Strategy for Sustainable Health System Strengthening

The project's primary objective is to help countries achieve universal health coverage by reducing financial barriers to care and treatment, ensuring equitable access to essential health services, and improving the quality of health services. The LHSS approach emphasizes the importance of local capacity strengthening, which involves partnering with local actors to jointly improve the performance of a local system and produce locally valued and sustainable development outcomes. This approach is grounded in USAID's Local Capacity Strengthening Policy, which recognizes the diversity of existing local capacities in partner countries and shifts the focus from "capacity building" or "capacity development" to "capacity strengthening." The LHSS strategy consists of five steps, which are represented in Figure 1. These steps include co-assessing the present state and desired change, co-creating solutions, local implementation, collaborating, learning, and adapting, and local adaptation. The strategy also emphasizes the importance of mutuality, which involves building reciprocal partnerships that benefit both USAID and its local partners. The LHSS approach is guided by seven mutually reinforcing principles for effective capacity strengthening, which are organized around the themes of effective programming and equitable partnerships. These principles include starting with the local system, strengthening diverse capacities through diverse approaches, and planning for and measuring performance improvement in collaboration with local partners. The LHSS strategy also recognizes the importance of conflict-sensitive, political economy, and "do no harm" approaches to capacity strengthening. The project strives to create a collaborative environment in which the country team can effectively and continuously engage local actors early on and throughout activity implementation. The LHSS approach is designed to support the scale up of local capacity through country and core activities. The strategy provides a framework and details on how to develop, implement, monitor, and evaluate sustainable health system strengthening activities. By supporting the strengthening and scale up of local capacity, the LHSS project aims to contribute to the achievement of universal health coverage and sustainable health system strengthening in low- and middle-income countries. The LHSS strategy also emphasizes the importance of mutuality, which involves building reciprocal partnerships that benefit both USAID and its local partners. The project strives to create a collaborative environment in which the country team can effectively and continuously engage local actors early on and throughout activity implementation.