Nossal Institute's Global Course in Health Systems Strengthening for UNICEF, May - September 2017

Between 28 August to 22 September 2017, 85 UNICEF staff participated in a two-week workshop on Health Systems Strengthening (HSS), offered in back-to-back cohorts. This was the final component of a blended learning program that began in May 2017.

Participants came from over 50 UNICEF country offices (from all continents), Regional Offices, and UNICEF Headquarters in New York, and a from variety of sectors, including Health, WASH (Water, Sanitation and Hygiene), Supply, Nutrition, Operations, and HIV/AIDS. As a prerequisite to the workshop, all workshop participants had completed the distance learning component of the programme.

The blended HSS programme built their capacity to:

  • Institutionalize a health systems approach in UNICEF country programmes;
  • Position UNICEF as a strategic partner in supporting governments’ efforts to improve health systems, particularly for the benefit of disadvantaged children and women;
  • Interact meaningfully with other partners and governments in the design and implementation of HSS interventions that are evidence-based, sustainable and aligned with UNICEF’s mandate on children.

During an intensive 16 weeks before the workshop, 12 online modules introduced participants to major issues in HSS, including analytical frameworks, national, sub-national and community health systems, supply chain management, data requirements, financing, human resources management, social protection, quality of care and roles of the private sector and civil society. The modules were highly rated by participants.

Cohort 2 on the steps of the Mt Eliza campus of the Melbourne Business School, where the second week of the fact to face training was held.

“The online modules provided a very strong foundation in understanding health care systems and the issues around strengthening them, especially for those of us who are not health sector specialists”.
- Martin Worth WASH Manager, Eritrea

“Even before completing the training, I have begun applying many of the concepts. I´m currently in the planning phase of a Maternal, Newborn and Child Health intervention for indigenous communities in Peru.  Approaches to bottleneck analysis, as well as the use of tools to measure inequity and address quality of care, have been of great utility for discussions with implementing partners and government counterparts.”
-Hugo Razuri, Health Officer, Peru

“Despite the fact that I was managing a four-year HSS project involving significant funds, I was not very familiar with the HSS concept. This course really broadened my understanding of the topic beyond my expectation. Once back to my duty station, the HSS course will help me deeply re-think our projects and manage the implementation in a structured manner.”
-Fazil Ahma, Immunization Specialist, Afghanistan

The workshop built on knowledge gained in the online component. In the first week, participants explored the use of various tools to identify the most deprived populations, define epidemiological priorities, guide choices of interventions, identify bottlenecks, causes and strategies and assess their impact and cost. Using the 7-step approach of UNICEF’s HSS framework, they enhanced their skills in using EQUIST, One Health, LIST, HEAT and DHIS 2.

“EQUIST is an exciting planning tool. I loved the way it can help you tell the story of your country and determine where you need to focus.  I particularly enjoyed the bottleneck analysis and fiscal space sessions.  I will definitely apply the information as we go into MTR processes in my country office.”
-Shelly Chitsungo, Health Specialist, Programme Section, Zimbabwe

In the second week, participants found themselves transformed into Mythican health experts tasked to advise the Health Minister who is determined to strengthen the health system in the fictitious country of Mythica. Using the Harvard Business School Case Method, they applied their learning to this simulated country situation. Over a period of four years in Mythica, participants used a systems thinking approach to provide well-reasoned and evidence-based policy advice to the Minister of Health on matters ranging from developing a national health insurance scheme, to a strategies on a public-private mix for the health system, decentralization, and dealing with a sudden outbreak of disease.

Participants envisaged many ways in which the learning would benefit their current and future programmes.

Cohort 1 participants.

“As a UNICEF staff in a region of rapid transition, the EAPRO, I find this course very relevant. Transitions in government, transitions to MIC, and transitions to upstream work require strong HSS skills and an integrative view. The course content will be easy to apply when I return to the Philippines, especially at this time that we are writing our Country Programme Document.”  
-Mariella Castillo, Health & Nutrition Specialist, The Philippines

They also appreciated the cross-sectoral nature of the programme and the mix of participants from different sectors.

“I am more than ever convinced that only by having operations staff involved in programmatic discussions, including training, will we be able to build "bridges" to improve the efficiency of our programmatic implementation. As Chief of Operations, colleagues expect me to be an enabler. The course has provided me with appropriate ‘tools’ to provide better solutions in making things happen.”
-Devraj Daby, Chief of Operations, Fiji

“The HSS course like a coin had a 2 sides: One - it’s a well-structured course that provided UNICEF witha knowledge and expertise of  top notch experts from academia and practice; and Second – it’s an amazing opportunity to enrich each other with the experience from different regions, countries with different backgrounds and being involved in discussions reflecting on the rapid changes in the world as well as in the health sector.”
-Aigul Nurgabilova, Health & Nutrition Specialist, Turkemenistan

A robust monitoring and evaluation framework is being applied to assess the effectiveness of the online modules as well as the workshop component. A follow-up assessment will be conducted mid next year, to gauge how the participants have applied the learning.

The Nossal  Institute plans to deliver the course in 2018 and 2019, and is developing a Massive Open Online Course based on the online content ready for launching in 2019.