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About HSAN: Why a Health Systems Action Network?

Participants from Health Policy and Systems Strengthening meeting held in Washington D.C., May 2005

Increasing recognition of the obstacles that weak health systems pose to the achievement of the health Millennium Development Goals (MDGs) and other global health targets has led to increased momentum for building stronger health systems. A multiplicity of partners is now interested in this area. Yet for many, it is not clear what health systems strengthening actually entails, and how to proceed. There is a need for credible information, rooted in country experiences, about how to address the need for stronger health systems.

The need for a Health Systems Action Network (HSAN) was recognized at a WHO meeting on “The Montreux Challenge: Making Health Systems work” in April 2005. It was thought that HSAN could serve as a means to:

  • Build on the growing interest and momentum around creating stronger health systems by providing a vehicle through which diverse partners could help maintain attention on health systems
  • Improve communication and flows of credible information about health system strengthening (HSS) and
  • Help promote greater coordination and collaboration both regionally and globally

Following this meeting a group of interested partners (including WHO, the Thai Ministry of Public Health, the Partners for Health Reform plus Project, the Global AIDS Alliance, and Health GAP) jointly developed a concept note that further elaborated on the idea of HSAN. This concept note was widely circulated for comments and was debated at an open meeting during the Global Health Council conference in Washington DC in June 2005.

After debating the concept note at the Global Health Council and based on the issues that emerged, a stakeholder consultation took place between October and December 2005 in the context of:

  • Growing recognition that, to achieve disease- and service-specific objectives, health systems must be strengthened
  • Global Health Initiatives (GHIs) increasingly moving into funding health systems strengthening
  • Increasing concern about the high transaction costs imposed by GHIs at the global and country levels
  • At the same time, desire to preserve the benefits of GHIs
  • Tension between a short-term focus and the longer-term horizon required to build and sustain strengthened health systems.
  • Changes to the global architecture of development assistance for health

The objectives of the consultation were:

  • To achieve clarity about what HSAN should be and what it should do including:
    • Objectives, value added, activities and organizational form
  • To build support and momentum for HSAN
  • To obtain guidance on how to move forward

These consultations concluded that there is significant need for a global network focused on health systems that would be grounded at the country level. This led to the idea that HSAN could become a reality by bringing together likely beneficiaries and potential members of the network from developing countries to define priorities and assume leadership. As a result, a consultative meeting was held in Toronto, Canada on 18-19 August, 2006.

The Toronto meeting brought together 31 health systems experts from around the globe.  Participants were policymakers, clinicians, economists, human resource professionals, pharmacists, and journalists selected through a highly competitive international process. These participants became HSAN’s founding members. The aim of the meeting was to discuss health systems strengthening needs not being met by other initiatives, to provide a forum to crystallize the vision of a Health Systems Action Network and to agree on how best to move forward. The Toronto consultation launched HSAN with the aim of increasing understanding at both the global and country levels on the importance of strong health systems to achieve urgent health priorities.  Participants came from Bangladesh, Chile, Costa Rica, Georgia, Ghana, India, Indonesia, Kenya, Malawi, Mali, Nigeria, Russia, Senegal, South Africa, Thailand, Trinidad and Tobago, Turkmenistan, and Uganda and represented the public and private sectors, academia, civil society, and the media. 

Through a participative process, these founding members clarified the vision and mission of HSAN, identified its value added, determined priority activities for the next two years, and outlined a preliminary plan of action.