Strengthening Health Systems


Weak national health systems impede the expansion of essential health services and pose a significant barrier to achieving universal access to health services. Persistent regional challenges include acute shortage of skilled health workers, inadequate facilities and poor infrastructure, limited access to medicines and supplies and non-conducive policy and regulatory environments. The World Health Organization estimates that the Africa region faces an acute shortage of more than 1.5 million health workers and East African countries workforce density falls below the recommended threshold level of 2.3 professional health workers per 1000 persons.

USAID/East Africa (USAID/EA) provides support to strengthen health systems consistently with the Global Health Initiative’s principle of building sustainability through engaging governments and other stakeholders to identify needs, and develop appropriate strategies in ways that ensure country ownership. The health systems strengthening work is cross-cutting and supports the sustainable achievement of health outcomes in maternal and child health, nutrition, family planning and reproductive health, HIV/AIDS and tuberculosis (TB).

USAID/EA works directly with African regional partners and governments, international partners, and USAID bilateral missions to provide support to health systems strengthening in the East, Central and Southern Africa (ECSA) region in the following areas:

  • Service delivery; improving quality, efficiency, and pharmaceutical management;
  • Leadership and governance; supporting health policy and strategy development;
  • Financing: mobilizing funds, organizing risk pools and allocation of funds, and long-term planning to increase sustainability;
  • Information and data: supporting data collection to enable M&E in in health care delivery
  • Human resources planning and management.

In order to better align health investments with country plans, USAID/EA is planning to support regional African institutions to work with countries to develop and implement regional and country-led health policies and programs.


In the last three years USAID/EA has supported the following:

  • Training health experts to conduct National Health Accounts (NHA) expenditure surveys. Trainees serve as trainers of trainers in the ECSA-region and advocate for institutionalization of NHA within health care systems. NHA surveys assist policy makers to better align priorities to available resources
  • Provision of technical support and training in Community-Based Health Insurance in Tanzania.
  • Strengthening of ECSA-HC’s M&E capacity, resulting in improved ability to monitor progress of MDG goals and in implementing resolutions of ECSA Health Ministers.
  • Development and use of a pharmaceutical management assessment tool in ECSA-HC countries to monitor pharmaceutical management and improve access to essential medicines and medical supplies.
  • Assistance to ECSA-HC to carry out an assessment of health workforce competency in safe delivery in Kenya and Tanzania.
  • Support to ECSA-HC to carry out a regional assessment of the efficiency of health care training in Kenya, Uganda and Tanzania.


Issuing Country 
Thursday, October 31, 2013 - 7:15am

Last updated: May 15, 2015