sources, methods and responsibilities
• Ethical protocols address consent, privacy, safeguarding and referral obligations

Participants can communicate a health systems strengthening case to decision-makers.

• Investment cases connect burden, intervention logic, costs, risks and expected results
• Decision briefs present options, trade-offs, recommendations and evidence limits
• Donor proposals align results frameworks with funding requirements and reporting commitments
• Implementation narratives explain sequencing, partner roles and delivery controls
• Visual Theory of Change diagrams communicate causal claims without oversimplification
• Review criteria test coherence, feasibility, evidence, equity and measurability

Participants can build, review and present a complete health systems strengthening design for a real challenge.

• Capstone scope selects a real health system challenge and target population
• Diagnostic evidence defines the problem, bottlenecks, stakeholders and baseline
• Theory of Change maps pathways, interventions, assumptions, risks and equity considerations
• Results framework specifies outcomes, outputs, indicators, targets and data sources
• Costed implementation plan assigns milestones, owners, resources and governance arrangements
• Peer review tests causal logic, feasibility, evidence quality and presentation clarity