In Guinea, the Ebola outbreak further damaged an already frail health system suffering from a combination of weak governance, transparency, and accountability at all levels. It highlighted shortcomings at the district level, where district health teams are increasingly responsible for management of services and resources. To successfully take on these management responsibilities district teams require increased capacity and support to respond holistically and proactively to local health system challenges.
Strengthening Guinea’s health system at the district level is critical for ensuring access to quality reproductive, maternal, newborn, and child health (RMNCH) services. Through improved planning and management, district health managers are able to identify local priority challenges, assess their root causes, and determine what available and potential resources can be leveraged locally. Continually developing locally-generated solutions to local priorities enables these subnational teams to achieve and sustain improved health outcomes with more efficient and effective health systems.
Through the USAID-funded Maternal and Child Survival Program (MCSP), R4D supports Guinea’s Ministry of Health (MOH) in strengthening its health system by identifying health systems priority challenges and using a holistic approach to develop plans for solving these challenges locally. In Guinea, R4D supported the MOH to implement a Rapid Health Systems Assessment in four MCSP-supported regions that experienced the highest Ebola burden, Conakry, Boké, Kindia, and N’Zérékoré, with the aim of rapidly diagnosing health systems barriers and opportunities for effective delivery of RMNCH services.
Rapid Health System Assessment results were then used to adapt an innovative district health management approach called the Comprehensive Approach for Health Systems Management. The Comprehensive Approach is a MCSP-developed process developed to strengthen the capacity of subnational health system managers so that they can take the lead to orchestrate holistic planning and implementation processes that address local health system challenges in a holistic and proactive manner. As part of the Comprehensive Approach methodology, district teams identify priority problems, conduct root cause analysis, identify local resources, and determine problem-solving activities and plans with allocated resources during workshops. In addition to supporting this process, R4D has provided technical support to MOH national-level staff to build their capacity to implement the approach. R4D is currently supporting district teams to implement and monitor their district plans with ongoing mentorship throughout the process. Through this work, R4D is assisting Guinea in strengthening its ability at all levels of the health system to facilitate successful functioning of quality RMNCH services for all.