AIDSTAR-Two Reports Make the Link between Health System Strengthening Requirements and a Stronger HIV Response

Summary Document Presents Findings from Vietnam and Jamaica

The AIDSTAR-Two Project has published a summary document of the health system strengthening activities required to reach populations most vulnerable to the HIV/AIDS epidemic.  This brief, seven-page report puts forth an analytical framework to help prioritize the health system strengthening activities that are required to reach most-at-risk populations, and presents selected findings in Vietnam and Jamaica.

The report, entitled “Know Your Epidemic, Know Your System, Know Your Response,” was prepared by Management Sciences for Health in collaboration with the International HIV/AIDS Alliance, under the auspices of the AIDSTAR-Two project, an organizational capacity building project funded by the USAID Office of HIV/AIDS.

The study began last year, when the PEPFAR Health Systems Strengthening Technical Working Group asked AIDSTAR-Two to develop an innovative approach to understanding the requirements for making health systems more responsive to most at-risk populations (MARPs) in Vietnam and Jamaica, and achieving reduction in HIV incidence.  These populations include men who have sex with men, people who inject drugs and sex workers.

AIDSTAR-Two used an approach that demonstrated how to identify the best health system strengthening recommendations based on both an understanding of the epidemic including risk factors as well as the system bottlenecks that inhibit the most effective and cost effective interventions being delivered at scale to the right population groups. Importantly, it also demonstrated through the study methodology how to make a causal link between health system strengthening and a desired health outcome.  Causal pathway analysis is an analytic approach which focuses on designing projects to achieve maximum attributable health outcome. Its application in project design maximizes the probability that interventions will achieve desired health outcomes, and helps managers to identify the most appropriate indicators for monitoring progress.

Earlier this year, AIDSTAR-Two completed individual, full-length studies, one in Vietnam and the other in Jamaica, on using the causal pathway analysis within a health system strengthening approach to address the most-at-risk-populations in each of these countries.  The study results were presented at USAID in Washington DC on September 15, 2011. The study findings in Jamaica have been used to inform the recent external evaluation of the National HIV Program and the report is also being used as the basis of developing the GFTAM Round 11 Proposal. In Vietnam, the Provincial AIDS Council of Ho Chi Minh City is undertaking a review of their MSM program utilizing the methodology and findings to determine if they are putting resources into the right interventions for the right populations at the right time.

Read the summary document.