Table 7 PHIT crosscutting strategies across countries using WHO health system building blocks
World Health Organization Health System Building Block | Tanzania | Zambia | Ghana | Mozambique | Rwanda |
|---|---|---|---|---|---|
Service Delivery | Community health worker training | Clinical training and supportive supervision, partograph introduction | Clinical training, sustainable emergency referral care | Action planning focused on addressing quality gaps | Clinical training sustained with on-site mentorship |
Health Workforce | Strengthened front-line community health workers | Strengthened community and facility health workers | Implemented program to upgrade community health nurses to nurse midwives | Training on data interpretation and review; improved data-driven supervision structures | Supported management and organization of staff through quality improvement efforts |
Information and Research | Data sharing annually | Electronic medical record introduction, support for data feedback at community and facility levels | Death audits, referral audit study and feedback loops | Data feedback and action planning | Data feedback, gap identification, quality improvement implementation and data monitoring |
Medical Products and Technologies | Ambulance support, cell phone provision to key health care providers | Provision of key equipment for complete antenatal and postnatal assessment | Neonatal resuscitation equipment provision | Action planning on how to ensure availability of essential commodities | Provision of essential package of equipment |
Health Care Financing | Decreased cost through task-shifting | Support for TBAs and community health workers with a monthly stipend | Catalytic financing of $0.85 per capita per year | Funds to support action plan implementation | Some QI projects focused on cost reduction/insurance enrollment if identified as barrier to services |
Leadership/ Governance | Â | Training for District Medical Officers in Health Management | Advocacy with district political systems to improve health care financing and catalyze support for expanding coverage of primary health care | Strengthened management and data driven decision-making by district leadership | Staff motivation and leadership development through quality improvement activities |